Category Archives: Health

March 21, 2014 · 4:00 pm

Mexico’s Seguro Popular—A model of inefficiency–Dr. Viejita

So we went to the Regional in Uriangato, which is the hospital where my mother-in-law died. My husband had gone the day before to inquire about the procedure and was told by the pharmacy that I needed to make an appointment with archivos (archives) first to open a file. Archivos (archives) opens at 7 and it’s on a first come, first serve basis. Therefore we were up at the crack of dawn so that we could take animals out to pasture and drive to Uriangato. It is about a 30 minute trip by moto, but seems much, much longer in the frigid early morning. We arrived at 6 a.m.

The security guard on duty would not let my husband in, so I took the paperwork and queued up. The clerk arrived at 7:15 and started processing appointments. I was about the 10^th in line, so it was about 7:40 when I reached the desk. I explained my situation and showed her my papers. She looked them over and told me that it was the responsibility of the clinic that gave me the prescription to continue giving me the medication and that if they wanted to send me here, they needed to give me a referral. Well, they hadn’t and she knew that, so she went ahead and gave me an appointment with a general practitioner anyway.

I checked in at the nurse’s station and had my height, weight and blood pressure checked and returned to my seat.

I was #3, but as the doctor doesn’t begin seeing patients until 9 a.m., I had to wait. Meanwhile, my long-suffering husband was shivering in the cold. After 9, he suddenly appeared in the waiting room. He had waited until the guards had changed, then asked permission to use the bathroom, which was on the other end of the hall where the consulting offices were. He did use the bathroom, but instead of returning outside, he headed down the hall to see where I was. By this time, there were so many people, one more wasn’t noticed.

So 9:30 came and it was finally my turn. I was shown into a small consulting office and sat down in a chair next to a tiny space heater. The female doctor was at least 80 years old and was extremely disconcerted that I was not Mexican. She asked me several times if I could understand her questions and each time I assured her I did. I explained what it was that I wanted. She then said I would have to be referred to a specialist. She pulled up her Olympia typewriter and started in on the referral. She asked where I lived, but didn’t understand me, so I handed her the policy which had our address on it. Then she asked about my age, place of birth, religion, age that I began menstruating, age that I married, if I had my son vaginally or by c-section (she even mimed this one for me in case I didn’t understand her meaning), and if I lived permanently in México or was just here for a visit. I answered her questions, but tried to explain again that I had hypothyroidism and told her that I had had preeclampsia and pregnancy-induced hypertension, but she made no note of those issues. I told her about surgeries I had as well, but again, nothing written down. She apparently made a mistake on the form, so she pulled the sheet out of the typewriter and started again.

I waited. When she had finished I showed her the prescription that I had been given at the clinic and told her I needed a refill. She looked it over and said that she would write a prescription and that I would need some blood work too. That seemed reasonable, since in the States, I would periodically go for TSH level blood tests. I thought perhaps she had understood my problem after all. Silly me.

I was there about an hour while she filled out these forms. She made no attempt to examine me and when we were finished she asked if I felt I had been treated fairly. I suppose I had.

So then, I went back to archivos (archives) to schedule an appointment with a specialist. There the clerk gave me pink appointment booklet and scheduled the appointment with Dr. J for January 30 at 9 a.m. Then I went to the lab desk to schedule an appointment for the blood draw. That was set up for January 27 at 7 a.m. Finally, I went to the pharmacy to fill the prescription, but they didn’t have the medicine there. Since I was already late for work, I didn’t have time to hunt down some other pharmacy. I sent my husband later in the day to find the referral pharmacy and get the prescription filled.

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March 14, 2014 · 3:38 pm

Mexico’s Seguro Popular—A model of inefficiency–Getting Started

CAISES in Moroleón

I have hypothyroidism which was diagnosed shortly after the birth of my son. It’s a chronic condition that requires a pill each and every day. A box of these pills costs $400 pesos and lasts about 2 months. Sometimes we don’t have the $400 pesos and I do without. A long period of doing without means that I become over-emotional, weepy and exhausted.

My husband decided that we needed to find a way for me to get my pills and applied for Seguro Popular, the Mexican version of Medicare. We qualified, despite the fact that I am only a Mexican resident, because my husband has been out of work for the last 3 or 4 years and the fact that we live in La Yacata without electricity, water or sewage. However, in order to get the all-important policy paper, we had to provide a comprobante de domicilio (proof of residency) in the form of a water or electric bill. On other occasions, we have borrowed a bill and claimed we were renting at the address on the bill. We were tired of doing this and therefore solicited a letter bajo protesta decir la verdad (under oath to tell the truth) from SuperPrez saying that we were living in La Yacata without utilities. Thankfully, the office accepted it as adequate proof and we went for our initial family consult at the hospitalito (clinic).

The reason there isn’t a line at 9 a.m. is because everyone knows they must arrive at 4 a.m. to get a number!

We arrived well before 8 a.m. which was good since it took 40 minutes for the staff to determine which module La Yacata belonged to. Finally they decided that we should be assigned to module 5, which was only open in the afternoon. Since we were already there, and a little peeved, the nurse on duty said that she would do our consults that morning, so we waited. Our examination consisted of each of us being weighed and measured, a blood pressure and diabetes check and a health questionnaire about vaccinations, illnesses and surgeries. I explained that I needed to take levotiroxina, but that I had run out of pills. The nurse had a doctor write a prescription for me, but the pharmacy at the clinic didn’t carry that medicine. My husband went to another clinic, but they wouldn’t give him the medicine because the doctor had written a prescription for 2 boxes and they said they never give 2 boxes. So my husband returned to the first clinic for another prescription for a single box and then back to the second clinic for the medicine. It took all day but I got a box with 100 pills.

The nurse told me that when I ran out, I would need to come in again for a full examination to get a prescription refill. So that’s what I tried to do. We arrived before 8 a.m. for a ficha (number) for module #5 but were told that all the fichas (numbers) had already been given. The nurse said we could come back at 2 p.m. to see if the doctor had time to see us after all the people with fichas (numbers) had been attended to. So we did. And we waited. Then another nurse told us that we would need to go to the Regional (regional hospital) in Uriangato to get a receta permenente (permanent prescription) since my condition was chronic. It would have been nice to know that before we wasted the entire day.

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February 7, 2014 · 3:22 pm

Animal Doctoring

Having as many animals as we do guarantees that some will fall sick on occasion, no matter how attentive we try to be.

For instance, there was that horrible week when the hens would get the hiccups then fall over dead, and we had no idea what to do. It did eventually run its course, but we lost 5 chickens.

Then there was the sad event when our new puppy somehow managed to get on the other side of the wall and was accidentally stepped on by Beauty. Sometimes the only thing to do is to sit by an animal’s side.

But in other instances, the illness or injury is completely treatable, if you know how. My husband often calls me to “traer el libro” (bring the book) for me to do some on the spot research on a new symptom of one or more of our animals.

Our library is small and consists of Barnyard in your Backyard and Keeping Livestock Healthy, but for the most part, that’s enough.

When our rabbits kept getting sore hocks, we changed the entire way we kept rabbits, from caged to free range, well, within our yard range anyway based on a section of the Barnyard book. When the chickens looked droopy, my husband cut a hole in the wall so that they could forage in the goat and horse poop while those animals were grazing, and sure enough, the extra vitamins did a world of good, all based on the Healthy Livestock book. When one of our nanny goats developed mastitis, we checked the books to see what we could do and did what we could to ease her agony until the infection cleared up.

In addition to our resource books, there are local folklore methods concerning the care of animals. Fortunately, my husband is not one of those men afraid to ask for directions, when it comes to the welfare of his animals that is. Some of the information he gets seems to be a bit hokey at times, so we cross reference with our books. If the treatment appears to have some sort of valid basis and not entirely dependent on the warts of a frog during the lunar eclipse, he often gives it a try.

My husband has treated swollen eyes with a spit of salt water. The first patient was Duchess, the goat, who was accidentally hit by a slingshot stone. (Apparently, there was a passing squirrel my son was aiming at.) A spit of water and the swelling was completely gone within the hour. The second patient, Shadow the yeguita (female colt) also was struck by a misdirected stone thrown to scare her back from jumping a fence that was much too high for her young legs. Again, the spit of salt water, my husband actually spits into the eye, and the swelling went down.

The most recent examples of this folklore animal medicine can be illustrated with the unfortunate injuries sustained by our horses, Beauty and Shadow.

Beauty came up lame one day and what appeared to be a superficial cut above her front hoof became a gaping hole overnight. My husband thinks that she opened it with her own hoof while dancing. Yes, she actually dances continuously in her stall at night. As it was on the bend of her foot, it could not be sewn up. He was, at first, dismayed and unsure how to help in the healing since she opened it anew every time she went out to graze. He asked around. One person told him to echar aqua de la mata de toro (bull’s weed water). Another told him to cover the wound with hoja de sábila (aloe leaves).

mata de toro

Now, I had never heard of mata de toro (bull’s weed), so I couldn’t be too sure of its effectiveness. However, aloe is a herb that I know to have soothing qualities for burns and endorsed its use. Beauty’s treatment ended up being a periodic dash of Azul (Blue) for infection, a daily wash with boiled mata de toro (bull’s weed) and an overnight bandage of sábila (aloe). The Azul we purchased at a local vet place, but the other two herbs grew wild in La Yacata, and it was just a matter of harvesting. Her wound is slowly healing, and we hope she will be back up to her regular dance routine soon.

Little Shadow

Shadow also recently sustained an injury. One day, she wandered a bit from where her mother was grazing and tried to leap a barbed wire fence. She’s only 6 months old, so she really didn’t know any better. A good section of her skin on her underbelly was ripped open, the fur hanging off in one big sheet. Poor thing. My husband called in a more experienced horse keeper for advice. He brought a needle and thread to sew her up. Of course, she wasn’t too keen on this procedure, so she had to be lightly sedated. Even under anesthesia, she kicked out several times and had to be held down to get the stitches in. This was quite a group project. In attendance in the operating theater, a.k.a. Shadow’s stall, was the tailor, my husband and his father for front and back leg holding, my son, for head holding and nerve soothing, and my sister-in-law, the light holder. I stood outside the stall and ran for things like clean water to wash with, alcohol to sterilize the needle, rags for blotting, etc. Beauty, the anxious mother, was behind me looking on and expressed her emotions noisily every few minutes. It was over in about 30 minutes and took another 30 minutes or so for Shadow to recover from the sedative.

Warming aloe vera to make a poultice

In the morning, my husband made a dressing from hoja de sábila and fashioned a bandage out of a costal (feed bag). He heated the aloe leaves on the comal (tortilla pan) so that the juices would run well. Then he cut the sharp edges off the leaves and sliced them down the middle. The inner sides he placed up so as to be the part that touches the wound and tied on the bandage. We also have been using periodic treatment with the Azul, which is an animal antiseptic, although it is more purple than blue and a round of penicillin and tetanus shots just to be on the safe side. We are all hoping for a quick recovery for our little lady.

Attaching the bandage with the aloe vera poultice

I won’t say that we know everything about healing animals and we may yet discover that what we do on these occasions is not the best way to treat injuries, but we do what we can with what we have and have found that the natural remedies offered in our area often outdistance any man-made chemical when it comes to effectiveness.

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