In the early hours of 29 December 1993, a baby in a hurry to be born brought forward the opening of the Costa del Sol Hospital in Marbella. The new facility was not due to receive its first patients until later that day, but when a local woman, Belén Ortiz, whose waters had broken, drove past with her husband on their way to Malaga and saw lights on, they decided to stop and see if someone there could help.
The surprised staff set to work and Nuria, the baby, "christened" the hospital which at the end of this year reaches its 25th anniversary.
Later that day, the hospital opened its doors officially, at the allotted time. There was no ribbon-cutting, just a guided tour for the media given by the then hospital director, José María Bonet, and Francisco Cano Bueso, the provincial Health delegate.
Since then the hospital has continued to evolve to adapt to the needs of the fluctuating population of the western Costa del Sol. Its unique catchment area has meant that from the offset, a large proportion of patients were foreign. Now 25 per cent of the annual patient total is of a nationality other than Spanish.
From day one a group of volunteers was there to deal with the problems the language barrier poses for foreign patients. Coinciding with the opening of the hospital, journalist, volunteer and fundraiser Marion Winter set up a small group of volunteer interpreters.
The language barrier
"I had been working at the Universitario hospital in Malaga for five years and I approached the newly appointed director of the Costa del Sol before it was finished," said Marion whose proposal was accepted and she had her volunteers ready for the opening day.
Now, 25 years on, the group has grown and continues to help make communication between patients and hospital staff less stressful. Three years ago the interpreters set up an association, AVICS, presided over by volunteer Vicki Rhodes. Now coordinator Mónica Pons organises the shifts for 19 volunteers, who among them speak English, French, German, Dutch, Arabic, Polish, Swedish and Danish, among other languages.
Recently the hospital has also set up a video interpreting service for sign language to help communication with deaf patients.
The hospital has received numerous accolades over the years, from both public and private organisations, and has grown in innovation and technology. Its aspirations to grow physically, however, were truncated almost a decade ago when work on the new extension came to a standstill.
The contractors had accepted the job in exchange for the right to run the new underground car park. In 2010 the council objected to users having to pay to park at the hospital and refused to issue a licence. The political and legal dispute was to go on for years. Meanwhile, hospital staff and patients have been coming and going in the shadow of the skeleton of an unfinished extension building.
A new chapter in the long saga was written just this week, however, when the Junta de Andalucía announced it will come to the rescue with public funds to finish the project.
Over the last 25 years patient figures have increased along with the population, while activity at the hospital has also varied with the country's economic situation. Growth slowed in the years of the financial crisis and picked up speed again in 2014 and 2015.
The average daily total of emergency cases was at 110 in 1994 and reached a maximum of 358.7 in 2007. From then it started to fall to 293 in 2012. Last year the daily average number of cases in accident and emergency was 325.
In 1994 there were 5,892 admissions. This figure hit a peak of 19,201 in 2008 and last year it was at 18,111. The average bed occupation figure was 84% in 2006. Last year this was back down to 65%, only just slightly higher than the initial figure of 64.5% in 1994.
The increase in the local population is best reflected in the outpatient figures. In 1994, a total of 23,196 visited a specialist as outpatients. Since 2014 this figure has remained steady at around 246,000.
"This hospital has continued to evolve and is in good health," said Torcuato Romero, the current director of the Costa del Sol Health Agency (which includes the Hospital Costa del Sol, the Hospital de Alta Resolución in Benalmádena, which opened in 2008, and the CARE centre in Mijas, open since 2005).
"We have adapted to society's new circumstances and problems, and we have done that with a team of dedicated professionals who feel proud of being here and taking part in a common project," said Romero.
The Costa del Sol's accolades have come on a local, national and international level. This was the first hospital in Spain to be accredited by the Joint Commission International system in 1999, and in 2017, it received the 'Best in Class' distinction as the best hospital in the country. This year the Costa del Sol was runner-up in the 'Best in Class' hospital category and was singled out as the hospital with the 'Best Service' in the Internal Medicine section.
"One of the biggest achievements of this team is that we continue to take on new challenges, always with the patient at the centre of every decision. The evolution of the hospital has shown that we are not scared of innovation," said María Luisa Hortas, now the director of the clinical laboratory, who has worked at the hospital for the last 20 years.
Francisco Gutiérrez was among the first professionals brought in to help set up the hospital. "I came in to help them set up and I stayed and now I've been here 25 years," the 54-year-old says with pride. He has fond memories of the hospital's early days. "This was something very different from what this area had before. It was much needed," he said.