Miscellaneous Medical Matters in Mexico

Discussion Thread Forum

BLOOD TRANSFUSIONS IN MEXICO
MEXICO AND DIABETES
CHIROPRACTORS IN MEXICO
MED EVAC POLICIES
ASSISTED LIVING/NURSING HOME FACILITIES IN MEXICO

BLOOD TRANSFUSIONS IN MEXICO

Posted by becky on Abril 10, 2000

I heard a news report on the radio recently that said many foreign countries do not check the blood they use for transfusions thoroughly enough, therefore contributing to the transmission of HIV. The report also stated that visitors to foreign countries should also avoid activities in foreign countries that may necessitate a transfusion if an accident occurred such as motorcycling and riding motor scooters. Since motor scooters are a major source of transportation in Mexico, I was wondering what other people’s thoughts on this report were. Does anyone know what sort of policies Mexico has in place concerning donation of blood and blood transfusions? Also, I have heard rumors from a number of people that Mexico has the highest rate of HIV among people in the world. I thought it was Nigeria or someplace in Africa. Does anyone know the truth?

Posted by Bill on Abril 11, 2000

Last night, I went through my files to see what I had on AIDS in Mexico. I found a November 1998 article from the Journal of the International Association of Physicians in AIDS Care. The article is entitled “AIDS in Mexico.”

AIDS in Mexico
Patricia Uribe Zúñiga, MD, Carlos Magis Rodríguez, MD
Enrique Bravo García
From the November, 1998
Journal of the International Association of Physicians in AIDS Care

AIDS is primarily a sexually transmitted disease (STD) intimately related to the sexuality of individuals and populations. In Mexico, as in other countries, AIDS has become a complex healthcare challenge, with many psychological, social, ethical, economic, and political dimensions that transcend the usual focus of healthcare. This is why it is critical to coordinate an interdisciplinary response from diverse organizations, institutions, and other sectors of society to more effectively meet this challenge.

HIV transmission patterns in Latin American countries are similar to transmission patterns in industrialized countries. While it appears that the current rate of infection is decreasing or at least stabilized, the outlook is not uniform across the Latin American region. In most Latin American countries the epidemic is classified as “concentrated” in specific populations.

Seroprevalence rates in these at-risk populations range from one to 25 percent. A seroprevalence rate of under five percent is seen in the total population. However, in recent years some countries in the region — Nicaragua, Venezuela, and Peru — appear to have rapidly increasing seroprevalence rates.

Mexico ranks 13th globally and third in the Americas in the total number of HIV cases reported. However, when rated on the accumulated number of cases, Mexico ranks 69th globally, 29th in Latin America and the Caribbean, and in 11th place in the Americas, which reflects a comparatively low incidence rate.1

The first AIDS case in Mexico was diagnosed in 1983. Based on retrospective analyses and other public health investigation techniques, HIV in Mexico can be traced back to 1981. Since 1981, the increase in new cases has been continuous, with four types of trends noted: (1) up to the end of 1987, the increase was slow; (2) from 1988 to 1991, the increase was exponential; (3) from 1992 to 1995, the increase was exponential but subdued; and (4) as of 1996 there appeared to be a leveling off of the epidemic, stabilizing with an average of 4,000 new cases of AIDS annually. (see Figure 1).

Epidemiological analyses of HIV/AIDS in Mexico are made by classifying patients by age, sex, and method of transmission. In males, the primary source of transmission has been sexual (homosexual and heterosexual) and only secondarily through blood transfusions. In women, the initial source of transmission had been by blood transfusion, but now it is primarily through heterosexual contact. The initial cases of pediatric (children under 15) transmission were also by blood transfusion. However, that has now shifted primarily to perinatal transmission with a few incidences of sexual transmission.

Since the beginning of the epidemic in Mexico, 37,381 cumulative AIDS cases have been reported through October 1, 1998. When adjusted for undernotification and delays in notification, this total increases to 58,900 accumulated cases3 (see Figure 2).

AIDS has been reported in all states of the Mexican Republic. Fifty-five percent of AIDS cases are concentrated in the Federal District, State of Mexico, and in Jalisco. The majority of cases are in the 25 to 44 age group. Thus, AIDS has become the No. 3 cause of death in men and the 6th cause of death in women within this age group.

Pediatric AIDS represents 2.6 percent of the cumulative number of cases in Mexico; of these 50 percent were infected perinatally.

Global patterns of HIV transmission vary by region and country, and are influenced by culture, values, social conditions, sexual dynamics, and socioeconomic situations. In Mexico, two primary patterns have been reported: (1) an urban pattern, observed primarily in the large cities of the Mexican Republic and in the northern border with the United States, where there is a larger percentage of males infected and longer incubation periods (18 months); (2) and a rural pattern, with a higher proportion of females infected and shorter incubation (eight months), which is being observed in the central and southern regions of the country.

Because the dynamics and rate of HIV infection in Mexico is changing, it is more difficult to accurately predict the total number of people infected. The estimated number of persons infected by HIV in Mexico ranges between 116,000 to 174,0004. This estimate is based on HIV incidence in blood donors, sentinel studies in pregnant women, and seroepidemiological studies in specific subpopulations. (see Figure 3, Figure 4).

Based on current HIV surveillance data, the HIV epidemic is primarily concentrated among men who have sex with men (homosexual and bisexual). Most of those infected live in large cities where the seroprevalence rate has remained stable for several years. However, the seroprevalence rates in smaller and medium cities has begun to increase.

There has also been an increase in seroprevalence rates in heterosexuals, particularly in females who are sex workers and/or sexual partners of HIV-infected males. While the current infection rate in heterosexuals is low, risk factors are present which could increase the rate of infection in this group. For example, there is an increasing trend in HIV seroprevalence in tuberculosis patients.

Injection drug use is unusual in Mexico, with the practice more common in northern border states. Thus, the incidence of HIV infection in injection drug users is primarily concentrated there. Seroprevalence rates in this group are increasing.

The national response for the prevention and control of HIV/AIDS In 1986, Mexico established the National Committee against AIDS. Initially the committee was comprised of professionals who provided their services on a part-time basis to coordinate the fight against AIDS. In August 1988, the National Council for Prevention and Control of AIDS (CONASIDA) was established by presidential decree. CONASIDA became the official government agency charged with the responsibility for meeting the diverse challenges of the HIV/AIDS epidemic in Mexico.5

The number of CONASIDA staff gradually increased. Initially financial support came from international funds. As of 1991, most of the activities were financed by the Secretariat of Health. At present, more than 90 percent of funds used by the program are provided by the Mexican government.

CONASIDA initially carried out various activities according to a strategic plan. Unfortunately, many of these activities were not properly carried out at a state level. For many years, the Secretariat of Health was centralized, with human and financial resources concentrated at a federal level, and services varied significantly in each of the 32 states.

In 1995 the need for healthcare reform was proposed to respond to existing challenges. A fundamental part of this reform is the decentralization process which transfers the operation of services to the federal entities, as well as restructures the functions of the Secretariat of Health at a federal level. This was expressed in the 1995-2000 National Development Program and the 1995-2000 Reform Program of the health sector.

In 1997 an analysis of healthcare services and needs was made to help prioritize the primary responsibilities of the Secretariat of Health. As a result of this analysis, substantive programs were identified and recommendations were made for new programs at both the federal and state levels. Thus, eleven substantive programs were defined, one of which was the Program for HIV/AIDS and other Sexually Transmitted Diseases6, which is the direct responsibility of the CONASIDA.

Integration of HIV and STD services was based on recommendations by various federal and state agencies who had been working together to better coordinate activities and services between both programs. CONASIDA is a part of the federal level of the Secretariat of Health. Its main function is a normative one of coordination and counseling at a national level. Similar to most Latin American countries, Mexico has a segmented healthcare system. Mexico’s three-tiered healthcare system is based on the economic status of the populations served. Individuals who fall under the first tier — private sector — are those who have sufficient income to pay for the cost of their own healthcare. The second tier is public sector healthcare, otherwise known as Seguro Social, or “Social Security,” which provides to employed individuals within certain income brackets comprehensive healthcare services, albeit somewhat more limited than those which can be accessed by individuals in the private sector tier. The third tier includes low-income individuals who receive limited, federally subsidized healthcare. The medical care available to an HIV patient is determined by her or his ranking among the three tiers.

At the end of 1997, it was estimated that 55 percent of people living with AIDS in Mexico did not have social security.

In 1992 a guide was developed for the medical care of patients with HIV/AIDS; this guide has been updated at various times according to internationally-excepted treatment guidelines. This medical guide is evaluated by HIV/AIDS experts in Mexico and it has the approval of all institutions that make up the health sector.

As of 1996 the system was streamlined to allow internationally approved drugs to be rapidly approved and available in Mexico. The average approval time for new drugs was reduced from four years to two-to-four weeks. Currently most of the antiretroviral drugs are listed in the Medicines Catalog, which makes it compulsory for Social Security institutions to provide them free of charge. Parallel to this, four regional laboratories were installed which provide the special tests required for the attention and follow up of HIV/AIDS patients. These four regional laboratories are located in Mexico City, Guadalajara, Monterrey, and Villahermosa.

To ensure the appropriate care of persons who live with HIV/AIDS, various training courses were given to establish in each federal entity a specialized service for the attention of persons affected. Out of the 32 states, 19 already have a specialized service integrated to state health services.

In healthcare institutions for uninsured populations, persons with AIDS are provided with medical attention, consultations, laboratory, and medications for the prevention and treatment of opportunistic infections. However, no antiretroviral drugs are provided. The estimated cost of ideal ambulatory care, including triple combination therapy with protease inhibitors for 1997 is $10,197.50 (USD), with 86 percent of total cost represented by the expense on antiretrovirals7.

In Mexico, an alternative was proposed to increase availability of antiretroviral drugs for the population with neither Social Security nor independent financial resources. FONSIDA A.C.’s main purpose is fundraising for the purchase of antiretroviral drugs, with donations sought from all sectors of society.

The FONSIDA, A.C. project was presented on December 12, 1997, at the Health National Council, and was made official three days later when an incorporation deed was signed. The initial fund of $30 million was allocated by the Secretariat of Health; National Autonomous University of Mexico freely provides facilities, equipment, and personnel for project operation; Banamex grants an exemption of fees for the trust; Merck Foundation provided financing for the training of health personnel in charge of specialized services of integral care at the state level; and several specialized laboratories have donated medications. FONSIDA A.C. today provides free treatment to 100 percent of minors under age 18 who have neither Social Security nor other financial resources, as well as to HIV-infected pregnant women for the prevention of perinatal transmission and postpartum for their own treatment. The fundraising campaign has not yet started, but as more funds are obtained coverage is expected to increase8.

Mexico has 138 non-governmental organizations (NGOs), and organizations of persons who live with HIV/AIDS. Both have played a decisive role in meeting the challenges of HIV/AIDS since the epidemic began in Mexico; this is why CONASIDA maintains a strong connection and coordination with these organizations9.

CONASIDA’s main activities focus on the following areas:

• Prevention of HIV transmission — perinatally, through blood transfusions, injection drug use, and sexual transmission.
• Reduction of the impact of HIV on individuals, families, and society.
• Coordination of institutional, interinstitutional, territorial, and intersectorial programs.

CONASIDA’s main goals established for the year 2000 are to:

• Reduce by 50 percent the number of cases of children infected by HIV during pregnancy, delivery, or lactation.
• Reduce HIV transmission through blood transfusion to 0.1 percent.
• Reduce AIDS incidence rate to two percent.
• Increase the use of condoms by 30 percent.
• Provide timely and appropriate care to 80 percent of persons infected by HIV and other STDs.
• Eliminate all health sector violations of human rights of persons with HIV.

CONASIDA’s recent accomplishments include:

• Creation and/or enhancement of state programs for AIDS prevention and control through the decentralization of the Secretariat of Health. Since 1997 the federal entities with programs at the state level were increased by 72 percent.
• Gradual reduction of HIV transmission through blood transfusion since 1992.
• Implementation of an effective mass media HIV/AIDS educational campaign, with a budget increase of 78 percent from 1996 to 1997, 56 percent increase in impact (800,640 vs. 1,247,152), and continuous evaluation of same.
• Introduction of effective HIV/AIDS prevention programs for specific risk groups (migrants, homeless boys/girls, injection drug users, men who have sex with men, pregnant women, adolescents, female sex workers, and long distance drivers).
• Increase in distribution of printed HIV/AIDS educational materials by 157 percent (309,584 vs. 796,584).
• Introduction of a telephone HIV/AIDS educational program which receives an average of 700,000 calls per year and has a toll free service from the various federal entities.
• Coordination of activities with SEP — Public Education Department — (Military Service Guide, contents of text books, and joint evaluation of media plans).
• Increasing access to HIV tests in high-risk populations (during 1997 a total of 12,095 HIV tests were carried out in general population with risk practices, 22 percent more than in 1996, resulting in a seroprevalence of 7.65 percent and 2,413 HIV detection tests among sex workers with a seroprevalence of 0.24 percent).
• Improvement of dialogue and consultation with NGO’s and organizations of persons living with HIV/AIDS. (167 meetings with NGO’s and 191 with governmental organizations) .
• Increasing social participation by healthcare personnel in the VI AIDS National Congress (October 1997, more than 1,600 participants).
• Facilitating Mexico’s membership in the Government Council for AIDS World Program (UNAIDS) as of 1995.
• Facilitating Mexico’s membership in the Latin American Horizontal Technical Cooperation Group as of 1996.
• Facilitating the signing of the 1996 Trinational Agreement between Mexico, United States, and Canada to improve conditions of persons who live with HIV/AIDS.
• Reduction of bureaucratic redtape for the rapid approval of HIV/AIDS drug and diagnostic tests. From 1996 to 1997 final registry was granted to ten antiretroviral medications and seven of them have been included in the medications catalog. Final approval was granted for four viral load tests within one-to-two weeks of their application, as of 1996. In 1997 an evaluation was carried out by a national laboratory institute for recommendations for their use.
• Installation of four viral load regional laboratories. Funds were obtained to equip these laboratories (Federal District, Monterrey, Guadalajara, and Villahermosa), and to train the personnel selected in 1997. The first viral load laboratory of Secretariat of Health started work in August 1997.
• Development of new 1997 edition of “Guide for medical care of patients with HIV/AIDS infection in external consultation and hospitals,” and distribution of 30,000 copies.
• Development of “Integral Care Model” (persons responsible for AIDS specialized services) and distribution to 31 federal entities.
• Training of 1115 healthcare professionals in HIV/AIDS clinical management (712 in ordinary courses and 397 in special courses). In 1998 five regional courses are taking place for the integration of a specialized service for the integral care of persons with HIV/AIDS in all the states.
• Reduction in human rights violations in the healthcare sector through collaboration with the National Human Rights Commission (CNDH) and with the National Commission of Medical Arbitrage (CONAMED). Violations were reduced by 30 percent between 1994 and 1996, and by 81 percent between 1996 and 1997.
• Development of a “Procedures Guide for the Defense of Rights of Persons with HIV/AIDS” and updated revision of the Mexican Official Standard.
• Increasing access to antiretroviral drugs to all children under age 15 and all HIV-infected pregnant women without social security through FONSIDA A.C. Project.

In many countries there is little experience in horizontal cooperation orimplementation mechanisms to incorporate the participation of community in the planning and evaluation of health programs. In Mexico, as in other countries, AIDS is a public health challenge which has accelerated the process of learning to listen, incorporate, coordinate, and work jointly with various sectors of society, including civil organizations and representatives of persons affected by this epidemic.

It is undeniable that achieving an ample and efficient answer that reaches communities to which the various interventions are addressed, including native groups, migrants, prisoners, teenagers, women and men of the most remote communities, requires the support and active participation of community-based organizations. Likewise, it is indispensable to create regional and international networks of communication and interchange of experiences among all parties to potentiate the efforts each country carries out at a national level.

Patricia Uribe Zúñiga, MD is coordinator general of the National Council for Prevention and Control of AIDS (CONSAIDA). She is also conference chair of the Second International Conference on Healthcare Resource Allocation for HIV/AIDS and Other Life-Threatening Illnesses. Carlos Magis Rodríguez, MD, is deputy director for investigations at CONASIDA. Enrique Bravo García is chief of CONASIDA’s information systems department.

References

1. OPS. Vigilancia del SIDA en las Américas. Actualización al 10 de septiembre de 1997.
2. Magis-Rodríguez C, Bravo-García E., et al. “El SIDA en México: panorama en 1997”. SIDA ETS (México). Vol. 4, no. 3, nov/dic 1997.
3. CONASIDA Mexico Web Site, https://www.cenids.ssa.gob.mx/conasida
4. Magis-Rodríguez C, Bravo-García E., Anaya-López L, Uribe-Zú ñiga P. “La situación del SIDA en México a finales de 1998”. SIDA ETS (México). Vol. 5, no. 4, oct/dic 1998 (en prensa).
5. MEXICO. Secretaría de Salud. Decreto de creación del Consejo Nacional para la Prevención y Control del SIDA. Diario Oficial de la Federación. 24 de agosto de 1988.
6. CONASIDA. Programa de fortalecimiento para la Prevención y Control del VIH/SIDA y otras enfermedades de transmisión sexual. México, 1997.
7. Saavedra J. Magis C. et al. Costo y gastos en atención médica del SIDA en México. México: Secretaría de Salud, 1997 (Serie Angulos del SIDA) .
8. See details in https://www.cenids.ssa.gob.mx/conasida
9. See NGO’s catalog in https://www.cenids.ssa.gob.mx/conasida

(c)1998, Medical Publications Corporation

This article was provided by the International Association of Physicians in AIDS Care.

Posted by Diana on Abril 10, 2000

I’m an American attending med school in Mexico. While at a Halloween party last year, I struck up a conversation with a first year surgical resident (he works at an IMSS hospital here in Guad). After finding out that I used to work for an AIDS service organization in CA, his eyes got kinda wide, and he said, “Oh, we don’t have an AIDS problem here in Mexico.” Denial?

Posted by Dru on Abril 10, 2000

I suppose in an accident you would have no choice but to hope for the best. But, if you were having elective surgery, surely you could follow the practice in the States of “banking” your own blood prior to the surgery.

Posted by Andy in the Ozarks on Abril 10, 2000

The blood supplies in the U.S. and Canada are now about as safe as anywhere in the world. We still have people who “Dump” tainted or untested blood and compromised medical supplies on 3rd world countries. Being exposed to “Blood borne pathogens” is one of the major concerns of the emergency medical services in the U.S. HIV isn’t the only problem. You are much more likely to be exposed to Hepatitis B or C. Both very bad in their own right. In the end, I would be very concerned if I had to have major blood work done in a 3rd world country. All of our training involves protecting yourself from exposure and contamination as a provider, not as a patient. If you are strapped on a back board it is a little hard to be pro-active about protecting yourself. My advice, be careful. If I were intent on participating in some “Extreme Sports” like they hype on the TV now, I’d do it close to home. Don’t get me going on these idiots that have to exercise their right to be stupid and jump off of a cliff face using a bed sheet as a parachute, and then they call us to rescue their butt when they get in trouble.

Posted by Andy in Dallas on Abril 10, 2000

I decided to spend a few minutes on a search to see if I could quickly disprove the notion that medical treatment in Mexico had problems with AIDS. I was unable to do so. I am surprised. And will continue to try to learn more of this. Lots of info is available, and none that I have quickly looked over was encouraging. Here is a website in which the tone of the articles suggests that it may well be a problem in Mexico. https://www.freerepublic.com/forum/a36c100260870.htm#article1 Andy

Posted by Bill on Abril 10, 2000

The Mexican Cruz Roja (Red Cross) coordinates the blood supplies in the country. Personally, I don’t trust the blood supply to be completely reliable. However, many Mexicans receive transfusions and I’m not aware of any alarming rate of HIV being passed along. Refraining from any activities negates the purpose of your vacationing, or enjoying leisure activities while living in Mexico. Motor scooters are not a major means of transportation in Mexico, based on my observations. One of the big secrets (for foreigners) about Mexico is that there is a very high rate of bisexuality among men. And, visits by men to prostitutes (especially in the major metropolitan centers) are frequent. For these, and other reasons, HIV has spread in Mexico like it is spreading in other countries.

Young people in Mexico are sexually active at an earlier age than are young people in the U.S. or Canada, I’ve observed. The machismo influence stands in the way of many men from using condoms. I do not think that the HIV rate in Mexico for young people is the highest in the world. I do think, however, that the HIV explosion has not yet hit Mexico; it’s a ticking time bomb. AIDS patients in Mexico do not have the same opportunities as their neighbors in the U.S. and Canada have when it comes to new therapies and drug regimes. Treatment is very expensive, and most of the patients rely upon government assistance for medications and care. The Mexican government does not have adequate resources to fund the level of care as do many developing nations. Mexico has, however, talked more openly about HIV and how to avoid it than has the government in the U.S. Being such a heavily Roman Catholic country, many people have been surprised by the openness of the discussion in schools and in public advertising. As for the blood supply, again, many of the wealthy people have stockpiled blood supplies in case of emergency. Most people, however, aren’t that fortunate and don’t have the financial resources, or education, to do so. Remember that the problem in the U.S. and some other developed nations with blood supplies came to pass because of policies in those countries that solicited donors from the highest of risk groups–alcoholics and drug users. The system of blood donations in Mexico is different. The only caution I would take is, if possible, to be taken to the best medical facility available, which may reduce any risk of blood contamination. I travel the back roads of Mexico extensively, and am not afraid to do so. Enjoy your visits to Mexico!

Posted by geri on Abril 10, 2000

I can only talk from personal experience. I have a blood condition that necessitates that I have blood drawn at least every six months. Although, my condition cannot be passed from me to the recipient, the rules in the U.S. preclude the use of my blood, hence I have to pay $47 to get my blood drawn or lie, as some doctors in U.S. suggest I should do. Here in Oaxaca, the local blood bank owner is wonderful and very interested in my case (he has attended seminars on it). He is NOT allowed under Mexico law to either pay for blood or to charge me for extracting mine. He is muy amable and draws out my blood, as needed. He said, based on his information, that he would use my blood only in an emergency. He agrees with comments here, that most donors in Mexico are family and that “giving blood” is not a common philanthropic pastime. I would suggest that, if you need blood in Mexico, get it from a reputable blood bank, if possible. The Red Cross here had not heard of my condition. geri in Oaxaca

MEXICO AND DIABETES

Posted by Danny Lineham on Marzo 28, 2000

Any diabetics living in Mexico on the forum? In anticipation, a couple of questions: How is the availability of Glucophage (metformin hydrochloride), and what is the approximate cost? Same questions for test strips for an Advantage or Advantage II glucometer. TIA, Danny

Posted by harris gottlieb on Marzo 28, 2000

i don’t live in mexico yet but on my previous trips to lake chapala and mazatlan i’ve checked out the availability of glucophage and glyburide and it’s there and Definitely cheaper than the states. someone else will have to answer the question about the strips but almost everything you can get for diabetes in the states you can get in mexico and it’s much cheaper.

Posted by Danny Lineham on Marzo 29, 2000

Thanks for that info . . . I’m still hoping someone in Mexico can give me an approximate price on things. I assumed they would be cheaper than in the States, but I’m living in New Zealand at the moment, where I pay only a $15 dispensing fee for 3 months of Glucophage and get my test strips virtually free from the Diabetes Society. I’m sure Mexico will be more expensive than that — I’m just trying to get a handle on how much more it’s going to cost me. I heard a figure (on a TV show) of $100 a month for Glucophage in the States . . . is that about right? Danny

Posted by David Eidell on Marzo 31, 2000

Glyburide is available as a generic medicine and costs about 15 cents US per 5 mg. tablet. Glucophage is not available as a generic and costs thirty-nine cents per tablet. Test Strips are costly. Figure something on the order of eighty cents U.S. per strip. On the open market test strips seem to be least expensive in the USA at membership warehouses (Wal-Mart and Costco). There they cost thirty-eight dollars per 100 strips. There are a large number of diabetics in Mexico as compared to the United States. Native Americans seem to be afflicted to a greater degree than Caucasians, although many of these cases are Type I insulin dependant.

David

CHIROPRACTORS IN MEXICO

Posted by Rick A. on March 31, 2000

Are there any? Do they have educational/licensing requirements? Anybody with experiences with Mexican chiropractic?

Posted by Diana on March 31, 2000

I go to one in Guad. He’s Mexican, was educated in Iowa (Palmer Chiro College, I think the name is), and has been practicing many years here. He’s much different than my guy in the States — different schools, different techniques, different ages (which probably also has a lot to do with technique). He told me there are two or three others here in Guad. They don’t have chiro schools here in Mexico, to my knowledge. My chiro did have to be approved to practice in Mexico by some governmental body…

Posted by Warren in Ajijic on March 31, 2000

…one here in Ajijic with whom my wife was consulting. I indicated to him that I was “not a believer in Chiropractic” (although my wife is) whereupon we were both thrown from his office. Not the most professional of behavior and one which tends to confirm my personal beliefs.

Posted by Warren in Ajijic on March 31, 2000

…that the “doctor” was an expatriate.

MED EVAC POLICIES

Posted by D Cretcher on Abril 16, 2000

What are the best med evac policies for people living (rather than visiting) in Mexico? We want the kind that actually pays to ship you out, as opposed to those that just help you make arrangements.

Posted by Braulio in Mexicali on Abril 18, 2000

I carry Med Jet International and wouldn’t travel without it. Time is critical in receiving medical attention. The decision to return to one’s own country or city is a personal one. What might be considered “adequate” to one person might be “substandard” to another. The quality of medical care in Mexico goes down rapidly as you move away from one of the 6 or 8 major metropolitan centers. To each his or her own. Best regards – Braulio

Posted by Carole on Abril 16, 2000

We have one from Medjet International which, though we’ve not ever used it, seems to be a good one. Their website is www.medjet.com.

Posted by Gary on Mayo 26, 2000

I see people talking about “MedJet” and I am wondering if there is some kind of insurance policy available for emergency medical transport to the states? If anyone has any info on this it will be very much appreciated.

Posted by Jimena on Junio 02, 2000

Lewis & Lewis have Med Tet – they charge $50.00 a year. Sorry, since I am in the process of moving to Chapala, I can’t find their number. I found that their car insurance was the most reasonable. Good luck. Jimena

Posted by Braulio on Mayo 29, 2000

Gary –
You might check out https://www.medjetassistance.com/. Their plan costs $150 for individuals and $225 for families per year. At the time I investigated (several years ago) they seemed to be the best, but things might have changed by now. I recently renewed my AAA coverage in the U.S. I noticed that their “Plus” plan includes emergency medical transportation coverage in the U.S. and abroad. To be eligible for the Plus plan you have to have been a member for a year. It costs $83 a year but of course you get a lot of other AAA services along with it. They didn’t include a lot of details in the brochure but it might be worth checking out. Good Luck – hope you never need it. Braulio

Posted by David Eidell on Mayo 27, 2000

I punched in “Careflight” and sure enough they have a web site. There are several others, but this should get you started. Care Flight International, www.careflight.org

ASSISTED LIVING/NURSING HOME FACILITIES IN MEXICO

Posted by Steven Ogella on Junio 23, 2000

Is anyone aware of a website which lists nursing home facilities available to nationals AND non-nationals with high custodial care needs in Sonora, Jalisco and Tamaulipas (or other areas with a large population of U.S. expatriates? I am interested in both private and public facilities…thanks.

Posted by James Miller on Junio 23, 2000

In Chapala, State of Jalisco, an American, Shirley Beverly, runs a wonderful home. Last time I heard, costs are about $1200 US but this is much better than stateside. We lived there for a number of years. There are also other ones, but I do not know of a website for them.

Posted by RickS on Junio 23, 2000

La Casa Nostra (in Chapala) = https://mexico-assisted-living.com/

Posted by Peggy S on Junio 25, 2000

Many thanks, this is just what I have been looking for. I have heard so many great things about this facility and Mr. Beverly Ward, the administrator. Thanks for the website!!

Posted by al smith on Septiembre 06, 2000

I posted a similar query on the Ajijic board and appropriately got Chapala-specific answers. I’d be interested in comments regarding the referenced topic in other areas of Mexico, i.e., is it better to retire to Mexico, but plan to return to the US/Canada, if assisted living or worse is required, or are there good facilities in Mexico? Thanks, Al Smith

Posted by Rick on Septiembre 17, 2000

Actually, you might want to contact The Melville, which is a beautiful retirement community in Mazatlan that offers independent or assisted-living services. The apartments are very nice and even though they each have cooking facilities, The Melville provides two meals a day. You can check out their web page at https://www.themelville.com Regards, Rick

Posted by Michael Kenneth Evans on Junio 10, 2000

Sir/Madam,
Could you give me information on any government agencies that help people with disabilities? I have heard of EL DIF but would like to know exactly what areas it covers and if there are Independent Living Centers in Mexico. Thank You.
Sincerely,
Michael Evans