When Meagan Parsons and Ben Cook arrived in Teotitlan del Valle, Oaxaca, three weeks ago to start their month-long public health clinic externship, they expected that people would be friendly and open since they had traveled before in Latin America. They didn’t know quite what to expect about Mexico’s health care system.
What the two physician assistant students from Methodist University in Fayetteville, NC, discovered was that
- local resources were more advanced than they imagined,
- the federal and state government funding and delivery of health care provides excellent continuity of care,
- patients are more appreciative of the health care they receive compared with what they see in the United States,
- there is no poly-pharmacy — meaning that patients are not over-medicated, and there are few if any drug interactions,
- pharmaceuticals are free with a doctor’s prescription,
- the types and choices of medicines dispensed are limited
- there are few resources for state-of-the-art equipment, and
- people here are hardworking and dedicated to doing things well, taking pride in what they do.
After only a few days “on the job,” Meagan and Ben assisted in a labor and delivery, which was a highlight. This primary care practice experience compares with a family medicine practice in the U.S. for which they receive academic credit as part of a clinical rotation.
Some of the most common medical problems that present at the clinic are diabetes, hypertension, intestinal and respiratory infections. Dr. Jonas Gutierrez explained that there is no breast or cervical cancer here. Neither is there Dengue fever or malaria.
The clinic staff, which includes five primary care doctors (one assigned to each residential section of the village), a pediatrician, psychologist, dentist, nurses, a social worker, and physician administrator who is also a surgeon, concentrate on preventive medicine through regular check-ups, health education, and administering vaccines. Complicated labor and delivery cases are referred to the tertiary care hospital, as are critical cases.
The doctors included Ben and Meagan in social activities, inviting them to lunches, sports events and family outings. There was no relationship hierarchy.
For a look into Meagan and Ben’s Oaxaca blog click here!
After the first few days, Meagan and Ben’s “ears turned on,” they began to hear the words and their Spanish improved, especially the medical terms that got bandied about. Meagan says that she developed keener non-verbal skills and could begin to pick up cues given by patients, which will help her immensely when she returns to North Carolina.
Ben says he will take home the language and how to better relate to Hispanic culture. He saw first-hand how everyone in the family is involved in health care decision-making, and this awareness will benefit him as he moves on in his career after December 2013 graduation.
Academic advisor Deborah Morris, MD, PA-C, who came for a one-week site and supervision visit, talked with Meagan and Ben about developing a Spanish-language diabetes education pamphlet to leave behind for patients, since this is a pressing health care issue for the village. The content will include treatment choices, self-care, diet and nutrition, and exercises. There will be lots of visuals to make it easy to understand. The doctors will review the content and provide feedback before the document is ready to print.
Each of the doctors who Meagan and Ben worked with said the students were very helpful, learned a lot and so did they. This was an excellent “intercambio” — an opportunity for cultural exchange, mutual sharing, learning, and collaboration.
Medical training in Mexico involves five years of study to become a family practice generalist M.D., plus a one year internship and one year of social service (medical education is paid for by the government and is nominal to students), for a total of seven years of education and service. To become a specialist, doctors add an additional four years on to their education by doing a hospital residency.
Thank you to the doctors and nurses of the Centro de Salud, Teotitlan del Valle, Oaxaca, for welcoming students to the clinic to gain valuable experience, especially Clinic Director Dra. Elizabet Lopez Martinez, Dr. Jonas Gutierrez, Dr. Pablo Aredondo, Dr. Jesus Morales, Dr. Faustido Hernandez, Administradora Mayra Mendez, and Dra. Jessica Lopez. Thanks also to the Public Health Committee of Teotitlan del Valle, and to Deborah Morris, MD, PA-C, for facilitating this collaborative health care exchange.
Note: All photo subjects gave their permission to be photographed.
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A Prayer for Guadalupe
Many women in Mexico are named Guadalupe in honor of the Virgin, Our Lady of Guadalupe, who many say was Aztec high-priestess Tonantzin and Earth Mother, adapted to the religious needs of New Spain.
Our Guadalupe is a woman in her early forties with thick, luscious long black hair that hangs down to her waist. Most of the time she wears it braided with ribbon in the local Zapotec style. Lupe is a widow and mother of three boys. Her youngest is age eight. She has aspirations for all her children to go to and complete university.
Lupe was just diagnosed with breast cancer and had surgery to remove the tumor. Depending on biopsy results, the follow-up treatment will be either chemotherapy or radiation. We are waiting to hear. As I write this, I am waiting for flights that will take me back to Mexico today. As soon as I get to Oaxaca, I will be able to find out more.
The cost of the surgeon is 18,000 pesos. That’s about $1,350 USD, a substantial out-of-pocket amount for a weaver who is always working to make ends meet anyway. Then, there will be the cost of treatment. We anticipate that Lupe will not be able to work for a while, so there mayl not be enough to buy food or pay for school tuition and books.
Friends of Guadalupe:
Make Your Gift for Breast Cancer Treatment
Click the PayPal button above to make your gift. It will be deposited into my Oaxaca Cultural Navigator PayPal account and I will convert it to pesos and give your gift to Lupe. If you want to send along messages or prayers for healing, please include this. If you just wish to send money from your account to mine, my PayPal account is oaxacaculture@me.com
Breast cancer does not discriminate and affects women of all ages, at all economic levels and in countries throughout the world. I am certain there are many stories like this one.
Several Oaxaca expat women have pledged to help Lupe with her expenses. If many more of us come together to offer a small gift, we can make a big difference for Lupe and her family and share the cost of her treatment and recovery. Will you join us?
Lupe says she wants to pay back what is given to her by weaving rugs and cleaning houses. We think that’s too much to ask for a friend recovering from this diagnosis and treatment. We believe she needs to concentrate on taking care of herself.
Let us join together to do a small part to repair the world. Thank you, And, can I add your name to the Friends list?
Norma Hawthorne
Friends of Guadalupe
For a complete list of donors, click on the link above!
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Posted in Cultural Commentary, Health Care
Tagged breast cancer, costs, coverage, diagnosis, donation, health care, make a gift, Mexico, Oaxaca, treatment