At times I actually get some rare thought provoking feedback from blog readers. The last one was a curiosity about social welfare programs in Mexico and specifically in Catemaco.
So consulting my notes and a little Googling:
Half of Mexico's federal social welfare funding is concentrated in a program called "Oportunidades"
Most of the state of Veracruz's social welfare programs are concentrated in an agency called DIF - Desarrollo Integral de la Familia (Integral Development of the Family).
In addition, the Veracruz Department of Civil Defense also assumes a large role in doles for the needy.
All municipios have their own DIF departments.
Oportunidades is the most popular program, apparently available to people without political connection (rare in Mexico) and provides stipends related to the educational status of children. In Catemaco 4,368 out of app. 11,000 families (2007) receive benefits of 200 to 2,000 pesos per month.
DIF of Veracruz, a sub-agency of the Veracruz Department of Health is the main provider on a state level. The agency is run by the wife of the Veracruz governor.
Although studded with many worthwhile programs, apparently none are uniformly applied and depend on political influence to be accessed. Nevertheless there are free milk, free breakfast, aid to the infirm and the aged and other typical relief programs. Their cost is nebulous.
The Civil Defense Agency typically provides help to the needy in disaster areas. And annual heavy rains, storms and flooding make this a very busy agency. Unfortunately just as annually there are news stories of politicians hoarding and hiding supplies provided by the agency to be used for political favors.
On a county/muncipal level, DIF again is the provider of local social programs, usually funded by state resources but presented as funds coming from the local administration. And that is about as transparent as a moonless night on Laguna Catemaco.
Catemaco's entire federally assigned budget for 2008 is 74.8 million pesos, about 1,600 pesos per person per year. Oviously few municipal funds are available for social welfare programs. Anecdotally, a last resort for many locals is a direct plea to the mayor for cash help to defray costs of surgery, burial or just possibly starvation.
Local benefits bestowed from who knows whose funds include free boats and motors, cement to replace dirt floors (program called Piso Firme in conjuction with CEMEX, a giant Mexican cement conglomerate), scholarships for needy children, raffles of refrigerators, candy and presents for Christmas, free seed for farmers, sheet metal roofing and dozens of others.
Health care is technically free and people are dying to get some of it. Clinics are understaffed, ill equipped and lack medications.
Electricity costs are heavily subsidized by the federal government on a staggered usage scale. Water, too, is inexpensive in its basic category.
The most popular welfare item is a despensa, a plastic sack filled with about 100 pesos of basic groceries often available to most anyone expected to attend the hundreds of annual political events.
Basically - (considering the minimum wage of less than 35 dollars a week)- social welfare programs often almost double the magnificent income of many of the most impoverished provincial Veracruz inhabitants.
References:
Short description of Oportunidades
DIF of Veracruz
Apr 25, 2008
Catemaco welfare
Jun 13, 2007
Worming Catemaco
My dogs fairly regularly produce feces with wiggly things and we rush them to the veterinarian.
My Popoluca regularly deworms herself and is incredulous that I prefer not to do so, and she thinks it is an outright lie when I tell her I have never been de-wormed in my adult life.
Since she also knows a few gringos, we have compared notes. Now she is convinced that Mexican worms do not like gringos.
Beautiful small town Catemaco is not that far removed from the days when shoes where a luxury, and topless bathing in the laguna was the norm. And a trip into the higher surrounding sierras will reveal that to still be the norm in many riverside communities.
Parasite infection is a serious problem in rural children in Mexico and the Mexican health system has serious preventative and control measures in place. But apparently the message that once you took all those preventative measures and reached adulthood, that ritual practice of de-worming became unnecessary, has not filtered down. And the drug producers are happy.
Or maybe I have worms and don´t know it.
Dec 28, 2006
Catemaco nose doctor
We just returned from not-beautiful Lerdo de Tejada, Veracruz where my Popoluca's youngest daughter just finished her internship at the 40 bed federally run hospital, staffed with 22 interns and a few doctors. The fresh doctor was smart and on her last day opted for some free elective surgery to remove some stuff from her nose.
Medical training in Mexico is somewhat different from the US and nothing like ER. High school (bachillerato) is followed by 5 years medical school and one year internship. Then the new doctor is obliged to provide one year of medical service, usually in a one person clinic, usually in the outback.
The new doctor and her improved nose are now looking in the hills and valleys surrounding beautiful downtown Catemaco to find an adequate location to continue her solitary on the job training.
I wish all her patients well.
Oct 14, 2006
Catemaco Cut and Dice
Cesarean sections instead of natural birth are a gift for women fearful of pain, late for an appointment, concerned about fatty tissue, or actually having a health problem requiring this surgical intervention.
The procedure is also alleged to increase complications in both mother and baby, and additionally to create havoc with financial planning among the parents, especially among the lower economic stratum of society of which most of Catemaco consists.
In beautiful downtown Catemaco, Veracruz, I recently counted three cesarean sections. (Big deal! These were the only pregnant women I knew in Catemaco. So I studied the subject a little.)
It turns out that Mexico has a 34% cesarian rate, well above the 29% US rate, and substantially below the 50% rate in South Korea. Mexican private hospitals are way above the 50% rate of cesarean versus vaginal deliveries.
So I asked my intern doctor, daughter of my resident Popoluca. Yes, most cesareans are performed not because of necessity. Yes, people pay bribes to have the operation performed. Yes, many gynecologists prefer to perform cesareans to not interfer with their social life when attending interminable labor pains.
A cesarean birth delivery is indicated if either the baby or the mother’s health are in danger. The UN (United Nations) maximizes the percentage of live births subject to cesarean intervention to 15% as the probable percentage of needed intervention.
Unfortunately no exact long term studies have been done on the differences between cesarean and natural births. Folklore heavily leans to the natural birth side, so the use of cesarean methods, at present, seems to be a judgment call.As far as an impoverished country like Mexico, and especially its provinces, cesarean operations are a heavy duty consumer of available health resources. In that impoverished environment, cesarean births cost Mexico millions of pesos more than natural births.
Those three babies in Catemaco are doing great. One paid 1,600 subsidized pesos at the Catemaco Hospital, another paid 6,000 pesos at the Mexfam clinic, the third paid 10,000 pesos at a private sanatorium.
That is still a lot cheaper than liposuction.
Sep 3, 2006
Catemaco Generics
After petroleum, mind blowing drugs, terrorism intervention and automobiles, the medicinal drug industry is the most influential business in the world. Huge sums are expanded on research and testing to bring a new drug to market, at which time a branded drug receives 20 years patent protection and its sales price is pitched to the maximum profit.
The cost to 95% of the human population is usually outrageous, and sick and dying people worldwide have to wait 20 years for their chance at an affordable version of that patented drug.
After 20 years, the drug loses its patent protection and any pharmaceutical company can then copy the drug and sell their generic (not patented) version. Usually the drug’s price drops to near its actual cost, which is usually less than a few pesos per pill or tablet.
But that is true only in countries that adhere to international patent rights. Many do not. And counterfeit copies soon appear from many countries. Mexico adheres to international patent law but is also known as a source of much of the counterfeit drug trade in the US.
Mexican health care is split into a private and public sector. Drug pricing and availability was controlled by the usual handful of Mexican oligarchs in bed with international drug giants and with very little desire to provide generic products. Along came Dr. Simi in 1997 with a chain of cheap generic drug stores, along with some changes in Mexican prescription laws, and started a generic drug revolution. By now Dr. Simi is one of the richest men in Mexico, and drug costs have plummeted.
Effficacy of generic drugs as compared to branded drugs has been studied various times, usually paid for giant drug companies. Yes, some advanced composition drugs have shown different effects, but in general, if the chemical composition and quality of ingredients is equal, generic drugs are as effective as patented ones. The few studies demonstrating otherwise have and are being used by drug giants to frighten the public off generic drugs and preserve
their profits in their versions. Mexico is fighting this battle and has implemented laws to oblige public sector doctors to precribe both generic and patented drugs if available. The drug industry is fighting back with high priced private brand generic drugs, which allow pharmacists to double their profits. The physician sector is not immune and known to be receiving kickbacks to prescribe high priced private brand generic drugs.
I fell victim to this fraud recently, because I left my reading classes at home. A doctor prescribed me Italnik, and after my third try, I found a pharmacy who actually stocked it. I then returned home and read the box. Ciproflaxine it said in fine print, made by a small Mexican drug company recently purchased by an international drug giant. And I was about ready to explode because I knew the price of Cipro thoroughly because of former stock ownership of the generic manufacturer Teva/Ivax .
Cipro was originally produced by Bayer AG of Germany and generated several billion dollars in annual sales at prices of more than 4 dollars per tablet. The drug lost patent protection several years ago and is now produced by dozens of generic manufacturers and sells for as little as 25 cents per pill.
So now here I sit in beautiful downtown Catemaco, and like a dummy, I get cheated!
Farmacia Roma charged me 196 pesos for 8 generic cipro pills, named Italnik, at 24.5 pesos per pill.The prescription was for 2 per day for 10 days, total of 20 pills. Thankfully the farmacia’s sales staff does not read well and only sold me 8.
After I climbed off the roof, where I had exploded to, I went to visit Dr. Simi. His Farmacia Similares charged me 70 pesos for 12 cipro pills, named Bacproin, at 5.83 pesos per pill.
To double check, I visited Farmapronto, across the street from Farmacia Roma, who offered me a product named Ciproina at the same price as Dr. Simi.
To be fair, I did not return to Farmacia Roma to ask whether they had a cheaper version!
The Moral of the Story?
Without going into too much detail, can anyone imagine the impact of overpriced drugs on more than half the population in Catemaco which earns less than 10 dollars a day? I do not have to imagine; I had to advance money to many of my workers for drug purchases, which went to fatten some pharmacist because those poor workers all “KNOW!!” that generic drugs are not as good as brand name drugs.
