The newly renovated hospital stands 3 stories tall, a stark contrast to the run-down burrito shack next door. It is in Juarez, only about a hundred yards from the US-Mexico border and it almost looks out of place. There are people loitering next to the hospital and street vendors attempting to sell a pack of chips or a stick of gum.
Juarez was known for being dangerous and was sometimes referred to as “the murder capital of Mexico.” That’s all I really knew about this city before I came here for my first international clerkship. The hospital director assured me that was a few years ago and that now it was much safer. I’ve been here 3 weeks and I have a very different idea of Juarez than when I first came here. Despite the language barrier, the people are extremely nice and I have felt quite safe; safe enough to walk around town on my own (although, I was told not to walk alone in the dark).
The hospital is a NGO that gets a lot of referrals from the government owned women’s hospital in the city. Although the hospital was recently renovated it is evident that it runs on donations and grants. Much of the equipment is old and has stickers stating the institution it once belonged to before it was donated. If something can be reused, they will reuse it. The 4 bed ER has a pantry with a box of only large gloves, some gauze, sterilized tweezers and scissors in a metal bin with some sort of sterile solution, and thermometers in a cracked cylindrical container kept sterile with antiseptic solution.The delivery room and OR seems oddly empty, even with all the equipment necessary for the procedures done here. They use the print function on the ultrasound machine because there are not enough computers to view the images. The only place in the hospital using EMR is the ER and some doctors still use a typewriter for their notes.
The majority of the patients are poor and can only afford treatment because of social health insurance provided by the government. Still, patients have to pay for paracetamol suppositories out of pocket at the pharmacy because the hospital does not stock them. X-rays are only done if absolutely necessary and optional for people who can pay out of pocket. Often, patients do not seek treatment until the disease has run its course. There were a few patients with severe diabetic feet who sought treatment after their toes had become necrotic.
Despite the lack of equipment and technology, the doctors here are very knowledgable and dedicated to their patients. Despite the language barrier, they have been very helpful and taught me how medicine works in Juarez. Thank you!