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NACO, Ariz. — Last October, îscar Amaya, a 31-year-old elementary school teacher from Naco, Sonora, Mexico, escorted his mother across the border to Naco, Ariz., for a free health screening provided by the Naco Wellness Initiative.
îscar hadn’t intended to get a screening himself, since doctors and medical exams have always made him a little nervous. But after a little friendly coaxing from the volunteers at the clinic, he decided to take advantage of a free check-up.
He was glad he did. For the first time, he learned he had high blood pressure.
 John Mather, president of the Naco Wellness Initiative, says that 75 percent of the people who come to his organization’s free clinics are residents of Sonora, Mexico. (By Jonathan Clark-Herald/Review) |
“I never felt bad, so I had no idea,” he said. “I never had a headache or any other symptom to suggest I had a problem.”
Once back in Sonora, îscar made an appointment with a cardiologist, who talked with him about controlling his blood pressure. On Saturday, he returned to the Naco Wellness Initiative clinic at St. Michael’s Catholic Mission to see how he was doing.
“You have to take care of yourself,” he said.
According to John Mather, president of the Naco Wellness Initiative and CEO of its Phoenix-based parent organization, Cathedral Health Services, 75 percent of the people who attend the free monthly clinics, are, like îscar Amaya, residents of Sonora, Mexico.
“We are open to everyone, whether they are from the United States or Mexico,” he said.
And while it might seem odd that so many people from a country with free, socialized health care would cross an international border for a simple check-up, a closer look at Mexico’s healthcare system provides some understanding.
Public healthcare in Mexico is largely provided by the federal Social Security Institute, known by its Spanish acronym as IMSS. Those Mexicans employed in the formal economy and who pay social security tax can use IMSS clinics and hospitals free of charge.
However, according to the national statistics institute, known by the acronym INEGI, more than 11 million Mexicans — 28 percent of the working population — labor in the informal economy where they pay no social security taxes. Some independent experts say the number is probably closer to 50 percent.
In addition, in order to avoid paying legally required benefits, many formal sector employers hire workers as independent contractors who are responsible for deducting their own taxes.
According to INEGI, 63.9 percent of those Mexicans who worked during the first trimester of 2005 did not gain access to healthcare through their employment. For these people, there is still some level of cost-free IMSS and state-run healthcare available, but patient-to-doctor ratios are high and equipment is scarce or outdated.
In Naco, Sonora, for example, there is one IMSS health clinic staffed with one physician to serve a population roughly the size of Bisbee’s.
And while residents speak highly of the clinic’s Dr. Cuevas, they say he is simply stretched too thin to attend to the needs of all the members of the community.
The Naco Wellness Initiative not only offers an additional local health care option for residents of Naco, Sonora, it also provides services — such as cardiovascular ultrasound — not available at the IMSS clinic.
As a result, it has been widely popular.
“(The clinic) has brought people to healthcare who have not been using it for years and years,” Mather said.
Still, he noted, problems can arise when a problem is detected during a screening and the patient requires follow-up care.
“For our patients on the U.S. side (of the border), we work to get them into the healthcare system here,” he said. “Unfortunately, on the other side, patients have to travel three or four hours to the nearest major hospital in Hermosillo (the Sonora state capital).”
“We work with Dr. Cuevas to get them follow-up care, but often, it’s a real challenge.”
Because the screenings attract so many international clients, organizers have taken Mexican cultural norms as well as cross-border issues into account in designing the program. As an example, HIV and STD screenings are conducted in an intentionally low-key manner.
“Because of the stigma attached, there is not a lot of HIV testing done (in Mexico),” Mather said. “We try to make it just another, natural part of the screening process. We don’t put up a big sign saying ‘STD screenings here.’ ”
And on Saturday, Brain Oertel of Cochise County Public Health Emergency Planning and Preparedness, was handing out Spanish-language pamphlets on anthrax in an effort he said incorporated an element of national security into the project.
“We know that the border is just a line in the sand,” he said, explaining that diseases can easily cross national boundaries.
Julieta Amaya, 51, îscar’s mother and also a resident of Naco, Sonora, has access to IMSS health care in Mexico and expressed general satisfaction with the care she receives there. But she also admitted frustration with the long waits and paperwork that are endemic to Mexico’s public institutions, and so she has come to the Naco Wellness Initiative on four occasions for screenings.
“Here, they just ask you to sign in,” she said.
Julieta praised the volunteers at the free clinic for their humanitarian efforts.
“I have Social Security, but here, they also help the people who have no way to get help for themselves,” she said. “They are helping the humble people.”
Of course, the clinics held in Naco, Ariz., can only serve those Naco, Ariz., residents who have visas to legally enter the United States, and many of the most humble do not have the necessary paperwork. As a result, the Naco Wellness Initiative has begun offering screenings in Naco, Sonora, as well.
Of the 11 clinics scheduled for this year — they are held one Saturday a month every month except August — eight will be held in Arizona and three in Sonora. Mather said screenings in Sonora have attracted up to 127 patients, as compared to an average of 80 to 100 in Arizona.
The process of getting permission to bring equipment and personnel across the border was extensive, said Mather, “but both ports of entry, in Mexico and the U.S., have been incredibly supportive.”
“Some groups come to the border with agendas other than what they say,” he said. “But (Mexican and U.S. officials) know we have no other agenda. They know we are about wellness.”
HERALD/REVIEW reporter Jonathan Clark can be reached at 515-4693 or by e-mail at svhnews@transedge.com.
Bill Stein wrote on Nov 22, 2008 7:45 PM: