Wabash Blogs Health Care in Chiapas
 

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June 24, 2008

A great, but long day

A woman and her three boys.  Her outfit is common of this particular group of indigenous Chiapanecos from around Zinacantan I think.  

Today was much different from the last two weeks. I got to spend about 8 hours working in a small village about 45 minutes away from San Cristobal. I believe its name was Navenchauc. I may have mentioned before that the culture here is saturated with indigenous influences. Chiapas is the only state in Mexico where over 50% of the population identifies as indigenous. The people in this community largely spoke a Mayan dialect called Tzotzil. I knew three words in the language and somehow managed to use them all. I got a friendly grin when I was combining them with the Spanish I was speaking. It was amazing. By some fortune, with the connections I am making here, I was able to travel with a volunteer group of United States citizens providing international medical assistance. It appears that they worked with the government to augment support for one day in each community surrounding San Cristobal. They aren’t here for as long as I will be, but I will probably get to spend the rest of the week with them. I was happy to be able to use my Spanish to help. I usually had to go through a Spanish to Tzotil translator as well, so it became a bit of a puzzle to find out how people were hurting or what illnesses they were suffering from. I covered some history and basic questions with probably 100 people throughout the day. This isn’t something regular in the area, so we were a bit of a spectacle and more than 300 people probably got in line to see the docs. Just to give you an idea of what children experience here, especially under 6-7 years old: Often symptoms include loss of appetite, head colds, fevers, and diarrhea. I don’t think the people understand how important water is to their health. I tried to tell that to as many people as would understand me. Usually the cause of a lot of these problems is intestinal parasites. I’m wishing I had taken parisitology right about now…haha. I got to take some pictures finally, but they aren’t the best quality. I promise to get some more. I might be taking some patients blood pressures tomorrow, so that will be something new and exciting. I am still desperately waiting to see how the MCAT went. Scores were supposed to be released today at 5 pm, but so much for that. Look forward to more updates later this week!

Some info on the wall at the clinic tries to warn parents how to care for diarrhea in their children or of precautions to take during pregnancy, among other things.  

The group's makeshift pharmacy and people waiting for prescriptions.

June 20, 2008

Lots of Thoughts

This is a long post since it’s been a while. Thanks for reading.

Over the last week, I was shadowing a doctor in his work on preventative measures to control the spread of disease in the area around San Cristóbal at ISSSTE. This is what I mentioned in my last post. I have been thinking about a lot more than just the shots I’ve watched nurses administer. In my biology classes at Wabash I learned about diseases and their transmission. In my political science and economics classes I learned about globalization and central power theory. In my history classes with Dr. Warner I learned about the history of Latin America, a part of the world rich in resources but prone to corruption. I learned about Mexico’s history and its relationship with the US over time. Here I can see first hand the problems that the developing world faces.

I guess what has affected me most, is hearing about border crossing and the implications it has on families, economics, and international politics. The mother of one child we vaccinated explained her concerns for her brother who had head the US to earn money. The people here are genuinely struggling to make a living. They leave behind families to seek better opportunities and more money. Here Mexicans work very hard but are short of employment. Even people with post-secondary degrees struggle to find jobs. The current Mexican government seems to be heading in the right direction, trying to make its actions more transparent to increase confidence and credibility. The government web pages are being revitalized and less money is being wasted on unnecessary things.

I’ve found myself at conflict here though because I tend to fall into idealism, and I have had to realize that there are several limiting factors that are going to keep parts of the world like this from developing very quickly. I guess one thing that is going to limit this over the next several decades is population growth. Here in Mexico, preventative health experts are facing serious problems. Weekly reports of diagnoses all over the country show that when vaccinations are available, Mexican health officials can generally control infectious agents causing tetanus, meningitis, gastroenteritis, poliomyelitis, and many other diseases. The government fortunately has the resources to administer vaccinations, but the realities of international relations prevent this from always happening. Countries like Korea and India are large producers of the vaccines that Mexico uses. Because of population growth, there are strict quotas on vaccination exports to countries like Mexico.

Today I was happy to hear from Dr. Castro that the Secretary of Health has started an effort to develop and produce vaccines and other biological agents for the control of disease. They are calling on Mexicans all around the world that work as research scientists and engineers to come back and help in an effort to protect Mexicans from preventable diseases. This made me think about a paper I wrote in Latin American history. My hope was that strong nationalism could help struggling Latin American countries advance and develop into countries with stronger economies, higher qualities of life, and honest politics. Now, I am by no means an expert on anything related to Latin American politics or Latin American history, but my liberal arts education (thanks to Wabash), has led me to make some interesting observations. This is an amazing way to create a sustainable industry within Mexico that could create more jobs, as well as provide for a demand that is seriously under supplied. It could prevent the spread the spread of disease and overtime cut down on the amount of financial resources expended in responding to outbreaks or on individual treatment. Maybe then, the efforts in place for social development in Mexico could become more effective; Goals for improving water supply and sanitation would become more realistic, for example. I grew up in a place where we don't have to worry about getting a parasite from drinking tap water. I grew up in an environment where I had the resources to get eyeglasses or dental care if I needed it.

These are small things we often take for granted. So as I mentioned, I feel nationalism could help these Latin American countries advance, but I also see a strong international awareness of the worlds problems as absolutely necessary. It’s going to be interesting to see how immigration is controlled over the next ten years, but my hopes are that whatever is done is sensitive to the reality facing Mexico, and I hope to see strong lines of communication and cooperation between our world’s leaders. Doctors here in Chiapas are very aware of the situation of the national government and international politics in terms of healthcare. That’s the kind of doctor I aspire to be. It’s amazing how much one person like Dr. Luis Castro can do. He and his team of vaccination techs do marvelous jobs in keeping people from getting sick, helping them obtain treatment when they are, and educating them on the resources they do have access to. These are the minds that are struggling to find solutions for Mexico.

It’s hard for me to get any pictures in the workplace, but I may be able to post some soon. On the weekends, I have been fortunate enough to make some trips. Last weekend I went with one doctor and his family to see a beautiful canyon just about an hour from San Cristobal. Here’s a photo of the scenery from last Sunday. Have a nice weekend. Next time you hear from me will hopefully be with news from my next experience at a newly built hospital in San Andes Larrainzar, a small community in the Tzotzil indigenous area. I will probably have some information to share with you regarding the Zapatistas you may have heard about in Chiapas. I am going to see a documentary about them tonight.

June 11, 2008

Preventative Medicine Through Vaccination Brigades

I have been working for three days with the ISSSTE hospital in San Cristobal preventative medicine program. It’s a federally funded health center in San Cristobal that offers free healthcare.  I got to visit a school and spend time walking from house to house with a vaccination brigada.  Literally, these are vaccination brigades that are composed of a pair of vacunadores that visit patients and make sure they have all necessary vaccinations according to the national schedule for vaccination.  Sometimes it’s just checking records, but other times its actually visiting the home to give a vaccination.  These house calls are for kids from birth to 6 years.  

 

Just some observations and things I have yet to figure out:  I don’t understand why, but apparently a lot of people who are enrolled in the federal programs for free healthcare don’t take advantage of them.  The people I have been working with try really hard to stress the importance of preventative medicine, but sometimes people straight up refuse free vaccinations. I do admire their efforts and the way the vaccination schedule is promoted through cartillas that every registered newborn is given to keep track of their vaccination record (since the 1970s).   The vaccinations applied here are quite different from those given in the US, and as new vaccinations are developed the schedule tends to be updated or changed, so that can become a challenge.  For example, within the last five years, the schedule has changed about three times.  It also can be hard to apply vaccinations when a lot of kids are sick.  This is the rainy season and a lot of kids have fevers, coughs, and head colds.  Giving a kid a vaccination, especially a live one, under these conditions could be bad, so we haven’t had a lot of chances to vaccinate.

 

The preventative health program is headed by Dr. Luis Enrique Castro, a young doctor who recently completed public health training in Mexico City at the National Institute of Public Health.  It turns out that the Institute has a US accredited degree program for a masters in public health.  They work with the University of Guadalajara, which happens to have a degree program for US citizens in the med school.  While it’s not something I had really given consideration, I will most likely be applying there now.  Most classes are taught in English but I could get some really good clinical exposure in a Spanish-speaking environment in the third and fourth years of med school.  So far it’s looking very interesting!

 

This is just a small update of what’s been happening the last few days.  I might get to give some vaccinations next week, so I’ll keep you posted. 

 

The other night I got together with Brandon and Michael, and we came up with a list of some things we are currently liking about Mexico.  I’ll leave you with that!

 

Walking everywhere

Nutella on corn tortillas

Speaking Spanish all the time

The nice people, coworkers, bosses

Orienting ourselves by using the surrounding hills and mountains

Taquerías

Salsa dancing

The churches

No te Metas con Zohan

Chiles

Foreign perspective on US and International issues

Presidential election discussions in Spanish at the dinner table

The mealtimes

The marimba music

Sobremesa

Guacamole

The end of stomach problems

 

June 05, 2008

Chiapas!

It’s only been a few days since last writing, but a lot has happened. Brandon and I spent a few days in Mexico City staying with my Aunt and Uncle. We were overwhelmed with Mexican hospitality. My cousins who are much older than me were really helpful despite their busy schedules with work and children. We got a tour of the central part of the city and then were taken out for tacos. We also spent one of the few days we were there at the pyramids just outside of the city. Teotihuacan is the name of the ancient city with ruins over 2000 years old. Don’t confuse these with the Aztecs who were around much later. The sun was high and bright as we climbed the pyramids of the sun and of the moon. We got some pretty nice pictures.

Also as part of that excursion, we stopped by the Plaza de las Tres Culturas (Plaza of the Three Cultures). These are the remains of what was one of the two major islands on in lake Texcoco, where the Aztec city, Tenochtitlan once existed. It’s named after three cultures because you see evidence of the indigenous remains, examples of Spanish colonialism, all surrounded by examples of modern Mexican culture. We also got to see the Basilica of Guadalupe, on the largest Catholic attractions in the Americas. This is something I highly recommend seeing if you are ever in Mexico City. Religion plays a large role in Mexican culture and the story behind the apparition of this particular Virgin says a lot about the Mexican people and their history.

I love the culture here because of the way it embraces the mixture of influences that make the people who they are today. You see examples on the street in artwork, crafts, language, clothing, etc. I’ve been speaking so much Spanish in just a few days that I’m already beginning to pick up so much more. It’s nice to gain comfort in speaking the language. The people you talk to and spend time with hear really teach you something you can’t get in the classroom. Languages take a lot of practice, and I am certain that for the next several weeks that’s exactly what I will be doing.

Today is Thursday the 5th of June and we arrived in Chiapas just last night. The environment is beautiful. The terrain is more mountainous and the vegetation more green than up around the city. Unfortunately for us, we arrived to experience the effects of a tropical storm that has affected the area. It’s kind of gloomy but last night the sun came out. We got settled in our sweet apartment and decided to head out to find some stuff we needed. We bought a couple food items and toiletries and ran into Michael Opiecionek on the street. If you don’t know Mike, he’s a student at Wabash too. He’s Polish, with only two semesters of Spanish under his belt, but he’s managed to get around perfectly for the last few weeks in San Cristobal de Las Casas, the town we are living in. It was funny because we also ran in Jorge Alejandro Diaz. He just finished his freshman year at Wabash and lives here. This was all coincidental and all within the first few hours we were here.

Just an hour ago, I met with the doctor who is organizing my summer projects. I’m getting started quickly and am pretty excited. I know the biggest challenge will be picking up the medical jargon in Spanish. Tomorrow morning I am going to bombarded with it in the doctor’s class here at the university. He deals with medical law, and apparently I’ll be presenting some stuff to the class later this summer on an issue of interest to me. I have yet to find out all the info, but it seems to be exciting. Monday I get to work with another doctor in his clinic. I’ll be meeting with him tonight to discuss what will be happening. Keep looking forward to more updates. I’m kind of unsure at this point but I am really excited to see what’s next.

Much Still to Be Determined

This entry was written on June 1, 2006.

Well, I am on the plane as I am writing this. We’ve been experiencing a little turbulence, enough to keep me from sleeping, so I decided to type a little entry into my laptop to save for later.

I’ve been to México several times throughout my childhood, the last time being in the summer of 2005 just before leaving for freshman year at Wabash. I’ve experienced a lot and am pretty proud of the Mexican heritage I have. This will be the longest time I’ve been out of the US consecutively and I’ll probably be speaking español todo el tiempo, much more than I ever have at home. This is also the first time I’m traveling without my family.

Part of the excitement of traveling abroad without your parents is the amount of uncertainty. I’m not talking about traveling across borders with only a couple dollars in my pocket and a single bag containing the bare necessities. No, no, those of you who know me, know that that I would never travel like that. I’m referring to the amount of uncertainty I have about how I’m going to adapt to the situations I’ll be presented with. It’s not going to be a trip with a strict itinerary, but it’s focus is going to be my personal experience. I know what I want to accomplish, who I’ll be working with, and where I’ll be staying, but what I’ve learned at Wabash, is that you can plan all you want, but you have to be prepared for taking one of about a million possible paths or combinations of different paths to reach the goals you’ve set for yourself.

It’s going to be about the experience of making my own decisions about what to see, how to structure my time there, and make my own experience of the adventure. The Dill Grant gave me the opportunity to independently design the course of my stay abroad, along with the invaluable help of some very generous people who were interested in seeing me succeed. I’m excited about getting away, in some sense this is my ideal vacation. I won’t get to stay at a fancy resort and sit in the sun on the beach all day, but I’ll get some good time to make my own decisions, my own experiences, my own memories, and develop my own dreams for a career in medicine and the healthcare field.

As I write this summer with hopes of keeping you all informed, please be patient between posts. I will keep up my writing with consistent journal entries but it may sometimes be a couple of days before I can access a computer and post this stuff to the website. These entries aren’t just for the web, they’re something I hope to take seriously for my own benefit so I can reflect on my experiences as I look forward to the future. I’m sorry to break it to you, but if you didn’t already know, the telecommunications infrastructure widely prevalent in the United States is lacking in the global South, so my only access to the Internet will probably be through a local café. When I am in the field in some indigenous villages around San Cristobal I will likely have no access, but that is still to be determined.