Powering Public Health

I received a briefing from Jaime Naves, Director of Planning for the Zacatecas health department. Through a great deal of effort and the efficient use of resources, Zacatecas is outperforming many national norms on a variety of measures.  One of the reasons for this is the accessibility of care at community clinics.  I visited one of these clinics, and even though this clinic was a Level 1 clinic (basic services only), it still had two general exam rooms, a gynecological exam room, and a dental suite.  In keeping with the countrywide zeitgeist, the name of the game at this clinic is prevention.  A premium is put on vaccinations, and multiple times a week there are exercise classes and workshops on healthy living including, to my surprise, a robust discussion around reproductive health and family planning. The lead nurse will also go outside the clinic to schools and teach age-appropriate disease prevention techniques.  She also get kids to sign up as promotores (health promoters).  Those that do get more extensive training at the clinic, empowering them to help their peers (and their families) to adopt healthier lifestyles.

                             With Jaime Naves (center) and Marisol Marroquín of Hospital ABC

I also visited Zacatecas General Hospital.  Here ones adds efficiency and maximum use of resources to the emphasis on prevention. The most obvious facet of this effort is the telemedicine center linking five regional hospitals.  Through this system, specialists at one hospital can consult with internists at another.  A med-bot that looks like something out of a Hollywood movie is the main tool.  It wheels its way to the appropriate exam room and its "head" is a screen with the face of the doctor at the telemedicine center in Zacatecas.  As circumstances dictate, the face changes to an x-ray, a lab result, or any other document or image from the patient's e-chart. If the specialist is not available at the hospital, there is a mobile app from which they can connect through their mobile device anywhere there is wifi.

I can't help but be impressed at the Mexican commitment to prevention.  Everywhere I turn, there is a program, an activity, or an advertisement for healthy living.  Even at my hotel, there is a sign at the buffet line suggesting that my best choice is the fruits and vegetables.  I didn't heed that sign very well, but I did climb an enormous number of steep steps to get to a local museum. And given that the elevation here in the heart of Zacatecas is 8,200 feet, that has to count for something.