Mexico 1998

International staff: 5 Hurricane Paul wreaks havoc Confident that new health reforms will transform the current health system, the government is reluctant to accept outside assistance. This is particularly the case in regions of unrest in which there are major groups of indigenous peoples, such as Chiapas. Although MSF had no projects in Mexico when Hurricane Pauline struck the south coast province of Oaxaca in October killing more than 400 and making 300,000 homeless, human resources from the team in Guatemala and pre-positioned emergency stock from Costa Rica were soon on hand in the province of Oaxaca. As 90% of the wells on which the rural population depend for drinking water were contaminated by the consequent flooding, MSF responded to a government request for assistance in providing emergency water supplies and in disinfecting wells in the affected areas. The structures at the most basic level of health care were most affected: at least 300 of the 600 casas de salud (rural health posts) were severely damaged and medical material destroyed or rendered unserviceable. MSF provided kits containing simple diagnostic equipment, medicines and medical supplies for two months. Excerpts from the MSF manual for health workers describing correct use of drugs, basic sanitation, diarrhoea, cholera, dengue and malaria were also included. Subsequent to this two-month intervention, the environmental health service of the Ministry of Health asked MSF to work with them on the development of an emergency preparedness manual.