MEXICO.- Sitting in a small office just under two square meters the Topilejo neighborhood of Mexico City, Vladimir Román, a general practitioner who works for a private pharmacy, received hundreds – maybe thousands – of patients suffering from COVID-19 in front of a small table and a shaky bench.
The conditions for which he worked in the last years of his life were so precarious that it is impossible to disinfect the space between each patient. And finally he was infected.
He survived by the miracle of nature, because he is 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 improve 10 million daily consultations to private medicine and even so the president doesn’t want to vaccinate us … Because of the hours! ”.
Since January this year, private doctors have unsuccessfully asked the government to include them in vaccination as extremely vulnerable staff.
even 76,000 of these medical agents provide general medical services daily in small clinics located near pharmacies, in neighborhoods and popular settlements or in medical buildings. In the country, 43% of medical consultations are performed in private clinics; of these, 17% are outpatient cases.
First aid for patients with symptoms COVID They went there to find these doctors who received them without objection, despite the risks and disagreement they have had for decades because of what they consider unfair competition from some pharmacy chains that have reduced consultation with 90%.
In the late 1990s, a medical consultation in private practices cost between 50 and 80 pesos. Then came a company called Similar pharmacies which began to provide medical services for 10 pesos. “In this way, he bankrupted all general practitioners, because the Government did not regulate unfair competition, because he saw that it was convenient for him: that alternative system and parallel to the health sector eliminates 10 million queries per month”.
Cheap consultations in the private sector are obtained due to the low salaries paid to doctors employed as independent professionals.
Their only gain is the consultation of two dollars and they do not retire. Vladimir Román says that he has colleagues in such difficult working conditions that he would soon be surprised if they beg on the street. “Many were pious and died“, He says.
Vladimir Roman contracted the disease in February last year. He stayed in bed for three weeks and they were about to intubate him. They placed a high-flow tower with 80% pure oxygen. Then they released him, with nothing else. It is not antifibrotic, without steroids or antigulants and could be complicated by sequelae without any protection.
Dr. Vladimir Roman calculates that if he dies, his wife stays on the street because she has nothing.a, he failed 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 show us that we are privileged if we are not? Why don’t you say we charge 40 pesos per consultation? “Private medicine” sounds very good, but private medicine in Mexico is as bad or worse than public medicine with this system of pharmacies; the doctors in the big hospitals who could earn a lot are few and even so, they can’t buy the vaccine ”.
Since vaccination began in Mexico, the federal government has centralized the application scheme and made a timeline based on people’s vulnerability. First there were the doctors of the public hospitals and clinics, then the elderly, then the teachers and later in a countdown, the Mexicans of 50, 40, 30 …
Thus, health professionals who do not work as part of the state health system have been left in a kind of language that generates more disagreements every day. At this moment, the battle is due to the fact that the vaccines are administered on an equal footing with the teachers, a stage that began these days.
Protest
chairman Andrés Manuel López Obrador He warned that private doctors will not be vaccinated because they are not yet eligible, according to the list of priorities. He described the statement as unfair and said it was a manipulation campaign to confront the government with members of the private health sector.
“I’m not against them, but it’s not fair to say ‘you’re vaccinating me,'” the president said. “No. If it doesn’t suit you, no,” he reprimanded at a press conference at the National Palace.
The president’s response came after various demonstrations by doctors who did everything possible to draw attention to his situation to the authorities.
On Tijuanafor example, they were stationed near the San Ysidro checkpoint to attract 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 with them and they will be vaccinated shortly, a decision that displeased the president.
If there is an amparo and a judge orders us: “let us vaccinate this person”, we must vaccinate him, because we must respect the law. But I say to that person: Is that right? Is it a legal issue? Don’t you think it’s a moral issue? Why do we go to temples? Why do we go to church? Are we taking communion? Why do we confess if we do not act with integrity, if we want to be the first? He asked in one of the morning conferences.
In an effort to reconcile with the government, some unions of doctors who remain unvaccinated, such as dentists, have proposed paying out-of-pocket vaccines to the state, an idea that has been flatly rejected.
“Of of the Mexican Dental Association and the National Council of Dental Surgeons We also proposed to do a social service as volunteers in the pandemic in exchange for immunization and the answer was no, “he warns Mayra Torres, dentist and dentist at the Pediatric Care Clinic.
As a dentist, Mayra Torres works every day with the most contagious element of COVID-19: saliva. Through microdroplets, the coronavirus can be transmitted when you talk, sneeze or cough. In addition, attachments for cleaning or fixing teeth and molars generate scattering and this is what is impregnated in the environment of the dental office, on clothing, on furniture.
“We are more than exposed: there is a very high risk of contracting the virus.”
Mayra Torres knows of several fellow dentists who have died. She was not infected because she is extremely safe because of her husband’s high risk of illness. Every day, when he enters his office, he wears surgical pajamas, glasses, a double mask, a mask, a hat, a double glove and a disposable shoe.
Subsequently, between patient and patient, they must sanitize, clean, disinfect and ventilate the area for at least one hour with the window and door open, as the World Health Organization prohibits them from using air conditioning or fans.
The risk of infection is also very high, as Mayra Torres works with children who may have asymptomatic images and could cause a cross-infection. In short: that the coronavirus is coming out of the office.
Mexico has had delays with the vaccination schedule despite the fact that the government has announced the purchase of millions of doses. The delay in some laboratories has meant that, in some cases, the placement of the second dose is still pending.
In some states, it has not been possible to stop vaccinating even doctors in public hospitals. In the Tehuantepec Isthmus, Oaxaca, there was a work stoppage of medical staff in jurisdiction 2 to request the vaccination of nearly 800 administrative staff and doctors of health centers, who were told that the vaccine does not correspond to them because they are not the first line .
So far, state and municipal governments have not been able to buy the vaccine, which is why they have failed to help vaccinate private doctors, unless there are still doses that the population refuses to apply: Mexico also has , a broad anti-vaccine movement. .
On MichoacanThe statements of doctors, nurses, dentists, nutritionists, chemists, private radiologists were heard and, after a meeting with federal and state authorities, it was agreed that they will be vaccinated depending on the availability of biological. The official number of immunized by this agreement is not yet known.
Doctors or teachers?
The open demand for private doctors to be vaccinated coincides with the announcement of the mass vaccination of public school teachers in order to reopen education and this has generated resentment in the private medical union.
Leobardo Castro, who runs a private clinic in Mexico, complained of insensitivity by the authorities when they make the decision to immunize the teachers’ union by circumventing their demands.
“It is very sad to see that there are retirees, the elderly, teachers, professionals who are not on the front line and are already vaccinated against COVID and one who works privately and is at risk, we are not.”
Mexico will begin the vaccination process for teachers next week of public and private schools with the CanSino vaccine in five states where the level of infections is lower and will continue with the rest of the entities progressively throughout May, so that all students can return to face-to-face classes before finishing school in July.
Campeche (in the Gulf of Mexico) was the first state to vaccinate its teachers a few months ago and will be the first to return to class starting next week, exactly when immunization begins 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 steps to return to school. Mexico is the Latin American country where schools have been closed for the longest time due to the pandemic, and the agency has warned that the closure of schools will intensify the learning crisis that the country was already suffering before the health situation.
‘„The 2018 results of test plan shows that 80% of primary school students have not achieved the expected knowledge in math, reading and writing, he detailed.
In August last year, the Ministry of Public Education reported that there were no conditions for students to return to school due to the pandemic, so it decided that the school year to hold distance learning classes with agreements with Televisa, Grupo Multimedios and Grupo Imagen to disseminate the school content prepared by the institution with the help of teachers.
The vaccine will speed up the face-to-face return to classes, But it will not be enough, some teachers note. Diana Laura Vela, a teacher at an elementary school in Aguascalientes, says schools do not have the necessary hygiene materials, such as cleaning products for sanitation or healthy distance conditions in classrooms.
“Due to the absence of students, it has also caused schools to be vandalized and many have to be declared as total irreparable losses due to infrastructure damage.”
On the other hand, the lack of technological means to maintain distance communication with teachers has led many children to give up. “In my case, I lost contact with 30% of my students.”
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