In recent days, the President of Mexico made various statements related to health workers. On the one hand, he mentioned that there is a lack of specialist doctors to occupy rural positions and, on the other hand, he said that they were going to bring Cuban doctors.
In relation to the Cuban doctors, it was mentioned that there were going to be five hundred. Which is an insignificant number for the health problems we have in the country. From this statement the problem arose of how they were going to practice the profession if they did not have the legal requirements, but we all already knew the answer: illegally. The same thing happened in previous years when Cuban doctors came to Mexico City during the pandemic. In matters of health, it is common for the authority not to comply with the law and the case of Cuban doctors is no exception.
The most important issue mentioned by the President was not that of Cuban doctors, but rather the lack of specialist doctors in the country and, above all, the lack of doctors who want to go to rural areas. Apparently the President mentioned these two problems simultaneously to create a false narrative that there is a rejection of the Mexican health personnel before the arrival of foreign doctors, this to avoid talking about the most serious problem: the Mexican government has not created the right conditions so that doctors can work properly and safely outside the big cities. It is false that the health union rejects foreign doctors, moreover, each year a significant number of ENARM positions are for foreign doctors. Whom we welcome each year with open arms. What the medical union rejects are the poor working conditions that are currently experienced.
After the president’s announcement, two medical movements in different parts of the country gained strength. One was that of the IMSS general practitioners in Mexico City who were unjustly fired after COVID-19. This despite the fact that they had been promised bases and contracts. The other was a movement of residents at the Valdivieso Hospital in Oaxaca. These two movements have something in common: the health personnel protested the poor working conditions and the terrible health authorities in the country.
If someone wants to understand why Mexican doctors do not want to go to rural areas to practice medicine, then I recommend studying these two movements. In the case of general practitioners, a common (albeit illegal) practice on the part of the government is to give them temporary contracts. By law they would be entitled to indefinite contracts with all the benefits, but in Mexico that does not happen and it is an abuse. In addition, the president himself promised that they would be hired once the pandemic was over. These doctors risked their lives treating patients in the midst of a very serious pandemic and yet the government turned its back on them and left them on the streets. These are exactly the working conditions that health personnel condemn and for which they do not trust their authorities. It has nothing to do with Cuban doctors. The reality is that health personnel in Mexico are treated as disposable and, at the whim of a manager, a doctor can lose his career.
The other case is that of the residents of Oaxaca. All that remains is to take a look at their list of demands to see the terrible conditions in which they work: they are not assigned, the food is of very poor quality and sometimes non-existent, they do not have educational resources within their reach, nor rest areas. All these are not the whims of resident doctors, they are obligations of the health authorities according to the NOM of medical residences. If the authorities do not comply with the norm, they should be sanctioned, but in our health system those who raise their voices are sanctioned and not those who commit illegality. The truth is that in our country the first ones who do not respect the laws are the authorities. How are we going to trust them? How are we going to leave a city for a rural region if we know that for them we are disposable? At least, in the cities, there is the possibility of getting another job or giving private consultation. In the rural regions, if something happens, no one reaches out for the health personnel and they lose everything.
The real problem in our country is not whether Cuban doctors come or not, the problem is that health personnel are fed up with poor working conditions and insecurity. We hope that the movement of the general practitioners of the IMSS and the residents of the Valdivieso Hospital will be successful and improve their working conditions. Also, we hope that all the rural places are filled, that good working conditions are offered and that the authorities begin to appreciate the work of the health personnel.
If you were interested in my column, I invite you to read my books: In the medical residence and From victim to tyrant: R2 chronicle, published on Amazon.mx in physical and digital format or follow me on my twitter account: @Sarmientomau.