Andres Achury Garcia (G, Urban Studies and Planning)
Andres will be working at The Instituto Mexicano del Seguro Social (IMSS) in Mexico City during the summer of 2016. He expects to learn how the decisions taken by social and health care institutions can transform the social fabric of the urban environment. Andres will conduct interdisciplinary research, combining methodologies and approaches from several fields and theories from different sectors in order to truly comprehend cities and their social needs. The Job Objectives and Expected Results are to develop a geospatial analysis methodology to plan strategic spending as well as to identify key variables that are relevant to the statistical analysis. With this new methodology, the IMSS would be able to set indicators and metrics to create a reliable and efficient decision-making process.
Check back for his updates!
________________________________________________________________________________
Goodbye Mexico
August 7, 2016
For me, this was an amazing experience full of great memories but also with enormous challenges. Before coming to this internship I was told, I would be doing only maps (geospatial analysis) however, in the first week of the internship the project shifted its scope. After that turn, the director and I decided that the best way I could contribute to the IMSS could be developing a new methodology for the decision-making process. That methodology would be a guide of how the IMSS should invest their resources in health care infrastructure.
I might already say this in a previous post however, I think that one of the most important things I have learned from this project was to be flexible and resilient and to be able to overcome the challenges that appeared along the way in order to accomplish the goals you set from the beginning. I am convinced that there is always several ways to get to the same result and the people who are more successful achieving their goals, are the ones who learn how to accommodate better to the challenges and situations that appear during the process.
I am very happy with the result of this project because at the end of this project we were able to give to the IMSS a new methodology that includes a more comprehensive view of the deficit and quality of medical infrastructure across the country. Likewise, we also included a geospatial analysis where they will be able to integrate socio-economic variables of the geography and urban conditions of each region, in order to produce a ranking that identifies the healthcare centers and hospitals with the greatest needs.
Ranking to prioritize the needs of the hospital in the state of Guanajuato (Made by Andres Achury)
Although we only applied that methodology in a case study for Guanajuato the idea is that in the long run, the team inside the IMSS should implement that methodology to other states. Thus, at the end of this year, the IMSS should have a case study for all the states of Mexico. Once they have the analysis for all the states, they would have all the information to develop the investment strategic plan for the IMSS for 2018. With this tool, they will be able to distribute the resources in a more efficient way in order to reduce the inequalities of the health care system in Mexico.
Field trip to Celaya’s Hospital in the state of Guanajuato (Photo: Andrea Santiago)
This experience has been very positive for me because during this process understood the limitations of the institution and learned about how to manage bureaucratic procedures in one of the biggest public institutions in Latin America. This project opens me the option to develop my MIT thesis on this topic and in the future I could implement everything I have learned about the Mexican health care system in my hometown country, Colombia.
________________________________________________________________________________
From Teotihuacan to Tenochtitlan
July 24, 2016
Before coming to Mexico I knew a little bit about the Mayan and Azteca culture (and other pre-Columbian culture) however, once I arrived at this city I was surprised for the vast history that this country has about its ancient history. In the Museum of Anthropology, I had the opportunity to see the incredible importance of the Pre-Columbian heritage of this country.
View of Mexico City June 2016 (Photo: a stranger who I asked to take a photo)
I went to the Museum of Anthropology, located near the Chapultepec Park a central area of Mexico City. This museum is the most visited and largest museum in Mexico. It contains significant archaeological and anthropological artifacts and relics from the Mexico’s pre-Columbian heritage, such as the Stone of the Sun (or the Aztec calendar stone). In the territory know as Mexico during thousands of years a number of peoples inhabited together and left material vestiges, which can be appreciated in this museum. A long my visit I Had the opportunity to see the history of Teotihuacan a Mesoamerican city located 30 miles from Mexico City and it is considered the largest city in the pre-Columbian Americas with a population of 125,000 inhabitants.
But that city was only one of the many other cities built by the several inhabitants of this territory. I also learned about Tenochtitlan. It was founded in 1325 and it was located in the lake of Texcoco and it became the capital of the Aztec empire. Unfortunately when the Spaniards arrived in Mexico to conquer the Americas they destroyed the entire city. Today its ruins are located in Mexico City’s downtown, below the Zocalo or main plaza, Mexico City Cathedral and the National Palace in Mexico City.
Painting and model of Tenochtitlan (Photo: Andres Achury)
Mexico City has an amazing history with ancient societies with multiple urban settlements and complex social networks, which develop in cities and after that some of them in empires. I dare to say that the Mexican pre-Columbian heritage has an immense value in the global history. All those societies should be considered as important as other ancient cultures such as the Chinese, Greek or Egyptian.
The Stone of the Sun (photo: Andres Achury)
________________________________________________________________________________
Geospatial Analysis
July 17, 2016
Parallel to the construction of the model, the geographer Andres Santiago from the IMSS and I, were working on a project to consolidate all the socio-economic variables from the entire country and implementing them in a Geospatial Analysis tool. (ARCGIS SOFTWARE) Last week we finished that migration from the IMSS database (that we also constructed from the data they have inside their intranet called DATAMART) that was in tables (Excel format) and put them in a more interactive tool.
This is a very important goal first because the IMSS was trying to do that migration since 2012 unsuccessful. Second, now they would be able to visualize all the socio-economic variables from the users in addition to the administrative variables from the IMSS in a map. (Geospatial analysis) From this point, they will be able to see all the variables that I mentioned before and that affect the healthcare system in addition to the localization of all the healthcare infrastructure they own. I have to say that I am very excited about having the opportunity to participate in that project.
Map of the distances of the IMSS users to the medical centers (map: Omar De La Riva)
________________________________________________________________________
The Project
July 10, 2016
On the first 3 weeks, we focused on recollecting all the information needed to start the project. At the beginning I though it would be straightforward to find the information, however, after the first week of work I couldn’t find anything. Looking into their system I saw a lot of holes in their databases and I discover the reason of that situation only after I did a field visit to some the hospitals and one medical center in Mexico City. The problem was that within the hospitals there were a lot of procedures that have been registered on paper and not in a computer. I saw some dependencies of the hospitals where the doctors were filling out the patients’ forms with a typewriter. After seen that, we had to redesign the parameters that were looking at the data sets and the methodology of collecting the data we wanted in order to be able to continue with the analyses. We also decided to use a case study to narrow down the project. We are going to do a case study for the city of Guanajuato.
The actions that we took those weeks were two. The first one was to contact all the hospitals and medical centers of Guanajuato (around 50) and we asked them for some information that we thought it would be necessary for our analyses. The second action we took was to calculate the variables we needed with the information we have available in the databases and the ones we could get in the paper. Although this wasn’t the ideal scenario I thought we found a good middle ground between the information needed and the one that was available.
Collecting the data for the project was a tough task. We faced a lot of challenges. Such as the way the data were collected and also finding methods to clean and transfer the paper base data into a computer base dataset. However, This experience showed me that sometimes you have to be flexible and resilient to be able to overcome the challenges that appeared along the way in order to accomplish the goals that I had for this project. I am convinced that there is always several ways to get to the same result and the people who are more successful achieving their goals, are the ones who learn how to accommodate better to the challenges that appear during the process.
Macgregor Hospital’s Database (Photo: Andres Nigenda)
Map from the Zip codes attended by the Hospital (Photo: Andres Nigenda)
________________________________________________________________________________
THE IMSS
July 3, 2016
With more than 54 million users countrywide, the Mexican Institution of Social Security (IMSS) is the largest Social Institution in Latin America and most important public agency in Mexico. By providing health care service to 45% of the population, the IMSS is able to provide basic needs such as vaccination, ambulatory patient services, emergency services, hospitalization maternity and newborn care, mental health and laboratory services, which are essential to the workers and their families’ wellbeing. The IMSS has more than 1,700 units distributed along the Mexican territory, serving more than 5,000 hospital admissions per day. This is a quick overview of the impact that the IMSS has in the Mexican society and it also showed me that even a small improvement in one or more of the policies implemented by this institution it could generate an enormous impact on people’s life.
View of headquarters of IMSS (Photo: Andres Achury)
The first day I met with my supervisor Armando Romero who showed me all the different areas of the IMSS. After that introduction, I spent all the first-week reading documents from the IMSS (presentations, reports etc.) and academic literature in order to understand how the Mexican Healthcare system and the role that the IMSS plays within the system. I also did some research looking for governmental or public agencies documents that implemented spatial analysis in the decision making of how to invest public resources for health care infrastructure.
I also had a meeting with Daniel Broid of the CPIM (Medical infrastructure planning Coordination) an area that is part of IMSS. On that meeting, we defined a list of projects where I could help with. After a couple of days, we decided to do the project that would redesign the planning methodology for the investments in healthcare infrastructure for the health care centers and hospitals.
Having the opportunity to work on this important project that IMSS made me very happy. One of the biggest challenges during this first weeks was to understand how the entire Mexican Health Care system work and which are the biggest challenges that the system is facing right now. This project is a great opportunity for me to learn about how to improve the quality and efficiency of the Mexican health care in order to apply all that knowledge back in Colombia.
________________________________________________________________________________
Mexico City Mega City
June 26, 2016
Before landing at the international airport Benito Juárez in Mexico City you can see through the window the magnitude of this city. With more than 22 million inhabitants Mexico City is one of the biggest Megacity in the world. But it is not only its population what impressed me but the extension of it. We were flying from almost 15 minutes above the city and the only pattern that I could see were buildings and roads. At first sight, it seems like the city is not very dense (most of the buildings are two to three story buildings) however, the magnitude of this megacity is astonishing. It was 5:00 pm and like most of the afternoons in Mexico City during the summer (June to August) the cloudy sky seemed to indicate that today it was going to be a rainy afternoon. After we landed the forecasts were true and it started to rain.
View of Mexico City June 2016 (Photo: Andres Achury)
_______________________________________________________________________________