Longtime director of Metro Health connected with families, city
As the face of public health in Bexar County for more than two decades, Dr. Fernando A. Guerra saw the community through the AIDS epidemic of the 1980s and ’90s, panic and uncertainty after the 9/11 attacks and humanitarian support for 30,000 Hurricane Katrina evacuees brought to the city in 2005.
As a pediatrician and director of the San Antonio Metropolitan Health District, Guerra worked long hours and made personal connections with families, guiding the city through crises with a steady hand.
Guerra, 82, died Friday at the Village at Incarnate Word.
Former Mayor Henry Cisneros, who relied on Guerra as a public health adviser and as the primary care doctor for his son, John Paul, said Guerra brought compassion, holistic approaches and firsthand experience to the role of Metro Health director from 1987 to 2010.
“He taught us new ways to see the challenge of public health. Many lives were touched both by his personal practice, but also by his progressive look to the future on matters of public health,” Cisneros said. “He had pursued public health out of personal interest, out of a sense of ideals, a sense of values and beliefs, and the combination was just perfect for what San Antonio needed at that time.”
Guerra was born in San Antonio on Aug. 11, 1939. His father, Fernando Guerra, ran a pharmacy on the West Side — he was just the second person of Mexican American descent to graduate from the University of Texas at Austin College of Pharmacy.
The younger Guerra was in middle school when he decided to become a doctor, said his wife, Beverly Purcell-guerra. He received his medical degree from the University of Texas Medical Branch at Galveston in 1964.
He served with the Army Medi
cal Corps from 1965 to 1967 and treated the wounded as a battalion surgeon in war-torn villages of South Vietnam. The experience sparked his interest in public health advocacy.
“He saw things like plague and things that you would not normally see in the United States, or at least not in most parts,” his wife said. “He’s always said his time in Vietnam created his interest in public health.”
When Guerra returned to Texas, he taught at UTMB before moving back to San Antonio. He was running his own practice in 1987 when city officials asked him to take over Metro Health on an interim basis.
It was shortly before Pope John Paul II’S visit to San Antonio on Sept. 13 and 14 of that year. The previous Metro Health director had resigned over fears that medical facilities and water supplies would be inadequate for the huge crowds expected when the pope celebrated Mass at Westover Hills.
Guerra stepped in to oversee
preparations, and the papal visit went off without major problems. His work so impressed city officials that they put him in charge of Metro Health on a permanent basis.
Throughout his career, Guerra focused on child abuse and neglect, domestic violence, obesity, diabetes and health disparities. Bexar County Judge Nelson Wolff, a former San Antonio councilman and mayor, said Guerra was a “classy guy” and dedicated professional who advised the city on its response to the AIDS crisis.
At the time, public officials across the country were struggling to understand AIDS and “address the ways it attacks the immune system,” Wolff recalled. “It was a struggle to accommodate those that had AIDS,” he added.
In a 2011 interview with the San Antonio Express-news, Guerra said “there was a lot of anger” about AIDS. At one point, community activists called for his resignation. His first pediatric AIDS patient was a 3-year-old with hemophilia who had been infected by tainted blood products. Yet even in those contentious times, the city “maintained a supportive
relationship” with nonprofits that assisted people with AIDS, Guerra said.
Wolff, who has played a key role in guiding San Antonio through the COVID-19 pandemic, said that under Guerra, Metro Health “had to learn a lot about that (AIDS) pandemic, and that in some form or fashion probably helped us” deal more effectively with the coronavirus.
Cisneros spoke with emotion as he recalled the birth of his son, John Paul Anthony Cisneros, in 1987 at Southwest Texas Methodist Hospital. Guerra explained to him that John Paul had a “serious malfunction” that didn’t appear “fixable” and would require “a lot of time and effort getting as far as you can.” It turned out to be a serious heart defect, accompanied by other medical problems.
“This is my dear friend. This is somebody I worked with telling me to my face, but with great pain,” Cisneros recalled.
Guerra took on the care of John Paul “as a personal cause” and gave medical advice to the Cisneros family and referrals to other doctors for the next 17 years. John Paul overcame his childhood medical problems and now is CEO of an infrastructure investment company he and his father co-founded.
Henry Cisneros said the experience reflected Guerra’s approach to anyone in need. He treated people affected by addiction, gang violence, depression and other societal issues with deep humanity.
“To bring a higher level of passion, understanding — that, I think, captures the importance of the way Dr. Guerra balanced his obligations,” Cisneros said.
Guerra is survived by Purcellguerra, six children and eight grandchildren. Because of the pandemic, his family plans a public memorial service at a later date by arrangement with Angelus Funeral Home.