Medical care is expensive everywhere. But in Mexico, only the wealthiest two percent get the best care. Half of Mexico's population of 100 million is uninsured, with more than half of all medical expenses for everyone paid out of pocket. Earlier this month Faith Sidlow joined a group of valley doctors that has adopted a small town in the state of Sinaloa, to help right these health care inequities.
On the first weekend of each month the Flying Doctors of Mercy, or Liga, travel in small planes to a half dozen poor villages in Northern Mexico. The Fresno contingent goes to Ocoroni where they volunteer their time to take care of a range of routine medical problems and occasionally save a life.
Ocoroni is one of the poorest pueblos in the Mexican state of Sinaloa. The streets of this 400 year old town are dirt. Seasonal floods wipe out homes and farm and spread bacteria from cattle and agriculture into the drinking water. Unemployment is high. Medical care is scarce and expensive.
We departed at 6:00 a.m. from Fresno’s Sierra Sky Park Airport, a privately owned public use airport, at Herndon and Brawley Avenues. Pharmacist Larry Justis piloted the 4-seater Cessna 210. At a refueling stop in Yuma, Arizona, we met up with the only other plane from Fresno going on the mission. In addition to Justis the pharmacist, we traveled with three doctors, a physician’s assistant and three interpreters.
Seven hours after leaving Fresno, we arrived in Los Mochis , Mexico. We were greeted by armed federales who questioned us about the medicine we were taking to the clinic. After passing through customs, members of the Rotary Club drove us an hour away to Guasave, where we would spend the night before driving another hour to Ocoroni the following morning.
In years past, the Liga pilots landed their planes on the dirt airstrip next to the Ocoroni clinic. But the landing strip hasn’t been maintained and has fallen into disrepair. “It just wasn’t safe,” said pilot Larry Justis. “There were just too many pedestrians, cattle trucks running up and down the runway, so rather than waiting for an accident to happen we just stopped using it.”
Liga then began landing at an airport in Guasave, about an hour from the clinic. But the federales have shut down that airstrip because of drug interdiction efforts. And so the volunteers must now make the two-hour drive from Los Mochis to Ocoroni in order to get to the clinic.
Saturday morning, we found dozens of people at the clinic, waiting patiently for the doctors to arrive. The physicians, assistants and interpreters immediately began working. Fresno x-ray technician Maria Torrez is the clinic coordinator. She has volunteered with Liga for the past 16 years. It’s her job to triage each patient who walks through the door.
“I do it because it’s very rewarding and a good thing to do for the people here in Mexico,” said Torrez. However, working in the clinic can also be a challenge. Because of a shortage of planes, a dentist and surgeon were not able to make the trip—and many of the townspeople had been expecting them.
Dora Lugo and her two daughters had been waiting at the clinic since 4 a.m. Lugo says she comes to the clinic because her family is low income. Her husband works odd jobs, making the family ineligible for state health insurance, and she can’t afford to pay out of pocket.
Within a few minutes Lugo’s daughters were seen by Fresno pediatrician Dr. Gracie Esquivel-Aguilar who quickly diagnosed 3 year old Idali with a case of asthma. ”The little girl had problems with allergic rhinitis,” said Esquivel-Aguilar. “She had a little bit of asthma, and her mother didn’t know that. She just knows that she’s always had a cough, and she has been here before. We’ve given her some nose spray and she says that really works. But she ran out, so of course she didn’t have the money to get any more.” Dr. Escquivel-Aguilar gave Lugo allergy medication and explained which foods her children should eat and which they should avoid.
It was the same for one year old Carla Viscara who was also diagnosed with asthma. In fact, most of the patients seen by Dr. Esquivel-Aguilar had some type of allergy or asthma induced condition. “We don't have our modern equipment like in the U.S.” said the doctor. “So we're going to have to make our own inhaler, aero chamber and mask.” The pediatrician poked an inhaler through a Styrofoam cup which doubled as an aero chamber and mask. Esquivel-Aguilar placed the mask over Carla’s nose and mouth and administered the dose. Immediately Carla began to cry, which was a good thing said the doctor. It would cause the baby to inhale deeply and breathe in the medicine.
Mercedes Viscara, Carla’s mother, says the Liga doctors provide care she can’t get on her own. Her family lives outside the town, and there aren’t many doctors available. “There are times when I take Carla to the pediatrician and they tell me he’s out of town,” she said.
Fresno OB-Gyn Dr. Bob Wilson is on his first Liga trip. He says he’s not sure what to expect. “We're not able to do pap smears because there's no one to read them, so we're limited on what we can do.” As it turns out, most of the patients he sees are general medicine, like school teacher Luz Arrelia who lives in a nearby town. She too suffers from asthma. Ordinarily Arrelia would go to a state run clinic and possibly not get any medication. “It’s very bureaucratic,” said Arrelia. “If there is an emergency, you have to wait in line.”
Dr. Bob Crooks is a Fresno Internist. His first patient was Emiliano Ochoa, who complained of a bad headache. “I’m getting a very high reading: 210 over 110,” said Crooks. He turned to interpreter Jose Solorio and asked whether Ochoa has been told in the past that he has very high blood pressure.” Solorio repeated the question to Ochoa in Spanish. Ochoa, who is a fisherman, told Solorio that he has visited the clinic many times and has received medication for hypertension. But he has always had high blood pressure.
“It's high enough that's it s probably causing his headache,” said Crooks. “And there's risk for stroke, if he knows what that is, and it also can cause kidney failure. So he should be sure to be taking the medications and come back to get his blood pressure checked.”
Ochoa went home with three months worth of medication and stern instructions to take the pills and monitor his pressure. “Thank God,” said Ochoa. “Because what can we do without the doctors? Nothing. And that’s the truth because we’ve got nothing.”
By the time the last patient left, the volunteers were exhausted but satisfied. In five short hours they saw 250 patients. In spite of the shortcomings they say the clinic was a success. “We saw everybody, we didn’t turn anybody away, and we cleaned up a bit,” said Esquivel-Aguilar.
And therein lies the rub. The people of Ocoroni need the Liga doctors. But after 20 years, the Liga missions could be in jeopardy. “This is a remote location,” said Crooks. “It's not convenient to get here by any public means. It’s really cut off from the mainstream Even in Mexico."
With no nearby landing strips because of drug interdiction and the increasing Mexican bureaucracy, the doctors say they may be more productive going elsewhere. That’s a decision that would leave the people of Ocoroni at the mercy of Mexico’s non-system.
The next trip to Ocoroni is the weekend of December 5 to 7. So far only one doctor is signed up to go. Liga needs more physicians, practitioners and a pharmacist to make their next trip a success. If you'd like to help, go to Liga or call :(559) 970-4940. For more information about the flying doctors check out History of Liga
