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MSF personnel at a mobile clinic in Guerrero. MSF personnel at a mobile clinic in Guerrero.

Health care in rural Guerrero: ‘We haven’t had a doctor in four years’

Doctors Without Borders delivers care with mobile clinics

Violence in Guerrero is having a direct impact on the accessibility of medical services in rural areas, according to the medical humanitarian organization Doctors Without Borders.

Also known as Médecins Sans Frontières (MSF), the organization said in a news release published today that many of the state’s local health care centers are staffed by a single nurse who also sleeps at the same facility.

“These nurses have very few resources and must carry the burden of health care in their communities,” MSF said.

Traveling to larger population centers in the state to seek medical attention can sometimes be complicated due to turf wars between criminal gangs fighting over territory where opium poppies and marijuana are grown.

In response, MSF has deployed teams of doctors, nurses, psychologists and logistics specialists to operate mobile clinics in 11 vulnerable communities in the Tierra Caliente, north and central regions of Guerrero.

MSF personnel are also stationed in the state’s biggest tourism drawing card Acapulco, which has also suffered from increased violent crime in recent years.

A doctor working in MSF’s mobile clinics said “a lot of our patients cannot access basic health care because of the violence in the region,” adding that ingrained poverty exacerbates the situation.

Javier López de la Osa cited a lack of follow-up care for pregnant women as a particularly widespread problem and one that can lead to serious complications and even death during childbirth.

However, López pointed out that people suffering from a range of conditions lack the medical attention they require.

“There are hardly any services for chronic diseases like diabetes and high blood pressure. Without medical care, conditions that were previously well managed get progressively worse and eventually become acute, severe and in some cases life-threatening,” he said.

A resident in one of the communities where MSF’s mobile clinics operate highlighted the severity of the problem.

“A lot of doctors don’t want to come anymore; the nurses do, thank goodness. We haven’t had a doctor for four years, so the MSF visits are essential of course,” said the man, identified only as Bruno.

Beyond complicating access to medical services and posing a physical risk, gang-related violence in the state can also take a toll on residents’ mental health, so MSF is prepared to treat that as well.

Consequently,  said that the organization also provides mental care to people affected by violence.

“We run individual and group sessions and psychosocial activities to strengthen patients’ coping mechanisms and help rebuild the social network damaged by violence,” said Laura Moreno, MSF’s mental health activities manager in Guerrero. “This can be challenging as we only visit each community once a month because of the volatile context.”

“We carried out 1,270 consultations in 2017, and treat people who have been through very traumatic experiences. Some have had family members killed, and others have family members forced into criminal gangs. People in Guerrero have a tough, fighting spirit, but if the fear and violence persist, the fabric of society could be torn apart. This is why providing mental health care is so important here,” she added.

Juan, a 61-year-old farmer who visited an MSF mobile clinic, provided one example of the harmful psychological effects violence can have.

He told medical staff that his two sons, aged 10 and 11, had been frightened and traumatized ever since their home was attacked by armed men a few months ago, and now they refuse to be left alone.

Abel, aged in his 20s, told MSF “that every now and again we see corpses dumped in public places.”

Doctors Without Borders projects in Guerrero.
Doctors Without Borders projects in Guerrero.

He also recounted witnessing a friend being dismembered and decapitated by a criminal gang.

A group of women who attended a meeting with a local health committee in one of the towns MSF recently visited described how violence had affected their community.

“There’s fear, there’s mistrust, there’s no happiness anymore,” one woman said.

“I used to go out at night without any hassle. But now we go straight home. I go to bed and I don’t know what will happen.”

Another spoke of the anxiety about who would be the next victim of violence.

“We’re a group of chickens in the coop, we don’t know who’s going to be grabbed next for the pot,” she said.

Source: MSF (en)

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