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Mexico enjoys new health as Salinas brings hospitals, vaccinations to poor

THE BALTIMORE SUN

OCOSINGO, Mexico -- The people of this village in the middl of the lush Lacandon Jungle live in huts of dried branches with few modern conveniences. Until a little more than a year ago, they confronted illness and disease in the way of their ancestors, with prayer and magic.

But that's changed now in Ocosingo, as it has in scores of other places all over Mexico. This place now has a government-funded, state-of-the-art hospital. In the year since it opened, villagers say, they have seen remarkable progress in their fight against disease and malnutrition.

"Before the hospital, before the doctors, there were many illnesses," said village leader Carlos Chambor Kin. "There were forests and rivers and flowers, but there were also diseases that were killing my people: fevers, parasites, diarrhea.

"There were no roads, and the nearest hospital was hundreds of miles away, so we tried to cure our sick with our own magic, and we sang words to the God of the universe.

"But now we are not alone. We have friends in this hospital."

The new health care here and in other once-unattended parts of the country is the handiwork of Mexican President Carlos Salinas de Gortari and his determination to bring Mexico out of its poor health.

In an exhausting, two-week tour recently, he inaugurated hospitals in six different Mexican states -- from Ocosingo in the southern state of Chiapas to the northeastern border town of Nuevo Laredo in the state of Tamaulipas.

At each stop he boasted that in the four years since he took office, his government had built 81 new hospitals -- one every three weeks -- across the country. And doctors and nurses explained the advances that had been made in the prevention of disease, especially through childhood vaccinations, and the slowdown in the worrisome population growth.

His boasts are supported by objective studies. A recent report by the United Nations Children's Fund said Mexico had done more than any other Western nation, with considerably less financial resources than some, to reduce its infant mortality rate.

In Ocosingo, doctors at the new medical center received government support for a food program to fight malnutrition in the region, inhabited primarily by subsistence farmers. Through the project, about 600 million breakfasts were distributed last year to children below school age, and tens of thousands of pounds of rice, beans and corn have been distributed to needy families.

The rate of malnutrition, say the doctors, was cut by more than 50 percent.

Through a nationwide vaccination program, more than 95 percent of Mexico's preschoolers are vaccinated against diseases including diphtheria, measles, polio and tuberculosis.

About 56 percent of U.S. preschoolers are vaccinated, according to the U.S. Centers for Disease Control and Prevention in Atlanta. That figure rises to 96 percent for children who have entered school.

And because of an increase in the use of contraceptives, the rate of population growth in Mexico has dropped from more than 3 percent to less than 2 percent.

"This is a declaration that speaks of progress," Mr. Salinas told his audience in Chiapas, about 300 Lacandon Indians, most of whom wore white cotton gowns and straw hats adorned with red and fuchsia ribbons. "Great was the need, and great was the unified response of Mexico in favor of the people of this region."

Mr. Salinas said he had been able to spend more money on social programs by renegotiating the country's external debt and reducing internal debt with money from the sale of nationally held companies, such as the telephone company, banks and sugar mills.

"That gave us a lot of freedom to spend on social programs," the president said, pointing out that four years ago, 70 percent of Mexico's gross national product was spent to pay off debt, and now that figure is less than 25 percent.

The reforms have meant most to Mexico's large population of poor people who live in villages of dirt roads with no electricity, no clean water and no reliable supply of food and medicine.

Maria Elena Posada Encinas gushed words of gratitude to Mr. Salinas for sending a health care worker to her village of Huepari. Only 106 people live in the community, and it is more than three hours by car from the nearest hospital.

"Huepari was not even on the map," she said. "It's very old, but it was not on the map.

"But now we have a small health center, and a doctor visits us once a week.

"We have learned how to use soybeans in food. That has been very good for us because when there are no deer, we do not get any meat at all."

When Mr. Salinas took office, health officials said one of the president's priorities was to cut the infant mortality rate.

In the lush, jungle state of Chiapas, for example, about 34 of every 1,000 infants die, compared with the national rate of 20.7 infants per 1,000.

In the United States, the average is about nine infant deaths per 1,000.

The Salinas administration will spend about $1 billion this year to provide clean water to rural communities throughout the country. The government has spent about $1 million on acute care wards and mobile care units for the prevention and treatment of cholera and diarrheal diseases.

But the centerpiece of the government's efforts has been its Universal Vaccination Program. The campaign resulted in the vaccination of 95 percent of Mexico's children, up from 47 percent in 1989.

Vaccinations are "the most cost-effective preventive health measure," says Jaime Sepulveda, undersecretary in Mexico's Health Ministry. "To create the vaccine and deliver it costs only about $10 per child, so it's really quite affordable."

The program was started in 1990 after a devastating measles epidemic the year before. Health care workers used census data to find out where children lived. Volunteers went door-to-door to interview families. A red sticker was left on the home of every child who needed a vaccination. A green sticker told health care workers that no child in the home needed shots. Some 130,000 towns were covered in two years.

"It was a very intense program. I don't even want to think about all the work that was involved," Mr. Sepulveda said. "Now the challenge is to maintain it. It would be a pity to lose all that work."

But with this, Mexico has only completed the "easiest" phase in its overall efforts to improve the health of its citizens. Now, Mr. Sepulveda says, the leading causes of death are changing to more intractable illnesses, including heart disease and diabetes. acknowledges, "These problems will not be as easy to fight."

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