This paper presents a summary of the problems of surgical care in the Cauca Valley and proposes as an alternative solution to these problems the design of a system of surgical care that, on the basis of maximum utilization of existing resources, can substantially reduce costs and increase coverage. The ideas expressed here have been analyzed by an interdisciplinary team (surgeons, anesthesiologists, nurses, engineers, an architect, a sociologist and an educational physicologist) currently working on the projects in this research program, some already completed and some still under way. The results will be published in medical literature. The health policies of most countries are based more on the needs of the institutions furnishing these services than on those of the community. In the case of surgery space planning and the development of human resources is based on data on satisfied demand and not on data on the need for surgery, information that frequently does notexist at all. The consequences of such ineffective planning include the defective allocation of budgetary funds and the inadequate utilization of human resources, space, equipment and other resources. (AU)