Response: Re: The Emergence of Primary Care in Latin America: Reflections from the Field

Dr.Nisly expresses frustrations about her daily work as a mission physician in El Salvador and notes several examples of how the health care system is failing there. She is absolutely correct in noting that the reality of health care in El Salvador is far from perfect. I suspect that pretty much the same could be said currently about any system in any place around the world.

That such frustrations and realities exist, however, should not blind us to the hope of building more rational systems of health care delivery. Efforts to develop community-based, locally accessible primary care services are worthy of support. Four years after the first peaceful democratic transfer of power in El Salvador's history, the current Ministry of Health is slowly making progress on its platform of reform. I applaud it for even trying.

More to the point for readers of the Journal of the American Board of Family Medicine, every system of health care around the globe has weaknesses and strengths. Our greatest challenge as practitioners in the global community is to learn both from failures as well as successes—be they “theirs” or “ours”—and to acknowledge them honestly with measures of humility and respect. Above all else, that is the take home point from my article and this response.