Carlos Astudillo, MD
Carlos Van Buren Hospital, Valparaiso, Chile
|The Van Buren Hospital after the 1906 earthquake.|
In the sixteenth century Valparaiso was a small village with a few hundred inhabitants. Despite this, it was the principal port of the Kingdom of Chile, where ships from Europe arrived after the long and dangerous passage around Cape Horn. In this port ships took on food and water. The village had no hospital, but despite this it received those who had become ill on the voyage. In 1786 King Charles III of Spain issued a royal proclamation ordering "the erection of a hospital in the Port of Valparaiso under the care of the Religious Order of San Juan de Dios."1 In the founding charter it was established that the soldiers of the garrison and the crews of the merchant ships should pay for their hospital care, and that only if resources were sufficient could women also be treated. It was only after 1836 that the hospital began to accept women as patients.
During the seventeenth and eighteenth centuries the hospital continued operating under precarious conditions until it was destroyed in the 1822 earthquake. It was decided to rebuild the hospital, which was relocated from the hills of Valparaiso to the center of the city. In this new and spacious location were built wards, operating rooms, and the Chapel del Carmen of the Sisters of Charity, who remain with the hospital to this day.
In the second half of the nineteenth century, through the contributions of benefactors and philanthropists, the hospital was able to expand as the demand for its services increased. In the admission log from 1868 the most frequent admitting diagnoses were phthisis and syphilis, which were major causes of illness in the population at that time. Other listed admitting diagnoses included skin rash, abscesses, straining, swellings, dead body, convulsions, madness, indigestion, and hydrops. Causes of death were listed as phthisis, bubonic plaque, cholera, smallpox, flatus, and sudden death. At the dawn of the twentieth century Valparaiso had 153,000 inhabitants, most of whom lived in unhealthy locations where water quality was poor and typhoid fever and dysentery were rampant. The hospital had 18 wards, 556 beds, and 14 physicians.2
On August 16, 1906, Valparaiso was hit by an earthquake lasting four credos (recitations of the Apostles' Creed), with 3,000 dead and 20,000 wounded. Despite damage to the hospital its physicians helped to prevent epidemics in the city through their outstanding and efficient efforts. These experience with epidemic illness and natural disasters demonstrated the need for emergency services in Valparaiso, and in 1907 the hospital opened the first emergency department in Chile.
After the earthquake of 1906 the banker Carlos Van Buren became the hospital's administrator, and the reconstruction which he directed served the hospital well throughout the twentieth century. He dedicated funds from his personal fortune for the construction of wards, operating rooms, a laundry, a clinical laboratory, a radiology suite, and a morgue. Upon his death in 1929 the leaders of Valparaiso recognized his contributions by changing the name of the hospital from Hospital San Juan de Dios to Hospital Carlos Van Buren.
In the 1930's Dr. Salvador Allende, future President of Chile (1970-1973) worked in the hospital's Service of Anatomic Pathology.3 Today the hospital's museum bears his name and is located in the Department of Anatomic Pathology.
In 1949 Doctors Svante Tornvall and Pedro Uribe founded the Medical and Surgical Cardiovascular Unit together with Doctors Carlos Patillo, Jorge Kaplán, and Kenneth Jackson. This team performed the first closed mitral commissurotomy in Chile only two years after the operation was first done in the United States.4 In 1956 together with British surgeon Sir Thomas Holmes Sellors, the team performed the first open heart operation using hypothermia in Latin American. This was repair of an atrial septal defect.
The growth of the hospital required the construction of a surgical tower in 1970 and ten years later a medical tower was added. In this manner, for over 200 years the Hospital Carlos Van Buren has been a part of the lives of thousands of citizens of Valparaiso. It has also been a part of the history of Chile, where successes, failures, and natural disasters have forged the soul of Chile and of the Chilean people.
- Archivos del Consejo de Hijiene de Valparaiso. Valparaiso : El Consejo, 1896-1903.
- Cuad Med Soc (Chile) 2007, 47 (1): 48-50.
- Rev Med Chile 2009; 137: 1253-1260.
CARLOS ASTUDILLO, MD, received his medical degree from the University of Chile. He remained in Valparaiso to complete his internship and residency in Internal Medicine and Clinical Cardiology in the Carlos Van Buren Hospital, University of Valparaiso. In 1992 completed his cardiology fellowship in Echocardiography in the Hammersmith Hospital in London. Since 1994 he has been Cardiologist in the Carlos Van Buren Hospital, Professor of Cardiology in the University of Valparaiso and from 2010 to 2013 President of the Valparaiso branch of the Chilean Society of Cardiology.