STEAMBOAT SPRINGS, Colorado — Mexicans have access to universal health coverage, yet the system’s disparities prove access and quality issues for most, particularly in rural, remote regions. Barriers to healthcare for rural communities are the result of a lack of resources, funding and health care professionals.
Partners in Health is a “social justice organization that responds to the moral imperative to provide high-quality health care globally to those who need it most.” The organization collaborates in 11 countries across four continents, providing care that extends beyond the medical and addresses the whole patient. Based in settings of poverty, it works to provide modern medical science to the most vulnerable populations, ultimately serving as an antidote to despair.
The Borgen Project spoke to Partners in Health’s Community Physician in Mexico, Dr. Javier Guarin, and former volunteer, Jack Strotbeck, to learn how the organization works with local communities, changing the global health landscape for poor populations.
The Beginning: Paul Farmer’s Story
Paul Farmer, a world-renowned doctor and global health visionary, founded Partners in Health in 1987 after visiting Haiti and witnessing the needs of those plunged into poverty neglected by health care systems globally. Since then, the organization has continued pushing the boundaries of global health, innovating and strengthening health care systems and serving millions of patients.
Farmer installed a lasting legacy that empowers the power of partnerships. Creating long-lasting, honest relationships with the people who know their communities, giving them resources and confidence to innovate and strengthen healthcare systems that can withstand the complexity of threats that poor communities face. This is especially prominent in conversations of communities in clinical deserts that now benefit from improved academia that has changed how doctors, nurses, researchers, operations and administrative students are educated.
Former Partners in Health Mexico volunteer, Jack Strotbeck, marks his decision to join the organization as “in a world with the resources that we have, no one should have to live like a lot of the world does. I connected with that, if you are a capable person, you ought to be doing it for the people that need it. I think that on the surface, everyone would agree with that, but in practice, and especially in medicine, it does not always go that way.”
Theory of Change: The Five “S”s
The five “S”s translate the keys to strengthening and building sustainable health systems: staff, stuff, space, systems and social support. Partners in Health stands on the pillar belief of accompaniment, prioritizing that health care is a human right. In establishing relationships with community members, local health authorities and global health advocates, the organization navigates and invests in local health systems. In the role of community physician, Dr. Javier Guarin says, “Our job is to re-establish the right to health for all in a dignified and inclusive manner, through a complete clinical team, with special and commonly used medications. All of us who collaborate in Compañeros En Salud, try to give dignified, equal and quality treatment to all the people we care for, which implies respect for the sense of community.”
Through employing integrated, comprehensive practices, the organization accompanies patients and communities in solidarity through times of struggle and triumph. Strotbeck explains, “Partners in Health fertilizes existing health structures because that is sustainable. They want to work with what is there. Accompaniment is the big principle, we will walk with you, we will work with you until you do not need us.” Considering health care as a multifaceted network, current and future leaders apply accompaniment methods, bridging gaps between communities, clinics and policies.
Compañeros En Salud
Since 2011, Partners in Health Mexico (locally known as Compañeros En Salud) has worked in the Sierra Madre region of Chiapas, “one of the most marginalized states” in Mexico where poverty strikes more than half the population. Due to its geographic isolation, economic and educational growth are stunted as resources and pay are limited. Before Partners in Health Mexico, Chiapas residents lacked reliable and available health care, having to go far distances to reach a clinic that often could not guarantee care or supplies.
In response, Partners in Health staffs and supports nine primary care clinics, a birthing center and a community hospital, passioning long-lasting engagement with local communities to fulfill the needs of residents adequately. Additionally, it establishes five prominent programs for Chiapas communities: Pasantes, the Maternal Home, Community Health Workers, Complex Care and Mental Health.
Pasantes and Community Health Workers
The pasantes program stands as a pivotal initiative of Partners in Health Mexico. As part of Mexico’s higher education requirements, health care service graduates must complete one year of social service. PIH is a participating healthcare organization offering first-year doctors and obstetric nurses a space to gain valuable professional, applicable experience. The pasantes receive mentorship and training alongside Partners in Health professionals and experts, reaching new heights of impact. The program trains around 25 first-year clinicians annually. In return, this program recruits the next generation of Mexican health care workers, furthering the impact and reach of the organization in Mexico.
Additionally, its community health worker program, locally named acompañantes, works to extend and ensure patient care through the reach of local residents. Every month, community health workers complete more than 500 home visits, charging forward not only health care but also mental and social services and educational campaigns that empower community members to take charge of their own health.
Among maternal mortality rates in Mexico, Chiapas ranks among the highest. Because of strained access to hospitals, complications induced at birth threaten the lives of mothers and newborns. In partnership with the Ministry of Health, PIH opened Casa Materna, providing prenatal care, lactation advice, and a space for new mothers to stay before and after their pregnancies. At a close distance to the PIH-supported hospital, additional expert medical support is readily available in the case of complications, as well as the support of traditional midwives according to the patient’s preference. At Casa Materna, their support averages care for around 100 expectant mothers every month and 20 healthy deliveries.
In April 2023, PIH Mexico extended its model, introducing a second Casa Materna in the municipality of Siltepec. This new addition develops the safety of women’s health in rural communities, providing greater service to those in need.
Complex Care and Mental Health
From providing financial support to scheduling appointments to companionship, Partners in Health Mexico responds to patient’s needs, approaching care with integrity. Realizing that some patients may require far-away care enacts its resources and mission to enable health systems to respond and react. Dr. Guarin notes the importance of these initiatives in rural communities, “Partners in Health is breaking the geographical barrier and the difficulty of access to the most remote communities to restore their right to health through medical brigades.”
PIH staff deliver mental health as another category, accommodating house calls, mental health in primary care settings, education, referrals and treatment, such as psychotherapeutic intervention. Community health workers and pasantes participate in training sessions focused on the most effective clinical methods for diagnosing and treating mental health issues.
Since its inception, Partners in Health Mexico has accomplished quality healthcare for rural Chiapas communities. Parallel to Paul Farmer’s global health pursuit, the needs of local people are approached through collaborative practices that strengthen health systems, establishing sustainable care for the world’s vulnerable. Farmer and all of the Partners in Health staff, volunteers and partners principle the narrative of the human fundamental right to health. This philosophy has pioneered global health systems that treat the whole patient, prescribing not just medicine but viable solutions to building and maintaining resilient health care frameworks.
– Emmalyn Meyer