María Ruzza: “This Government has never thought of clinics as collaborators to protect the health of the community”

@mlclisanchez

With three rented premises in the La Económica shopping center, in San Félix, and with the television, the hooks on the doors and the tables of the founding couple’s house, the Centro de Cirugía Ambulatoria Clinic (Ceciamb) was born, an institution that today He is 30 years old and whose growth is counted today with 35 rooms, five operating rooms and active services, in addition to the Venezuelan hospital crisis.

María Ruzza, general manager and co-founder of the company, defines the beginnings of the project that, together with her husband, the surgeon Héctor Rafael Hurtado, built since 1991, as times of a lot of work. Ruzza is a civil engineer, and upon graduating from the University of Carabobo she initially worked in Valencia, the capital of that state, as an inspector engineer at the old National Institute of Sanitary Works (INOS).

In 1989, she and her husband moved to Ciudad Guayana, where Ruzza worked at the Corporación Venezolana de Guayana (CVG) in parallel with his own construction company. With his own company, Ruzza supported with the remodeling of the first premises of the Ceciamb project.

Today the Ceciamb Group, which its founder directs with the unique idea of ​​being “a bubble for patients”, includes the Ceciamb Clinic (founded in 1991), the Ceciamb Clinic Hospital (1998), the majority of the shares from the Instituto Clínico Infantil (ICI) and the Instituto Cardiológico de Guayana (the latter, from 2003). It is the only institution in the east of the country that has a Cardiovascular Institute with much more than hemodynamic rooms.

How was what today is the Ceciamb Clinic born?

We start with nothing, with the nails. My husband, Rafael Hurtado, always had the ideas and I supported him. We stayed in the first place for four years. Rafa and I have always been for everything, with God first. They were beautiful times, but beginning and without experience they were times of a lot of work. With a bank loan, Ceciamb started only with a ground floor, which was the emergency, and there we enabled a single operating room in which we attended only minor surgeries, until we decided to enable hospitalization with three rooms and then we opened our offices to have our specialists there, And we started! In two years we had active offices and eight rooms in the first location.

I am satisfied with what I have achieved so far. Am I missing? Yes, and hopefully we change, that the country changes because we would go with a safe step, right now we do not know what they are going to shut us down or what they are going to block us, what they are going to expropriate us “

Venezuelan health to therapy

From one moment to the next, the clinic grew small compared to the demand for the service, and that’s when the real expansion began. With another bank loan and a brief negotiation, the Hurtado Ruzza family acquired in 1994 the premises that today is the Ceciamb Clinic, in the Caura shopping center, with an extension of 20 stores. “Then, we were given the opportunity to buy the facilities of what is now the Ceciamb Clinic Hospital (in 1998) linked by a walkway to the Ceciamb Clinic, which was left as an outpatient clinic,” explains Ruzza.

Five years ago, 90% of the income received by all clinics in the city came from the Hospitalization, Surgery and Maternity (HCM) insurance that the Venezuelan Corporation of Guayana (CVG) guaranteed workers. Only 8% of the clinic’s income came from other insurance policies, and 2% from individuals.

“I think they have always been difficult… this government administration has put us many obstacles. They create a scale that kills us “

Everything changed when CVG grouped all the management of the basic companies, suspended the workers their HCM policies and stopped paying the debts that they already had with the private clinics. Without this benefit, the occupancy for hospitalization in clinics decreased to 90% and surgical interventions to 70%, calculates Ruzza.

Losing the alliance with CVG was a serious blow to the private health sector, which is why then the figure of the Association of Private Clinics, which Ruzza chairs, had to emerge. “We call them ‘cousins’, with that we try to help each other (between clinics)”.

What challenges have you had to face in recent years?

Challenges? Countless! I am the head of the three (ICI, Hospital de Clínicas Ceciamb and Instituto Cardiovascular de Ciudad Guayana). And, at least at the ICI, a year ago I said ‘I have to close it, I can’t take it anymore, no’. As if my soul were being ripped apart because we spent a whole year subsisting on X-ray and laboratory income, nothing more, because no one was admitted for hospitalization, with a payroll of 150 people! What was the challenge? To think that we were not going to close, that we could achieve it, that the ICI has a lot of potential.

Have you thought about quitting?

No, I have not wanted to leave. The idea was that my children (three) would stay with this, but they migrated, they formed their family and we know that they will not return, but what do we have left? This great Ceciamb family. I am satisfied with what I have achieved so far. Am I missing? Yes, and hopefully we will change, that the country changes because we would go with a safe step, right now we are not knowing what they are going to close us or what they are going to block us, what they are going to expropriate from us.

Despite…

In the midst of the emergency, the Ceciamb Group projects continue to expand. A specialized cardiovascular emergency area is currently being built on the ground floor of the Hospital de Clínicas Ceciamb, right on the premises of the former Jesús de Nazareno dialysis unit, which closed its doors in September 2020.

Many people have been able to attend moderately, we make arrangements for them to pay in parts, we balance between losing in one case, but winning in another, is to turn it around … “

How does the Ceciamb Clinic stay afloat?

With Ceciamb it is a little easier for me because we have staff who live nearby, the fuel consumption is lower, the services are permanently open, we have an oxygen tank there, and we have had fewer difficulties. However, every 15 and last is … at times the payment comes in foreign currency, bolivars are scarce, so … it is very complicated (laughs).

When did things start to get tough?

I think they have always been difficult … this government administration has put many obstacles in our way. They create a scale that kills us. For example, they force us to charge two thousand bolivars for the hospitalization service when it costs us ten thousand … And if they establish that, then the insurance policies also establish that this must be so and that is where they go … They have never thought in us as collaborators to protect the health of the community, as support. Hospitals are not well provided, but they are not helping …

What is the current relationship of the clinics with the CVG?

I want to understand CVG, but I can’t (laughs) … I want to put myself in the middle and say that they don’t get money … but I can’t understand how they could abandon so many people … We have good and good treatment communication, but they are only cases that they authorize and they may pay soon … it may not.

How were things for Ceciamb before the crisis in the health sector?

Before all this we made agreements with the hospitals when we were in Ceciamb. We operated here and sent the patient back to the hospital and the expenses were minimal because the patient had just finished recovering at the hospital. They were great conventions!

What have they had to readjust to stay upright?

We think about reducing costs here and there, about holding conferences, putting up balloons, giving it life. And we are getting up again. Many people have been able to attend moderately, we make arrangements for them to pay in parts, we make a balance between losing in one case, but winning in another, is to turn it around …

The cure is to keep rowing

How do you reconcile that of accessibility with the high costs of hospitalization and other services?

The collection part has been the hardest part my entire life. Insurance paid six months, eight months, a year or who knows when, many went bankrupt, many left … the losses have been very large as a result of inflation. The insurance that remained improved a little with payments sometimes in a month or three months, that in three months the dollar is not the same and like any clinic, we have to pay payroll and therefore we have to collect. But the first thing is to work for the people.

The Ceciamb Group’s Guayana Cardiological Institute is the only cardiovascular center in the eastern part of the country. Its expansion is still a project

Since October 2003, the Ceciamb Group invested in a key service for Ciudad Guayana and the entire eastern part of the country: a cardiovascular institute where cardiovascular surgery and interventional cardiology, including children, are developed. A team made up of 14 cardiologists, intensivists, generals, hemodynamists, and cardiovascular surgeons.

Two haemodynamic rooms, an operating room, intensive therapy, a chest pain unit, a coronary care unit, sonography, and others make up the services of the Instituto Cardiovascular de Guayana.

If you had one iconic memory from the clinic, what would it be?

Of the beautiful times that I want to remember are those social days that we did with the Chamber of Commerce and Industries of the Caroní municipality (CamCaroní) What times! Together with them we have organized health conferences at the regional level. It was a spectacular experience, the emotion that people went with! We brought laboratory people from the ICI, we brought internists, cardiologists, pediatricians, we brought medicines … Well, in the old days laboratories gave us medicines, just like pharmacies, we carried boxes! We had milk, other things … how nice …

The Ceciamb Group’s Guayana Cardiological Institute is the only cardiovascular center in the eastern part of the country. Its expansion is still a project

How long did this initiative of the social days that you once had last?

Like five years (from 2004 to 2009). Later I was very scared because the places became more and more dangerous. Imagine, I take the risk because I was taking a team of 20 or 30 people and they are my people.

Do you have any other Ceciamb Group projects for the future?

Yes! A project created seven years ago. A facility only for the Cardiovascular Institute, will be on a 7,000 square meter land that belongs to us, and is between the ICEA Clinic and Fragachán.

This project is designed for 40 hospital beds, two pavilions, two hemodynamic rooms, intensive therapy, and even a helipad! But all projected so far. Unfortunately the country situation has not allowed us to grow there yet, we have been limited.

What keeps you anchored here to continue providing all the services that the Ceciamb group offers?

Look, the need for the community, the city. Really, keep betting that it is possible because our services are essential, because health is basic.

It motivates us to know that we have health personnel who also need us. We have to support them, so we are in a critical area where patients do not have much to turn to and we are a reference center and here we will be waiting for them.

A specialized cardiovascular emergency area is currently being built on the ground floor of the Hospital de Clínicas Ceciamb