Week 2: Viva México! Viva la Independencia!

Last weekend, Rahul and I went to go visit Rancho Nuevo, a cave system with a path winding more than ½ a mile underground. After we emerged from the cave, we walked around the coniferous forest surrounding the cave and passed lots of families picnicking. There was a small stable with a few horses and we decided to go for a horseback ride with a guide around the park (it was Rahul’s first time horseback riding!). Before leaving, we couldn’t pass up the irresistible smell of the food stands and decided to get some quesadillas. We took a combi (minibus) back to San Cristóbal and then walked up a street where the Institute of Health is located. It was a small building, but had signs on the walls reading “eat fruits and vegetables”, “exercise”, etc. We followed the same street until we arrived at the outdoor food market where we bought a few things for dinner. I also decided to add “Los Pinguinos Papa” (Mr. Popper’s Penguins) and “Los Pitufos” (The Smurfs) to my pirated DVD collection (shhh, don’t tell anyone) J

Rahul rode the black horse, I rode the blonde one :-)

On Sunday, I went for a long walk up Calle Real de Guadalupe towards the Iglesia (Church) de Guadalupe. The walk up the steps of the church was tiring, but it was worth it when I saw the view of the city. On my way down the hill, I stopped for lunch and got ‘chile relleno’ (stuffed pepper) and rice, which was incredible. My next stop was “Museo de la Medicina Maya”, a museum introducing the system of traditional medicine used by many indigenous people in the highlands of Chiapas. I watched a very interesting movie about midwives (untrained) in indigenous Mayan communities of Chiapas. The movie quoted a midwife saying, “sometimes babies don’t want to come out…then I have to talk to God and light candles so that the baby will be born quickly.” The midwife may try to speed up the birthing process by giving the pregnant women herbal tea or a raw egg. Once the baby is born, the midwife cleans the baby with an egg “to counteract the jealously of others” and cuts the umbilical cord. If the baby is a boy, the midwife cuts the cord at a length of around 20 to 25 cm so that when the boy grows up he won’t be afraid of heights and will have the strength to work. If the baby is a girl, the midwife cuts the umbilical cord at 15 cm, so that when she grows up and has a family of her own, she won’t be tired or suffer difficult births. The husband buries the placenta in the house: if the next child the family desires is a boy, the husband buries the placenta face down. Outside of the museum there was a medicinal plant garden with placards explaining the name of the plant, the medical use, and the part of the plant used. For example, the leaves and the stem of the “Sitit Vomol” (Vernomia patens) tree are used for treating diarrhea and post-partum bleeding. Very interesting indeed. I’m excited to learn more about traditional medicine in the communities I may work in.

'El Parto'

Medicinal Plant Garden

On Monday, we talked about designing health surveys during our research methodology class at ECOSUR. Surveys can be self-administered (where the person independently fills out the survey) or through an interview. Usually at ECOSUR, surveys are done through interview. The interviewer should speak the same language and come from the same region as the person being interviewed and should ideally be of a similar socio-economic status. Esmerelda showed us an example of an ECOSUR household survey. The survey consisted of questions about demographics, how many years of schooling each person in the family had completed, as well as their occupation. Other close-ended questions included, “do you have health insurance?” and “what do you do when you get sick?”. There was also a section in which the interviewer was supposed to ask whether any persons in the household had experienced any symptoms in a list provided (the list included folkloric conditions, such as “pérdida de alma” = loss of soul). The survey also included a section for the interviewer to fill out that could give an indication about the family’s socioeconomic status, such as the type of floor/walls in the house, the types of animals belonging to the family, how often the family ate meat, whether the family had electricity, water, a refrigerator, a radio, a TV, and/or a latrine in the house.

This week I decided to try out a salsa class that was recommended to me by Katy and Linda who went last year. The class is held every day from 6 p.m. – 8 p.m. I was a little nervous the first time I went to the class, but it turned out to be super fun and I have learned a lot in the 3 classes I went to this week!

Preparing for Independence Day

Tuesday during class we talked about indicators for the evaluation of health services (such as the number of hospital beds per 100,000 people). Dr. Ochoa also gave a brief presentation outlining the health system in Mexico. In the public sector, there are various health insurance schemes. IMSS covers roughly 50% of the population and is financed by the employer, the employee, and the government. ISSTE is like IMSS, but only for government workers (such as Dr. Ochoa – he automatically gets money deducted from his paycheck for ISSTE, even though he also chooses to pay for private health insurance). There is also SEDENA (for the military) and PEMEX (for workers in the Mexican Petroleum Company). For the “poblacion abierta” (the poor, rural, and indigenous populations), there is the Secretaría de Salud (SSA) that exists in every state and gives health services to the population without health insurance, as well as IMSS-Oportunidades (*not the same as the federal Oportunidades program) that offers services to rural, indigenous populations. Each health insurance scheme has its own facilities and health personnel. Seguro Popular is a relatively new insurance scheme that was created for the poor populations without health insurance and offers a packet of interventions through the Secretaria de Salud and IMSS-Oportunidades. There are also private health insurance schemes for those who can afford it. So, as you can see, the Mexican health system seems to be almost as complicated as the US health system!

The view from my walk up to Iglesida de Guadalupe

Wednesday and Thursday we reviewed qualitative research methods with Dr. Enrique Eroza, a medical anthropologist. He reviewed how to conduct in-depth interviews and focus groups. We also watched a very well-made and captivating movie titled “The Constant Gardener” (I recommend it to everyone reading this) about medical experimentation in Africa. On Wednesday after class, we passed people in the main square celebrating the acquisition of Chiapas into Mexico (187 years ago J). The square in front of the cathedral was filled with food stands selling churros, pizza, cotton candy and people sitting in the plastic chairs eating with their friends and family. That night, we had dinner with two other people in our class and went to a surprise birthday celebration for Esmerelda’s husband, Uriel. At midnight, we all waited outside Esmerelda and Uriel’s house and when the clock struck 12:00, a band started playing in the patio until Uriel emerged from his house. The band continued playing and the party ensued J It was a lot of fun, but we were all very tired during our class on Thursday!

Rahul and the piñata

On Thursday after class, Dr. Ochoa and Rosario invited us to their house for an Independence Day celebration. Their 3-year-old daughter, Ceci, greeted us wearing a pink dress that made her look like a Disney princess and we also met the family’s parrot, cats, and dog. We ate a very yummy late lunch/early dinner and then went outside for the piñata! Ceci and the other two children were very excited and did a much better job of hitting the piñata than Rahul and I J The party ended with a birthday cake for Uriel, Dr. Ochoa (his birthday is coming up), and, of course, Mexico! We stayed at Dr. Ochoa’s house for a while chatting and then at 9:00, we walked to the main square for “El Grito” (the shout). The streets were packed with people whose faces were painted with red, green, and white (the flag’s colors) and there were two giant stages set up in the main square. At 10:45, ‘El Grito’ commenced and everyone was shouting “Viva Mexico! Viva la Independencia!” Fireworks exploded in the sky and the Mariachi band began to play on the stage. Rahul and I met up with Paco, another person who works at ECOSUR, and we celebrated 201 years of Mexican Independence with Paco and his friends J

Rosario and her daughter, Ceci

It’s amazing how easily Rahul and I are accepted here. Despite the somewhat strained US-Mexico relations, I never feel judged here and everyone we have met has been kind and welcoming to us. There is a wonderful sense of community and constant celebration of life among friends, family, and even strangers. It’s something that I think the US could learn from J

Dr. Ochoa (right), Ceci, and Uriel