Rebuilding a Primary Health Care System in Rural Mexico

Below is an except from Partners In Health around their and sister organization Compañeros En Salud (CES) work in southeast Chiapas. Green Mountain Coffee Roasters, Inc, (GMCR) is funding this project to revitalize a primary health care system in the long-neglected region.

" “I didn’t know what to expect,” Dr. Abelardo Vidaurreta says. “I didn’t know where I was going.”

Such uncertainties were rare for the 27 year old. But after finishing medical school at Tecnológico De Monterrey, an elite university that produces some of Mexico’s finest physicians, Vidaurreta ditched the urban commodities he was accustomed to and went to work with Partners In Health’s sister organization Compañeros En Salud (CES) in southeast Chiapas. It’s among the poorest and most isolated regions in Mexico, nestled at the tip of the country along the Guatemalan border. 

The move wasn’t entirely impulsive. In Mexico, newly graduated medical students are required to spend a year working in a public health clinic to earn their professional license. Often they’re assigned to far-flung outposts with few resources and even less oversight. This baptism-by-fire approach can be overwhelming. It can also be frustrating, especially for the community members who are left seeking medical care from a rotating cast of fresh-faced doctors who’ll stick around for only a year. 

Vidaurreta had heard of CES when his social service year arrived, but he didn’t know much about the group, let alone its plans to revitalize a primary health care system in a long-neglected region. Doubts loomed when he agreed last February to be among the first doctors to spend a year working alongside CES in Chiapas.

“I thought I was going into the jungle,” Vidaurreta says. “I thought I was going to be alone.”

Now, as CES—whose work is supported by Vermont-based Green Mountain Coffee Roasters—celebrates its first anniversary and more than 10,000 patient consultations, Vidaurreta jokes that he was wrong on both counts. The landscape is more Martian than jungle, marked by towering mountains and a startling lack of infrastructure. And while he would encounter countless challenges in the field, he wasn’t going to be tackling them alone.  A core mission of CES is to alleviate that daunting sense of solitude by pairing the new doctors, known as pasantes, with resident physicians from Brigham and Women’s Hospital in Boston. 

“They’re doing all the work,” says Dr. Patrick Newman, 29, one of the first resident physicians from Brigham and Women’s to take part in the program. “But we see their consults with them, answer their questions, help guide their thinking, help to challenge their thinking, and encourage their ongoing growth.” Newman is quick to point out that the exchange of insight flows both ways. For instance, he recalls visiting a family whose newborn had a cleft palate. His instinct was to hospitalize the baby, insert a feeding tube, and perform surgery when the child reached an appropriate weight—standard procedure in the U.S. 

“That was my first suggestion. But it was obvious after talking with the pasante and visiting the family that doing so would result in absolute and total financial ruin for the family,” Newman says.  “You have to understand that there are cultural aspects to care that the pasantes are going to understand better than we ever will.”

In the area where CES works, patients might travel more than an hour for a simple blood test. Getting to a hospital could take half a day. And though there are brick-and-mortar clinics, it’s been years in most cases since a full-fledged physician has staffed one. To make sure the pasantes are equipped to provide the best possible care in this difficult setting, they receive monthly visits from CES staff and attend regular workshops.In the area where CES works, patients might travel more than an hour for a simple blood test. Getting to a hospital could take half a day. And though there are brick-and-mortar clinics, it’s been years in most cases since a full-fledged physician has staffed one. To make sure the pasantes are equipped to provide the best possible care in this difficult setting, they receive monthly visits from CES staff and attend regular workshops."

To read the full article with images, visit Partners In Health's website.