International staff: 4
National staff: 55
Since early 1999, MSF has been working in the state of Oaxaca, helping the Ministry of Health (MOH) reinforce primary health care services that had not been widely available in some marginalized indigenous communities. At the core of MSF's work is an underlying respect for cultural health supports such as traditional medicine, traditional birthing attendants and women's groups.
The idea is to empower communities by fostering active participation in the health system - an approach that differs from the more top-down method used by the government in some indigenous areas. Around 17,000 indigenous people in 60 communities benefit from this pilot project, scheduled to be handed over to the MOH by January 2001.
In the state of Chiapas, MSF works in ten indigenous communities in the Altos, the mountainous area of Chiapas that was the birthplace of the EZLN (Zapatista) rebellion in 1994. Indigenous people there have little or no access to basic health care due to the ongoing low-intensity armed conflict between the government and the Zapatistas, and because of a largely inadequate public health system. In areas where MSF works, in which indigenous people make up about 70% of the population, there are only four doctors for every 100,000 people.
With the goal of reducing the risks of humanitarian or health crises in the area, MSF provides primary health care services (including a small trachoma treatment program), and maintains a visible presence. The organization is raising awareness of the health plight of indigenous people and is building up a rapid response capacity to intervene in case of natural or man-made disasters, such as epidemics or an extension of conflict.
MSF continues to look at other health and humanitarian needs in southeastern Mexico. The organization first worked in the country in 1994 and has had a continuous presence since 1997.