Bringing Surgical Care to a Mexican Region Cut Off from Public Health Service
The people of the Sierra Madre in Chiapas, Mexico face a series of unique challenges, including access to essential services like health care. Christianson Grantee and pre-med student Will Pavlis reflects on his service year building a desperately needed surgical care program at a local hospital in the region.
As the surgeon stepped away from the table, the anesthesiologist prepared the patient for transfer to the post-op room. The nurses moved about, readying themselves for the next surgery. In this flurry of motion, the significance of the moment seemed to be lost on the team. We had just completed our first hysterectomy at the Hospital Basicó Comunitario Ángel Albino Corzo (HBCAAC), a rural community hospital in the Sierra Madre Region of Chiapas, Mexico.
In the operating room of Hospital Basicó Comunitario Ángel Albino Corzo. Image courtesy of Will P.
I’ve been volunteering with Compañeros en Salud (CES)—an affiliate organization of the U.S.-based NGO Partners in Health—to establish a functional surgical program at HBCAAC. The hospital’s operating room had long been unused due to inefficiencies in the public health care system. We aimed to re-open it and offer communities of the Sierra Madre an accessible, safe, and affordable option for surgical care.
Hospital Basicó Comunitario Ángel Albino Corzo in the Sierra Madre region of Chiapas, Mexico. Image courtesy of Will P.
In the first four months of our program, our team performed 57 surgeries, a mixture of tubal ligations and cyst removals, all without complications. This hysterectomy marked our most complex case to date, and its controlled success a strong indicator of things to come.
When the nearest hospital is two hours away...
These modest successes are best understood in the context of surgical care in the region. One of the poorest regions in the country, the rural Sierra Madre is not only marginalized from government services, but also from the NGO support that many other areas of Chiapas receive.
Image courtesy of Google Maps.
After HBCAAC, the next closest public hospital is two hours away, creating delays in receiving emergency care and making elective surgeries, especially gynecological ones, nearly impossible to obtain. A majority of our patients have been waiting for surgery for more than a year, many for more than five years. An unlucky few have been living with painful and disabling hernias or cholelithiasis for more than two decades.
Overlooking the rural community of Sierra Madre in Chiapas, Mexico. Image courtesy of Will P.
As a result, Compañeros en Salud set out to create a surgery program at HBCAAC in 2018, and eventually grow the hospital into the best in the region. Our work began far from the operating room, starting with partnership development and building trust among hospital staff.
Many professionals working in the healthcare system have become beaten down by structural violence, weary of broken promises and suspicious of others’ intentions. Through continued open communication, we built an equitable partnership and mutual trust within the hospital that has been key to the program’s success. Overcoming other challenges, such as securing funding, equipping the operating room, and recruiting specialists, seems secondary to this accomplishment.
Embracing a nascent program with grace
We still lack a full-time anesthesiologist and need to continue building surgical capacity among the staff. Thus, we have only performed a few types of procedures to date and as word of the new program spreads, waiting lists for consults and surgeries continue to grow longer. Nonetheless, in conversations with patients, reciting their disparaging stories with healthcare, I am met only with kindness, good humor, and an unwavering strength.
Lush forest surrounds the Sierra Madre community of Chiapas, Mexico. Image courtesy of Will P.
In this manner, many of the people of the Sierra Madre reflect their region. While steep mountains, thick forests, and heavy rains make the Sierra Madre an isolated and rugged place, it is also breathtakingly beautiful—home to a density of animal life, mountain views, preserved rainforests, and pristine lakes beyond compare.
Similarly, the people of the Sierra Madre brave a series of unique challenges. They are largely cut off from accessing many essential services, health care being only one. Natural disasters, climate change, and fluctuations in the global coffee market are omnipresent, growing threats.
Despite it all, though, Chiapanecos live with a contagious zeal and generosity. They are eager to share their food, homes, and rich cultural heritage with outsiders. This carries itself into the hospital, where a long line of unmet needs is answered with a smile and thanks. These daily acts of authentic humility strengthen our resolve to keep improving until we provide the kind of holistic care that the people of the Sierra Madre both deserve and have a right to.
In the operating room with my co-worker Erick. Image courtesy of Will P.
As my year in Chiapas comes to an end, I’m encouraged by our progress and appreciative of all I have learned. It was the experience of a lifetime to work alongside such highly capable and compassionate people at Compañeros en Salud. I have found many role models and lifelong friends here and I look forward to seeing how the surgery program grows under their watch. I am grateful for having learned from true professionals who nurtured my passion for social medicine and epitomize what it means to devote your life to a cause.
I’m grateful to the people of the Sierra Madre who exude grace and humility in the face of adversity. And I’m grateful to the InterExchange Christianson Grant for making this service year possible.
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