MEXICO.- Sitting in a small office of just under two square meters the Topilejo neighborhood in Mexico City, Vladimir Román, a general practitioner who works for a private pharmacy, received hundreds – perhaps thousands – of patients suffering from it COVID-19 for a table and a rickety sofa.
The conditions for which he worked in the last years of his life were so precarious that disinfection of the space between each patient is impossible. And in the end it was infected.
He survived by a miracle of nature, because he’s strong, but not because of their working conditions with a salary of two dollars per consultation, without social benefits or health insurance.
“They have us in trouble despite the fact that we relieve 10 million daily consultations to private medicine and yet the president doesn’t want to vaccinate us … Because of class! ”.
Since January of this year, private doctors have unsuccessfully requested the government to be involved in the vaccination as highly vulnerable personnel
At least 76,000 of these health workers provide general medical services daily in small clinics next to pharmacies, in popular neighborhoods and colonies or in medical buildings. In the country, 43% of medical consultations are performed in private clinics; 17% of them represent outpatient cases.
The primary concern for patients with symptoms COVID They went there to find these doctors who received them without objection, despite the risks and disagreements they have carried on for decades due to what they consider unfair competition from some pharmacy chains that have cut consultations by 90%.
In the late 90’s, a medical consultation in private offices cost between 50 and 80 pesos. Then a company appeared that bears the name of Similar pharmacies that started with offering medical services for 10 pesos. “In this way, it caused all GPs to go out of business because the government failed to regulate unfair competition because they saw it was right for her: that alternative system and parallel to the health sector. removes 10 million searches per month”.
Low-cost consultations from that private sector are achieved thanks to the low wages paid to doctors hired as freelancers.
Their only advantage is the two dollar consultation and they don’t earn seniority. Vladimir Román says he has colleagues in such difficult working conditions that he wouldn’t be surprised if they beg on the street any time soon. “Many have had covid and passed away“, He says.
Vladimir Román contracted the disease last February. He was bedridden for three weeks and they were about to intubate him. They installed a high-flow tower with 80% pure oxygen. Then they released him without anything else. It is not antifibrotic, without steroids or antigulants, and it can be complicated by the consequences without any protection.
Dr. Vladimir Roman calculates that if he dies, his wife will stay on the street because she has nothing.a, he hasn’t been able to save, he has no social or life insurance and now he can’t even feel protected when he returns to the office because they don’t want to give him the vaccine.
Why does the president make us look privileged if we aren’t? Why don’t you say we charge 40 pesos per consultation? “Private Medicine” sounds very nice, but private medicine in Mexico is just as bad or in worse shape than public medicine with this pharmacy schedule; there are few doctors in the big hospitals who can earn a lot and yet they cannot buy the vaccine ”.
Since vaccination began in Mexico, the federal government has centralized the application process and established a calendar based on the vulnerability of the people. First, the doctors of public hospitals and clinics, then the elderly, then the teachers, and later in a countdown, the Mexicans of 50, 40, 30 …
Thus, health workers who do not work as part of the state health system were left in a kind of limbo that leads to more disagreements every day. Right now, the battle because they are getting the vaccines is on par with the teachers, a phase that started in these days.
Protest
President Andrés Manuel López Obrador He warned that private doctors will not be vaccinated because they are not yet eligible according to the priority list. He described the allegation as unfair and affirmed that it is a manipulation campaign to confront the government with members of the private health sector.
“It’s not that I’m against them, it’s that it’s not fair to want to say ‘you are vaccinating me,'” the president said. “Not. If it doesn’t agree with you, no,” he reproached at a press conference at the National Palace.
The president’s response came after several demonstrations by doctors who did everything they could to bring his situation to the attention of the authorities.
On TijuanaFor example, they were stationed near the San Ysidro checkpoint to get the attention of the American press. There are several sit-ins in Mexico City, and a group of 15 doctors recently filed a legal appeal with a judge to force the state to vaccinate them. The judge agreed and they will be vaccinated shortly, a decision that displeased the president.
“If there is an amparo and a judge orders us to ‘vaccinate this person’, then we have to vaccinate him, because we have to obey the law. But I say to that person: is it fair? Is it a legal matter? Don’t you think it’s a moral issue? Why do we go to temples? Why do we go to churches? Are we taking the sacrament? confess when we don’t act with integrity, when we want to be first? He asked during one of the morning conferences.
In an effort to reconcile with the government, some unions of unvaccinated doctors, such as dentists, have proposed paying the state out of pocket for their vaccines, an idea that was flatly rejected.
“Through of the Mexican Dental Association and the National Board of Oral Surgeons We have also suggested volunteering to provide social services during the pandemic in exchange for immunization and the answer was no, ”he warns Mayra Torres, dentist and stomatologist in the Pediatric Assistance Clinic.
As a dentist Mayra Torres works with the most contagious element of COVID-19 every day: saliva. The coronavirus can be transmitted via microguticles when you speak, sneeze or cough. In addition, the attachments for cleaning or fixing teeth generate scattering and this is what is impregnated in the environment of the dental office, on clothing, on furniture.
“We are more than exposed: it is a very high risk of contracting the virus.”
Mayra Torres knows several fellow dentists who have passed away. She is not infected because she is extreme in her safety due to her husband’s high risk of illness. On entering his office, he puts on a daily pair of operating pajamas, safety glasses, a double mask, a mask, a hat, a double glove and a disposable shoe.
Then, between patient and patient, they must sanitize, clean, disinfect and ventilate the room for at least one hour with the window and door open, as they are prohibited by the World Health Organization from using air conditioning or fans.
The risk of infection is also very high because Mayra Torres works with children who may have asymptomatic images and cause cross-infection. In short: that the corona virus is out the door.
Mexico has been delayed in the vaccination schedule despite the government’s announcement of acquiring millions of doses. The delay in some laboratories has meant that in some cases placement of the second dose is still pending.
In some states, it was not possible to even vaccinate doctors in public hospitals. In the isthmus of Tehuantepec, Oaxaca, there was a work stoppage of jurisdiction 2 health personnel to demand the vaccination of nearly 800 administrative staff and health center doctors, who were told the vaccine does not match them because they are not frontline.
Until now, state and municipal governments cannot buy the vaccine, so they have not been able to help vaccinate private doctors, unless they have doses left that the population refuses to use: Mexico also has a widespread anti-vaccination movement.
On MichoacanAllegations made by doctors, nurses, dentists, nutritionists, chemists and private radiologists were heard, and after a meeting with federal and state authorities, it was agreed that they would be vaccinated depending on the availability of the biologics. So far, the official figure of how many have been immunized by this agreement is not known.
Doctors or teachers?
The public demand from private doctors to be vaccinated coincides with the announcement of the massive vaccination of teachers in public schools with a view to reopening education, and this has sparked resentment in the private medical union.
Leobardo Castro, who runs a private clinic in the state of Mexico, complained about the lack of sensitivity by the authorities in making the decision to immunize the teachers’ union, circumventing their demands.
“It is very sad to see that there are retirees, the elderly, teachers, professionals who are not on the front lines and already vaccinated against COVID, and someone who works privately and is at risk, we are not.”
Mexico will begin the teacher vaccination process next week of public and private CanSino vaccine centers in five states where infection rates are lower and which will progressively continue with the rest of the entities in May with the goal of allowing all students to return to face-to-face classes before completing school year in July.
Campeche (in the Gulf of Mexico) was the first state to vaccinate its teachers months ago and they will be the first to return to class starting next week, just when immunization will begin in Veracruz, Chiapas, Nayarit, Coahuila and Tamaulipas.
The country has received a lot of pressure from the United Nations Children’s Fund (UNICEF) to take the necessary measures leading to a return to school. Mexico is the country in Latin America where schools have been closed the longest as a result of the pandemic, and the agency warned that closing education centers would amplify the learning crisis the country was suffering from before the health crisis.
“The 2018 results of the test plan show that 80% of primary school students did not achieve the expected knowledge in math, reading and writing, he explained.
Last August, the Ministry of Public Education reported that there were no conditions for students to return to schools due to the pandemic, so it decided the school year would keep distance classes with agreements with Televisa, Grupo Multimedios and Grupo Imagen to broadcast the school content prepared by the institution with the help of the teachers.
The vaccine will accelerate the face-to-face return to classes, But it won’t be enough, some teachers note. Diana Laura Vela, a professor at a primary school in Aguascalientes, says the schools do not have the necessary hygiene materials, such as cleaning products for sanitation or the conditions of a healthy distance in the classrooms.
“The absence of students has also resulted in schools being destroyed and many should be classified as irreparable aggregate losses from damage to infrastructure.”
On the other hand, the lack of technological means to communicate with teachers remotely caused many children to drop out. “In my case I lost contact with 30% of my students.”
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