In Mexico City and Beyond, Connecting Patients to Care

Children wait by the dozens before being seen at a dental clinic in Zacozonapan, Mexico, sponsored by Baxter International Foundation, Asociación Gilberto and Direct Relief on Nov. 9, 2017. The clinic was part of a larger three-year effort, called Driving Your Health, which aims to connect residents in and around Mexico City with health care. (Photo by William Vazquez for Baxter International Foundation)

The mining town of Zacozonapan lies at the western edge of Mexico State, the most populous in all of Mexico, a three-hour drive along winding mountain roads from Mexico City. It’s beautiful country, with dramatic rock formations bursting through pine forest and open fields, shorn flat under a warm, mid-November sun.

That afternoon, the elementary school was crowded with children and their mothers waiting in line to be seen by one of eight dentists from Mexico City who’d come for the week with the Asociación Gilberto, one of Direct Relief’s newest partners in Mexico. Most of those children would be seeing a dentist for the first time in their young lives. “At a private doctor, they’ll charge you 500 pesos for an extraction,” said Rita Revollar, whose two primary school-aged children had both come to the center for care. “My girl was scared because this was her first time, and her teeth seem fine, but you never know.”

“Of the 120 kids that come in each day, I’d say maybe 10 have healthy teeth,” said Dr. Fernando Cabrera Enriquez, who oversees the other eight dentists providing care. “One girl came in today with eight cavities and we’ve found four- and five-year-olds with really serious pathologies in their gums. I’d say Mexico State is really badly affected by these problems.”

Zacozonapan is just one of 72 communities in Mexico State that the local branch of Asociación Gilberto has reached in the last year, using funds from Baxter International Foundation (philanthropic arm of Baxter International Inc.) and channeled through Direct Relief. Though Zacozonapan is relatively prosperous, with most families earning their livings either as employees of the government or at the nearby mines, Maricela Sanchez Paz, who came that day with her two young daughters, said “the economy makes it hard to access a dentist. Work here is okay, but dental care isn’t included in public health service.”

Children and families filled a temporary clinic set up to provide dental care last month. Options for care are limited without a substantial drive to a neighboring city, restricting access for many. (Photo by William Vazquez for Baxter International Foundation)

That’s exactly why Laura Franco, the president of the Asociación Gilberto’s Mexico State branch, chose to focus on dental care when she started this program in January 2015. “The government offers certain services, so I thought, what they can’t offer – and that’s what we can do. So why dental care?” she asked. “Because it’s a luxury – and a necessity.”

For many families in Zacozonapan, logistics present an even more substantial problem than finances. The closest major city, the state capital of Toluca, is a two-hour drive on a good day, and the dental care that does come through Zacozonapan, Dr. Cabrera said, is woefully inadequate. That’s where Baxter Foundation and Direct Relief came in.

The dental program is part of a three-year comprehensive initiative funded by Baxter International Foundation called Driving Your Health. The program’s primary goal is to avert preventable medical conditions by expanding access to health care, providing health education, and increasing the early detection of potentially serious health conditions. The program was officially launched on September 22, 2016 in Mexico City.

As part of the Driving Your Health program, Direct Relief has channeled the Baxter International Foundation funds to four different organizations, all focused on bringing healthcare to communities in need. The Mexican Diabetes Association directed its portion of the funding toward establishing mobile glucose test sites that travel throughout Mexico City, raising awareness about diabetes – the single largest killer in Mexico – and, in many cases, providing people with a first warning of a developing or fully-blown glucose problem. Casa de la Amistad, or Friendship House, a center for pediatric cancer that has, to date, helped 9,000 children with limited resources, has used its funding to purchase a bus to transport patients from its center in Mexico City’s southern extreme to hospitals scattered around the city. The Order of Malta brings medical care to 150 underserved communities in and around the capital’s metropolitan area.

For all these organizations, the dissemination of care through mobile medical units is also a means of disseminating information, arguably an even more important mission for improving health in underserved communities. “Most people have at least three cavities in Mexico because they don’t know how to care for their teeth, so our Dentists talk with mothers about how to brush correctly,” said Franco. “In Mexico our culture is to give love through food – if you give more you love more – so we’re also trying to teach families to prepare healthier food.”

Young patients were seen by dentists in Zacozonapan, where dental care is limited. (Photo by William Vazquez for Baxter International Foundation)

Families in Zacozonapan are, evidently, eager to learn. The school director who helped organize the event that week has, Franco said, already asked to schedule a date for next year. Franco, for her part, heaped praise on the community for doing so much to welcome them and make the process go smoothly by distributing information in schools and dividing visit days by age to avoid confusion, over-crowding, and disappointed families leaving without help. Numbered tickets were given out each morning to 120 families, some of whom traveled from smaller villages as much as two hours away. All of them waited patiently for their turn.

“Some people have already left,” Revollar said that afternoon as she waited with her daughter, both smiling nervously as they advanced slowly in line, “but you have to be patient for your health.”

– Michael Snyder is a journalist based in Mexico City.