Yucatan Living

Medical Care Merida Style

In the past two days, the Working Gringos have had two medical experiences; one of them was comfortingly similar to experiences we have had in the States, and the other was a bit different. The first was a mammogram. You can probably imagine which one of us went for this procedure. The mammogram took place in a company that specializes in X-rays, CAT scans, ultrasounds, etc. The outfit occupies an old turn-of-the-century building with the de rigeur (around here) pasta tile floors. The small rooms that are traditional in these old houses and line the central corridor are perfect for a series of examining rooms. Inside the rooms, the interior decoration consists of modern imaging equipment mixed with fifty year old chairs and tables, the kind you would see in an old episode of Mayberry R.F.D. if Opie had to go to the doctor.Once inside the room for the mammogram, the procedures and efficiency were pretty much the same. Do this, stand here, lift that arm, wait. Thank you very much. Nothing new or different in that regard, comfortingly modern, all for $850 pesos (about $80 US) paid up front in cash.

A note about health insurance may be of interest here. We pay health insurance to a Mexican corporation called GNP. Our insurance has a high deductible ($3,000 US) and doesn't cover anything preventative (thus the payment for the mammogram). That deductible is for the first $3,000 of any problem that we may have. If we are diagnosed with cancer, a hernia or a broken arm, we pay the first three thousand dollars. After that, GNP pays everything for that problem. Everything. And not only in Mexico. It pays everything anywhere in the world where we may choose to get treatment. For this service, we each pay about $2,200 US a year. So far, we haven't needed this insurance and we hope we never do, but we could someday.

The other medical event happened last night. Arvi (in the blue shirt), the young 18-year old Yucateco who walks our dog URL every afternoon, came home after a particularly rambunctious paseo (walk) with a big gash on his foot. He had apparently run into one of the pieces of iron, which he called a hierro (the word for 'iron'), that just sticks up out of the sidewalk or out of a lawn. His big toe was bleeding and he was in a bit of pain. We sat Arvi down and cleaned the toe, and then we discussed tetanus. He couldn't remember the last time he had had a tetanus shot, so we all decided one was in order. We drove Arvi to one of the big farmacias (pharmacies) down by the central mercado. For $90 pesos, we bought 2 tetanus shots, a syringe, a big bag of cotton balls, a bottle of alcohol and another of hydrogen peroxide (the last two recommended by the pharmacist upon hearing what the problem was). Then we suggested we had to go to a doctor so Arvi could get his injection, but Arvi had another idea.

One of his friends, Javier, is a medic by training, but he is currently running his family's chain of convenience and guayabera stores. Javier was behind the counter at the convenience store at 7:30 PM. Upon hearing the story and examining the contents of Arvi's bag of purchases, Javier loaded up the syringe and brought Arvi into the back room. We waited in the front by the potato chips. A minute later, Arvi emerged with his grin intact and a reminder from Javier to come back in a month for his booster shot. Mucho gustos were exchanged, and we were off.

Another note is perhaps in order here. We Working Gringos got our tetanus boosters this year in our office. A very efficient young lady in a nurse's uniform came by one day and knocked on our office door. She was paid by the IMSS, a Mexican government social services agency, and was going door to door administering tetanus shots to whomever agreed to get them. But, we explained, we are extranjeros (strangers, foreigners). " Ni modo", said she. This program is for everyone. So we dutifully accepted our free tetanus boosters and she went on to the next household.

Now, class, compare and contrast how this experience would have gone down in Central California where we moved from four years ago. Someone cuts their foot. The wound is not too bad so no emergency room services are required, thank goodness. But a tetanus shot is definitely in order. If we go to our regular doctor, we might have to wait a week or two for an appointment. Forgetting whether or not we should even wait that long, the doctor visit would probably cost about $25 (if we have insurance, and a lot more if we don't, as Arvi doesn't) and the shot would be extra. And getting to see someone would take a lot longer. On the other hand, perhaps the conditions are more sterile and the oversight and knowledge of the attending physician, once you get to him or her, will be more thorough. And needless to say, we have *never* had anyone come to our door in California and offer to give us a tetanus shot for free.

So where does this leave us? The jury is out. For routine daily medical problems, we think Mexico provides more than adequate care in an environment that is hassle-free and respects our ability to think for ourselves. Most medicine can be obtained without a prescription. Pharmacists are educated and knowledgeable and act as medical advisors for the people who come to them with minor complaints. Doctors in Mexico, in our experience so far, are well-educated (most of them with some time spent in the US), caring and knowledgeable. If we came down with a major disease or needed special surgery, however, we would probably elect to get treatment back in the US or Europe. (With our policy, we have a choice!).

And in the meantime, we now know where to go if we need someone to administer an injection. And we can even pick up a coke and bag of chips to make it all feel better afterwards.

Tetanus boosters needed by older folks