The hospital in Chiapas where the indigenous people pay with oranges, coffee and corn


Inhabitants of the southeastern region of Chiapas travel roads for up to 12 hours to get to San Carlos Hospital, financed by civil society, without financial help from the Federal Government.

ALTAMIRANO, Chiapas.- Chiapas is the poorest state in the country. In the communities of the southeast, we’re going to the hospital requires a transfer of several hours, a diagnosis of cancer involves taking the patient to the state capital … or retiring home to die with the family.

The  Hospital San Carlos is perhaps the only alternative health care for the poorest indigenous communities in the southeast of the entity. Among jungle roads, inhabitants of the Tzeltal, Tzotzil, and Ch’ol peoples travel up to eight and twelve hours to reach the place that, since 1976, has been treating diseases of the region financed by philanthropic organizations and civil society, until now without financial help from Federal government.

This hospital, located in Altamirano, Chiapas, records up to 100 daily consultations with 70 stretchers, a surgeon, and an anesthetist. It is one of the four projects that the San Vicente Social Work Foundation has.

The benefactors of San Carlos Hospital are the Merced Foundation for institutional strengthening, Direct Relief for doctors and supplies, the Dutch Schumacher Kramer Foundation for the construction of infrastructure, and National Monte de Piedad.

The Mexican pawnshop contributed 13.8 million pesos in facilities and equipment between 2005 and 2018, this represents 13% of the total funds of the hospital during that period, according to the general director of the Social Works Foundation San Vicente, Gustavo Cano strap

How does it work?

The diseases that most frequently reach these offices are chronic diseases, such as cancer and diabetes. Malnutrition also causes a demand for epidemiological diseases that are almost non-existent in other states of the country. During 2017, San Carlos Hospital treated 78 cases of tuberculosis patients, while in the first half of this year it received 36 cases, mostly minors.

The Tzeltal community does not need registration to receive medical service at the San Carlos Hospital. “We only ask for name, age, and region where they live. The service is free, but the drugs are not. Some Tzeltals pay with symbolic things: oranges, coffee, and corn, but here we can not make medicines with oranges, “explains Sor Adela Orea, a general practitioner for La Salle.

Endless challenges

The Hospital San Carlos offers service twenty-four hours a day, however, the work of doctors and nurses are still limited due to lack of supplies, technological resources, and specialists.

The mountains in this geographical area make it difficult to use fiber optics in the region. The diagnoses are still written on a typewriter and there are no computers inside the offices or internet communication service.

“One of the strongest deficiencies of the hospital is the supplies”,  explains Marissabel Casas Marroquín, medical coordinator.  From medical equipment such as a defibrillator for resuscitation in cardiac arrests, ultrasound for ultrasound, cardiac monitors for measurement of unstable vital signs and pediatric pulse oximeters, to gauze, surgical meshes, orogastric probes for intubation.

During times of heat, the demand increases due to infections such as diarrhea and other gastrointestinal and respiratory diseases, while the attention of specialists from other states of the Republic and abroad lasts only two weeks every three months.

The diseases that most attend are the epidemiological diseases such as malaria and tuberculosis, while the specialties that most require are gynecology, anesthesiology and otorhinolaryngology, and pediatrics.

Treatment for cancer still implies one of the most costly limitations for the indigenous population. The cultural and family influence does not allow medical exploration in women, as is the Papanicolaou test for the prevention of cervical cancer.

After a positive diagnosis of cancer, the Hospital San Carlos does not continue the maintenance of a treatment, so the immediate solution is to channel the patients to the Hospital of High Specialty in Tuxtla Gutiérrez, “this represents greater physical, economic and emotional for families, sometimes this is impossible to fulfill “, explains Marissabel Casas Marroquín, medical coordinator.

Only one in every 7 women diagnosed with cancer accepts a transfer to Tuxtla Gutiérrez, the rest decide to stay in Altamirano with their family.

This hospital performs an average of 70 surgeries per month, with only one surgeon and one anesthesiologist. “When patients arrive who need surgery in the emergency room and the doctor is not here because his day has ended, we contact him and he arrives. It is always available, but we need more specialists. ”

Until now, the intervention that Hospital San Carlos has with the Federal Government consists solely of health jurisdiction. Some treatments require medication with regulatory regulation, as is the case of tuberculosis. “We can not get medication of that type in any pharmacy, we have to go to the municipality of Ocosingo by strict regulation. We have not seen any governmental economic resource, only civil society “, argues Casas Marroquín.

Chiapas ranks first in the country in extreme poverty with 28.1%, just above Oaxaca and Guerrero. The state registered 253 general hospitals of the public sector in 2017 and a total population of 5.3 million people until last year, according to figures from Mexico

Architecture and maintenance

Chiapas is the second state in the Republic that reported the most seismic activity during 2017, with 22.9% of the epicenters of the earthquakes in Mexico, according to a report from the National Seismological Service (SSN).

Against this, the Mexican architect and designer for the Hospital San Carlos, Kees Grootenboer, explains that the structure of the place is fortified with curved shapes to distribute the pressure of seismic shocks. “The corners are very delicate points in case of an earthquake because there they generate shocks and then everything breaks down; in curves, the pressure is distributed and have more possibilities of resistance. ”

“The Tzeltal community can feel welcome at the San Carlos Hospital. The doctors translate us from Spanish to Tzeltal, which helps us feel in trust and respect. I say that since my grandfather’s time this is our hospital, in other places they do not make us feel so good, “says Jesús, an indigenous musician of Tzeltal origin.

Chiapas, located in the southeast of the Republic, contributes 1.7% of the Gross Domestic Product (GDP) to the national economy. Between 2016 and 2017, the economic growth of the state registered a loss of 2.8%.


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Source: Forbes

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