Mexico: Changing care to fit current needs

Kadir van Lohuizen

In Mexico, an estimated two million people are infected with Chagas disease. However, Mexico stands alone as the only Latin American country lacking a comprehensive national program to fight the disease and help those infected.

With military fighting ending and the struggle becoming a political one instead, MSF decided to close its programs there as the Zapatista "conflict" no longer resulted in urgent civilian health problems. Before its closure in mid-2004, MSF had been using mobile clinics to give basic health care and hospital referrals at ten sites within Chiapas's Las CaÃ?±adas region.

In addition, the team had trained a network of health promoters and vaccinated children living in the clinic areas. In the program's last few months, MSF followed up on the remaining medical needs and trained local health promoters who would continue activities after MSF withdrew.

During 2004, MSF gave extra attention to the need to improve treatment for marginalized groups suffering from neglected
diseases including Chagas disease (American trypanosomiasis). Chagas is a parasitic disease transmitted by an insect's bite. Once in the blood stream, it attacks the heart and digestive organs, often resulting in early death. In most cases, it is impossible to diagnose the disease clinically and so it is often overlooked.

In Mexico, an estimated two million people are infected. However, Mexico stands alone as the only Latin American country lacking a comprehensive national program to fight the disease and help those infected. The problem is bigger than this. Because Chagas disease almost exclusively affects the poor, efforts to develop medicines to treat those with the disease have been minimal. Treatment is only possible for children, otherwise the risk of serious side effects is high and treatment too often ineffective.

Even among children, the cure rate is not better than 70 percent.

MSF launched an exploratory mission in Chiapas to look at the prevalence of the disease and transmission rates to determine if there was a need to launch a new program to help those with Chagas. The exploratory mission found that there were not high rates of infected people in the studied areas. However, the team will
provide care for those found to have the disease during the exploratory research phase.

MSF will also carry out health promotion activities in the exploratory areas and encourage policy change to get the disease recognized at a national level. Furthermore, MSF's involvement with a network of individuals and groups working on Chagas disease is expected to help advance the momentum to formulate a national or regional strategy to improve care for those with Chagas in Mexico.

In May 2004, MSF staff investigated the health problems facing undocumented immigrants traveling along the Guatemalan border. This activity was triggered by reports of attacks carried out by organized groups against undocumented immigrants trying to enter the country.

However, because others are already providing emergency aid to this high-risk group and the government seems to be respecting the rights of immigrants with severe medical needs, MSF did not intervene. MSF also undertook exploratory missions following an earthquake in Colima and severe flooding in Tuxtla. MSF plans to end its work in Mexico at the end of 2004.

MSF has worked in Mexico since 1997.