On a windy spring morning, Dr. Anne Foster stopped by a makeshift construction command center humming with activity just up the hill from the site of the new Presbyterian Santa Fe Medical Center.

A few staffers held down the fort in the trailer-turned-office.

Foster greeted them as she picked up her hard hat — required equipment for anyone entering the hospital building. She struggled for a few seconds to affix it.

“I can do surgery,” she said, chuckling. “But I can’t put on a construction hat.”

It had been several months since Foster, an OB-GYN and the new hospital’s medical director, had visited what will soon be a 30-bed facility on Santa Fe’s south side — the most expensive health care facility in the city’s history. Foster couldn’t wait to see what was new: freshly taped drywall, perhaps, and maybe the birthing bathtub had gone in.

Overseeing the vision and implementation of medical care at the new hospital is just the latest in a series of hats Foster has worn in her 30-year career, one that’s taken her from the unpaved streets of Taos Pueblo to the jungles of Central America, and from the operating room to the halls of health care bureaucracy.

“I look at everything I’ve done in my life,” said Foster, 56, “and I go, ‘Wow.’ It’s almost like this is a final common pathway of all the experiences and skills and education I’ve had.”

Foster was 6 when she moved with her mother to Taos Pueblo. Her mother, Roxanne Foster, served as the first librarian at the Taos Day School.

Her ancestors had lived in Las Vegas, N.M., Foster said, but the pueblo was her first in-depth exposure to the state — and to many of the social issues that plagued it.

At Taos Pueblo, she saw excess health problems, high levels of alcoholism and a struggling U.S. government-funded Indian Health Service that, she said, often failed to fully address the needs of its Native American patients.

“You have these experiences where you see part of the population being discriminated against, not having access to good health care, not having access to education and other job opportunities, and it’s wrong,” Foster said. “It reinforces those [social-justice] values, and I think it sets the stage for a lot of cultural sensitivity.”

After medical school, Foster, pregnant with her first child, packed up and headed to Central America.

Through her mentor at The University of New Mexico, Dr. Ben Curet, she had enrolled in a grant program to help reduce high rates of maternal death in Nicaragua, El Salvador, Honduras and Guatemala.

Improving medical care wasn’t Foster’s only objective in the program.

“It meant not only dealing with the quality of care and the staffing and protocols and resources,” she said, “but it also got down to real basic stuff — like, what do we believe is the value of a woman’s life that we would not rearrange or reform our health system so as to ensure that women survive?”

The level of care afforded pregnant women and new mothers, she said, is “a pretty sensitive thermometer of gender equity or lack thereof in those countries.”

Foster said she appealed to doctors’ and policymakers’ sense of responsibility. By the time she left in 2004, she had given birth to two children of her own. And the maternal death rate in Nicaragua had dipped to 189 women out of every 100,000 live births from 242 deaths, according to data from the World Health Organization. Today it stands at 150.

Curet said Foster was “very, very dedicated” to her work — and very successful.

“When Anne asked [doctors] to do something, they went in and did it,” he said. “She spoke Spanish, she was a very caring, loving person, and her services were needed no matter where she was.”

Foster lived in San Francisco for nearly 20 years. In 2011, she returned to New Mexico to help implement the Affordable Care Act and expand Medicaid in the state as the program’s chief medical officer.

The job was worlds away from the operating room, but during her foray into bureaucracy, Foster said, she had a chance to put her social-justice skills to work — back in the state that taught her to care.

“I had been so interested in coming back to New Mexico, but coming back to a purpose that would create some substantive change for the population,” she said. “When I got the call, I was very excited.”

In her post at Presbyterian, which started nearly a year ago, Foster said she is excited to see the effects of the broad policy decisions that she helped craft.

“I get to see all of that implemented in a very in-the-flesh way, benefiting the patient and the community directly,” she said. “It’s not some kind of a murky policy meeting. It’s not on paper. This is it. We get to take care, in this facility and in our practices, of the very people who benefited from the Medicaid expansion.”

Before the hospital opens in October, recruiting will be one of her main gigs. So far, she’s signed about 20 of the 30 physicians, physician assistants and nurse practitioners to the hospital’s full-time payroll.

Additional physicians will split time between the hospital and Presbyterian’s clinic on St. Michael’s Drive.

Targeting providers with New Mexico roots — like Foster — has proved a valuable strategy for Presbyterian.

“We have seen a number of folks really make a beeline, so to speak,” she said. “And that’s really great because … we want people to want to be here.

“And then when somebody from the state comes back highly qualified and trained and wants to serve their community,” she added, “that’s, like, the best combination.”

Contact Sarah Halasz Graham at 505-995-3862 or sgraham@sfnewmexican.com.