CEOInterviews.AIPresident Nayib Bukele addresses the Salvadoran people tonight

N

Nayib Bukele4:27

How are you, director? Good evening, Mr. President, Dr. Marvin Ailar, director of Rosales Hospital. It's a pleasure to welcome you to the new Rosales Hospital. Well, you know that on June 1st, it's tradition for the president to give a speech.

M

Marvin Ailar4:42

Of course. For the anniversary, in this case it's 7 years of government, but I thought it was better for the Salvadoran people, instead of hearing a speech, to hear from you what this new hospital for the people will have. And as we always say, the public should be better than the private, money is enough when no one steals. And what better speech than a great work like this?

N

Nayib Bukele5:07

Of course, Mr. President. We are in the emergency service, which is undoubtedly the center or the entry point of our hospital. Also, this is the largest hospital in the country, it is our tertiary level hospital, and therefore this work represents something wonderful for the population because they will be able to receive any type of care in this hospital, no matter how complex. Here we have everything from the most basic, like a general medicine consultation or wound suturing, to highly complex surgeries that are not performed in other hospitals in our country.

M

Marvin Ailar5:46

And this is also the largest hospital in the country, as you already mentioned, but now it's bigger.

N

Nayib Bukele5:51

It's bigger. There has been a considerable expansion in both infrastructure and services that we will provide. And now we will have services that historically have not been provided in any institution in the country, and now as a public institution we will be able to provide them, which is the best.

M

Marvin Ailar6:11

And I was told, well, this whole process of buying the equipment, the best equipment in the world, all the medications, hiring doctors, etc., we will be able to provide some services that are not even offered in private hospitals, in any hospital in Central America.

N

Nayib Bukele6:28

That's right. We have, for example, robotic surgery, a hybrid operating room, and services like bone marrow transplant, one of the most expensive in the private sector, but which are not provided here in the country. Patients who need these treatments travel to South American countries to receive them. Yes, I remember that even when someone needed a bone marrow transplant, what was usually done was a national fundraiser to pay for their treatment in Brazil or the United States or countries where they could get that treatment. Now we can do it here. And this represents hope for our population, for those suffering from these complex diseases, because we will be able to give them that treatment. This is a completely free hospital for the people, and any Salvadoran can come here.

M

Marvin Ailar7:20

That's right. An example of this is these areas, which are the maximum urgency areas, meaning those patients who come in critical condition due to an accident or a serious decompensated illness and require immediate stabilization, we will be able to treat them here.

N

Nayib Bukele7:36

So here there is surgery, we stabilize the patient and then transfer them to surgery if needed. This hospital, this emergency room, has historically been characterized by receiving complex patients from traffic accidents, which is very common in our country. So now, with all these conditions, we will guarantee timely care. Another thing I see, for example, is that the corners are lined with stainless steel, and the floors have that curve so that germs don't settle.

M

Marvin Ailar8:11

Yes, the floor is actually vinyl flooring that has material characteristics that prevent the accumulation of bacteria or any type of microorganism. And this curve is a sanitary curve that precisely prevents that and makes cleaning and disinfection of the areas easier. This is the observation area.

N

Nayib Bukele8:32

This is the observation area. It's huge.

M

Marvin Ailar8:35

It's very spacious. We have the capacity to treat 48 patients. These are the observation beds in the emergency room. So someone comes into the emergency room, they are treated, stabilized, and then, well, they are stable, but we say, we need to observe them to see if we move them to hospitalization, if we can discharge them, or what we are going to do with them.

N

Nayib Bukele8:56

We have them here in observation. Correct. That's right. But it's immense. I mean, I remember that it has nothing to do with the previous Rosales Hospital, there weren't even beds, right? But this is not just that we put beds, but even seeing the equipment above each bed, the monitors, each bed has its monitors.

M

Marvin Ailar9:18

Each bed has its equipment. We have vital signs monitors, we even have mechanical ventilators. If a patient were to complicate here, we stabilize and then transfer to the critical care area.

N

Nayib Bukele9:29

Yes. Before the pandemic in El Salvador, there were 26 mechanical ventilators. 26. And with the pandemic, with the El Salvador hospital, we brought it to 100. Yes. At that time here at Rosales, the doctors were famous for using plastic bags called ambu bags. Yes, with ambu. And so each doctor with one hand, with both hands, an ambu in each hand giving air to each patient. It was unthinkable now, right? Definitely that went against the patient's health, and now that won't happen because we have all the conditions to treat any type of patient we have here, whether complicated or not. An example of this is that all beds have their vital signs monitors, infusion pumps, perfusion pumps, everything you see behind has medical gases. That's another thing, there are no oxygen tanks.

M

Marvin Ailar10:24

No, no, there are no oxygen tanks because having oxygen cylinders also goes against patient safety. There is a great risk, and now having them all centrally supplied facilitates care and does not put us at risk. Also, we have monitors there that are the so-called nursing monitors.

N

Nayib Bukele10:43

Ah, those monitors, right? Not the big ones, the small ones on the wall. The patient just presses the button and automatically at the nursing station they identify which patient needs help. That's important because I've heard from the population, from the people who have used the hospital, that sometimes they call the doctors or call the nursing staff and no one comes.

M

Marvin Ailar11:08

That's right. And they say, 'I was calling, I was there bleeding and no one paid attention to me.' That is one of the most important things. We can have the best facilities in the world, the best equipment, the best equipment definitely, there is no better than this. The best supplies, the best medications, but there has to be empathy from the staff.

N

Nayib Bukele11:29

Of course. And that is part of the work philosophy as an institution. It's quality of care from the technical side, but also the human side, because that is what will differentiate us from all other institutions. Yes. Oh, how beautiful that area is.

M

Marvin Ailar11:46

Here, Mr. President, we are in one of our surgical centers. This area is very important because there was both a complete remodeling and an expansion. First, creating conditions. Those are the operating rooms. They are the operating rooms. Downstairs we saw that there were operating rooms, but emergency ones. These are the main operating rooms, so to speak.

N

Nayib Bukele12:08

That's right. This is for treating patients who have scheduled surgeries. Previously there were only six operating rooms, now we have nine. And beyond the quantity, it's the complete remodeling, creating adequate conditions that must exist in an operating room, because they are very specific. They look extremely modern.

M

Marvin Ailar12:28

Yes. And we also have the lamps, all the equipment that is there, the monitors, all the equipment is completely new. Nothing here has been used before.

N

Nayib Bukele12:40

Not a single table, not even a chair, a water cooler, a faucet, nothing, absolutely nothing from before is here. Everything is completely new, down to the instruments, the smallest forceps. There isn't a forceps, a scalpel, a pen from the old hospital here.

M

Marvin Ailar13:02

No, nothing. Absolutely everything is new and it looks impressive. Well, it looks futuristic. Yes, all the finishes are appropriate for a surgical space and all the equipment. There is no need to wait for another surgery to finish to bring equipment over and start with another patient.

N

Nayib Bukele13:20

Ah, that's another thing. Yes, there could be one piece of equipment and they move it around. The equipment, let's say, the new one, they move it from operating room to operating room. Here, no. Each operating room has everything.

M

Marvin Ailar13:29

Each operating room has everything required to treat any patient in the different specialties we have. And these are for washing hands. All personnel entering the operating room must first wash their hands here, using the correct techniques to enter.

N

Nayib Bukele13:46

Yes. All with sensors, without needing to touch anything. Exactly. How are you, doctor? This time we are joined by Dr. Gendia Maya.

G

Gendia Maya13:56

Thank you very much, welcome. It's a pleasure for me to present the surgical center of the new Rosales Hospital. Follow me.

N

Nayib Bukele14:02

Thank you. This hospital, which for so many decades always treated patients with limitations, with difficulties in supplies and equipment, has now been transformed into a completely modern medical complex that has nothing to envy any private clinic in the country or the region. We have nine multifunctional operating rooms where surgeries of all medical specialties can be performed. All of them, we have all specialties. We have completely new equipment, for the brain, the heart, high complexity surgery, medium and low complexity. We have all three types of surgeries. All operating rooms are fully equipped.

G

Gendia Maya14:42

This is like a microscope. It's a microscope for neurosurgery. We have several microscopes for various specialties. There are many, many pieces of equipment for different specialties to serve the population as best as possible. We are going to reduce those long waiting lists of our patients waiting for an appointment for surgery. But we don't stop there. Mr. President, I present our robotic operating room for robotic surgery. We have two robots. Follow me, please.

N

Nayib Bukele15:12

Wow.

G

Gendia Maya15:13

This is our robotic surgery room. We have two like this one. Right now I present the robot for general surgery and its other specialties. This will allow us to have greater millimeter precision when performing high complexity surgeries. It allows, of course, to make very small incisions in the patient. We have a simulator, it's like the patient is in that position, the surgeon sits at the console we have over there.

N

Nayib Bukele15:39

So the surgeon wouldn't be next to the patient but over there at the console.

G

Gendia Maya15:42

Exactly. It's like remote surgery through the console.

N

Nayib Bukele15:47

Wow.

G

Gendia Maya15:47

The surgeon is at the console and the arms move automatically performing the surgery. So technically the surgeon could be in another room.

N

Nayib Bukele15:55

Of course. All the equipment works synchronously with the surgical team. Of course, there are also surgeons assisting the other surgeon because it's a whole team that performs the surgery, but technically it's the robot that does the surgery.

G

Gendia Maya16:09

And the robot is those four arms. Yes, they are the four arms. All four can work at the same time.

N

Nayib Bukele16:15

How impressive. And all these monitors, because that one is the console where he is seeing the patient, so to speak, or the operation. Those are vital signs monitors. But what about these other monitors?

G

Gendia Maya16:28

These monitors are connected to the console. It's so that the entire team can see the surgery simultaneously. Why? Because you need to use 3D glasses to see in the console. So he is there operating and the entire team follows the progress of the surgery simultaneously through the screens. We also have all our instruments completely new and completely available to perform any additional intervention that is required.

N

Nayib Bukele16:53

Impressive.

G

Gendia Maya16:56

Well, I'm also going to show you the other robot because we have two different robots. One is for general surgery, urology, oncological surgery, gynecology. And this one we are going to see now is for orthopedic surgery and traumatology, where hip replacements, knee replacements, among others, can be performed. So this is our second robotic operating room that will allow us to better plan the surgeries to be performed on our patients. It works with a sensor that acts like a kind of GPS. It does a 3D planning on the monitor and helps the surgeon make more precise cuts and, of course, reduce complications of the surgery.

N

Nayib Bukele17:41

These are less complicated operations than the previous ones, or is the technique different? Because these are on joints, these are on knees, hips, and the robot over there is for surgeries we do in the abdomen or chest. So the complexity varies depending on the patient and the organ, but both are completely...

G

Gendia Maya18:02

And in the other operating room, the other robot we saw a while ago, but for cancer even.

N

Nayib Bukele18:05

Yes, of course. It's for oncological surgery, specifically for very complex cases where conventional surgery would be very risky for the patient. With the robot, it decreases... Sometimes removing a tumor is very risky because it touches arteries and that kind of thing. Of course, the robot being more precise, millimeter by millimeter. So the cuts are absolutely fine, precise, and we reduce complications and the risk of patient death. So, Mr. President, I leave you here. Thank you very much.

G

Gendia Maya18:33

Thank you very much, doctor.

N

Nayib Bukele18:34

Mr. President, this is a small sample of everything we now have in this hospital. This is providing quality care. There is a pharmacy, biohazard waste disposal, a lot of things we don't have time to see because we don't want to bore people with a 6-hour chain, but there are many things. These are complementary areas indispensable to guarantee care, like the medical supply warehouse. This is important because I remember in the past they couldn't do dialysis. I remember people complained, from the previous government of course, that they couldn't do dialysis because there was a kit, a little bag with some tubes, catheters, and some cotton. It was a kit that cost about $15, something like that, and they couldn't do dialysis because those kits were missing. And at that time I was mayor and I told them, 'I'll buy the kits, how many are there?' 1000 kits are $15,000. Why can't they buy them? But they didn't even have that, not even the most basic medical supply. Now, of course, we have all the supplies, from the most basic to the most complex for any type of procedure, both here and in the rest of the hospital areas.

M

Marvin Ailar19:52

Well, here we are heading to our central operating rooms, which is our hybrid operating room. It is the highest specialization we have in the hospital, in the country.

N

Nayib Bukele20:03

This operating room we are going to is the highest specialization, meaning the ones we just saw that were extremely modern are not the highest specialization.

M

Marvin Ailar20:12

No, no. These are much more specialized, with very complex equipment that will allow us... I thought I had seen the most technological.

N

Nayib Bukele20:22

No, no. Here, truly, this is not only the best in the hospital, but in the country and in Central America. Very few countries have this technology integrated in the same space, which is actually the most innovative, because it allows us to perform procedures and diagnostic studies in the same area, without needing to move the patient. Yes. So you don't have to take the patient out of the operating room, that's very important. I've seen it in the United States, you don't have to take the patient out of the OR, move them, do an image or a study, and then bring them back.

M

Marvin Ailar20:57

That's right. It's vital time for the patient. So here we integrate it. And again, doctor, hello again, how are you? Good evening.

G

Gendia Maya21:06

Welcome to our surgical center, the third surgical center. Imagine that in this space we will be able to perform diagnosis and treatment at the same time, without taking the patient anywhere else.

N

Nayib Bukele21:18

Normally in almost all hospitals I've seen outside of one in the United States, all the imaging places are not for surgery, they are separate. And if you have to move the patient, you have to move them anesthetized to the imaging center to get the image and then return them to the OR.

G

Gendia Maya21:39

That's correct. That increases the risk of complications and exposes the patient to many complications. So in our center, we don't have to take them out of the OR, we can simply transfer them on the same stretcher where we are operating them, we can transfer them to perform this image. Here we have our CT scan room. We have three CT scanners in our entire hospital. We have one in the emergency area, we have one in tower one, in the new tower, and of course we have the one in the hybrid OR. Here our state-of-the-art CT scanner will allow us to make better diagnoses, much sharper images, and we will also be able to perform interventional procedures. What does that mean? That if we want to enter an organ, take a sample, we can do it guided by this CT scanner that gives us such sharp images that simply through a small incision we take a sample of an organ that requires it, and the patient walks home.

N

Nayib Bukele22:37

And you can tell, just by looking at the equipment, that it's state-of-the-art, of course. And it can also be transferred from the OR. The patient is simply transferred here and the image is taken without increasing their risk of complications, all within the same complex. Now I'm going to show you the heart of our hybrid room, which is the advanced hemodynamics room. Wow, welcome.

G

Gendia Maya23:02

It's impressive.

N

Nayib Bukele23:04

It's very impressive, and even more impressive is that our equipment, the angiograph, is the only one of its kind in all of Central America. In this hemodynamics room we will be able to perform interventional procedures, as you can see there, we will be able to diagnose and treat at the same time. What does that mean? That we will be able to map the arteries of many organs: the heart, the brain, the liver, the kidney. And at the same time, if we detect that there is an obstruction in an artery, as we can see there, we can immediately perform an interventional treatment. So we can place a catheter right here, everything here. So we are doing the imaging study, the imaging study indicates there is an obstruction, and in the same place we do the treatment.

G

Gendia Maya23:49

We do the treatment and we save the patient's life. We reduce care time and, of course, improve quality of life because care is faster, more effective, and of higher quality.

N

Nayib Bukele24:01

It looks like the latest thing. Definitely, right? This is at the forefront. This positions us as an incredible reference at the Central American level.

G

Gendia Maya24:08

Yes, even in a developed country, in Europe, the United States, they can have the same, but this is the best model, right? This is the latest model of this type, and only we have it.

N

Nayib Bukele24:18

So in this hybrid room, in this hybrid OR complex, we have three imaging rooms and three operating rooms. This is where the highest complexity surgeries will be performed. Cardiovascular surgery will be performed. Sorry, doctor, when you showed me that first robot, I thought that was the latest technology we were going to see now.

G

Gendia Maya24:38

No, we still have more technology.

N

Nayib Bukele24:43

So, I present one of our high complexity operating rooms. Here we will perform neurosurgery, cardiovascular surgery, and we will be able to carry out our great program, which is innovation in the country, in Central America: our transplant program.

G

Gendia Maya24:58

But that's impressive. I mean, I've never seen an operating room like this, honestly.

N

Nayib Bukele25:04

This operating room is completely at the forefront of the first world. Let me give you an interesting fact: our microscope, there are only three in all of America, two in the United States and one that we have. So of the three on the American continent, two are in the United States and this is it. Yes. And here we will perform all neurointerventional surgeries. Brain surgeries will be possible. We also have the other two high complexity operating rooms where cardiovascular surgery will be performed and the transplant program will be carried out.

G

Gendia Maya25:35

And just by looking at the type of screens and everything, it's all state-of-the-art, and the auxiliary equipment, monitors.

N

Nayib Bukele25:42

All of them. Yes, all these monitors are to help the surgeon improve surgery planning. We have a neuronavigator that will allow us, like a GPS, to scan the brain and detect and make better precision when extracting a tumor, when performing very complex surgeries. Yes. And it's worth remembering that this is a free public hospital for the people, right? Because one would think, well, a super high-end clinic in the United States, right? This is a public hospital.

G

Gendia Maya26:12

We also have a 3 Tesla MRI, so that's our entire hybrid room integrated. So we have the MRI room, the three operating rooms, and the three imaging rooms.

N

Nayib Bukele26:23

Can we see that?

G

Gendia Maya26:24

Yes, we can see it, but we can't go past these bars.

N

Nayib Bukele26:26

Ah, I see. Why is that? Because of the electromagnetic field. Normally MRIs are 1.5 Tesla and this one is 3 Tesla. So when we see hospitals, clinics, what they have is 1.5 Tesla, and that's already advanced technology, right? And that in itself is an advanced MRI, but this is the most advanced 3 Tesla because it allows us to make much more precise images, better precision, much sharper images, and in less time. Normally an MRI took 2 hours, 3 hours. Here in 40, 50 minutes we can have sharp images with much better resolution, and we can detect much faster some, let's say, lesions, millimeter tumors that with other exams we couldn't detect. What a joy to give this to the people, because normally in other countries, those who have money can have something good, those who don't have money can't. And here in El Salvador, even having money, because these machines are not in any private hospital either. So someone with money in El Salvador cannot pay for this, they have to come here to Rosales.

G

Gendia Maya27:34

Yes, thank you for this transformation. Thank you very much for making this possible. Have a good evening.

N

Nayib Bukele27:39

It makes me happy, truly, that we can give this to the people here. Well, this is the old area.

M

Marvin Ailar27:46

That's right. This is the historic part of our hospital.

N

Nayib Bukele27:49

Of course, of course. We restored it. I remember there were complaints from some people in the opposition who said, 'They are destroying the heritage.' And rather we have saved it because it was rotten.

M

Marvin Ailar28:01

That's right.

N

Nayib Bukele28:01

I even knew that... Hello, architect, how are you? Nice to meet you, Mr. President.

A

Architect28:06

We present the historic part, which has been completely restored and renovated. Really what was here, they sent the photographs and told me, 'This is what there is.' And there were many rotten ones, others eaten by, I imagine, time or rats or everything. It was completely deteriorated. So the internal part, the internal structure, in cases where it was wood, has been changed. The sheets that are originally from Belgium, more than 100 years old, have been restored.

N

Nayib Bukele28:39

But they have been restored, but they are the originals.

A

Architect28:41

They are the originals, Mr. President. It's not that it doesn't appear, because I know they are the originals, but what was there before was rotten, ruined. It's a high-level restoration work. And I imagine that here in El Salvador there are no companies that restore this type of construction material because no one builds like that now.

N

Nayib Bukele28:59

That's correct. International personnel were brought in to restore all these sheets, the structure. What's more, these structures even had snakes inside them, according to the photographs. So we had to restore it no matter what. This is the chapel, right?

A

Architect29:18

This is the chapel.

N

Nayib Bukele29:19

The truth is, seeing it like this, before it was sad to see. It was like a house of horror, really, but now seeing it so beautiful, illuminated, it even makes you want to learn more about the history.

A

Architect29:32

Topics that interested us a lot were the conservation of culture. What does this hospital represent? So the work that has been done to restore it is great. We have four structures completely conserved and restored, which are the two main ones on the facade. On 25th Street we have the tower...

N

Nayib Bukele29:52

There are two, there are two like houses, right? Two buildings that are twin.

A

Architect29:56

Uh-huh. They are on... I've seen them. Yes, correct. We have the clock tower, which is the main one, the one that says Hospital Rosales, with the clock. Yes, that one was completely restored. If you like, we can go over.

N

Nayib Bukele30:06

Yes. The foundations of the Clock Tower were restored, the internal part because it was really completely deteriorated. I also see that the railing has been restored. The gardens are new, I imagine, because this is beautiful.

A

Architect30:22

The gardens are completely new, the railings were also restored and some are new to blend in with the environment.

N

Nayib Bukele30:29

Of course. To complete, perhaps.

A

Architect30:31

That's right. And also the floor, these mosaics, this floor is old, right? They were completely restored to give it shine again.

N

Nayib Bukele30:40

Yes. So I see that all the railings also, I think to complete, but also all the columns, all the lights, the structures of the columns were completely restored. The railings are completely restored and new to give continuity and provide a historical enclosure to the central part of the hospital. The roofs were restored, the metal beams just like 100 years ago. The lights also, the bulb part is the only thing that has been changed, but the structure of the light fixture is original. One question, will this part be open to the public? Because normally hospitals are seen by patients, doctors, nursing staff, technical staff. But if someone from the population wants to come and see...

A

Architect31:36

The garden area is completely public.

N

Nayib Bukele31:39

Ah, yes, it's completely public. The only thing that remains private is the part of the walkways that lead to the hospitalization area. The middle part is public.

A

Architect31:52

This is one of the entrances, Mr. President, from the hospitalization pavilions to the gardens with the main view of the chapel, the frontal view of the chapel.

N

Nayib Bukele32:04

That's right, completely conserved. It has been restored. Well, I think it has never looked so beautiful because it also has architectural lighting that didn't exist 100 years ago.

A

Architect32:14

That's right. Previously this was hidden in ruins, so it was restored and we have this view.

N

Nayib Bukele32:21

And there is the house with the clock tower.

A

Architect32:25

That's right, restored almost from its foundations. Metal infrastructure completely restored, the sheets completely restored. The main rosette was also restored. Everything is restored, completely restored. Even the furniture has been restored, Mr. President.

N

Nayib Bukele32:44

The chapel is not so small. Here it has... Those steps are for the choirs. Restoring it was a real challenge because it was very deteriorated. And there are the towers.

A

Architect32:59

The tower. This was the main building or entrance of the hospital when it was delivered in 1902. This was the main facade. From there came expansions, very organic growth. Yes, it was really very deteriorated, its foundations, the structural joints were completely non-existent due to oxidation, the passage of time.

N

Nayib Bukele33:23

Yes, I imagine that before there was no maintenance, zero, no one ever cared about this hospital. They never invested in it, and now thank God this could be done.

A

Architect33:33

Correct. Yes, Mr. President, at this moment we are going to head to the intensive care unit, another very important area.

N

Nayib Bukele33:42

Architect, see you in a bit. Thank you.

S

Sofía Vázquez33:45

This time, Dr. Sofía Vázquez will... Good evening, Mr. President. It's a pleasure to present the intensive care unit of the new Rosales Hospital. Each intensive care unit is fully equipped with new, high-quality equipment. We have machines to provide renal replacement therapy, which is a frequent epidemiological profile. Each ICU bed has its own dialysis machine. Here you will see eight, we have three varieties, and the NCU18 is specifically for this type of therapy. We have two others that can also be used for hemodialysis, but also have specific functions for plasmapheresis, for some types of autoimmune diseases like Guillain-Barré syndrome, systemic lupus erythematosus, which are this model.

N

Nayib Bukele34:29

Ah, of course. It's different. Now, normally ICU beds don't each have their own equipment, right? Before, in the old Rosales, they had two dialysis machines and no more. The rest was by service, they made contracts and didn't have their own machines available. Now that's one of the things that will benefit... And you can see the type of monitors, the type of equipment, everything looks...

S

Sofía Vázquez34:53

Yes, the monitors are multiparameter because they give us greater precision in data, vital signs, and help us provide better management. One of the novelties that will have the greatest impact in the intensive care unit is the machine that will be used for non-dialyzable poisonings. There are poisoned patients who can be dialyzed, but there are other poisonings that cannot. For example, pesticides, which is important for our agricultural population. Another type of machine is the DX10, and it is the only one in the country at the moment. Now we will be able to respond to this type of...

N

Nayib Bukele35:33

So before, let's say, there was no way to treat that.

S

Sofía Vázquez35:35

No, those that are non-dialyzable, there was no way anywhere in the country.

N

Nayib Bukele35:40

Nowhere in the country. Neither private nor public.

S

Sofía Vázquez35:42

No, now yes.

N

Nayib Bukele35:43

Now yes. There is now a response for this type of patient. Here on the first level we have capacity for 21 rooms, and on the second level we have capacity for 40, giving a total of... Here we are seeing, each one is also independent.

S

Sofía Vázquez36:00

Yes, because they are for patients with isolation conditions, meaning they need to be alone to avoid infecting others, or they are immunocompromised and any infection can complicate their clinical picture.

N

Nayib Bukele36:13

Yes. A bacteria can take advantage of a depressed system. Here there are 21.

S

Sofía Vázquez36:18

Exactly. Here there are 21. But on the second level we have intermediate care where they are not separated because the condition allows it, and also intensive care for other types of pathologies, and we have mechanical ventilators for each unit because a characteristic of an ICU patient is the necessary ventilatory support.

N

Nayib Bukele36:36

Of course, of course. Congratulations.

S

Sofía Vázquez36:38

Thank you. Nice to meet you. Thank you very much.

N

Nayib Bukele36:40

This was part of what you mentioned in the area of... Yes. Before there was nothing. There was a doctor with two plastic bags. Yes. And now there are 61. There are a lot of areas, it's truly gigantic. I thought I would like to show everything, but obviously it would be too long, but the patients will get to know it. Each one will come to an area, go to another area, and in the end they will realize that what we are showing now is about 10%.

M

Marvin Ailar37:09

Yes, of course. The hospital is immense, and each patient will come to receive different things. For example, there is inhalation therapy, and there are a lot of things in there. That's right, but if we go to the therapy area, that's another 5 minutes.

N

Nayib Bukele37:23

That's right. Architect.

A

Architect37:26

How are you? How are you? Nice to meet you again.

N

Nayib Bukele37:29

Well. Mr. President, this is the transition between the historic part and the modern part of the hospital. You have already toured the historic part, where the hospital has been completely restored, renovated, everything is new. What was maintained are basically the things we wanted to keep for heritage.

A

Architect37:48

Correct. So, go ahead.

N

Nayib Bukele37:50

And this is the connection to the new building.

A

Architect37:52

This is precisely the connection, the walkway, so to speak.

N

Nayib Bukele37:55

Yes, the walkway that divides the outpatient consultation area. But here we are at floor level. It will go up gently, I imagine that's for stretchers.

A

Architect38:06

Exactly for that. This has a slope of 7%, which is very little, as dictated by regulations, to allow transport of patients on stretchers or wheelchairs. It will only function to transfer patients. This is not public, these are only transitions. It is public, but only for hospitalization, not for people to come and see this.

N

Nayib Bukele38:39

Like the garden is, like the chapel is, like the historic building is.

A

Architect38:43

That's right. This part is only to connect both buildings.

N

Nayib Bukele38:50

The new building looks very impressive from here with the connection of the walkway.

A

Architect38:56

And well, the walkway itself has its charm too, it's beautiful, modern, glass.

N

Nayib Bukele39:02

It was designed...

A

Architect39:02

And here you can see one of the houses. That is one of the historic houses on 25th Street that was completely restored. Here we are going to open a coffee shop next door.

N

Nayib Bukele39:14

Yes, that's right. So the general public can come and have a coffee, and it also serves because sometimes you go to see your relative or the doctors themselves working, and there is a hospital cafeteria, but that's how it is, but sometimes you want to eat some sweet bread or something.

A

Architect39:32

Also in those buildings, we are implementing educational areas that Dr. Aguilar has kindly provided in this area. We are going to have the teaching part. We have more than 50 mannequins of different types, of different parts of the body, and we have conditioned all this to have a simulation room.

N

Nayib Bukele40:01

Where is that? In this first house?

A

Architect40:03

In this first house.

N

Nayib Bukele40:04

In this first house they are going to do the simulations.

A

Architect40:06

That's right. As practices to learn how to do it.

N

Nayib Bukele40:09

That's correct. It's part of the training of our new professionals. A teaching hospital, basically.

A

Architect40:14

That's right. It's a teaching hospital. So, these spaces, in addition to preserving the historic, we are also going to integrate with the modern by having these simulation rooms.

N

Nayib Bukele40:24

And the coffee shop is in the other one.

A

Architect40:26

That's right. And right here, Mr. President, you can see the transition from history to the modern.

N

Nayib Bukele40:33

Of course. The update. Although the other part, the history is like in the middle, right? Because we come from modern, then that historic part that turned out beautiful, and then here we go to modern again, although more modern because this building is built from scratch.

A

Architect40:48

The infrastructure is from scratch. The specialties like electrical, hydraulic, architectural, all the finishes that have been integrated into the building are completely new, complying with all international regulations that correspond to a hospital. Here begins the completely new building that we built in front, completely new from the treatment plants, the oxygen generators that have been developed both in this stage and in the historic part, completely new.

N

Nayib Bukele41:24

Excellent. Thank you, architect.

A

Architect41:26

A pleasure, Mr. President. Let's continue.

N

Nayib Bukele41:28

Nephrology, which is very important so that people understand it, basically kidney problems, especially kidney failure, that's right, because here in El Salvador the incidence of kidney failure is extremely high, especially because the rivers are contaminated too. There are crops that use pesticides and chemicals, and well, they burn sugarcane and they are destroying health, but unfortunately there is still a culture that we have to change, and well, there is the preventive part that we have to do, but there is this curative part.

M

Marvin Ailar42:06

Of course. That's right. And here we have our largest hemodialysis service within the hospital. Hello, doctor. It is an honor for me to welcome you to the new nephrology unit of the new Hospital Rosales.

N

Nayib Bukele42:18

Nice to meet you. Thank you. It looks incredible.

M

Marvin Ailar42:21

Specifically, we are in the hemodialysis service, one of the most critical services we have within the hospital. All these machines are new, modern, latest generation. It looks very different from the hemodialysis machines that are normally in public hospitals.

N

Nayib Bukele42:41

Correct, Mr. President. They are state-of-the-art machines. They are recent technology that has been on the market for less than a year. So, we have the latest technology.

M

Marvin Ailar42:56

So, there can't be anything better in the world, there can be something equal.

N

Nayib Bukele42:59

As we all know, El Salvador has one of the highest rates of chronic kidney disease in all of Latin America. So, we know the challenge we have ahead of us, that first God, the human capital we have, the technology we currently have, we are going to respond to that great challenge that we have ahead of us, sir.

M

Marvin Ailar43:26

There are a lot of dialysis machines. Actually, we currently have 140 machines.

N

Nayib Bukele43:34

How many were there before?

M

Marvin Ailar43:36

Previously they had 61 machines.

N

Nayib Bukele43:38

61. And not these.

M

Marvin Ailar43:40

And not these. Somewhat obsolete previous technology, which served about 180 patients per day. With the new number of machines we have, we will provide care for 420 patients per day.

N

Nayib Bukele43:58

So, we are going from 180 to 420. And besides the number, which is exorbitantly larger, the quality of care is going to be much better because they are with state-of-the-art machines, state-of-the-art supplies, fully prepared human capital. We are ready to respond to the entire population. And a message I want to leave to all the Salvadoran people, let it be very clear. We are in a golden age of nephrology. We have never had so many scientific and technological advances, medications, and all that arsenal we have now, we have them here and now in the new Hospital Rosales.

M

Marvin Ailar44:47

I am sure that there is no private hospital in El Salvador with this type of machines, and even less with this quantity of machines, right?

N

Nayib Bukele44:54

Of course not. So, the care they will have here, in addition, the type of doctors, the type of staff, the supplies, as you mentioned, basically what is here for a nephrology patient, you won't find anywhere even if you pay. You will have all the current resources available in technology and medications. So, all those patients, our patients, rest assured that they will receive the best human treatment, dignified treatment, and with the best. It is important because before there were no facilities, no equipment, no supplies, not enough staff, nothing, but there was also a problem many times of empathy with patients, correct? And that is an issue that happens a lot in public hospitals in Latin America, not all, but it happens in many, and I think it is also important. Obviously, the capacity of the medical staff today is greater than before. The equipment is much better than before. The supplies, as you mentioned, are better. The medications have not only advanced in the world, but we have acquired them, because they could have advanced and we wouldn't have them.

M

Marvin Ailar46:08

Correct. Yes, sir.

N

Nayib Bukele46:09

But also the issue of human warmth, which in a hospital is vital.

M

Marvin Ailar46:16

Our care philosophy is patient-centered, not disease-centered. We focus our attention on the patient and that guarantees us much better results.

N

Nayib Bukele46:29

Excellent. Thank you, doctor.

M

Marvin Ailar46:30

Well, Mr. President, a pleasure and an honor.

N

Nayib Bukele46:32

Thank you.

M

Marvin Ailar46:32

Have a great day, Mr. President. Let's continue.

N

Nayib Bukele46:37

There is something important that we need to emphasize because I remember that at one time the opposition media and some opponents said, "No, they are bringing foreign doctors and not giving jobs to Salvadorans." And I think we need to clarify several things. The first is that we are hiring specialists of the highest level in the world.

M

Marvin Ailar47:01

That's right.

N

Nayib Bukele47:04

Number one, for the care of the people.

M

Marvin Ailar47:04

Correct.

N

Nayib Bukele47:06

And why wouldn't we have the best? Doctors like this one, why wouldn't we have the best? And here doctors are coming from Argentina, Colombia, everywhere. For example, the bone marrow transplant that you mentioned at the beginning, there was no one here who could do it.

M

Marvin Ailar47:20

That has never been done here.

N

Nayib Bukele47:21

They have never done one.

M

Marvin Ailar47:23

M.

N

Nayib Bukele47:23

So, if we want to give that service to the people, we have to bring people from outside who can do it and put Salvadorans alongside them to learn how to do it and in a few years they can do it too.

M

Marvin Ailar47:34

That's right.

N

Nayib Bukele47:35

And here we have hired because there was talk of layoffs and I said, "No, no, no." Obviously, much of the staff that was there was good, much was not, and they left, but much of the staff was good and was relocated to other hospitals and other hospitals were reinforced, but all the staff here is new.

M

Marvin Ailar47:52

All the staff is new.

N

Nayib Bukele47:54

And 3,200 people were hired.

M

Marvin Ailar47:56

That's right.

N

Nayib Bukele47:57

Of which 3,000 are Salvadoran and 200 are foreigners who come to teach Salvadorans and serve Salvadorans.

M

Marvin Ailar48:06

That's right. So, I think criticizing that would be absurd. We are hiring the best for Salvadorans, for the care of the people. All the people, but obviously especially the poor people, with limited resources, because they are the ones who most need public health. Those who have money can pay for something private, which won't be as good as this, but they can pay for something private.

N

Nayib Bukele48:28

That's right.

M

Marvin Ailar48:28

Those who don't have economic resources can't afford it. They have to come here or to another public hospital and receive care. Having this type of doctors we have hired, specialists of all levels, to serve the people and that, in addition, as a teaching hospital, they will teach Salvadoran doctors, mostly young, moreover.

N

Nayib Bukele48:50

Yes, mostly young, right? Like you, the director, that's quite young.

M

Marvin Ailar48:53

Yes. In fact, the experience that foreign colleagues bring, from different countries, different specialties, as you very well mentioned, gives us double, it gives us in the quality of care for the population, but also in training Salvadoran professionals, because the focus is precisely that, that we have high-level Salvadoran professionals, who have great experience and have that capacity to care for any type of patient. But for that we have to bring people to teach them.

N

Nayib Bukele49:29

That's right. And I think closing ourselves off to being taught how to do bone marrow transplants or other types of transplants or the best possible nephrology treatment, the best equipment, well, being able to handle that type of equipment in the operating rooms, those robots that you put on special glasses to handle the robots. We have to bring people to teach us first who can operate the equipment.

M

Marvin Ailar49:58

That's right.

N

Nayib Bukele49:58

But we have to bring the level of doctors of that level of equipment to be able to do the best surgeries in the world.

M

Marvin Ailar50:05

That's right.

N

Nayib Bukele50:05

What they do in Japan, what they do in the United States, to be able to do it here.

M

Marvin Ailar50:08

Yes. That they have that experience. And in fact that has been part of what we have considered to be able to select the doctors who are now part of our work team, the experience in the highest technology, in the best hospitals in the world, many of them even trained in three, four different countries. So, that broad experience is what will help us to train more professionals of that level here in the country.

N

Nayib Bukele50:32

Yes, they have been, well, I saw some resumes, they have been presidents of nephrology, oncology, cardiology associations, and neurosurgeons, that is, levels that we have never had in the country and today we are going to have, as you well said, double, we are going to have it for the care of the people, but also for the learning of our doctors.

M

Marvin Ailar50:58

That's right.

N

Nayib Bukele50:58

Salvadoran, who at the end of their process will have to repay it with work here in the hospital, of course.

M

Marvin Ailar51:05

And precisely another of the examples is in the specialty of urology, which is one of the most requested in this hospital, in the country, and we have high-tech equipment and also high-level specialists to use them and care for patients. And precisely, Dr. Josel will tell us.

S

Sofía Vázquez51:30

Nice to meet you, it is an honor for me to receive you in the urology area of the new Hospital Rosales.

N

Nayib Bukele51:35

Thank you. Thank you very much.

S

Sofía Vázquez51:37

Here we have our urodynamics room.

N

Nayib Bukele51:39

Urodynamics.

S

Sofía Vázquez51:40

Yes. In this room we will see patients with diseases like... but very modern.

N

Nayib Bukele51:43

Ah, it's beautiful.

S

Sofía Vázquez51:45

Here we will treat patients with urinary incontinence, obstructive pathologies, or any disease that affects the bladder musculature. It is an outpatient study where the patient afterwards to see the emptying and all those things.

N

Nayib Bukele52:00

Yes.

S

Sofía Vázquez52:00

Previously, urological pathology... I am Venezuelan.

N

Nayib Bukele52:04

Ah, very welcome.

S

Sofía Vázquez52:06

Thank you. Complex bladder urological pathology was in the dark, since there was no way to study it, there was nothing, there was no this type of equipment that we have, there was none in El Salvador, there was none in the hospital, and that patient who needed it had to pay privately. Now, with this type of technology, we can assure the patient a precise diagnosis for the treatment of complex pathology.

N

Nayib Bukele52:29

Of course. Lithotripsy.

S

Sofía Vázquez52:31

Yes, this is our lithotripsy unit. Here we perform extracorporeal lithotripsy. This is a non-invasive study or procedure in which, with an arm placed under the patient, with high-energy shock waves, we can crush or dissolve kidney stones.

N

Nayib Bukele52:46

They destroy kidney stones from the outside.

S

Sofía Vázquez52:48

From the outside.

N

Nayib Bukele52:48

Without surgery.

S

Sofía Vázquez52:49

Without surgery. By crushing the kidney stones or turning them into sand, they can be expelled through the urinary tract with less difficulty. This state-of-the-art equipment combines ultrasound images with high-definition X-rays. That makes us find the stone with more precision, with high power.

N

Nayib Bukele53:08

And what does it launch? What is the energy it launches?

S

Sofía Vázquez53:10

It is shock waves. Shock waves that are transmitted through a liquid medium and reach the stone. This equipment, Mr. President, does not exclude, since we can treat young patients, obese patients, elderly patients with associated diseases or complex stones with little mobility with the same effectiveness. Thus we reduce surgical waiting lists and they do not have to be taken to the operating room.

N

Nayib Bukele53:32

And besides, the operating room always has more risk, it is more traumatic, you have to make a wound.

S

Sofía Vázquez53:37

That's why a group that previously did not benefit now benefits, because now they don't have to go to the operating room with the same effectiveness.

N

Nayib Bukele53:44

Yes. Well, being able to not go to the operating room and get cured is wonderful.

S

Sofía Vázquez53:48

Of course.

N

Nayib Bukele53:49

Thank you, Mr. President.

M

Marvin Ailar53:51

This is also part of the technology and what we were talking about, right? Having the specialists, bringing the best, the best care for the people, so that our doctors learn from these doctors we are bringing, international specialists.

N

Nayib Bukele54:05

Not only Salvadorans are committed to this, but also colleagues from other countries.

M

Marvin Ailar54:10

Yes.

N

Nayib Bukele54:10

And it is also a message. I know that everyone here is committed because they have been selected partly for their ability, but also for their commitment. But I think it is also a great message when you see people from Argentina, Venezuela, Brazil, Colombia leaving their countries to come to serve Salvadorans. So if I am a doctor and I work here, I say, if he came from there, he probably left his family, he probably left his friends, and I am here in my country serving my people.

M

Marvin Ailar54:44

Yes.

N

Nayib Bukele54:44

Well, I have even more reason to give 200%.

M

Marvin Ailar54:47

Yes, we should feel prouder as Salvadorans, because it is ultimately for ourselves, for our people, this type of care, this quality of care. On this occasion, Mr. President, Dr. Yaneire Vázquez will comment.

S

Sofía Vázquez55:03

Good evening, Mr. President. It is a great honor to welcome you to the hemato-oncology unit.

N

Nayib Bukele55:07

Thank you. Thank you.

S

Sofía Vázquez55:10

Well, Mr. President, I tell you, this hemato-oncology unit has had two innovations that are very important, because it changes the traditional management of the cancer patient to a management that is modern and multidisciplinary. Before, in the old Rosales, cancer patients were only evaluated by hematology and oncology.

N

Nayib Bukele55:34

Correct.

S

Sofía Vázquez55:38

From now on, with the new Hospital Rosales, all the modernization in the management of the patient was done and a multidisciplinary management will be carried out. So, we have hematology and oncology, which are the usual specialties, but additionally we will have management with family medicine, management by oncological surgery, management by palliative care, nursing staff. We also have the integral support of psychology, nutrition, physiotherapy, occupational therapy, social work.

N

Nayib Bukele56:19

Yes, because for all of us who have lost family members to cancer or have had family members who have fought and won the battle, both, right? Both are hard, very hard, both are hard. Fighting cancer even winning is hard.

S

Sofía Vázquez56:33

Yes.

N

Nayib Bukele56:33

And losing your life, not to mention, everyone, I think we have all lost a loved one to that disease.

S

Sofía Vázquez56:41

Yes, definitely, and it is important, well, first of all, to have the best care that we are going to have here, everything, everything first class, but also what you mentioned, physiotherapy, psychology, social work, because all that is also part of the process.

N

Nayib Bukele56:57

Exactly. It is to change that vision that it is a patient, that is, it is the disease to manage the patient in an integral way, because that is the idea. The patient is not only him, because he also has his family environment, his community environment, and when you are diagnosed with cancer, it not only changes the patient's life, but also that entire network he has, the family, everyone, everyone.

S

Sofía Vázquez57:21

In this area, Mr. President, I present to you, this is another of the innovations of the hemato-oncology unit. This is called the Day Hospital. Here patients have four beds where those who are most fragile, most delicate, or who during chemotherapy might have events or decompensate, here they stay all day, the patient is hospitalized, all evaluations, all management, their treatments are done, and the idea is to recover them during the day so that at night the patient can return home.

N

Nayib Bukele57:57

This is like a hospitalization during the day, so to speak, it is not hospitalization that is in the other area.

S

Sofía Vázquez58:02

Of course.

N

Nayib Bukele58:03

Each of the beds has the gas towers. So, these are also, that is, it is individual. This was not there before, where here absolutely everything is administered to patients. Aspiration of their secretions or their oxygen can be done, that is, they will be monitored all the time. I see it has a nice view too.

S

Sofía Vázquez58:25

Beautiful, beautiful.

N

Nayib Bukele58:26

And during the day it must also be nice. At night it has its charm, but during the day it must be even nicer, right? And people can.

S

Sofía Vázquez58:31

There are many birds here. It is very beautiful. The sky too, that is, it is one of the things that I find so beautiful because the patient is here and he is, that is, it is giving him another environment, giving quality to that person. So, where you can not only be thinking about what he is feeling, but also be able to be with this beautiful view, that is, it is a wonderful area, Mr. President. These are the chemotherapy rooms. Before we only had 20 stretchers.

N

Nayib Bukele59:02

The stretchers are those chairs.

S

Sofía Vázquez59:04

The stretchers are the little beds, the simple ones. These are chairs that are completely modern, comfortable. Here each patient will receive their chemotherapy. Additionally, we have these teams for the administration of both medications and liquids, volumes. So, we have the pump that is the infusion part, which is when you need to give a lot of volumes to the patient, and this is the perfusion pump that is when you need a smaller volume, the management is stricter. The nice thing is that these cubicles will have, for each row, a nurse, so a nursing staff that will be attentive to everyone.

N

Nayib Bukele59:53

And I see it has all the medical gases, oxygen, all the connections.

S

Sofía Vázquez59:57

And everything is individual.

N

Nayib Bukele59:58

Individual.

S

Sofía Vázquez1:00:00

This part is special here because we also had a problem here that adolescents sometimes they are not small to be managed in the pediatrics part, but they are not big enough to be managed in other stays. So here no. Here we are going to have adolescent care.

N

Nayib Bukele1:00:22

This is an area for adolescents.

S

Sofía Vázquez1:00:23

It is an area for adolescents. And these chairs are dynamic. That is, for example, if one day we have more adolescents that occupy more than the seven chairs, they are distributed here, then depending on the need. So, it is distributed. So, this whole area is very dynamic. So, depending on the need, it is organized and the patients will always be within their management, that is, with the entire team.

N

Nayib Bukele1:00:52

Of course. Integral.

S

Sofía Vázquez1:00:54

All integral management. We have support from clinical laboratory, pathology, imaging, pharmacy, blood bank, that is, it is a huge network, a multidisciplinary team to give the best quality. We have to accompany them in that fight, right?

N

Nayib Bukele1:01:11

That's right. And first God, to cure.

S

Sofía Vázquez1:01:14

And first God, to be able to and not leave the families that will be here, the relatives also have to.

N

Nayib Bukele1:01:19

That is important because I have been told stories in the previous hospital of people who could not see their relative and two weeks passed without seeing him and then from a funeral home they notified him that he had died, for example.

S

Sofía Vázquez1:01:32

Yes.

N

Nayib Bukele1:01:32

And I say, how can that be? It is important that they have access to their family. It is important that the relatives are not only access to their relative, but also information. Empathy.

S

Sofía Vázquez1:01:44

Exactly. Yes, that is it. That is the idea that has been had, to manage integrally because with that the pain that the patient and his family are feeling, we can make the support that he requires. Truly, that is beautiful what is going to be done here, all the organization, all the multidisciplinary work, everything we have worked on, truly it is a blessing. It is a blessing.

N

Nayib Bukele1:02:08

Thank you. Thank you very much, doctor.

S

Sofía Vázquez1:02:09

No, thank you. It has been a great honor to give the tour with you, Mr. President, truly, a great honor. Thank you very much.

N

Nayib Bukele1:02:17

Thank you very much, doctor.

S

Sofía Vázquez1:02:18

Thank you. Thank you.

M

Marvin Ailar1:02:20

The capacity we have as a hospital. Only in the hospitalization areas, our sensitive beds, which is known as the patient who stays more than 24 hours, we have a capacity of 502 beds, and in addition we have 110 non-sensitive beds, that is, those through which they pass up to 24 hours, like the ones we saw here, for example, in the hematology part.

N

Nayib Bukele1:02:45

Yes, hematology and like the ones we saw in the emergency observation area too. So, well, there were many beds.

M

Marvin Ailar1:02:51

There were many beds. So this represents a considerable expansion of the institutional capacity. In fact, from now on it is open. From this moment we have the emergency area open and all the services we have in the hospital.

N

Nayib Bukele1:03:04

Of course, I am glad because this is a great dream that many of us had for our country. This is something transformative, the first of many, because this is going to be the first of many hospitals that will be like this. That is a transformation of our system, not just a hospital, it is a transformation.

M

Marvin Ailar1:03:24

Yes, in fact this network of hospitals was created precisely to build or transform hospitals into this, yes.

N

Nayib Bukele1:03:31

Which is what the people deserve. That is why today, June 1st, I preferred instead of giving a speech, because speeches are useful, but they are less useful than this. And so I said, well, instead of giving a speech, let's deliver this work. We had to rush a little because it was scheduled for 10 days from now, but I told them, let's work night and day to get it out on June 1st and instead of giving a speech that you have already heard several, better deliver this work for the Salvadoran people. This is a gift for all the Salvadoran people.

M

Marvin Ailar1:04:01

Definitely, we have other services or other areas such as our clinical laboratory areas that have also been considerably expanded and improved. The clinical laboratory is a complementary area, but fundamental in patient care. This helps us define the diagnosis and treatment.

N

Nayib Bukele1:04:24

Yes, many times you have to be monitoring white blood cells, procalcitonin, PCR, so you can send it quickly and if we have a good laboratory we will have fast, accurate results. And to tell us a little about this area, Ms. Silvia Chile will explain.

G

Gendia Maya1:04:45

Good evening, Mr. President. It is an honor to welcome you to one of the clinical laboratories and blood banks of the new Hospital Rosales. This is a completely new laboratory and blood bank, okay? And it has been designed precisely for that, so that the patient and the donor have an orderly, safe, but above all efficient care. We have incorporated technology that did not exist in our country until now. We are here.

N

Nayib Bukele1:05:17

Wow. Laboratory.

G

Gendia Maya1:05:19

This is a laboratory area. You are here in the integrated, automated, and fully digital modular laboratory. This laboratory consists of this pre-analytical robot that I am only going to load.

N

Nayib Bukele1:05:36

Ah, the robot collects the tubes.

G

Gendia Maya1:05:39

Exactly. The robot prepares the sample.

N

Nayib Bukele1:05:43

I imagine the error is minimal, 0.001.

G

Gendia Maya1:05:47

We greatly reduce human error because the robot classifies, prepares, and then distributes through all the bands that are connected. Everything goes with its barcode, all the information will be printed with the correct patient name, all the data, nothing will be lost, nothing will be confused. With a barcode we identify and make that sample traceable. That sample travels through all the continuous flow bands to all the automated platforms we have. It has the capacity to process or give results 2000 results per hour.

N

Nayib Bukele1:06:33

Per hour. I was going to say daily.

G

Gendia Maya1:06:38

The daily result, I said. That's good because if there are 1000 patients, 2000 patients, it's 2000 results per hour, which would lead us to do up to 30,000 results in a day. It is a fully digital ecosystem, which allows us not only to increase metrics, that is, we are not only going to increase quantities, but also the quality and precision of the result. Compared to what was previously served, 400, 500 patients per day, we are doing four or five times more than what was previously installed capacity at the clinical laboratory level.

N

Nayib Bukele1:07:19

I think it's impressive.

G

Gendia Maya1:07:21

Yes, of course. With openness, availability, and with a lot of vision, even the smallest dreams can come true and become much bigger.

N

Nayib Bukele1:07:33

That's how it should be. Thank you. Some of the best hospitals in the world, many of them, even in Latin America, do not have this technology, this integration, and in addition to this, to complete the patient care cycle, definitely the medications.

M

Marvin Ailar1:07:50

Yes, this is something very important.

N

Nayib Bukele1:07:52

Yes, because I often see complaints from people saying, "No, there is no medication." Or "I went to the hospital and they treated me, but they didn't give me such medication, or such medication ran out." And that is a recurring problem, we hear it every day and it shouldn't be like that. Everything is a chain: the care, the capacity of the staff, the capacity of the equipment, the integral care, the laboratory, the medication, the supplies, everything has to work like clockwork.

M

Marvin Ailar1:08:25

That's right. And that will cease to be one of the complaints in this new hospital, right? Here we can see our pharmacy area. This area has 13 windows, that is, considerable.

N

Nayib Bukele1:08:36

Yes. Here I saw, here come the patients.

M

Marvin Ailar1:08:40

Here the patients come to get their medication, like a kind of pharmacy.

N

Nayib Bukele1:08:43

Correct, that's how it is. Here is the pharmacy. Here we have the waiting room.

M

Marvin Ailar1:08:47

And here is air conditioning.

N

Nayib Bukele1:08:49

Yes, right? Here they will be comfortable.

M

Marvin Ailar1:08:51

Of course, the old Hospital Rosales with everything old, ruined, without medications, bad care, ugly, neglected, and now everything modern, air conditioning, available medications, good care.

N

Nayib Bukele1:09:05

When the doctor in the consultation indicates the medication and saves the prescription, the prescription automatically arrives at the pharmacy.

M

Marvin Ailar1:09:11

Ah, you don't have to wait for the little paper that the lady brings.

N

Nayib Bukele1:09:14

No, no. So, when the patient arrives here, their medication is ready and they will only see on the screen when they are called to which window their name appears and they go and get it. So, the little paper becomes a receipt of the prescription only.

M

Marvin Ailar1:09:26

That's correct, for the indications, right? How to take it.

N

Nayib Bukele1:09:28

That's right.

M

Marvin Ailar1:09:29

Even that they don't have to wait, it gives more time to the pharmacy attendant to explain how to take their medications.

N

Nayib Bukele1:09:38

Correct. So you have more time to serve them.

M

Marvin Ailar1:09:40

Exactly.

N

Nayib Bukele1:09:42

So many things to think about. Something escapes you, right? It slips away, but here everything is thought out, everything thought out. It's all there. And also, what happens if a blind patient comes and has no one to read the prescription? It's already in Braille.

M

Marvin Ailar1:09:56

Yes, that's correct. And we are going to accompany the patient at all times, from the moment they arrive at the hospital until they leave. And also not only the patient, but we also have our early childhood care center. The early childhood care center, the CAPI.

N

Nayib Bukele1:10:11

Yes, we have the CAPI, truly, with the best conditions too, like everything in the hospital. My wife Gabriela will not forgive me if we don't see the CAPI.

M

Marvin Ailar1:10:20

Yes, well, let's go then.

N

Nayib Bukele1:10:22

Because that is good, it is one of the many projects she has launched, but important. I see that there is a lactation room here too.

G

Gendia Maya1:10:29

Hello, good evening, Mr. President. Welcome to the Comprehensive Care Center for Early Childhood. My name is Gabriela Orellana and today I am in charge of showing you the facilities.

N

Nayib Bukele1:10:40

Thank you. Thank you very much.

G

Gendia Maya1:10:42

The Comprehensive Care Center for Early Childhood is a space dedicated to children from 4 months to 3 years. It is also important to mention that at the reception we do the initial filter to see who is the person who delivers each of the children. Thus we keep a record.

N

Nayib Bukele1:11:03

Of course.

G

Gendia Maya1:11:05

We are entering a multifunctional room. Here each child will carry out activities, they will be able to play, and we will have a sensory activation with them. We also have the infant room.

N

Nayib Bukele1:11:23

Ah, this is with cribs.

G

Gendia Maya1:11:25

This is with the cribs. It is for children from 4 months to 12 months. Here it is a very important area because what we are going to do with them is take care of them at all times, verify their feeding, and also sensorially activate their body. Not only is the hospital comprehensive, but we also join the comprehensive part and this is the most beautiful part we have for them. We have adapted to them.

N

Nayib Bukele1:11:58

Yes, it's a mini bathroom.

G

Gendia Maya1:11:59

It's a mini bathroom to teach them hygiene, start teaching them how to brush, how to wash their hands.

N

Nayib Bukele1:12:07

The toilet, mini, the sink, everything is for them.

G

Gendia Maya1:12:10

Of course, we have adapted to them because we cannot risk them being at the same height as us.

N

Nayib Bukele1:12:14

Of course, of course.

G

Gendia Maya1:12:17

We are always looking for the best tools to teach them, to go hand in hand with them. All our team has the necessary training and experience. That is, here we have graduates in maternal and child health, psychologists, and nursery school educators. This is something incredible. Thank you very much, Mr. President, for this project and for taking into account each of the workers.

N

Nayib Bukele1:12:48

Of course. Thank you very much.

G

Gendia Maya1:12:50

Thank you very much. Have a happy evening.

N

Nayib Bukele1:12:52

Thank you. Definitely, we have nothing to envy any institution. Here everything has been considered. Truly, having this hospital is a dream come true for the Salvadoran population, dignified care with everything needed and not stopping halfway with the treatment or incomplete, but everything they need.

M

Marvin Ailar1:13:14

And something you mentioned at the beginning, here you see all the specialties.

N

Nayib Bukele1:13:18

That's right.

M

Marvin Ailar1:13:18

Everything the patient needs, we can provide it.

N

Nayib Bukele1:13:23

What we were talking about, right? Someone says, "No, but we save a couple of million and lower the ceiling." But I say, "Well, why not do it right if it's for the people?" Even that influences the provision of services.

M

Marvin Ailar1:13:36

Of course.

N

Nayib Bukele1:13:36

Well, El Salvador has always been lagging behind, but the mission is to be the best hospital in Central America, public or private.

M

Marvin Ailar1:13:47

That's right. And we are focused on that vision and we have been working and we will continue to do so because the commitment is to our people, to our people, and we are going to give them the best as you always say, right? That is, the public has to be better than the private and this is that. That is what we must achieve little by little because there is so much left, right? But this is another step. If the transformation of a system is something that takes time and is complex, but here we have not taken a short step, we have taken a step, it is a big step. This is the largest and most difficult hospital. All the others will be easier than this, because this is the largest in the country.

N

Nayib Bukele1:14:26

That's right.

M

Marvin Ailar1:14:26

It has always been the largest. Not to mention now that it is larger than before, but now little by little to transform, continue transforming the entire country. There is still a lot to do. I understand that sometimes people get impatient and say, "No, but why haven't they fixed such a thing? Why haven't they done such?" I understand. But well, we have to run, we have to run, do it as quickly as possible.

N

Nayib Bukele1:14:48

Well, sir, it has been a pleasure. Thank you very much.

M

Marvin Ailar1:14:52

Thank you.

N

Narrator1:15:21

Press Secretariat.

President Nayib Bukele addresses the Salvadoran people tonight

About Nayib Bukele