Several populations, including Matlalapa, have not been fully vaccinated and, in many, they do not even know what the virus is. Care plans are «insufficient» due to the country’s conditions. A special report on what has happened and how Mexico is facing Covid.
By: Yamiri Rodríguez Madrid /México.
Matlalapa is a small indigenous community of just 530 inhabitants, nestled in the Cofre de Perote, one of the mountains of Mexico, belonging to the State of Veracruz, in the southeast of the country. Although almost 30 months have passed since the Covid-19 pandemic arrived, today there are no basic measures such as the use of face masks.
In addition to forgetting about basic sanitary measures, they never knew the filters or thermometers werw. Life goes on as if there were no pandemic; some of its inhabitants «don’t even know what that is.»
Además de olvidada esa medida sanitaria, nunca supieron lo que eran los filtros sanitarios, ni los tapetes o termómetros. La vida transcurre como si no hubiera pandemia; algunos de sus pobladores «ni siquiera saben qué es eso».
According to official data, Veracruz, the entity where this community is located, ranks seventh among the states with the highest number of cases.
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Changes over the years…
In Matlalapa a few years ago all the houses were made of wood and there were many more people who spoke the Nahuatl language, today, with government support, almost all of them have cement floors; “Roof and Firm Floor”, as the federal programs are called.
The air here, at 2,080 meters above sea level, is pure; and in extreme poverty.
With the view, the inhabitants of this small settlement dominate the valley; and it seems that they touch the stars on the clearest nights.
Most people live off what the land offers; some “go down” on weekends to slightly larger rural communities, such as Xico or Coatepec, on one of the three public transport, runs a day, to sell their “Chiva” cheeses and bunches of wildflowers, an hour away. away.
The largest medium-sized city is almost a two-hour drive from Matlalapa on a bumpy and partly dirt road.
On rainy days, the road is even more complicated because some kilometers are not paved and the mud makes vehicular traffic almost impossible.
Here, where the average level of schooling is just 5 years, there are no government campaigns to prevent the spread of Covid19, despite the authorities reporting that there are just over 15,600 active cases throughout the country -322 in Veracruz.
At the very least, it is an alert to take care of the new disease that has reached the country and the state: monkeypox or monkeypox, with six cases in that entity.
The stories of the people
Faustino Cortés Gómez, who claims to be 94 years old, rests on the steps of the Casa de Salud -it does not even reach a small clinic-. He has almost completely lost his hearing; he listens little, smokes one cigarette after another, and kindly smiles with the few teeth he keeps.
He is an eject ivario from Coatitla, a ranchería that is on the edge of another mountain.
When asked if he has already been infected with Covid19, the old man does not even know what the disease being talked about is; believes that it is a federal program delivered by the new government.
– “Hey Faustino, have you already had Covid?
– Yes
– Did you hit him?
– What?
– Did you get Covid?
– Yes, of course, that ‘s why we voted. El Obrador (referring to President Andrés Manuel Obrador) and Morena are giving us.
– Do you know what Covid is?
– No. I already pray to God. I already lived for so many years.
Vaccination schedules
Data from the Ministry of Health of the federal government, show that until September 10, the most recent report, 81,204,183 people over 18 years of age had at least one dose of vaccine against Covid19, which is equivalent to 91% coverage in adults.
While, 70 percent have the additional dose; that is, almost 57 million applied biologicals.
The agency’s technical report explains that 7,287,055 Pfizer-BioNTech pediatric vaccines have been supplied to girls and boys from five to 11 years old, for an advance of 47%.
According to that report, more than half of this population group that attends basic education is not protected.
The coverage of adolescents is 64 percent, with 8,527,054 people.
Piedad Gálvez Itza is the owner of the only grocery store in Matlalapa. His entire life, just over 50 years, has been spent in this mountain town. He affirms that in the community no one got sick of Covid19.
What he does acknowledge is that getting vaccinated was a bias crucial for them.
Neither the “Roadrunner” days run by the Mexican Army nor the doctors from the Ministry of Health went to town to immunize them.
An example…
- “For example, when I got vaccinated I had to go down to Coatepec.
- How much do you make on the way?
- It’s an hour from here to Xico; Well, about an hour and a half ”, he detailed while waiting for customers behind the counter, without wearing a mouth cover. but with the certainty that the three reinforcements that were applied, the 9 hours of travel invested plus the wait, were worth it.
But Sara María Juárez Mavil, a domestic worker who works in the Magic Town of Coatepec, and whose maternal family still lives in Matlalapa, assures the opposite; says her cousins got sick with Covid19; however, they did not receive medical treatment.
This was not provided to them, because they were not registered in the social security system, adding to the complexity of transfers.“Almost a year after Covid started in the news, my cousins came down with a cold, well, with all the symptoms that were in the news. We believe that not so many people were infected because they stopped going out on those days and because they drank dandelion tea -an herb that grows wild and whose flower falls apart with the slightest breeze-, in addition to honey with ginger, «he details.
The 37-year-old woman proudly points out that she has never contracted the disease.
However, his brother – who he says was treated only with chlorine dioxide drops – and his mother were «Both at the beginning of the pandemic, when people looked very bad and died.»
The lack of biologicals and the legal battle
On August 23, in the section called El Pulso de la Salud, which the authorities of the sector offer from Monday to Friday within the framework of the presidential morning conference, a complaint from the country to the international community was heard.
That day, the Undersecretary of Prevention and Health Promotion in Mexico, Hugo López-Gatell Ramírez, announced that the Government of Mexico has a formal offer to receive more than 10 million pediatric vaccines, through the Covax mechanism of the Organization of the United Nations (UN).
The official referred to one of the conditions: that they arrive no later than September because otherwise, the Mexican government would reserve «the right to take any action, even legal» if the Covax mechanism «does not fulfill the commitment that is established».
Of that agreement, 1.2 million Pfizer-BioNTech pediatric vaccines arrived on September 12.
Claims
Mexico has denounced that «access to vaccines through the Covax mechanism has been stormy.»
Late deliveries, and lack of clarity in the assignment criteria regarding the types of vaccines, quantities, and delivery schedules.
The North American country has managed to obtain the doses through direct contracts, «Covax has only been a complement with which, up to now, more than 24 million vaccines have been received, which correspond to a part of what we aspired to».
Criticisms have been directed at the United Nations system and others, «they have to improve to have a true, honest, sincere, deep philanthropy.»
Manuel Huerta Ladrón de Guevara, federal delegate of the Secretary of Welfare in Veracruz, affirmed that due to the population dispersion of the state, the Mexican Army -Secretariat of National Defense (Sedena)-, supported vaccination, mainly in indigenous areas.
They arrived in these areas with the “Road Runner Brigade” plan.
“The State Government is ultimately responsible for the issue of vaccination itself. In these 118 of 212 municipalities, it is done with the broad Roadrunner Brigade; where the Army acts, they are directly responsible for vaccination. All this has a national organization from the National Vaccination Committee,» he explained.
He added that they were the logistics assistants, the call, and the organization.
A health system with deficiencies in Matlalapa.
A constant complaint of millions of Mexicans is reaching a health center: there are no medicines and, worse still, no doctors.
The pandemic brought to light the state of the health system in the country and the need to improve infrastructure and hire more specialists.
In Matlalapa, if a sick inhabitant has to go down to Xico, there is only one “health home” there that operates from Monday to Friday during office hours, with a nurse and a Nutrition intern.
In the municipal seat, you can find a health center; more than an hour away. In Coatepec, there is a small regional hospital that attends mainly deliveries, and some minor operations.
If the condition is serious, then they have to travel to the state capital, Xalapa, where the most well-equipped hospitals are.
To this must be added the poor condition of the roads, since only from Matlalapa to Xico are there stretches of dirt and others where the constant rains and lack of maintenance have destroyed the asphalt that was once laid.
The Secretary of Health in Mexico, Jorge Alcocer Varela, stated that the calls for the recruitment and hiring of medical specialists will remain, with the aim of addressing the deficit in the country.
He also announced the beginning of the third day to advance in the transformation of the health system.
More doctors and improved health centers
For his part, the General Director of the Mexican Social Security Institute (IMSS), Zoé Robledo Aburto, reported that 3,248 specialists are in the process of being hired as a result of the two National Recruitment and Hiring Conferences.
More than 14,000 places have been made available in six health institutions in the country.
Zoé Robledo also stated that the federal government completed the rehabilitation of 180 hospitals and health centers that were unfinished, abandoned, or in some situation that did not allow their progress, with an investment of 11,536,000 pesos, as part of the Infrastructure Plan of the Institute of Health for Wellbeing (Insabi).
In 2019, 327 establishments were identified in 31 entities that were detained due to legal or technical problems; lacked an executive project «or had simply been abandoned»; and 20 were discharged.
Of the 307 that are in reactivation, 180 have completed the work; 36 are in process and 91 are under evaluation to be integrated into the Insabi Infrastructure Plan. This plan does not include the Coatepec Regional Hospital, nor the Xico Health Center, much less the small Makalapa Health House.
Indigenous, invisible in the statistics…
Mexico is a country that still has a high percentage of the indigenous population. According to data from the National Institute of Statistics, Geography, and Informatics (INEGI), there are 23.2 million people aged three and over who self-identify as indigenous, which is equivalent to 19.4% of the total population in that age range.
The same government body reveals that the total population of indigenous households in 2020, when the most recent census was carried out, was almost 12 people, which is equivalent to 9.4% of the total population of the country.
And that the average size of those households was 4.1 people.
According to statistics, Veracruz, located in the Gulf of Mexico, is the seventh entity, out of 32, with the highest number of Covid infections.
It is the fourth most populous state, with more than 8 million inhabitants; and one of those that still concentrates its original peoples, with 663 thousand 503, which represents 8.6 percent of its total population.
- 7.2%, 48 thousand 059 indigenous people from Veracruz, do not speak Spanish.
Of every 100 people who speak an indigenous language in Mexico, 12 of them do not speak Spanish. Even so, the campaigns to prevent Covid19 infections, as well as to urge the population to go and get vaccinated, were focused on the official language.
In solitary confinement…
In Matlalapa, 35 percent of the population does not have a television and 45 percent do not have a radio.
Due to the distance and height, there is no cell phone signal.
“Here the talks to prevent Covid were given at the school,” explains Piedad, the store owner.
45 minutes away from Matlalapa, there is another community with an indigenous presence: Plan de Las Hayas. Almost 30 months ago, Diana de Jesús de Jesús, who became a mother twice during the pandemic, came to live there.
The 26-year-old was born in a community in the neighboring state of Puebla, in Mezcal Chintla, which in Nahuatl means place of mages and rabbits.
Remember that in his town there are not even a thousand inhabitants; that the vast majority still communicate in the original language, although Spanish is spoken at school; and points out that the Covid there came very late, almost 6 months after it had already killed people in other parts of the country.
– «Were you afraid of getting Covid, what did you feel the first time you found out about that disease?», we asked him.
- «It gave us chills, at least for my daughter it scared me and since we have a little store there (in Mezcal Chintla), people came and bought, we didn’t want to neglect the store either, because that’s where we got it from,» he narrates from a chair in her mother-in-law’s house, where she now lives.
The language barrier in remote areas
Diana says that prevention measures, such as constant handwashing and courtesy sneezing, were learned from what teachers taught children and young people in schools.
«More than anything it was in the schools, because as such the campaigns did not reach there,» he says. She states that although she is vaccinated, she is afraid of getting sick.
So far, neither she nor the children have been infected.
In the state of Veracruz, 365,915 people speak Nahuatl; 122,595 Totonac; 46,236 Huastec, and 36,104 Popoluca de la Sierra.
Both in Matlalapa and in Mexcaltochintla some of the Nahuatl variants are spoken.
According to the National Institute of Indigenous Languages, in Mexico, there are 68 linguistic groups, each with its variants (). The languages with the largest number of speakers are Nahuatl, Maya, and Tze ltal.
Information campaigns
In November 2021, the Government of the state of Veracruz announced that the Ministry of Health would carry out a dissemination campaign, both in Spanish and Nahuatl, to remind the population of the importance of immunization.
On behalf of Governor Cuitláhuac García Jiménez, the head of the Secretary of Education of Veracruz (SEV), Zenyazen Escobar García, held a meeting with managers, supervisors, and heads of the sector to establish joint actions.
The objective was to favor the population that still lacks the biological, since he said that sometimes there is resistance to vaccination due to lack of information.
«It is important to join forces so that the population knows the benefits of being vaccinated,» he assured; but neither Diana nor Piedad remembers having seen or heard of a Covid prevention campaign in their localities in indigenous languages.
Different groups of the population in that municipality, nestled in the Sierra de Zongolica, will join this campaign.
At the beginning of the pandemic, together with the Chamber of the Radio and Television Industry (CIRT), some materials were produced asking the indigenous population to stay in their communities.
Means to reach the population
The businessmen of the media agglutinated in the CIRT explained that the indigenous population of our country found themselves in a particularly vulnerable situation in the face of the epidemic and that AM and FM radio was the only means of communication present in many remote or difficult-to-reach areas in the country.
So in 20220, they sent their affiliates the first nine spots with cultural and linguistic relevance.
- There are 318,900 children and adolescents orphaned by one or both parents as a result of Covid-19.
These contained data on the prevention measures against the spread of the Coronavirus and, weeks later, they added twenty spots with messages in new languages such as Tarahumara, Popoluca del Centro, Huichol, Guarino Lapan eco, and Serí, to name a few.
To make all these materials clarified, they had the advice of the National Institute of Indigenous Languages (INALI) and the collaboration of certified interpreters and translators.
“The message of “Stay in your community”, which was defined as the priority of this effort, contributes to compliance with the General Law on the Linguistic Rights of Indigenous Peoples and strengthens the social responsibility actions of this industry which, thanks to the contribution of its members, is consolidated as a pillar in the strategy to save lives in the face of the health emergency”, they detailed.
At the local level, there was no such effort.
There, they only used the two versions of spots produced by the CIRT in south-central Totonaco and Nahuatl from the Huasteca of Hidalgo.
If the Daily Technical Report issued by the Federation is reviewed, it is verified that infections are classified by sex, age groups, and by place of origin. but ethnicity is not mentioned; That is why Piedad believes that there are no cases in her community.
Mexico, two years after Covid
there are other edges around the pandemic. The Senator of the Republic, Kenia López Rabadán, affirmed that many absences could be avoided if the necessary measures were taken, for which she presented a Point of Agreement as an urgent resolution to urge the Executive Commission for Attention to Victims to issue the measures of help, protection, attention, assistance and comprehensive reparation to which minors are entitled.
On July 13, he presented a reform proposal so that the INEGI has detected orphaned children, both due to the wave of violence that is plaguing the country, and due to Covid19
«You have to determine where they are and in charge of whom,» he said.
According to a study carried out by the Imperial College of London, with figures updated until April 5, 2022, Mexico is the second country with the most orphans among 170 nations.
In the country, there are 318,900 children and adolescents orphaned by one or both parents as a result of Covid-19.
Back to school, with doubts and fears
Another concern, regardless of whether they are rural or urban areas, is that after two and a half years; girls, boys, and young people finally returned to the classrooms last Monday, August 29, although the Ministry of Health recognizes that only 44 percent of children between 5 and 11 years of age have been immunized with just one dose.
There is also a growing fear among the population in Saltillo, Coahuila, a city located in the north of the country, almost 1,100 kilometers from theirs. A 45-year-old primary school teacher was infected with smallpox. Monkey.
The teacher had gone to spend his vacations on the Yucatan Peninsula.
For the country’s authorities, the return to school is safe, since its Daily Technical Report states that hospital occupancy for COVID-19 care of beds with mechanical ventilators for people in critical situations is 4%.
While the figure for general beds is 1 percent.
Nor can it be ignored that another peculiarity of this state in the Mexican southeast is its migratory flows.
Regarding internal mobility, INEGI detected that the main causes that motivate it are meeting with the family, change or offer of work, looking for a job, marriage or union with a partner, for studies, but also due to criminal insecurity or violence, deportation, and natural disasters.
International migration, a challenge
Indigenous municipalities such as Tehuipango, Zacualpan, San Andrés Tenejapan, Mecayapan, Magdalena, Astacinga, or Ixhuatlán de Madero, experience part of this international migration.
Regarding international immigrants in Veracruz, the authority has detected migrants from Honduras, Bolivia, Colombia, Guatemala, and Cuba as residents in the entity.
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However, this state has been, for many years, an obligatory passage for migrants who go to the United States and who, out of necessity, have to stay for weeks or months on its territory in order to continue their journey.
The general director of Epidemiology in Mexico, José Luis Alomía Zegarra, reported that migrants who are in Mexican territory are considered to receive the Covid-19 vaccine.
To receive guidance in the absence of any official identification document -he indicated-, they can rely on the «Roadrunner Brigades» that are located at the vaccination points.
He recalled that the immunization of migrants is carried out by the stages defined in the National Vaccination Policy.
The director of Epidemiological Surveillance of Non-Communicable Diseases of the Federal Ministry of Health, Gabriela del Carmen Nucamendi Cervantes, revealed data on the ages and areas of this foreign mobilization.
- Of migrants from the United States, Honduras, Venezuela, and Colombia; most are between 20 and 44 years old.
- The highest concentration is identified in Baja California, Chihuahua, Mexico City, Guanajuato, Nuevo León, Querétaro, and Quintana Roo.
In Veracruz, the vaccination of migrants is carried out mainly by the «Brigada Correcaminos» at the Acayucan immigration station, one of the largest in the country.
This is located on federal highway 180, to Guatemalans, Hondurans, and Cubans, primarily.
The support of the academy is necessary
After all these edges, Elena Rustrián Portilla, Academic Secretary of the Universidad Veracruzana (UV), stated that today it is necessary to visualize Covid19 with a multidisciplinary approach.
He believes «it is necessary that Science and the Academy share experiences in relation to the pandemic, provide knowledge of the consequences that continue to be discovered derived from the disease, and its impacts on physical and mental health.»
Arturo Aguilar Ye, general director of the Academic Area of Health Sciences, of Veracruzana University, emphasized the need to develop care models for COVID-19, which telehealth and continuous care provide.
«The purpose of telehealth is for health care providers in rural or underserved areas to use information and communication technologies, to make them more accessible,» he explained.
An example is the Netherlands, where 91% of first-contact doctors serve their patients through the Internet, with prescription delivery being the most used service (66%).
Meanwhile, adolescents prefer to use digital technologies, as they give them greater confidence, unlike traditional methods.
However, many remind him of the technological conditions between the two countries and the advantages that exist in Europe.
Aguilar Ye also spoke about the comprehensive health care model, which focuses on the user and emphasizes promotion and prevention, with a focus on family health care.
Recomendations…
While this is happening, the insistence of the population is to heed the indications of their local and state authorities in relation to sanitary measures:
- Healthy distance, correct use of face masks, frequent hand washing with soap and water or application of alcohol gel, and ventilation of spaces.
Measures that, although they seem simple, «help reduce the risk of contagion.»
- In case of symptoms of COVID-19, the person must be isolated for seven days and be aware of the evolution of the disease; If you have complications, you need to seek medical attention.
Matlalapa is a sample of what is lived in many towns in Mexico. Like Faustino, there are hundreds of thousands of Mexicans who will never know, due to ignorance or indifference, if Covid19 entered their bodies; nor are they prepared for the other evils that are already at hand. Cases like Piedad’s should be the common denominator in a country that was plagued by the disease for 30 months. That is the X-ray of the Covid19 in Mexico.
