Diabetes Treatments

Diabetes, types 1 and 2, (12.6%) is the third highest cause of death with an It is relevant to mention that diabetes is one of the highest priorities at the …

HEALTH
1 General Health Assessment
The states health system is comprised of medical institutions
supported by the federal and state governments, as well as through private
funds, and offers health care at three levels: primary care initial
consultation and preventative medicine; secondary level of care
consultation and diagnosis with a specialist; and tertiary care medical
intervention
Of an estimated population of 476,674 inhabitants, 73 349,014 are
enrolled with medical institutions such as the Mexican Social Security
Institute [Instituto Mexicano del Seguro Social IMSS], which covers
workers and their families in the private sector, the Institute for
Insurance and Social Services for State Workers [Instituto de Seguridad y
Servicios Sociales para los Trabajadores del Estado ISSSTE] that serves
government workers, and the Armed Forces Hospital [Hospital de las Fuerzas
Armadas], which serves army personnel and other armed forces Of the
remaining population, 23 127,600 inhabitants are tended to by the State
Secretariat of Health [Secretaría de Salud Estatal
SSE] Of these, 38,
mainly in rural areas, do not have access to health services Healthcare in
Baja California Sur is mostly public and only eleven private healthcare
establishments exist in 2002 this sector served 8,683 patients[1]

Source: Compiled by author from information in the Anuario Estadístico:
Baja California Sur, Edición 2003 INEGI-GobEst BCS México, 2004, 99p

According to the National Population Council Consejo Nacional de
Población [CONAPO], Baja California Sur has one of the lowest infant
mortality rates in Mexico 1395 in 2002 and life expectancy is 7589
years The universal vaccination program covers 995 of the population
between one and five years of age Prenatal and obstetric healthcare
coverage is at a rate of 99, which is much higher than the national
average of 85 Since 1998, Baja Sur has consistently ranked highly in
national indicators of infrastructure and available human resources as a
proportion of the population, and it ranks first nationwide in number of
consultations and available facilities, and second in hospital occupancy,
only lower than the
Distrito Federal Federal District of Mexico City[2]
Although there have been some significant advances of some indicators
related to healthcare, it is also necessary to address those left out the
healthcare system, and vulnerable groups that are not receiving the care
that they desire A health assessment of this particular population has
been conducted in Baja California Sur and is highlighted by the following
list of healthcare concerns:
1 The high level of teenage pregnancy, with an indicator of 59 at the
national level of high-risk births due to prematurity the highest
level corresponds to the Distrito Federal at 177, and the lowest is
30 in the State of Mexico[3]
2 The high level of single mothers with an indicator of 188, with the
Distrito Federal the highest at 258 and Nuevo León the lowest at
163[4] 40 of births overall are high risk and cesarean sections,
a situation that has resulted in a rise in the 2003 maternal mortality
figure
3 In cases of alcoholism and drug addiction amongst the youth population
since 2002 in 1998, it was the same as the national average,

according to the Center of Juvenile Integration Centro de Integración
Juvenil, there have been 30 more registered cases of alcoholism In
2002, 187 patients were treated,,in 2003 that number climbed to 287,
and in the first third of 2004 there have been 87 new cases, the
majority of which are youths between fifteen and twenty-five years of
age[5] Another concern is the high level of underage suicides
4 The lack of attention to chronic degenerative disease for the
population over age 65 it is important to consider the projections of
the INEGI which indicate that one in twenty throughout Mexico are in
this age range, and that by 2030 this figure is expected to become one
in eight
5 Insufficient medical attention is given to the disabled community for
care and rehabilitation
In Baja California Sur, as well as the rest of the Mexican Republic,
the principal causes of mortality are:
1 Heart disease in 336 of the adult populations, 177 suffer from
hypertension, which is the primary cause of death in the state with an
overall indicator of 742 with the highest corresponding
indicator in
the municipality of La Paz is 812 and the lowest in the municipality
of Los Cabos at 616[6]
2 Cancerous tumors 50 are considered the second highest cause of
death at the state level with an indicator of 613, with the highest
indicator being for La Paz at 756, and the lowest indicator for the
municipality of Comondú at 402[7]
3 Diabetes, types 1 and 2, 126 is the third highest cause of death
with an indicator of 373, with the municipality of Loreto having the
highest indicator 698 and the lowest being in Los Cabos 278[8]
4 Sickness related to hepatitis and gall disease 50 of the population
suffers from gall bladder stones
5 Pneumonia and illnesses related to the respiratory system 77 where
pneumonia is the eighth cause of death in Baja Sur with an indicator
of 106, with the municipality of Mulegé having the highest
concentration of cases 259 and Loreto having the lowest 00[9]
6 Sickness related to the kidneys, such as failure and development of
kidney stones as a consequence of the inadequate management of
diabetes, it is considered the
thirteenth highest cause of death with
a state indicator of 44, with the highest indicator corresponding to
La Paz at 65 and the lowest to Loreto 00[10]
7 Nutrition-related illnesses, such as obesity and malnutrition amongst
children and the elderly, comprise the fifteenth highest cause of
death in the state with an indicator of 47 with La Paz having the
highest level 51, and Loreto the lowest 09[11]
8 Gastrointestinal disease 143 that significantly affects the infant
population In 2003, intestinal infections were the fourth largest
cause of mortality in the state[12] Mulegé had the highest indicator
1832 and Loreto had the lowest 00[13]

Table 20: Primary Causes of Mortality in 2003- Baja California Sur

|Illnesses |Rate for every 100,000 |
| |inhabitants |
|1 Heart Disease |676 |
|2 Malignant Tumors |621 |
|3 Diabetes |382 |
|4 Suicides |359
|
|5 Pneumonia and Influenza |187 |
|6 Vascular Brain Complications |183 |
|7 Perinatal Complications |168 |
|8 Liver Disease |155 |
|9 Congenital Deformations |78 |
|10 Accidents |69 |

Source: State Government of BCS, V Informe de Gobierno 2003-2004, Lic
Leonel Cota Montaño p 33

It is important to note that the high incidence of these diseases may be
reduced or prevented with nutrition modifications, preventative check-ups,
increased physical activity, and preventative measures related to water
consumption, sanitation, and temperature changes
2 Problematic Health Concerns
Dengue
Dengue is considered an endemic illness, as the vector insect
reproduces year-round with the highest reproduction rate during the
hurricane season In 2003, the epidemic outbreak that occurred during the
month of July was aggravated by the presence of Hurricane Marty and
Hurricane Ignacio, provoking the registered diagnosis
of 470 cases of
classic dengue and 423 cases of hemorrhagic dengue This resulting outcome,
considering the climactic conditions and the wide range of people affected
isolated communities and unhospitalized cases, indicates that dengue
could become a major problem if appropriate control measures are not taken
It is predicted that further cases will occur for both classic as well as
hemorrhagic dengue
Steps have been taken by sanitation authorities to initiate
prevention campaigns, such as Clean Patio, and the distribution of
larvacide for recipients to use in their water supply The Clean Patio
campaign works to disseminate information to the general population by
placing informational brochures in health centers, with the hope that
citizen participation will considerably reduce the reproduction of the
transmitter mosquito The systematic implementation of this program will be
ensured by inspectors who will follow up on a bi-monthly basis by
fulfilling two tasks: detecting potential breeding grounds for the
propagation of the mosquito, and orienting the community in the adequate
maintenance of
water consumption and the elimination of microbials through
the distribution of abatement larvacide The second stage of the
preventative program against dengue consists of the spraying of insecticide
in streets throughout the state
Diabetes
Undoubtedly, diabetes is one of the most prevalent diseases in Baja
California Sur in terms of impact and mortality During 2002, 10,885 new
cases were diagnosed in the state and the mortality indicator for this same
year was 3730 It is relevant to mention that diabetes is one of the
highest priorities at the national level, and that it has multiple causes,
starting with the nutritional tendencies of Mexicans in general Citizens
of Baja California Sur are particularly susceptible, as the basic diet is
rich in carbohydrates and sugars, and there is a general lack of physical
activity
The health sector of the state covers the treatment stage, but it is
probable that prevention efforts nutrition counseling, periodic exams to
control levels of glucose in the population, sports promotion, etc would
reinforce community programs, such as those that have been implemented by
the IMSS In
accordance with what has been reported by Lic Roberto Gómez
of the Social Security Center, they will initiate courses open to the
public on cooking and baking for diabetics, diabetes melitus, arterial
hypertension, first aid, and sexual health, with the objective that family
members of patients can offer in-home support and more integrated
attention[14]
The emphasis on prevention is indispensable given that diabetes can
compromise vital organs, such as the kidneys, provoking provisional visual
disability, inhibition of blood circulation, problems with blood
coagulation, and the loss of extremities as a result of gangrene in
addition to high blood pressure, among other complications that deteriorate
the patient both physically and emotionally
Substance Abuse
Alcohol and substance abuse continue to be highly prevalent in Baja
California Sur continues, in comparison to the rest of the nation The
state is above the national average for a sustained increase over the last
five years mainly in the fifteen to twenty-five year old population, but
continues to be below Baja California The most commonly
abused substances
are marijuana, cocaine, alcohol, crystal methamphetamines, sedatives, and
inhalants
This situation can be considered a grave public health concern now
that, according to the Secretary of State Health, Dr Eduardo Rodríguez
Pulido, addictions are related directly to the principal causes of death:
heart disease, accident, cerebral pathology, suicides, hepatitis,
cirrhosis, homicides and kidney lesions[15] In addition to being an
instigator of physical violence as well as psychological abuse against the
addicts family, social instability can frequently result
The prevention and support programs developed by the State Counsel
Against Addictions [Consejo Estatal Contra las Adicciones CECA] are
concerned with sufficient resources to address, inform, and guide the
population primarily children and youth about the inherent risks that
accompany the use of these substances The problem exceeds the existing
institutional measures of prevention and treatment A clear indication of
this is that the state only has two Juvenile Integration Centers one in La
Paz and the other in San José del Cabo, which
pales in comparison to the
high number of addicts This situation has resulted in the proliferation of
pseudo-centers of rehabilitation, in which the majority of participants
have little hope of exiting the program successfully, and ultimately ends
up escalating the addictive tendencies in the patient and exacerbating
family insecurity and related social concerns For example, centers exist
where treatments result in other dependencies or addictions to other drugs,
primarily prescribed tranquilizers and sedatives There are other centers
whose treatments could be considered drastic, and often result in patient
dropouts and subsequent relapse Other facilities fundraise through the
unorthodox method of having patients solicit money on the streets,
provoking negative community reactions and a lack of cooperation
It is necessary for CECA to find appropriate mechanisms to regulate
these centers with the objective of providing addicts with complete and
dignified rehabilitation, using model treatment guidelines established by
organizations such as Alcoholics Anonymous and the Center for
Rehabilitation and Recuperation
for Alcoholics and Drug-addicts [Centro de
Rehabilitación y recuperación de Enfermos Alcohólicos y Drogadictos
CRREAD] - institutions that have demonstrated professionalism in the
management of addiction rehabilitation programs
In a parallel fashion, the factors that promote growth of addiction
cases can be attributed to the ease with which drugs can be acquired - not
excluding the ease of access to alcohol In this sense, it is necessary to
introduce efficient controls in the struggle against narcotics trafficking
now that Baja California Sur, for geographic reasons, is considered a
significant thoroughfare for the distribution of drugs to foreign markets,
in addition to being a final destination Likewise, concerns should be
addressed regarding: the fashion in which alcohol is marketed and sold
discouraging the pretext of a hot climate; the lack of recreational
options and spaces, including adequate facilities catering to youth
interests; pressures from unemployment; and domestic abuse and violence

Respiratory Illness
Consistent with information provided in the Statistics Report of the
Secretary of
Health and Assistance for Baja California Sur, respiratory
illnesses are represented by a high indicator for mortality in the state
Within this category is pneumonia, which in 2002 was the eighth leading
cause of mortality throughout the state with an index of 168 The
municipality of Mulegé ranked pneumonia as the fifth leading cause of
mortality, having the highest index in the State at 259 Meanwhile,
chronic bronchitis, emphysema, and asthma were among the twenty principal
causes of death index 37; 17th place with Mulegé being the community
with the highest index and mortality rate index 80; ranked 7th as cause
of death This serious condition primarily affects children, and in 2003
it was identified as the eighth leading cause of death amongst the infant
population[16] This situation of child mortality, and the respiratory
health of the general population, could be related to high levels of
environmental pollution from chemicals used in agricultural production, a
deteriorating drainage network, a deficient waste management system, the
lack of a treatment plant for grey water, and the existence of
open-air
fecal exposure in some rural localities An effective strategy to address
these community problems and improve environmental air quality would make
these respiratory illnesses more manageable

Malnutrition and Obesity
In Mexico, 30 of children between the ages of one and five from
households with fewer economic resources have moderate to severe
malnutrition, while only 5 of children in the same age range from homes
with higher income levels suffer from moderate to severe malnutrition In
Baja California Sur, considered to have a high level of development the
national average is medium-high, problems of malnutrition are associated
with dietary habits, obesity and diabetes, and are mostly concentrated in
urban areas[17]
A high percentage of children 188 boys and 196 of girls between
the ages of five and eleven are overweight,[18] suggests that weight
problems in adults will be even more severe in the near future, and will
result in an increase in illnesses associated with obesity, such as
diabetes, hypertension and cardiovascular illness
The rise in cases of overweight and obesity, principally
in females
aged eleven to forty-nine, ranks Baja California Sur second in the nation,
based on an index of 308 with only the Distrito Federal having a higher
index at 318[19] This is due to a wide range of factors including high-
calorie diets associated with fast food, a rise in recent years of bottled
soda consumption México ranks 1st in the world in soft drink
consumption,[20], reduction in community levels of physical activity, and
an increase in sedentary lifestyles
Faced with such a dire situation, it is imperative that action be
taken to confront behaviors associated with overweight and obesity, such
as:
Promote physical activity and a reduced calorie diet These habits
shouldnt only be promoted for adults, but also for schoolchildren and
adolescents who are at ages where they are defining their patterns of
activity and dietary habits Schools are ideal locations for the
promotion of healthier lifestyles
Distribution of information to communities about obesity and
associated chronic diseases The enormity of the benefits of weight
control in the prevention and
treatment of diabetes and hypertension
should be emphasized
Strict regulation against public sector promotion of high calorie
foods, incorporating publicity about the risks associated with the
consumption of these products
Enact strategies to help identify risk factors and encourage early
diagnosis of illnesses related to overweight and obesity
The municipality with the highest malnutrition index for children and
obesity is in La Paz and the lowest index corresponds to Mulegé In 2003,
nutritional deficiencies occupied the 7th greatest cause of mortality in
the child population less than five years of age
Tending to this public health concern, the Integrated System of Family
Development [Sistema de Desarrollo Integral de la Familia DIF] works to
abate malnutrition and poor dietary habits through two primary programs:
Attention to Children Under Four and School Breakfast
Table 21: Packets and food rations distributed to children in DIF programs
Attention to Children under 4 and School Breakfast by municipality

|Municipalit|Packets |Rations |Packets |Rations |
|y |attention to
|attention to |school |school |
| |children under |children under |breakfast|breakfast|
| |four |four | | |
|Comondú |1 680 |29 400 |26 512 |245 472 |
|Mulegé |2 156 |37 730 |29 288 |283 920 |
|La Paz |12 600 |231 000 |59 466 |852 500 |
|Los Cabos |1 316 |23 030 |32 738 |703 976 |
|Loreto |672 |12 320 |13 384 |252 288 |
|B C S |18 424 |333 480 |161 388 |2 638,156 |

State Government of BCS, V Informe de Gobierno 2003-2004, Lic Leonel Cota
Montaño,
tomo II, p 36

Table 22: Individuals reached and dispensed services in the programs of
Food Assistance of the DIF in 2003 by municipality

|Municipality |Number of |Number of |Network of |
| |individuals |families |social promotion|
| |serviced |serviced |individuals |
|Comondú |24 114 |30 429 |3 255 |
|Mulegé |24 624 |18 498 |1 960 |
|La Paz |39 983
|80 691 |6 655 |
|Los Cabos |19 506 |35 208 |2 485 |
|Loreto |5 796 |7 572 |1 460 |
|B C S |113 883 |172 398 |15 815 |

State Government of BCS, V Informe de Gobierno 2003-2004, Lic Leonel Cota
Montaño,
Tomo II, p 35

Preventative Medicine
In Mexico, the health sector has implemented a systematic campaign to
detect cervical, uterine, and breast cancer In 2001, the mortality index
for cervical cancer was 19 out of 100,000 women, a trend that was
consistent in 2003, and is different from the mortality index for breast
cancer, which has been increasing, and continues to be a grave concern for
women between the ages of twenty-five and forty-nine[21] Baja California
Sur has had a decreased rate of cervical/uterine cancer thanks to a
detection program that has caused the state to go from the twenty-eighth
highest incidence in 2002, to a much improved eighth place in 2003 Even
considering this advance, the mortality index continues to be high, and it
is important that woman in urban and rural areas take
appropriate measures
of evaluation and prevention, especially in the most vulnerable population
ages 25-49
Physical exercise is a primary preventative measure to maintain
physical wellness The state has not been putting an emphasis on having
and maintaining a culture of sports, evident by the high levels of heart
disease, obesity, and diabetes, as well as consumption of alcohol and other
substances It is also noteworthy that there is limited participation by
citizens of the state in sporting events at a national and international
level, perhaps indicating that sport is not fostered amongst children and
youth of Baja California Sur as an important aspect of healthy development
On the other hand, infrastructure has been developed sporting facilities
have been installed in the five municipalities, including a cycling track,
rowing facilities, baseball stadiums, etc, that help permit the
development of these activities It is necessary to orchestrate programs
for participation by the general population and especially by the youth
Vaccination campaigns are another important factor in the prevention
of illnesses Mexico is
one of the best-organized countries as to the
administration of vaccines, and Baja California Sur has treated 995 of
children ages one to five with complimentary mumps and tuberculosis
injections This level of coverage positions the state in fifth place on a
national level in a complete vaccination plan that is administered year-
round in the health centers In addition, vaccinations have special
importance as part of the promotion of the nationwide National Vaccination
Week campaign during the first week of February, the second week of May,
and the third week of October In 2003, 93,091 children ages one through
four were registered with having received a polio vaccine, 29,994 with a
measles shot, and 39,341 with a multiple vaccination mumps, tuberculosis,
etc[22]
Through May of the current year 2004, 45,141 vaccines have been
administered against polio, diphtheria, tetanus, whooping cough,
tuberculosis, as well as a dose of vitamin A in the infant population under
age five In order to avoid atypical outbreaks of adult whooping cough and
epidemiological problems, as have occurred in other states, a program
has
been implemented for the administration of the vaccination to people
between thirteen and forty-nine years of age who have not been vaccinated
in the last fours years, according to a statement by the State Secretary of
Health, Dr Eduardo Rodríguez Pulido[23]
In Baja California Sur, officially, alternative medicine is not
considered an option in the prevention or cure of illnesses due to the
scarce representation of doctors who offer these services, as well as
patients who are covered by insurance for such benefits There are very
few specialists available for homeopathic and naturopathic medicine, as
well as acupuncture, most likely because the benefits of these different
treatments are not known by the population, but also due to the economic
investment necessary for consultation and treatment
In rural agricultural zones where medical attention is scarce, migrant
day laborers seek treatment by means of Traditional Medicine consisting of
a variety of forms and methods of application of natural products -
principally herbs - which are administered independently The knowledge of
these types of treatments are
passed down from generation to generation by
the majority of Mexican ethnic groups, and used as a means to cope with
illness rather than as a definitive cure It should be noted that many of
the natural ingredients are not easily found in the region, considering
that climactic conditions and the varieties of flora vary dramatically in
the South and Southeast of Mexico
Health institutions and some civil organizations have initiated
actions to promote a culture of prevention For example, the IMSS cooking
program for diabetics, and the Teddá Belmacú Heart Week campaign where
the public is informed about preventative and corrective actions related to
cardiovascular illness Undoubtedly, the impact of these campaigns would be
greater if the actions and efforts of health sector NGOs and public
agencies could be coordinated toward a common objective: the culture of
prevention amongst the Baja California Sur population
Mental Health
In Baja California Sur, there is a need for greater service coverage
related to mental health and all of its modalities prevention and
treatment, outpatient consulting, family
counseling, and group and
individual therapy The incidence of domestic violence in the region is
alarmingly high, as are cases of suicide and drug dependency where the only
option for care is the psychiatric hospital Ejido de Chametla in the
municipality of La Paz, leaving the other municipalities without any
options In Loreto and Mulegé, the creation of entities that offer
psychiatric care has become imperative, given the high levels of mortality
related to suicide and homicide present in both of these municipalities
Loreto is first place in suicides and murders in the entire state, and
Guerrero Negro is second-place in suicides but first place in attempted
suicides[24]
According to the INEGI, the state registered the highest frequency of
suicides in the eighteen to twenty-five age range[25] This situation
requires comprehensive attention to the social implications that goes
beyond therapeutic attention and demands more options for community and
economic development and for the general public and young people in
particular considering the principal causes that motivate suicide are
romantic
relations, familial discontent, economic difficulties, terminal
illness, mental illness, among others In Loreto and Mulegé, the options
for safe, recreational space in the communities are diminishing, primarily
due to expanding tourism and the lack options for adequate sites With the
objective of diminishing suicide rates and domestic violence, as well as
minimizing the consequences of acute drug intoxication, in March 2004 an
awareness module was initiated, called Citizens in Crisis, where services
of medical and psychological orientation and information are provided to
participants via telephone[26]
It is not only necessary to create and expand institutions and civil
organizations that serve those affected by psychological and physical
ailments, but also to address the causes that result in these outcomes

Tuberculosis
Although it is not considered by the State Secretariat of Health to be
a critical area of concern, tuberculosis in Baja California Sur had a high
incidence in 2002 when 1,820 cases were detected, concentrated in the
municipalities of La Paz, Mulegé and Los Cabos Of these cases, only
thirty-two were
treated and controlled[27]
In 2003, a program of control had good results, as 100 of the
detected cases were subjected to treatment with strict supervision, from
which 88 resulted in complete remission This puts Baja California Sur
amongst the top ten states for control of the illness
Dr Eduardo Rodríguez Pulido Secretary of Health commented that the
principle challenge facing the control of tuberculosis is that patients
abandon treatment as soon as they start to feel better If treatment is
not completed, the organism can develop a resistance to medications within
the affected population

HIV/AIDS
In 2002, the mortality index[28] for AIDS in Baja Sur was 1287, with
266 pertaining to women and 2246 for men The municipalities with the
highest indices were Los Cabos and Comondú
The primary means of infection with HIV are: sexual transmission at
927 358 homosexual, 285 bisexual, and 285 heterosexual and
intravenously at 64 36 transfusions and 18 drugs, indicating that
the most vulnerable groups are not just homosexuals and drug addicts[29]
In Baja California Sur, as with the rest of the Mexican
Republic, the
HIV/AIDS epidemic has not been controlled, given the increase of cases
amongst those under age fifteen pediatric AIDS, including prenatal
transmissions according to INEGI, 611 of children afflicted with the
disease acquired the virus from their mothers, while 39 - mostly
hemophiliacs - contracted the illness through blood transfusions, and the
remaining percentage for unknown reasons It is necessary to implement
strict detection measures for pregnant women via the ELISA test
Taking into consideration the medical, emotional, social, and
economic costs that impact patients with AIDS and their families, the best
way to combat the illness is a systemic and programmatic prevention effort
HIV/AIDS continues to be a stigmatized illness that has resulted in a
backlash against lifestyles associated, through popular imagination, with
the illness, and mostly the means of transmission This unfortunate reality
has manifested itself in discriminatory acts such as denial of medical
services and unjustified dismissals, clearly violating the human rights of
patients affected by this disease
This situation of
ignorance and prejudice towards the illness by an
important sector of society complicates the delivery and potential impact
of awareness and prevention campaigns In Baja California Sur, a concerted
effort has not been made in this sense, as there are few and insufficient
prevention campaigns directed towards the general public, and toward youth
and pregnant women in particular The safe sex campaign encouraging the
use of condoms has not had the desired results considering the high rate
of teen pregnancy, and given the alarming disease infection levels
beginning in 1998 when the state recorded its highest incidence of AIDS
transmissions 140 in 1998 with an accumulated index of 562,[30] in
addition to the mortality rate which, while not one of the highest in the
country, continues to rise year by year
In order to stop the epidemic there needs to be coordination across
multiple health care sectors and improved societal participation in key
strategies for prevention such as:
Increased condom use with 95 efficiency not only in the prevention
of AIDS but also other sexually transmitted diseases
Avoidance of
contamination from intravenous drug use
Interruption of vertical transmission mother-to-child
A lower number of sexual partners
Appropriate and safe interventions involving blood transfusions
The hope is that diverse sectors and institutions within the health-
care system, and other organized groups, will rally around the threat of
the AIDS epidemic to enrich and strengthen initiatives for prevention

Worker Wellness
With the proposed intention of protecting worker health, the Mexican
Legislation has decreed a series of standards that relate to aspects of
Safety, Hygiene, and the Workers Environment With regard to Safety and
Hygiene, necessary measures have been established for the prevention of
accidents and illnesses related to the workplace both short and long
term, while for the Workers Environment norms have been established for
appropriate control of natural and man-made elements that are potentially
harmful in the workplace It has also been recommended that measures be
taken to provide an appropriate number of exits in work areas, both for
normal use and for emergencies, in addition to an
emergency meeting area
The completion of these safety standards is under the authority of
the Federal Secretariat of Work and Social Precaution Secretaría del
Trabajo y Previsión Social [STPS], and the General Direction of Work and
Social Precaution of the State Government Dirección General del Trabajo y
Previsión Social del Gobierno del Estado [DGTPSE] In the federal branch,
the emphasis is to standardize labor environments under federal
jurisdiction, such as hotels, restaurants that are in beach areas, as well
as industrial consortiums within the federal registry such as Bimbo
Bakery, Coca Cola, etc, while the state branch regulates the remaining
workplaces
The standardization of work-place safety varies depending on the
landscape pertaining to the given economic activities, the work process,
and the level of risk within each business or establishment that
constitutes a threat to the life, health, or physical integrity of the
people involved and their surroundings Other criteria for the
organization of committees for labor health and safety are determined by
the type and scale
of the workplace, which are defined by the following
categories:
Industrial, commercial, or services sector
Level of risk
Geographic location
Number of workers
Aside from the efforts of the Mexican government to promulgate laws
that protect workers in all labor environments, in Baja California Sur
groups of workers exist principally in the agricultural and fishing
sectors that are coping with significant health risks This is explained
by a number of reasons, ranking from the lack of knowledge of labor norms
and regulations on the parts of both the employer and employees, to the
lack of human resources to regulate and ensure workplace compliance to
safety standards ie lack of inspectors to comprehensively visit all
entities in a given labor zone In this manner, both the short and long
term consequences of being in contact with chemical substances in
pesticides are often ignored, as well as the risks of skin diving without
adequate equipment The primary concern, however, is the case of
agricultural workers where both child and adult populations are equally
susceptible to health
risks, and secondarily to the workers in the fishing
sector

Allocation of Resources
In Baja California Sur, public health which pertains to 93 of the
population is a priority, and the level of monetary investment is high
when compared to other states - including the Distrito Federal - with
similar benefits for those with medical coverage as well as those without
medical insurance However, the reduction of the Federal budget assigned to
the state was 1,541,742,690 USD in 2003, distributed in the following
manner:
1 IMSS delegation: 1,127,140031 USD
2 Secretariat of Health: 422,625,035 USD of which 11,641,322 were
channeled by SEPUIE to increase and improve the health infrastructure
and 8,376,196 designated for programs of popular insurance, womens
health, and a national quality campaign
In medical infrastructure according to the Secretariat of Health
there has been a 40 increase since 1999, and 9,836,912 USD was released
for the completion of a tower at the Juan María de Salvatierra Hospital in
La Paz, which, upon completion, will allow for much needed space and added
accommodations for the
hospital Additional investment has included
through February 2004 1,804,410 USD in the expansion of Dr Raúl
Carrillo Huacuja de San José del Cabo Hospital For their part, the IMSS
designated 1,941,031 USD for expansion and remodeling of the Unidad de
Medicina Familiar 32 in the city of La Paz
On the other hand, the State Center Against Addictions Centro
Estatal Contra las Adicciones [CECA] received, in 2003, support in the
amount of 353,770 USD, via the State DIF[31]

Access to Health Services
In Mexico, public health is in severe financial crisis, principally in
institutions such as the IMSS and the ISSSTE, which are considered the
backbones of the health sector Their constituents represent the bulk of
the population, resulting in a situation with direct repercussions on the
quality and quantity of the services that are offered, where the scarcity
of human resources, medications, materials for laboratory analysis, as well
as hospital and equipment infrastructure have suffered from considerable
deterioration, affecting the services offered on a national level

SOURCE:
INEGI, Anuario Estadístico: Baja California Sur, Edición 2003
INEGI-GobEst BCS México, 2004, p 99

In addition, 33 of the rural populations are located more than
thirty minutes from a commercial center offering health services, compared
to 15 of the urban population Eighty-percent of households in rural
towns have access to health services less than five kilometers away One-
fourth of these marginalized rural homes do not have access to health
services less than five kms, compared to 16 of less marginalized
populations[32]
Given these circumstances, the possibility that the population in
rural areas that receives health services is shrinking shows a significant
deficiency of coverage, according to an assessment by the World Bank, and
shows Mexico as having high levels of exclusion compared to other countries
with comparable economies[33]
Baja California Sur is not exempt from this problem, although the
government has intended to provide sufficient health service twelve mobile
medical units, sixty-two health centers, and five second-level units, by
putting in motion popular insurance coverage which,
currently in its
initial phase, offers preventative, medical, and hospital attention to
4,700 families that meet an annual quota of 320 USD, in the localities of
La Paz, San José del Cabo, Cabo San Lucas, Ciudad Constitución, Ciudad
Insurgentes, Villa Morelos, and Santa Rosalía with the services of social
assistance from the Salvatierra Hospital during 2002, 2,870 family members
of patients in five municipalities were served and provided lodging, food,
orientation, and psychological assistance Without a doubt, a problem
exists within a portion of the population 38 located in remote and
dispersed areas that are lacking and do not have access to medical
attention, or that are granted biased or mis-timed services based upon the
occasional visits of mobile medical units to the communities
In this context, Baja California Sur needs the participation of
organized civil society to assist in providing medical attention for this
population segment that, due to their isolated condition and/or lack of
economic resources, does not have access to health services A plan is
needed for the creation of active programs
that would permit health
coverage, and promote means to conserve it, under the premises of education
and prevention

3 Capacity of attention to health problems
31 Governmental response and co-investment
Beyond the annual budget assigned by the health sector of state
government for the replacement of obsolete equipment in the state health
centers SSA, the authorities solicited BANOBRAS for 375 million pesos
348 million USD Thus, in order to facilitate the application to the
Popular Insurance program that benefits families of limited resources
that dont receive medical service, the federal government has apportioned
10 million pesos 930,000 USD to state resources
The preventative campaign, Clean Patio, against the propagation of
dengue, continues to function with bi-monthly home inspections the
campaign is eleven months long, ending in November This has resulted in
a considerable reduction in the number of people who contract the disease,
compared with the previous year
With the proposal to intensify efforts to prevent the abuse of alcohol
and other drugs, the Centers for Juvenile Integration Centros
de
Integración Juvenil [CIJ] participated in the National Project for the
Prevention of Alcoholism and Other Addictions sustained by an agreement
that includes Teléfonos de México, SA de C V, and these Centers
The delegation of ISSSTE, through the means of the Program of
Successful Aging Programa de Envejecimiento Exitoso offers older adults
between ages fifty-five and seventy-five methods to improve their eating
habits and to preserve their quality of life, since this is a critical age
wherein the potential for problems related to poor nutrition and chronic
degenerative disease can significantly increase
In preventative medicine, through the PREVENIMSS Program, the number
of early detections in 2003 improved for cervical and breast cancer 5,815
cases in all of the state, diabetes 19,945 cases, and hypertension
15,851 cases according to the preventative medicine program of the
delegation of IMSS
Supporting the laudable work of first aid workers and paramedics to
benefit communities, the state government started the construction and
maintenance of a new building for the State Delegation of the Red
Cross
equipped with a x-ray machine, sterilization unit, nurse and medication
stations, three exam rooms, an emergency and treatment room with four
beds, two hospitalization areas with six beds and a waiting area, a
paramedic station with space to store stretchers and equipment, and a
waiting area with a reception and restrooms[34]
With the intention of helping improve rehabilitation treatments for
the physically disabled, the state government and the Chrysler Foundation
convened the financing, in equal parts, of a therapeutic tank that will
benefit disabled children that go to the DIF in La Paz for treatment
In mental health arena, the state government has set in motion the
Chimali Program, dedicated to the prevention of psycho-social risks in
families With an attention model designed with a preventative focus and
maintained by the DIF, it offers psychological and legal assistance to
adolescents and their families
With the intent of reversing the increase in drug consumption by the
youth population, the State Secretariat of Public Education Secretaría de
Educación Pública del Estado [SEPE] has designed
a program called I
Pass The program is distributed in all schools and is designed to inform
students on how to cope with peer pressure such as friends invitations to
try drugs, and in this manner assists in the prevention of addiction in
the school population
Related to attention and care for the elderly, the health sector has
initiated National Week for the Older Adult, where many of the care
providers for the elderly organize information forums about management and
prevention of a variety of illnesses that affect older populations, such as
hypertension and malnutrition
With respect to preventative health, public events have been organized
such as The Walk for World Diabetes Day, which is planned each year by
the health sector
With the goal of helping disabled people with limited incomes, the
Baja California Sur Institute for the Disabled takes tours of the community
annually to request orthopedic equipment, such as crutches, wheel chairs,
and walkers, which are then redistributed to those in need

32 Responses from Non-Governmental Organizations
The Committee for Citizen Support of Psychiatric Hospital-Care of
BCS
El Comité de Apoyo Ciudadano al Hospital Psiquiátrico de BCS, AC helps
with the rehabilitation of the mentally ill through occupational therapy
such as the creation and maintenance of green houses which, in addition,
grant economic benefits for necessities related to patients medical care
Similarly, the Association of Family Members of the Mentally Ill
Asociación de Familiares de Personas con Enfermedad Mental AFAPEM AC
works for the rehabilitation of patients through studios that create
artisan handicrafts They also work with patients families, offering
orientation workshops for the detection of problems, and education related
to the administration of medication
Neurotics Anonymous Neuróticos Anónimos AC offers self-help groups
throughout the state Their work allows assistance for the population to
understand how to manage their emotions, and to avoid anxiety attacks,
resentment, depression, domestic violence, addictions, and suicides
Teddá Bemalcú, AC participates in the prevention, detection, and
appropriate placement of patients with cardiac illnesses in the cities of
La Paz and Ciudad Constitución,
through information forums, monthly classes
and seminaries with specialists; creation and distribution of a bi-monthly
information bulletin; annual recognition of Heart Week; and work to
adequately inform family members of patients with cardiac problems
Medical Assistance of Loreto, AC works to provide furniture,
equipment, medical instruments, and bed linens for patients at the health
center in Loreto In addition they coordinate two classes a year for
paramedics with the objective of updating their first aid knowledge
In addiction rehabilitation, with a program of integral body
detoxification, the Center for Rehabilitation and Recuperation for
Alcoholism and Drug Addiction Centro de Rehabilitación y Recuperación de
Enfermos Alcohólicos y Drogadictos AC is present throughout the state
Tending to the needs of reproductive and sexual health in marginalized
and rural communities in the municipality of La Paz, Women Center Centro
de Mujeres AC, through their program Women in Health, organizes and
prepares women health educators in womens rights and sexual health, as a
means of preventing intrafamilar
violence They also provide lessons for
early detection of cervical/uterine and breast cancer
With the goal of preventing the reproduction of dogs and cats without
owners that are affecting the health of citizens of Los Cabos, The
International Friends of Animals Los Amigos Internacionales de los
Animales AC works in animal control, and in educating owners to be
responsible for their pets in order to prevent infections that could affect
the entire population They also intend to build an animal shelter that
would help control the propagation of animals without owners, and to
administer vaccinations for pets with homes
To assist the most vulnerable populations, such as the elderly and
small children with mental and auditory disabilities, the Patronato del
Asilo de Ancianos San Vicente de Paul offers assistance and medical
attention to elderly at their shelter
The Comité Pro Construcción Guardería Angelitos de Dios A C helps
working mothers who are the principle providers for their families, and
offers care for their children with mental disabilities
The Baja Sur Association for Hearing
and Language Disabilities
Profesora Armandina Cota Martínez Asociación Sudcaliforniana del
Discapacitado en Audición y Lenguaje Profra Armandina Cota Martínez
AC supports deaf children by teaching sign language or lip-reading, and
helps children with weak hearing learn necessary gestures that will allow
the child to develop normally
The College of Medical Surgeons of Baja Sur Colegio de Médicos
Cirujanos de Baja California Sur has promoted a move to integrate the
State Council on General Medicine Consejo Estatal de Medicina General,
that will have the objective of improving the quality of medicine that is
practiced in primary care in all state municipalities, by providing
continued medical education and updates for general practitioners
The Association of Diabetics of Baja Sur Asociación de Diabéticos en
Baja California Sur AC operates in the city of La Paz although they
plan to expand to four other municipalities, and advocates a culture of
prevention and control of the illness through means of exercise and an
appropriate diet Their year-round program includes monthly lectures with
doctors,
dieticians, and psychologists about the illness, bimonthly classes
on cooking for diabetics, presentations in high schools about diabetes and
how to prevent it, as well as medical review of the organs that are most
affected by the disease eyes, blood circulation and pressure, and affected
extremities They also support and actively participate in community
activities that support the health sector and raise awareness for the
disease, such as the Walk for World Diabetes Day
Friends of Children of Cabo San Lucas Amigos de los Niños de Cabo San
Lucas AC has set out with the goal of offering complimentary medical
services to children of families with limited income, such as external
exams, clinical care hospitalization and surgeries, and special cases
that require specialized medical attention

33 Responses from Other Sectors
The Red Cross received a quantity of 182 thousand pesos from the
participation of students, parents, and educators in a fundraising effort
selling pencils at educational forums, which significantly contributed to
overall donations for 2004

4 Health Needs
41 Needs for the Municipality of Los
Cabos
Among the primary health concerns for this community is the lack of
control related to legal and illegal substance abuse Los Cabos has the
second highest mortality rate from cirrhosis of the liver, 122 for every
100,000 inhabitants, and is in first place for drug consumption In
addition, in 2003 the index of deaths and disability from automobile
accidents increased considerably These indicators express the necessity
to promote campaigns for addiction prevention
Los Cabos maintains and acceptable level of medical infrastructure
and human resources The Secretariat of Health and Care [Secretaría de
Salubridad y Asistencia SSA] operates thirteen rural health centers and
one urban one with hospital facilities, one general hospital, two mobile
units, and two ambulances The IMSS has two medical units on a secondary
level, and the ISSSTE has two primary level medical units The participants
of a Community Meeting that occurred in Cabo San Lucas agreed that there
are deficiencies in medical services and that it is necessary to increase
the number of medical units, adequate equipment, and
professional
development for personnel doctors, nurses, volunteers, and midwives; but
they emphasized the need to have access to medication, including basic
treatment supplies, in order to address the medical needs in densely
populated communities, marginalized urban areas, and isolated rural zones,
where the ability to provide adequate attention is insufficient
The work of the health sector related to preventative medicine has
resulted in Los Cabos being in first place in the early detection of
diabetes, family planning, maintenance of child health and infant
nutrition, as well as the management of hypertension This municipality is
emphasizing the importance of encouraging a culture of prevention,
especially for illnesses that have a direct relationship with particular
health deficiencies in the zone These areas include the poor quality of
water, leakages of grey water as a result of disintegrating piping, the
lack of paving, a proliferation of dogs that contaminate the environment
with their feces, and the general waste from humans and animals that
pollute the beaches and streets These types of
deficiencies are the cause
of many types of contagious diseases, such as respiratory,
gastrointestinal, and dengue, among others, that represent a latent
epidemiological danger It is necessary to take greater measures toward
sanitary control on the part of the authorities and associations that
promote educational programs and workshops for the prevention of AIDS and
dengue, where the whole community is involved, and to inform and explain
the health dangers that can result from not being responsible with our
bodies and the environment in which we interact
As to the control of dogs and cats, it is necessary to create an
informative and sensible campaign, stressing the responsibility that one
assumes in owning a pet and the care and maintenance that is required It
is necessary to emphasize the deterioration that can be caused in community
health by permitting pets to defecate on public streets as everyone is
susceptible to breathing in the resulting contaminated particles In
addition, periodic and thorough community awareness should be required for
vaccination and sterilization of pets
Improved animal control also
requires a clinic/shelter for stray animals
It is necessary to promote campaigns for environmental health that
involve the participation of the whole community to maintain cleanliness of
all common areas parks, streets, and beaches but above all it is
necessary to include a program for environmental education in schools
utilizing qualified educators, where children and young people can learn
the importance, and health benefits, of participation in the conservation
of a clean environment
Rural Areas: The deficiencies in healthcare are magnified by the lack
of medical personnel and medicine supplies and equipment in the health
centers, as well as in the spaces constructed for external examinations,
treatments and preventative medicine and other primary levels of patient
care The district of Boca de la Sierra does not have a health center or
doctor and, consequently, there is a lack of medical attention The
district of La Ribera receives specialized medical services in the
municipalities of San José del Cabo and Cabo San Lucas since it is
officially in the same urban
area
Ejido Boca de la Sierra: The ejido president, Sr Román Lucero
Rosas,[35] commented that the area does not have a health center, and
residents need to travel to Miraflores where sometimes there is not a
doctor, there is a lack of medicine, and a lack of medical supplies tools
for measuring blood pressure, temperature, etc The attention that is
available functions primarily as first aid In the interview, Rosas
considered that having a doctor and a health center in the ejido would
greatly help those suffering from diabetes the most common illness in the
area to take adequate control of the disease, now that it has become
common for the illness to cause kidney complications renal failure as a
consequence of a lack of medical attention In order to receive specialized
care, patients must travel to San José del Cabo or to La Paz for any
necessary surgery On the other hand, he considered that the ejido did not
have problems related to malnutrition, or addictions to drugs and alcohol
Ejido Cabo San Lucas: The health needs of the ejido population are the
same as for urban citizens, now that the district
officially includes the
city according to Sr Héctor Essau González Arvizu,[36] Judicial Assessor
for the ejido He considers healthcare to have both sufficient as well as
deficient aspects The government officials who have economic resources
look for medical attention from La Paz, Guadalajara, and even foreign
sources, while those who cannot coordinate these types of services are the
ones who suffer the most severe health problems
Ejido La Ribera: Sr Enrique Avilés,[37] President of the Ejido
Commissary, considers the principal health concerns to be related to
nutrition since in his district there are high levels of obesity and
diabetes With regards to this health concern, it is necessary for the
doctor in charge of the health center to provide improved orientation with
respect to adequate dietary habits, in addition to providing a doctor
during the weekends to be available for emergencies currently there is
medical staff available Monday through Friday The ejido La Ribera does
not provide any specialized medical services and inhabitants must travel to
San José or La Paz to see a specialist The most common
illnesses within
the population, diabetes and hypertension, need to be tended to by
specialists Within the ejido, the high level of consumption of alcohol and
drugs crystal meth, marijuana, and cocaine is of concern and if it does
not receive immediate attention could become a grave problem This effort
could begin by promoting organized sports there are underutilized soccer
fields in the area and holding workshops to discuss health problems that
result from addictions, particularly among young people
Ejido San José del Cabo: Sr Ángel Salvador Ceseña Burgoin,[38] ejido
President, commented that the primary needs of the community are related to
the detection and control of illnesses such as diabetes, hypertension,
chronic degenerative diseases, and malnutrition from advanced age, now that
the average age within the district is seventy years

42 Needs of the Municipality of La Paz
Given the population of the municipality La Paz is the most
inhabited municipality in Baja Sur with 210,855 residents out of 467,696
registered in the state overall-or 45 of the total population living there
in 2003,[39] La Paz has the best
infrastructure and human resources in the
state To provide health services to its citizens, the municipality has:
SSA: thirteen rural and seven urban health centers, a general hospital
and a psychiatric facility, as well as four mobile units
IMSS: one primary care hospital and one secondary care hospital
ISSSTE: three primary care hospitals and one secondary care hospital
However, this infrastructure is not sufficient to provide basic
medical services to communities that are impoverished or isolated, now that
the majority of the services are located in the capital of the state In
these communities, gastric and respiratory infections, malnutrition, women
with little access to preventative exams for cervical/uterine and breast
cancer, and lack of information on family planning and illness prevention
programs result in precarious health conditions for immigrants in the
agricultural camps where outbreaks of infectious disease that are not
tended to due to a lack of medication and treatment are common
Participants in community meetings consider it necessary to strengthen the
mechanisms of coordination
between the levels of government, civil
associations, and non-governmental organizations in order to agree on the
optimal means by which to approve and disperse resources for primary health
care needs This could be achieved through social outreach involving all
entities concerned with healthcare using a comprehensive information
campaign It is also important to take actions that mitigate the lack of
health services in rural areas, as well as marginalized urban zones, where
there is a necessity to fumigate periodically in order to avoid the
propagation of flies during periods of rain that cause cutaneous and eye
infections, but above all, to avoid the expansion of dengue and respiratory
and intestinal illnesses in children These infections increase during the
month of February when winds spread contaminated particles through the air
In general, it is necessary to tend to factors that contribute to an
unhealthy environment, such as insufficient drainage systems, a lack of
potable water, and the difficiency in animal management In addition, in
order to facilitate womens awareness of family planning decisions, there
is a
need for womens sexual and reproductive health education
One area of concern related to health coverage has a significant
impact on the residents of Todos Santos Residents there benefit from a
health center that provides initial level health care, however, in order to
consult a specialist, patients must be taken to the city of La Paz
Although there are two functioning ambulances, this is not sufficient given
that there are a high number of automobile accidents in the area due to its
close proximity to the state capital This situation has resulted in the
constant solicitation of the fire emergency personnel from the capital
resulting in an average of four alarm calls out 85 per day that require
firemen from La Paz to travel to this community in order to administer pre-
hospitalization emergency first aid caused by accidents[40] and indicates
a serious need for more ambulances and qualified paramedics that can offer
post-accident first aid care
One major health concern is manifested in the high level of heart-
related illnesses the municipality occupies first place in mortality due
to heart disease with 617 per 100,000
inhabitants and the lack of a
prevention program, as well as strategies for families to adequately help
those who are inflicted manage their illness The situation is the same for
diabetes mellitus in 2003, the municipality was first place in diabetes-
related mortality where prevention and control efforts are not reflecting
any improvement in reducing the number of cases It is necessary to
implement campaigns with an objective to create and distribute health
information to the public related to all types of illnesses and risks ie
what to do if diagnosed, what services are offered, what current treatment
options and resources are available, etc In order to help abate the high
levels of mortality, it is necessary to first intervene with sensible
prevention information for the public and then to provide adequate service
options The only way to achieve this is through organized societal
participation, which calls for volunteer and pro-bono participation by
concerned parties for the benefit of the community The costs of investment
in preventative medicine are much less in comparison to the costs of care
and re-habilitation,
and with respect to this reality, participants in
community assessment have proposed an emphasis on improving preventative
measures For example, there is a lack of an appropriate prevention
campaign related to automobile accidents where a number of people are left
disabled and associated consumption of alcohol and drugs, a pattern that
is increasing amongst the youth population In addition, it is necessary to
implement campaigns related to sexual and reproductive health including
PAP tests and breast examinations, especially focused on issues that
affect youth and adolescents ie prevention of teen pregnancy, detection
of breast and uterine cancer, and transmission of STDs including HIV/AIDS,
where the municipality occupies first place in associated mortality rates,
etc
Mental health is also an important health concern in the municipality
that needs to be addressed, above all, for the most vulnerable sectors of
society: abused children and adolescents,children from broken homes,
abused women, young alcoholics and drug addicts, the elderly, patients with
HIV/AIDS and their families, the disabled, as well as depressed adults
and
youths that need programs concerned with emotional and psychological care
integrated into their healthcare The psychiatric hospital of Chametla does
not provide this type of care, and is severely lacking in the treatment
that it is able to patients Among these deficiencies is the lack of
infrastructure it lacks wards that distinguish between the variety of
mental illnesses, insufficient numbers of medical, support, and
administrative personnel to tend to the ever increasing number of patients
currently there are adequate staff members for the care of thirty
patients, and is lacking the budget to provide adequate meals, provoking
malnutrition amongst patients In general, there is a lack of support for
people with mental illness, many of them with no access to medical
services, resulting in deficient health and poor nutrition In this sense,
the participants of the community health assessment consider attention to
dignified care for psychiatric patients as a priority, with a program of
recreational and occupational therapy that would help re-establish their
health It is important to encourage activities
that would result in active
participation of patients families, such as one that constructed a
greenhouse, with the objective of providing the benefits of therapy as well
as economic benefits resulting in patients ability to receive more
comprehensive care from hospitals and specialists in other areas, when
deemed necessary
Small children with special needs, such as children of single
mothers, are another vulnerable health sector, as they do not have access
to the services available from the IMSS and ISSSTE There is a need for
facilities where these children can receive comprehensive care to ensure
healthy growth and development, and especially to ensure the reception of
infant care from a young age within forty days of birth In this sense,
the community has called for the construction of a day-care facility to
tend to children with special needs between the ages of forty days and four
years or more, depending on the needs of the children and their mothers
Rural Areas: Seventy-five percent of those interviewed said that they
obtain healthcare from health centers, but they have concerns with the lack
of doctors
who are not covered as part their health plan Their visits to
urban areas are very sporadic and many times the doctors from whom services
are solicited do not have appropriate credentials, resulting in a lack of
credibility, and hence apathy by the population In addition, this
coincided with the perception that the lack of medications is another
factor that contributes to poor medical attention
Ejido Todos Santos: The ejido officials[41] feel that, given the high
level of population growth due to foreign immigrants in the ejido, the
presence of illnesses such as cervical and breast cancer, bronchial
complications such as asthma, and allergies provoked by the humid climate
make it necessary to facilitate visits by medical specialists to the area
at least two times a week the medical attention in the ejido is at the
primary level which includes external exams, treatments, preventative
medicine and partial care, yet people prefer to receive treatment in La
Paz Related to equipment, the health center has an x-ray machine and
ambulances to transport patients, but considers it a necessity to provide
adequate
maintenance and upkeep since they often break down In reference
to alcoholism, the officials feel that although a majority of the local
fishermen drink beer, health problems, including alcoholism, have not
resulted Further, there are few visible signs of the consumption of drugs
by the youth, yet it is a concern Although it is not known exactly how
many addicts there are, the ages most frequently associated with
consumption of drugs are between seventeen and thirty
Ejido Agua Amarga: The Ejido President, Sr José González[42]
considers the main healthcare priority to be the building of a health
center that has a doctor on staff there is currently no health center and
a only doctor comes once a week from La Paz to tend to the main health
concerns in the area related to hypertension and diabetes, influenza
strains in the cold season, and treatments In order to receive medical
attention, patients must travel forty-five kilometers to La Paz, and in
cases of emergency this is a very long way to travel According to the
interview with González, the ejido does not have problems with alcoholism,
drug
addiction, or malnutrition the population mostly eats fish, as
fishing is the principal economic activity in the region
Ejido El Sargento and the annex of La Ventana: The ejido President,
SrVíctor Manuel Manzano Cosío[43] stated that in order to have a properly
functioning health center that provides external exams and preventative
medicine, it is necessary to have a permanent doctor on staff, and adequate
medication and facilities to cope with emergencies The most common
illnesses amongst the population are gastrointestinal infections,
influenza, and embolisms, and that when medical specialists are required it
is necessary to travel fifty-eight kilometers to La Paz Sr Cosio
considers that a strategy to curb addiction there is a high level of
alcoholism and drug addiction, especially amongst youth would be for
authorities to exercise more controls on establishments that sell alcohol
For example, in Los Planes there is a bar that is known to serve minors,
coupled with the fact that there are no organized recreation activities in
line with youth interests With respect to recreation spaces, there is
a
small park and soccer field, and the ejido leaders have been considering
building a gymnasium to help deter the consumption of alcohol and drugs
The ejido also considers it necessary to reinforce awareness of
preventative medicine Now that the ejido has shown overall positive
results in relation to nutrition - people have been learning through
lectures and meetings about appropriate eating habits - it is necessary to
implement similar programs in order to prevent addiction
Ejido Melitón Albañez: Sr Rodrigo Márquez Arellano,[44] ejido
President, considers a permanent doctor in the health center as the
principal need of the district Currently, doctors visit the community once
every eight days In order to solve this problem, ejido officials had
initially contracted with the business, GRINDER The contracted doctors
and a nurse occupied the health center and tended to the general
population, but this agreement has since fallen apart and the community is
once again without resident medical attention Another important
consideration for the ejido is the relationship between the increase
in the
consumption of alcohol by people from outside the region that work in
GRINDER, which has made it necessary for authorities to regulate the retail
sale of beer This has had little effect because alcohol sales still occur
out of peoples homes The most common illnesses in the region are
diabetes, gastrointestinal infections the abundance of flies in the area
exacerbates this problem, influenza, and a few cases of dengue When
operations and consultations with specialists are needed, patients must
travel eighty kilometers to La Paz

43 Health Needs of the Municipality of Mulegé
Guerrero Negro: The participants in the Community Assessment agreed
that Guerrero Negro has many healthcare deficiencies, and the many of the
problems can be attributed to a lack of health culture The task of
securing and conserving residents health is a difficult one to resolve
The principal causes of this problem are: the vastness of the territory,
the dispersion of the communities, the limited and sometimes nonexistent
knowledge amongst the population of basic sanitation, an inadequate system
of waste collection, transport,
and confinement of garbage and organic
waste, the infection of potable water sources, the obsolete treatment of
grey water, and the existence of open air feces exposure in rural
localities In addition, it is also necessary to consider the insufficient
inter-institutional coordination between health authorities and municipal
service authorities In this environment, it is difficult to establish
functional health programs–especially those concerned with preventative
health–given the high frequency of respiratory illnesses, hypertension,
diabetes and cancer the municipality of Mulegé has the second highest
breast cancer level in the state
This situation principally affects children with recurring
respiratory illnesses and gastrointestinal infections such as parasitosis,
whose illnesses, if not given appropriate medical attention, can become
life threatening the municipality has the highest mortality index in the
state for infants under the age of five Another illness commonly
affecting young children is malnutrition, manifesting itself through anemia
syndrome as well as obesity, primarily in rural
areas For this reason, it
is necessary that the health sector distribute information on which foods
are nutritious versus those that only encourage weight gain This is
necessary as much in the urban areas primarily in schools with active
participation by the parents as it is in rural zones, where there is a
need to introduce and further expand the actions of the Food Program of the
DIF
Another need is related to the lack of attention given to those with
mental illness in the community, considering the high levels of suicides
and attempted suicides as mentioned before, the municipality is the second
highest in the state for suicide deaths and ranks first in suicide
attempts Failure to address this problem will lead to larger problems
with both physical damage many times suicide attempts result in
disability, as well as increased levels of depression Another indicator
related to deficiency in mental health care is the high occurrence of
domestic violence that primarily affects children and women and requires
professional attention In this sense, it is necessary to identify the
breadth of cases and
the causes that provoke them, and to develop
sensitivity toward and the ability among health sector personnel to address
these cases in an appropriate fashion It has been proposed that one
strategy to improve this situation would be to expand recreational space
and safe gathering spots for the community that are currently lacking and
would especially benefit children and young people
In Guerrero Negro, public health services are centralized in the
urban areas and although there is substantial infrastructure, human
resources, and materials that exist in addition to medical units for
primary and secondary level care IMSS and ISSSTE, it is not sufficient to
meet the populations health care needs and has resulted in transfer of
patients to other areas The rural zones have three Rural Health Centers
through the SSA, one mobile unit, and one ambulance, whereupon the
situation becomes complicated when the mobile unit takes a long time to
arrive at the most distant areas and is lacking in adequate medications It
is necessary to increase the capacity of medical attention to isolated
communities, particularly
toward vulnerable populations and the provision
of quality health services This could occur through strategies such as
improved distribution of basic medications, increased visits by the mobile
health units, the construction of health stations in clinics, intensive
first-aid classes, and substantial vehicles to transfer patients to other
areas when needed
Related to the lack of capacity to respond to health sector concerns
in an adequate fashion, there exists a severe lack of attention to HIV/AIDS
resulting in a relatively high level of incidence amongst youth The
management of patients is not administered using a comprehensive approach,
on the one hand due to the lack of doctors and nurses, and on the other
hand due to the lack of effective preventative measures, such as the
application of community programs of detection and sex education in
schools
The increase in addiction alcoholism, tobacco-use, and drug
addiction in the region is at a critical level that requires inter-
institutional attention There is an alarming lack of effective
intervention by authorities in the reduction of
narcotics trafficking in
Baja California, which could be considered a determining factor in the ease
of access to illegal drugs However, community members also recognize that
alcohol and tobacco are easy enough to get in a multitude of local stores,
even for underage youth They considered that cooperative work between the
health sector, local authorities, and businesses could result in effective
means to combat the increase in consumption, especially amongst the youth
population, through information campaigns that encourage community
participation
Santa Rosalía: In Santa Rosalía there is a distinct lack of
established education programs to inform community members about the
appropriate management of water resources keeping water receptacles
covered in order to avoid mosquito proliferation, especially vector
transmission of dengue, as the health statistics for the region have not
reported any reductions in transmissions over the last few years As to the
management of garbage and waste, it is necessary to stress the importance
of depositing garbage in closed bags in order to reduce the possibility of
infection
since the community does not have a designated disposal area
The current has resulted in an increase of infectious gastric and
respiratory diseases, mostly in the infant population the municipality has
the highest index of infant mortality of children under age five in the
state It is expected that the above-mentioned actions would assist in the
prevention of these diseases in the region It is generally perceived that
it is the responsibility of local government to prevent these diseases
through a comprehensive waste management program, a potable water program
for human consumption, a sewage and drainage system, appropriate disposal
of grey water, appropriate animal control in populated areas, and
maintenance of clean public walkways - aspects of community wellness that
have been neglected due to a lack of resources Another factor that
contributes to illness through contamination is related to the management
of residual water Adequate drainage does not exist and likewise there is
not a treatment facility for this wastewater
It is common for grey water to be discarded on the sides of streets
which can become
a source of infection for the population, not to mention
the fact the drainage system leads directly to the ocean, contributing to
overall pollution - a situation that is aggravated by activities related to
squid fishing in the area Fishermen leave the by-products of their squid
catches in open areas, such as beaches, creating focal points of concern
for potential contamination There is a serious need to establish
appropriate places to deposit the squid waste, and for the processing
plants that operate in the region to invest resources toward the
establishment and expansion of activities to clean up beach waste,
especially during squid season It has been suggested that the authorities
establish some sort of agreement with these businesses so that, in the case
that there is not adequate economic benefit derived for the community,
temporary suspensions or fines can be standardized and assessed
Due to problems related to sexuality and substance abuse, an area of
concern relates to the use of free time by children and young adults, the
maintenance of recreational space currently there is only one
principal
plaza, and the lack of sex education in schools and for families There
is an alarming number of teen pregnancies cases involving girls as young
as thirteen have been reported and sexually transmitted diseases
especially AIDS, because schools do not appropriately approach aspects of
sexuality and parents do not talk to their children about this theme Young
people and adolescents are not aware of contraception methods and the
prevention of sexually transmitted diseases, exacerbated by the refusal of
young men to wear condoms and the lack of women who demand them to do so
For this reason, it is necessary to intensify pregnancy and STD prevention
campaigns among the population, especially in high schools and amongst
parents, as well as economic investment in community recreation centers
Consumption of drugs and alcohol amongst the youth population
deserves immediate attention, given that it can result in an increase in
the number of automobile accidents as well as in violence A need exists
for corresponding authorities to exercise stricter control over the
expanding distribution of alcohol, most
specifically to underage minors
whom, when intoxicated, put themselves and others at risk In this sense,
the council suggests that first aid tutorials be given to highway police so
that they can adequately manage accidents and drunken individuals as well
as reinforce campaigns that intend to prevent addiction
Rural Areas: The ejidos of Zapata 2 and San José de Gracia do not have
medical centers or a permanent doctor The ejido of Gustavo Díaz Ordaz
does have a doctor and medical center Most other areas do have medical
centers; however, all of these lack a permanent doctor, lack medicine, and
have an insufficient nursing staff
Ejido Benito Juárez: The ejido officials[45] stated that although they
do have a medical center for primary medical attention, they do not have
a permanent doctor-one comes every Tuesday, but there is no one to attend
to emergency cases, especially in children, though there is one nurse in
the center who is qualified to administer basic treatments and provide
injections The officials commented that for other concerns and to see a
specialist, patients must travel to Guerrero Negro The most
common
illnesses in the ejido are diabetes, influenza, and gastrointestinal
infections frequently in children who consume well water Another
important need is related to the lack of preventative medicine and lectures
related to nutrition, now that approximately 50 of all ages of the
population suffer from some form of malnutrition, and as a means to manage
the high frequency of diabetes in the ejido The officials commented that
addiction is not a problem, and that beer consumption is simply to battle
the heat, and that significant drug addiction does not exist
Ejido Gustavo Díaz Ordaz: The president of the ejido, Sr Álvaro
Zapien Castro,[46] considers that the most important health concerns are
the lack of medications, doctors, medical specialists, nurses, and medical
equipment for both the Health Center SSA as well as the IMSS Clinic
which only administers basic treatment There is a need for the
construction of a General Hospital equipped with adequate gear, personnel,
and medical specialists, considering the recurrence of illnesses and the
numbers of residents approximately 1,300, as well as an average
of 10,000
agricultural workers that are employed by one of the eleven businesses in
the Valle del Vizcaíno and in the Caracol dairy during the agricultural
season The most common illnesses are breast and prostate cancer,
diabetes, and gastrointestinal infections related to pollution as a
byproduct of agricultural activity Given the high level of young people
who drink alcohol and a smaller portion who take drugs, it is necessary to
create programs of preventative medicine where these issues are discussed
with young people and forums are established to promote positive activities
during their free time in appropriately designated spaces the ejido does
not have any sports fields or recreational spaces, as well as nutrition
information for families 5 of the population suffers from malnutrition
Ejido Emiliano Zapata 2: Sr Manuel Aguilar Torres,[47] who is in
charge of this district, commented that the area is plagued by a lack of
water, as well as inputs and residents to work on the land The ejido has
200 occupants, among the few residents that have settled and remain In
this isolated environment, the lack of health care
is significant Since
the ejido does not have a health center, it is necessary to have an
ambulance that will allow for the transport of patients to Guerrero Negro
In addition, medicine is needed, especially anti-venom treatments, given
the abundant number of snakes and scorpions that frequently bite citizens
primarily children, and the inability to travel to Guerrero Negro in due
time It is also necessary to have a doctor that can come to the community
at least twice a week The population is comprised primarily of older
people and some children, and the primary illnesses that accordingly affect
the community are diabetes, kidney complications due to the inappropriate
management of diabetes, malnutrition amongst children and the elderly,
gastric infections resulting from environmental pollution produced by the
tomato farms, influenzas, and child-related illnesses such as the measles
Ejido Emiliano Zapata 3: Raúl Saldaña Alonso,[48] ejido President,
considered the primary needs of the community to be: the lack of
medications in the health center as well as a permanent doctor currently
there are only occasional,
temporary doctors who could improve the lack of
patient confidence The ejido also needs a nurse who can orient families
about the prevention of commonly occurring illnesses especially in
children, such as influenza and stomach illnesses resulting from
inadequate waste management There does not exist a common dump and people
discard their garbage haphazardly or burn it, resulting in environmental
pollution, as well as fly outbreaks during the planting season There is
also a need for awareness and education on how to eat more nutritious food
without necessarily spending more money there are a large number of
families and agricultural work does not provide them with adequate food
since malnutrition affects citizens of all ages The most commonly
occurring illnesses are diabetes and hypertension, and to see a specialist,
patients must travel to the IMSS in Guerrero Negro or in Santa Rosalía In
relation to alcohol and drug addictions, the official stated that the ejido
has almost none
Ejido Mulegé 20 de Noviembre: The ejido President, Sr Álvaro
Padilla,[49] considers the primary health need to be preventative
medicine
Addiction is the priority, as the consumption of drugs and alcohol is high
in proportion to the number of inhabitants 5,000 overall of which 20 is
transient The most consumed drugs are crystal meth and cocaine, and the
most common alcohol is beer In addition, it is necessary for authorities
to implement strict controls in order to reduce the use of narcotics The
need to slow the consumption of crystal meth among the youth population has
resulted in the prohibition of the sale of light bulbs to minors in the
community of Mulegé This effort, in addition, has included limiting the
number of light bulbs on the exterior of houses, in order to further
prevent access to them by those who might use them as an implement to burn
and consume the drug Preventative medicine is also necessary in order to
control epidemics, such as Lupus Erythematosus which is prevalent in Mulegé
alone, with seven or eight diagnosed cases Another important need is an
increase in the number of personnel who have the ability to provide
adequate medical attention to the populous, such as individuals educated in
nursing, as well as sufficient medications
and medical equipment as the
ejido health center does not have hospital facilities
Ejido San Ignacio: Rodrigo Martínez Zapíen,[50] President of the
District Commissary, considers health concerns in his region to be the
result of a health center in San Ignacio A need exists for a center near
the junction with the freeway where the majority of the population is
concentrated The health clinic that currently exists does not have
sufficient equipment, medicine, or a qualified staff Another need is for
social work providing preventative medicine information, with an assistant
and vehicle that would help facilitate adequate community coverage,
especially during the hot season The result would be to help avoid
addictive behavior among young people, some as young as fourteen, who are
abusing crystal meth It is also necessary for authorities to be vigilant
about policing the distribution of the drug from outside the district
Currently, residents must travel to La Paz or Guerrero Negro to consult
with medical specialists for information on and treatment of the most
common illnesses in the region, which
are: diabetes, hypertension, various
types of cancer, illnesses related to the kidneys, and gastrointestinal
infections mostly during the hottest time of the year
Ejido San José de Gracia: According to an interview with Sr Ángel
López,[51] legal authority of the ejido, the health needs of the region are
associated with the lack of a community health center coupled with the
isolation of the area Although there is a designated space for a health
clinic, the doctors that currently tend to patients are only available once
a month - making the clinic in need of a permanent doctor and nurse San
José de Gracia also needs an ambulance, especially since the ejido has a
high rate of child-related emergencies The transport of patients are
currently made in cars, which is not a problem when the roads are not
overly crowded, but is inadequate when there are traffic delays The
availability of sufficient medication is also of concern, as
pharmaceuticals are sometimes prescribed that are not available in San
Juanico and it is necessary to bring them from Ciudad Constitución which
requires at least six hours of travel, a serious problem for patients in
need
Another important
health concern to be addressed is the serious
increase in addictions that has begun to have an impact on the citizens of
the ejido, as these cases impact family incomes and increase domestic
violence In this sense, it is necessary to regulate permits for the sale
of beer, as there are currently four stores selling liquor to a mere 450
inhabitants In addition, there is a lack of awareness for the prevention
of marijuana, cocaine, and crystal meth consumption, a severe problem that
the authorities have been unable to control

44 Needs of the Municipality of Loreto
The lack of attention to mental health issues for the residents of
Loreto is of primary concern, since the high levels of violence and
depression have placed the municipality first in the state for mortality
related to suicides 151 out of 100,000 inhabitants, and the same for
homicides 151 out of 100,000
Respiratory illnesses Loreto has the highest mortality rate due to
tuberculosis in patients over age fifteen with 435 per 100,000 residents
and gastrointestinal complications as a result of the lack of pavement and
ground drainage, as well as the
proliferation of dogs and garbage on the
beaches, contributing to overall pollution affect the entire population,
but children are the primary epidemiological concern There is the need to
promote a culture that is concerned with the classification of waste ie
organic versus inorganic within the general population, and with schools
in particular, creating awareness about the need for cleanliness in public
areas through street sweeping, cleaning of park benches, avoiding garbage
dumping on beaches, as well as to enlist the cooperation of the appropriate
authorities to maintain the cleanliness of vacant lots
The health sector coverage in the region is insufficient SSA
operates a health center and a mobile unit; IMSS and ISSSTE both operate
one primary care medical unit each, and the patients that require
secondary level care must be transported to other cities generally to
Ciudad Constitución, in the municipality of Comondú, resulting in an
expense that the institutions are not in a position to absorb and that
family members are usually unable to make up due to the lack of a culture
of cooperation, further
exacerbating the problem Another healthcare
deficiency that results from the lack of health coverage manifests itself
in the recent increase in the number of suicides amongst the disabled
community both temporary and permanently due to a lack of adequate
mobility and rehabilitation equipment such as crutches, wheelchairs, neck
braces, canes, prosthetics, etc
Another area of concern is related to the lack of medical attention
provided to rural communities including San Javier, Agua Verde, Ligüí,
Ensenada Blanca, Juncalito, San Nicolás, and Peloteado, as the services
they do receive are administered by a mobile unit which is supported by six
volunteer assistants who do not have adequate medical training to handle
emergency situations ie infant dehydration, heart attacks, births, or
accidents Given that healthcare concerns of this nature amongst the
population are significantly high there are approxiamately 900
individuals, improved coverage and professionalization of medical service
is necessary
Related to cardiovascular illnesses, the mortality index is high the
municipality has the highest level of
heart disease in the state, and
corresponds to unhealthy lifestyles and the extensive use of automobiles
for transportation, even for short distances rather than walking
The number of teen pregnancies girls ages thirteen and fourteen is
on a slow but steady increase, primarily due to the lack of knowledge about
contraceptives A clear need exists for the healthcare sector to improve
coverage for the distribution of educational material and the frequency of
school visits currently done bi-annually with informative workshops
involving both parents and teachers
The ease with which children and young people can obtain drugs
mirroring the increase of drug trafficking and alcohol is alarming, and
has resulted in a dramatic increase in drug use within this section of the
population Prevention programs need to be implemented, where parents and
teachers are significantly active in their participation, there is a need
for the establishment of a rehabilitation center
Many of the communitys health problems are related to a lack of a
culture of prevention in Loretos society This can be seen through the
sparse attendance and
community participation at events intended to raise
awareness of preventative health measures, such as diabetes clubs,
pregnancy care groups, nutrition forums and hypertension management
workshops The population is equally apathetic toward vaccination campaigns
for children and animals, and for the prevention of infectious diseases,
such as dengue It is important for non-profit organizations to help
develop strategies to motivate community participation for the resolution
of health problems affecting the local population This could be achieved
through programs that would help finance the purchase of rehabilitation
equipment for the disabled, acquisition of medical equipment x-ray,
dental, mobile medical units, etc, investment programs to enable
microenterprises that provide employment for young people and the disabled,
and overall programs aiming to help sensitize the community at large to the
importance of their participation
Rural Areas: San Javier has a small health center and Loreto only has
a medical clinic, and in both districts, there is a lack of a permanent
doctor as well as an inadequate supply
of medications
Ejido San Javier: Sr Marco Antonio Martínez Delgado,[52] President of
the Ejido Commission, stated that health concerns are substantial and that
although there is a health center, there is not a permanent doctor there
are currently only Monday consultations, nor are there available
medications or an ambulance to transport patients in emergency cases For
immediate medical attention, patients must be transported to Loreto a
thirty-six kilometer distance The ejido has many elderly inhabitants,
some who suffer from hypertension, diabetes, and heart disease which
requires the monitoring of blood pressure and sugar levels, as well as a
shelter with forthy-three children who require medical attention where
children from ranches stay while attending grade school It is thus
considered imperative to find a permanent doctor for the community, as well
as adequate medicine supplies, and the service of an ambulance In order
for patients to consult with specialists, they currently need to travel to
Loreto or La Paz There does not appear to be a significant problem with
excessive alcohol use, but there is a
concern that that young people are
becoming socially involved in drugs due to new arrivals both temporary and
permanente in the area who encourage them to try drugs

Ejido Loreto: The health needs of the ejido result from the lack of
medical installations and medical personnel, as the clinic is inoperable,
making it necessary to travel to the health centers in Loreto operated by
the ISSSTE or the IMSS The Ejido President, Sr José Alfredo Murillo,[53]
stated that, considering the population 2,000 inhabitants, the need for
an adequately supported health center with substantial medications and
equipment is apparent, as well as a permanent doctor on staff For
specialist care and surgical interventions, people currently must travel to
Ciudad Constitución or La Paz a distance of approximately 500km However,
there are periodic visits by specialists from Ciudad Obregón dentists as
well as an ear, nose, and throat specialist Alcoholism is not considered
a problem, due to the fact that the ejido does not have a store with a
permit to sell beer, and drug addiction is very limited and only appears to
manifest itself in young people who
consume crystal meth The illnesses
that have the most significant effect on the community are influenza and
gastrointestinal infections

45 The Health Needs of the Municipality of Comondú
When prioritizing the health needs of rural areas, the primary
concern is the high level of infant mortality the municipality ranks
second for the state in number of deaths in children under age five,
mostly due to diarrhea and infectious gastroenteritis, respiratory
infections, conjunctivitis, urinary tract infections, prenatal
difficulties, and nutritional deficiencies This situation illustrates the
need to create and implement basic sanitation programs and increased
medical coverage the SSA operates fourteen rural health centers, two
medical units, and two ambulances, and preventative health programs for
women and children Given the dispersal of the population, the costs of
delivering the required health services to these areas is high, and
requires the participation and assistance of voluntary health advocates,
civil organizations NGOs, and community associations Lions Rotary
The
health afflictions that are most frequently treated within the
adult population of the municipality are arterial hypertension, diabetes
types 1 and 2, prenatal complications, and automobile accidents the
municipality is ranked first place in the state for traffic accidents with
247 for every 100,000 inhabitants
According to the municipal Health Sector, the principal causes of
mortality, in general, are: heart disease, malignant throat, lung, or
breast tumors, complications from diabetes, car accidents, brain
vasculitis, chronic pulmonary obstruction, liver disease, and congenital
deformations In addition, homicides and suicides are among the twenty main
causes of death in the region Another area of concern is the increase in
deaths from complications associated with AIDS, as it did not appear
amongst the principal causes up until 1998, and then appeared as the
fifteenth highest mortality indicator in 2000
Rural Areas: The Ejido Tepentú Ejido not have a health center or a
doctor to administer examinations The other areas do have health centers
but lack permanent medical staff except for the Ejido
Ley Federal de Aguas
5 which has a permanent doctor, the Ejido Ley Federal de Aguas 4 needs to
have its health center renovated, and all of the ejidos suffer from a lack
of medicine and equipment
Ejido La Purísima: According to the comments made by Sr José Jesús
Arvizu Higuera,[54] Secretary of the Ejido Commission, the health concerns
of the region are related to the lack of regulation for the sale of drugs
and alcohol, as well as the lack of preventative health programs There has
been a visible increase in alcohol, and most notably drug consumption
Narcotics trafficking occurs discreetly - individuals can be openly seen
under the effects of drugs, but transactions are rarely witnessed on the
streets Some of the factors that contribute to this problem are the lack
of recreational space Sr Higuera stated that we are battling to restore
an abandoned soccer field, and appropriate sporting events to unify the
community Gambling is traditionally popular in San Isidro, fomenting the
consumption of alcohol, and discouraging other activities and sports
Another health-related need is for medicine and equipment in the health
centers
There is a health center in La Purísima, and another in San
Isidro, that are operated by three temporary staff, are lacking in
hospitalization facilities, and only provide external examinations and
superficial treatments Another serious problem arises the transport of
patients, as there are only two ambulances one in San Isidro and the other
in La Purísima, both of which are in poor condition Therefore, it is
imperative to obtain dependable ambulances in order to transport the large
number of patients in need of treatment or who suffer complications from
the most common illnesses: diabetes, hypertension, and cancer the number
one cause of mortality in the ejido
Ejido Ley Federal de Aguas 2: El Sr Froylan Reyes Flores,[55]
President of the Ejido Commission, commented that it is important to have a
doctor in the district Generally, there is one person in the health
center, such as a nurse, who is not qualified to resolve health problems
In addition, there is a need to obtain necessary medicine; for example anti-
venom snake and scorpion bites are common amongst workers in the country,
and insulin for diabetes
patients, a disease which is very common There is
also a notable amount of stomach, kidney, and liver cancer When patients
need to see a specialist or get an operation, they must to travel to Ciudad
Insurgentes, Ciudad Constitución, or La Paz On the other hand,
malnutrition problems are not considered a health issue, due to dairy
production in the area, the overproduction being distributed to ejido
families The most common addiction is alcohol with significant consumption
between Friday and Sunday Alcohol consumption also peaks every eight days
at organized youth dances where alcohol related violence is common The
consumption of drugs is much less significant, although some use crystal
meth The ejido uses organized sports tournaments amongst the population as
a means to curb drug use, since they have the benefit of facilities for
soccer, basketball, and baseball
Ejido Ley Federal de Agua 3: The ejido authorities consider it
imperative to post a permanent doctor at their health center, as well as to
have sufficient medications on hand to treat the most common illnesses in
the ejido 40 of the population has
diabetes, hypertension, uterine and
breast cancer to a lesser extent, as well as gastrointestinal and
respiratory illnesses They also feel that there are prevalent nutrition
concerns because it is one thing to eat; it is another thing to know how
to eat,[56] especially amongst the younger population The permanence of
a doctor would allow for increased community knowledge of preventative
medicine, and help to promote a culture of awareness so that the need for
medical care could ultimately be less through methods such as forums on
the benefits of walking and sports as well as nutrition The health center
only provides primary level care; in order to obtain care from specialist
or undergo surgeries, patients must be transported to either Ciudad
Constitución or La Paz
Ejido Matancitas: The ejido president, José Miguel Cano Lagunas,[57]
considers the principal health concern of the district to be the lack of
doctors There is a health center in Villa Hidalgo and a Community Center
in Ramaditas, but neither has a permanent doctor For hospital care
operations and births and consultations with specialists, patients
must
travel to Ciudad Constitución The community requires significant
specialist care since the most common illnesses are diabetes, kidney and
vision problems, dental complications, cancer breast and uterine,
influenza, and gastrointestinal illness Malnutrition is not a significant
problem, and mostly affects the migrant population agricultural workers,
as the Secretary of Health has done a good job in promoting health through
latrine maintenance and safe food handling the community has changed its
way of thinking and has adjusted its way of eating In regards to medical
installations, the health center is being remodeled with resources from the
Secretary of Social Development SEDESOL Additionally, the ejido
recognizes that addictions affect a low percentage of the population, and
are mostly alcohol related within the worker population, which has some
impact on the general population
Ejido Tepentu: Rodolfo Alcantar Juzaino,[58] Ejido President,
considers the lack of medical attention there is no health center as the
most imperative concern, since patients must travel to Las Pocitas 84 km
away to receive
general medical attention For births, surgical
intervention, and specialist care, they must go all the way to La Paz a
distance of 184 km In addition, the ejido residents dont have medical
insurance through the IMSS or the ISSSTE, and there are not adequate funds
for this expense It would greatly help resolve community health concerns
if the Secretariat of Health could send a doctor to visit the ejido once a
month to examine, evaluate, and help control illnesses given the fact that
there are seventy residents of Tepentu It is also necessary to offer
lectures on preventative medicine and nutrition, considering that the
primary illnesses affecting the population are diabetes, malnutrition in
children and the elderly, asthma, kidney disease to a lesser extent, and
very sporadic instances of cancer Substance abuse is another problem in
the ejido, resulting in alcoholism as the consumption of beer is
comparatively high given that there are few recreational alternatives for
the use of free time there are no public sports facilities There is no
significant drug use, though, there are some young people who
study
elsewhere and are becoming involved with drugs
Ejido Ley Federal de Aguas 4: Sr Federico Franco,[59] Secretary of
the Ejido Commission, considers the primary health need of the ejido to be
a permanent doctor who can promote prevention strategies within the
population, given that the most prevalent illnesses are: diabetes,
gastrointestinal infections, alcohol consumption, and to a lesser extent,
child malnutrition Another need is the renovation of the health center it
is currently abandoned with adequate equipment and a supply of medicine so
that it can return to its former capacity of providing hospitalization for
births and operations, as it did previously, thus avoiding patient
transport to Ciudad Constitución Substance abuse among young people is of
immediate concern, and is mainly related to alcohol consumption, as drug
consumption crystal meth, marijuana, and cocaine is a lot less common,
due to the lack of established narcotics distribution in comparison to the
number of licensed alcohol vendors
Ejido Ley Federal de Aguas 5: The ejido president, Sr Vidal Saldaña
García,[60] noted that the ejido has a
Health Center that operates on a
permanent basis with a doctor who offers consultation from eight in the
morning until two in the afternoon, and if immediate medical attention is
required outside of consultation hours, hospitalization, specialist or
birthing assistance is required, patients must travel to the IMSS in Ciudad
Constitución The health concerns of the ejido would be best addressed
through the improved diffusion of preventative health education nutrition
campaigns, addiction prevention, adequate maintenance of latrines and safe
food handling, cleanliness of homes and land, etc There is a lack of
information, orientation, and campaigns for health maintenance in the
community, which directly contributes to the most common afflictions, which
are: influenza and gastrointestinal infections, diabetes, kidney stones and
youth alcoholism which is of substantial concern related to organized
youth dances that occur every eight days In regards to drug addiction,
efforts have been initiated to combat this potential problem with the
distribution of information on the benefits of sports, as well as
orientation
workshops for parents on effective means of communicating with
their children, as well as patterns of behavior to look out for related to
drug abuse
Ejido Santo Domingo: Heleobardo Higuera,[61] Ejido President,
commented that the most common illnesses of influenza, anginas,
hypertension, kidney stones, diabetes, and gastrointestinal problems in
children and adults could be diminished if a culture of prevention was
introduced, which, in the long run, would help avoid more serious health
concerns such exacerbation of symptoms and surgical operations In this
sense, one important health need is for preventative medicine information
that could be introduced if there was one more doctor serving the
community Currently, the health center is in good condition, with a
permanent doctor on staff who consults patients Monday through Friday, and
a nurse, but would require additional efforts to implement preventative
health education programs Lectures would be required about the adequate
handling of food, disease information, and orientation of prevention
strategies In addition, campaigns directed
at young people raising
awareness about the risks of drug abuse need to be organized especially
related to marijuana and crystal meth that have recently begun to be used

5 Donation Opportunities[62]
51 Donations
|NGO |Region or |Type of |Needs that would|Beneficiari|
| |Location |donation |be resolved |es |
|Teddá |City of La|Funding to |Help in the |1,000 |
|-Bemalcú, |Paz and |assume patient |preventions, |people with|
|A C |Ciudad |costs for |detection, and |prevention |
| |Constituci|expenses |routing of |and |
| |ón |related to the |cardiac |rehabilitat|
| | |distribution of|patients; ample |ion |
| | |bimonthly |distribution of |information|
| | |informational |educational |; 300 in |
| | |bulletins, |materials in an |lectures |
| | |seminaries, and|effort to |and |
| | |rehabilitation |prevent heart |seminaries;|
| | |courses for |disease |10
patients|
| | |cardiac |Information for |with |
| | |patients |families of |transfers |
| | | |patients to |and |
| | | |facilitate |facilitatio|
| | | |adequate diet |n of |
| | | |and care Ample|specialist |
| | | |promotion of |care as |
| | | |events and |well as |
| | | |distribution of |free |
| | | |information |examination|
| | | |related to |s during |
| | | |prevention and |sow a |
| | | |rehabilitation |heart |
| | | |during sow a |week |
| | | |heart and | |
| | | |harvest love | |
| | | |week in La Paz | |
|
| | |and | |
| | | |Constitución | |
| | | |Assist in | |
| | | |routing patients| |
| | | |who dont have | |
| | | |insurance | |
| | | |coverage to | |
| | | |receive | |
| | | |specialist care| |
| | | |Free community | |
| | | |consultation | |
| | | |programs for | |
| | | |people with | |
| | | |limited | |
| | | |resources | |
| | | |Systemic | |
| | | |dissemination of| |
| |
| |information | |
| | | |related to | |
| | | |heart-related | |
| | | |illnesses and | |
| | | |prevention | |
| | | |through | |
| | | |bulletins that | |
| | | |reach all | |
| | | |communities | |
|NGO |Region or |Type of donation|Needs that would|Beneficiari|
| |Location | |be resolved |es |
|Diabetics |City of La|Economic support|Promotion of a |Residents |
|Association |Paz |for disclosure |culture of |of La Paz |
|of Baja | |of planned |prevention and | |
|California | |activities, |illness control | |
|Sur | |radio and TV |and by means of | |
|[Asociación | |promotion, |exercise and | |
|de |
|web-site |adequate diet | |
|Diabéticos | |development, and|Their annual | |
|en Baja | |acquisition of |program includes| |
|California | |paper products |monthly talks | |
|Sur AC | |to promote |with doctors, | |
|ADIBACALS]| |activities |dieticians, and | |
| | |related to |psychologists | |
| | |ADIBACALS |about the | |
| | | |illness, monthly| |
| | | |cooking courses | |
| | | |for diabetics, | |
| | | |prevention | |
| | | |lectures in high| |
| | | |schools as well | |
| | | |as review of the| |
| | | |organs affected | |
| | | |by the illness |
|
| | | |eyes, mouth, | |
| | | |blood | |
| | | |circulation, | |
| | | |extremities, and| |
| | | |blood pressure| |
| | | |Participate in | |
| | | |health sector | |
| | | |activities , | |
| | | |such as Walk | |
| | | |for World | |
| | | |Diabetes Day | |

|NGO |Region or |Type of donation|Needs that would|Beneficiari|
| |Location | |be resolved |es |
|Teddá |State-wide|Donation of |The lack of | |
|Bemalcú, | |antibiotics, |medications | |
|A C | |antivenom |The transfer of | |
| | |medications, |patients
from | |
|Asistencia | |rabies |rural areas who | |
|Médica de | |treatments, |need immediate | |
|Loreto, A | |geriatric |medical | |
|C | |medicine, and |attention | |
| | |medication for | | |
|Patronato | |diabetes and | | |
|del Asilo de| |HIV Ambulances| | |
|Ancianos San| |for transport of| | |
|Vicente de | |patients in | | |
|Paul | |isolated, rural | | |
| | |areas to receive| | |
|Centro de | |medical | | |
|Mujeres A | |attention at | | |
|C | |health centers | | |
| | |in the | | |
|Amigos de | |municipalities | | |
|los Niños de| |of
Loreto | | |
|Cabo San | |community of | | |
|Lucas | |Loreto and San | | |
|A C | |Javier; La Paz | | |
| | |Todos Santos | | |
|Asociación | |and Agua | | |
|de | |Amarga; Comondú| | |
|Diabéticos | |La Purísima | | |
|en Baja | |andMulegé San | | |
|California | |José de Gracia | | |
|Sur A C | |and Zapata 2 | | |
|Comité de |Municipali|Economic support|Help the | |
|Apoyo |ty of La |to initiate the |rehabilitation | |
|Ciudadano al|Paz |occupation |of psychiatric | |
|Hospital | |rehabilitation |patients with | |
|Psiquiátrico| |program-Green |occupational | |
|de Baja | |House Project |therapy and | |
|California |
| |through the | |
|Sur A C | | |creation and | |
| | | |care of green | |
| | | |houses that | |
| | | |would also | |
| | | |provide economic| |
| | | |support for | |
| | | |costs associated| |
| | | |with medication,| |
| | | |care, and | |
| | | |patient | |
| | | |transport from | |
| | | |other areas to | |
| | | |receive | |
| | | |treatment | |

|NGO |Region or |Type of donation|Needs that would|Beneficiari|
| |Location | |be resolved |es
|
|Association |Municipali|Funding for a |Creation of | |
|of Relatives|ty of La |project to |employment | |
|of People |Paz |establish |opportunities | |
|with Mental | |artisan |for patients | |
|Illness | |handicraft |through shops | |
|[Asociación | |creation by |that craft | |
|de | |mental patients |desert wood and | |
|familiares | | |cactus | |
|de personas | | |Support for | |
|con | | |family members | |
|enfermedad | | |through | |
|mental | | |workshops for | |
|AFAPEM A | | |patient | |
|C] | | |detection; | |
| | | |orientation | |
| | | |about illnesses;| |
| | |
|education | |
| | | |related to | |
| | | |medical | |
| | | |services; moral | |
| | | |support; and | |
| | | |distribution of | |
| | | |medications | |
| | | |would directly | |
| | | |support an | |
| | | |average of | |
| | | |130-150 patients| |
| | | |as well as 3-4 | |
| | | |family members | |
| | | |in an indirect | |
| | | |fashion | |
| |Municipali|Financial |Equip the Health|Users of |
|Asistencia |ty of |support for the |Center of Loreto|the Health |
|Médica de
|Loreto |administration |to provide care |Center of |
|Loreto, A C| |of their |to patients |Loreto |
| | |programs |without | |
| | | |Provide x-ray | |
| | | |equipment and | |
| | | |furniture: beds | |
| | | |and gurneys | |
| | | |Medical | |
| | | |equipment: | |
| | | |electrocardiogra| |
| | | |phs, | |
| | | |defibrillators, | |
| | | |portable and | |
| | | |stationary | |
| | | |oxygen | |
| | | |dispersion, | |
| | | |diagnostic |
|
| | | |equipment as | |
| | | |well as washing | |
| | | |machines, | |
| | | |refrigerators, | |
| | | |and bedclothes | |
| | | |for patients | |
| | | |Paramedic | |
| | | |equipment E | |

|NGO |Region or |Type of |Needs that would|Beneficiari|
| |Location |donation |be resolved |es |
|Amigos de los|Municipali|Donation of | |Children |
|Niños de Cabo|ty of Los |pediatric |Provide quality |and young |
|San Lucas A |Cabos |medications and|medical |people from|
|C | |specialist |attention to the|families |
| | |consultations |children of Los |with |
| | | |Cabos up to 18 |limited |
| | | |years
of age |economic |
| | | |that dont have |resources |
| | | |other means of |that live |
| | | |receiving |in the |
| | | |medical |region of |
| | | |attention |Los Cabos |
| | | |Attendance at | |
| | | |external | |
| | | |examinations, | |
| | | |organized | |
| | | |clinics, and | |
| | | |assistance in | |
| | | |finding | |
| | | |specialized care| |
| | | |for particular | |
| | | |cases for the | |
| | | |severely ill or | |
| | |
|disabled | |
|Centro de |Municipali|Funding to |Through the |Woman who |
|Mujeres A C|ty of Paz|continue with |program Women |live in |
| | |detection |in Health, |marginalize|
| | |programs for |facilitate |d urban |
| | |breast and |health educators|areas and |
| | |uterine cancer|to provide |rural zones|
| | | |information of |of the |
| | | |sexual health |Municipalit|
| | | |and a womans |y of La Paz|
| | | |rights, as well | |
| | | |as prevention of| |
| | | |domestic | |
| | | |violence | |
| | | |Lectures would | |
| | | |also take place | |
| | | |regarding the | |
|
| | |opportune | |
| | | |detection of | |
| | | |cancer | |
|NGO |Region or |Type of donation|Needs that |Beneficiari|
| |Location | |would be |es |
| | | |resolved | |
|Centro de |State-wide|Economic |Committed and |Recuperatin|
|Rehabilitaci| |support |professional |g addicts |
|ón y | | |work for the |in all of |
|Recuperación| | |rehabilitation |the state |
|de Enfermos | | |of addictions | |
|Alcohólicos | | |through a body | |
|y | | |detoxification | |
|Drogadictos | | |program | |
|A C | | | | |
|Neuróticos |State-wide| |Through | |
|Anónimos A | | |self-help |The general|
|C
| | |groups there |population |
| | | |would be | |
| | | |improved | |
| | | |community-membe| |
| | | |r awareness of | |
| | | |how to manage | |
| | | |emotions, | |
| | | |avoiding | |
| | | |anxiety and | |
| | | |resentments, | |
| | | |depression, | |
| | | |domestic | |
| | | |violence, | |
| | | |addictions, and| |
| | | |suicides | |
|Liga Mac A C|San José |Funding for the | | |
| |del Cabo |construction of |Help the |The |
|
| |a community |community, |population |
| | |center |supporting |of San José|
| | | |vulnerable |del Cabo |
| | | |groups, | |
| | | |children, | |
| | | |women, and | |
| | | |elderly with | |
| | | |food, clothing,| |
| | | |and medical | |
| | | |assistance | |
|Los Amigos |Municipio |Funding for |Work in the |Municipalit|
|Internaciona|de Los |veterinary |control of pets|y of Los |
|les de los |Cabos |medical |and education |Cabos |
|Animales A | |equipment and |for their | |
|C | |for the |owners to make | |
| | |construction of |them | |
| | |an animal |responsible for|
|
| | |shelter |them thus | |
| | | |avoiding | |
| | | |sources of | |
| | | |infection that | |
| | | |affect all the | |
| | | |population | |
| | | |They also | |
| | | |project the | |
| | | |construction of| |
| | | |a shelter for | |
| | | |animals to | |
| | | |control the | |
| | | |propagation of | |
| | | |stray animals | |
| | | |and the | |
| | | |application of | |
| | | |vaccinations to|
|
| | | |those who have | |
| | | |homes | |
|NGO |Region or|Type of donation|Needs that |Beneficiarie|
| |Location | |would be |s |
| | | |resolved | |
|Asistencia |Municipal|Medical and |Disease |Inhabitants |
|Médica de |ity of |paramedic |prevention and|of rural |
|Loreto, A C|Loreto |personnel, with |the |areas |
| | |the ability to |encouragement | |
| | |conduct |of a culture | |
| | |preventative |of prevention| |
| | |medicine | | |
| | |workshops in | | |
| | |rural areas | | |
|Centro de |State-wid|Theater students|Prevention of |Children and|
|Rehabilitació|e |and professors, |addiction in |young people|
|n y | |actors that |children and |in all
of |
|Recuperación | |organize theater|rehabilitation|the state |
|de Enfermos | |workshops as a |of addictions | |
|Alcohólicos y| |means of therapy|in young | |
|Drogadictos | |for young people|people | |
|A C | |recuperating | | |
| | |from addictions | | |
| | |and emotional | | |
| | |problems As | | |
| | |well as to | | |
| | |diffuse | | |
| | |information | | |
| | |related to | | |
| | |damage that is | | |
| | |provoked by | | |
| | |drugs in school | | |
| | |space, with | | |
| | |goals for | |
|
| | |prevention | | |
|Patronato del|Municipal|Young volunteers|Attention to |Residents of|
|Asilo de |ity of La|to participate |elderly and |the shelter|
|Ancianos San |Paz |in the |disabled, | |
|Vicente de | |elaboration and |creating | |
|Paul | |implementation |positive | |
| | |of occupational |opportunities | |
| | |therapy |for their free| |
| | |workshops for |time | |
| | |elderly and | | |
| | |disabled | | |
| |State-wid|Participation of|Promotion of a|State |
| |e |multidisciplinar|culture of |population |
|No existing | |y professionals |prevention | |
|NGO that | |committed to | | |
|tends to the | |design and apply| | |
|need | |a preventative | |
|
| | |program in | | |
| | |different phases| | |
| | |at the state | | |
| | |level | | |
|No existing |State-wid|Volunteers that |Help |Addict |
|NGO that |e |participate in |rehabilitation|population |
|tends to the | |the organization|of addicts |in the |
|need | |of sports | |state |
| | |activities | | |
| | |directed towards| | |
| | |recovering | | |
| | |addicts | | |
|No existing |State-wid|Doctors and |Medical |Rural areas |
|NGO that |e |paramedics |attention in |in all of |
|tends to the | |available to |isolated areas|the state |
|need | |visit rural |that dont | |
| | |communities to |have needed |
|
| | |give attention |services | |
| | |to the ill and | | |
| | |provide | | |
| | |first-aid | | |
|No existing |State-wid|Committed |Prevention and|Statewide |
|NGO that |e |professionals |rehabilitation|population |
|tends to the | |that want to |of the | |
|need | |create NGOs that|consumption of| |
| | |specialize in |drugs | |
| | |prevention and | | |
| | |discouragement | | |
| | |of drug use | | |
|No existing |State-wid|People available|Promotion of a|Statewide |
|NGO that |e |to assist in |culture of |population |
|tends to the | |campaigns that |prevention | |
|need | |establish | | |
| | |systematic | |
|
| | |programs of | | |
| | |information in | | |
| | |the prevention | | |
| | |of illnesses, | | |
| | |accidents, and | | |
| | |their | | |
| | |consequences | | |

52 Volunteering

|NGO |Region or|Type of donation|Needs that |Beneficiarie|
| |Location | |would be |s |
| | | |resolved | |
|Centro de |Municipal|Volunteers that |Prevention of |Children and|
|Mujeres |ity of La|participate in |addiction, |young people|
|A C |Paz |orientation |STDs and teen |in the |
| | |campaigns for |pregnancy |municipality|
| | |children and | | |
| | |young people | | |
| | |with themes
such| | |
| | |as drug | | |
| | |addictions and | | |
| | |the use of | | |
| | |contraception | | |
|ONG |Región o |Tipo de |Necesidades |Beneficiados|
| |lugar |voluntariado |que pudiera | |
| | | |resolver | |
|Asistencia |Municipio|Personal médico |Prevención de |Pobladores |
|Médica de |de Loreto|y paramédico, |enfermedades y|de las áreas|
|Loreto, A C| |con disposición |fomento a la |rurales |
| | |de realizar |cultura de | |
| | |talleres de |prevención | |
| | |medicina | | |
| | |preventiva en | | |
| | |áreas rurales | | |
|Centro de |Estatal |Estudiantes y |Prevención de |Habitantes |
|Rehabilitació| |profesores
de |adicciones en |niños y |
|n y | |teatro, actores |niños y |jóvenes de |
|Recuperación | |que organicen |rehabilitación|todo el |
|de Enfermos | |talleres |de adicciones |Estado |
|Alcohólicos y| |teatrales como |en jóvenes | |
|Drogadictos | |terapia de | | |
|A C | |rehabilitación | | |
| | |para jóvenes en | | |
| | |recuperación en | | |
| | |adicciones y | | |
| | |problemas | | |
| | |emocionales | | |
| | |Además de | | |
| | |difundir los | | |
| | |trabajos | | |
| | |relacionados con| | |
| | |el daño que | | |
| | |provocan
las | | |
| | |drogas en | | |
| | |espacios | | |
| | |escolares, con | | |
| | |fines | | |
| | |preventivos | | |
|Patronato del|Municipio|Jóvenes |Estimulación y|Residentes |
|Asilo de |de La Paz|voluntarios que |atención a |del asilo |
|Ancianos San | |participen en la|ancianos y | |
|Vicente de | |elaboración y |discapacitados| |
|Paul | |aplicación de |creando | |
| | |talleres de |opciones de | |
| | |terapia |invertir su | |
| | |ocupacional |tiempo libre | |
| | |ancianos, y | | |
| | |discapacitados | | |
| |Estatal |Participación de|Promover la |Población |
| |
|profesionistas |cultura de la |estatal |
|Sin ONG que | |multidisciplinar|prevención | |
|atienda la | |ios dispuestos a| | |
|necesidad | |diseñar y | | |
| | |aplicar y | | |
| | |difundir un | | |
| | |programa | | |
| | |preventivo | | |
| | |integral en | | |
| | |diferentes fases| | |
| | |y a nivel | | |
| | |estatal | | |
|Sin ONG que |Estatal |Voluntarios que |Ayudar a la |Población |
|atienda la | |participen en la|rehabilitación|adicta en el|
|necesidad | |organización de |de adictos |Estado |
| | |actividades | | |
| | |deportivas | | |
| |
|dirigidas a | | |
| | |adictos en | | |
| | |recuperación | | |
|Sin ONG que |Estatal |Médicos y |Atención |Comunidades |
|atienda la | |paramédicos |médica a |rurales en |
|necesidad | |dispuestos a |comunidades |todo el |
| | |visitar |rurales que no|estado |
| | |comunidades |la tienen | |
| | |rurales y | | |
| | |aisladas para | | |
| | |atención de | | |
| | |enfermos y | | |
| | |capacitación en | | |
| | |primeros | | |
| | |auxilios | | |
|Sin ONG que |Estatal |Profesionales |Prevención y |Población |
|atienda la | |comprometidos |rehabilitación|estatal |
|necesidad |
|que quieran |en el consumo | |
| | |crear ONGs |de drogas | |
| | |especializadas | | |
| | |en prevención y | | |
| | |desaliento de | | |
| | |consumo de | | |
| | |drogas | | |
|Sin ONG que |Estatal |Personas |Promoción de |Población |
|atienda la | |dispuestas a |la cultura de |estatal |
|necesidad | |difundir |la prevención| |
| | |campañas que | | |
| | |establezcan | | |
| | |programas | | |
| | |sistemáticos de | | |
| | |información | | |
| | |preventiva de | | |
| | |enfermedades, | | |
| |
|accidentes y sus| | |
| | |consecuencias | | |

53 Binational and International Cooperation
Promote agreements with other non-governmental organizations that
specialize in national and international health that support local
organizations in capacities related to personnel, medication,
rehabilitation technology, etc
Establish accords to make funds accessible for disabled patients that
want to form their own mico-enterprises
———————–
[1] Baja California Sur State Government, V Informe de Gobierno 2003-2004,
Lic Leonel Cota Montaño
[2] Baja California Sur State Government, Compendio Estadístico 2001-2002:
Municipios de Baja California Sur, Cuadernos de Datos Básicos, Gob Est
BCS-Secretaria de Promoción y Desarrollo Económico, La Paz, June 2003
CD-ROM
[3] INEGI, Mujeres y hombre en México 2004, 8 edición, México 2004, p
153
[4] Ibid, p288
[5] El Sudcaliforniano Daily newspaper with state-wide circulation 21 04
04 Section A, p10
[6] Baja California Sur State Government, Compendio Estadístico 2001-2002
Municipios de Baja California Sur, Cuadernos de
Datos Básicos, Gob Est
BCS- Secretaría de Promoción y Desarrollo Económico, La Paz, June 2003, p
375
[7] Ibid, p375
[8] Ibid, p 376
[9]Ibid, p 379
[10] Ibid, p 380
[11] Ibid, p 380
[12] INEGI, Anuario Estadístico: Baja California Sur, Edición 2003 INEGI-
GobEst BCS México, 2004, p410
[13] Baja California Sur State Government, Compendio Estadístico 2001-2002
Municipios de Baja California Sur, Cuadernos de Datos Básicos, Gob Est
BCS- Secretaría de Promoción y Desarrollo Económico, La Paz, June 2003, p
382

[14] Bulletin: Panorama Informativo, Conductor Miguel ángel Ojeda,
Promomedios California, La Paz, August, 19, 2004
[15] Ibid, April, 2, 2004
[16] Baja California Sur State Government, Compendio Estadístico 2001-2002
Municipios de Baja California Sur, Cuadernos de Datos Básicos, Gob Est
BCS- Secretaría de Promoción y Desarrollo Económico, La Paz, June 2003, p
368
[17] SEDESOL, Programa Nacional de Desarrollo Social 2001-2006 Superación
de la pobreza: Una Tares Contigo, 1 Edición, México 2001, pp13-44
[18] INEGI, Mujeres y hombre en México 2004, 8 edición, México 2004, p
173
[19] Ibid, p175
[20] Secretaría de Salud, Programa Nacional de Salud 2001-2006 SSA, México
2001, p 51
[21]
Ibid, p 202
[22] Baja California Sur State Government, V Informe de Gobierno 2003-2004,
Lic Leonel Cota Montaño p 46
[23] Noticiero Panorama Informativo, Op Cit, 28 de abril de 2004

[24] INEGI, Anuario Estadístico: Baja California Sur, Edición 2003 INEGI-
GobEst BCS México, 2004, p 410
[25] INEGI, Mujeres y hombre en México 2004, 8 edición, México 2004, p
441

[26] Baja California Sur State Government, V Informe de Gobierno 2003-2004,
Lic Leonel Cota Montaño, p 51
[27] INEGI, Anuario Estadístico: Baja California Sur, Edición 2002 INEGI-
GobEst BCS, México 2002, p 407
[28] According to the OECD Glosarry of Statistical Terms, a Mortality
Index is defined as: a variant of the comparative mortality figure and is
a weighted average death rate, where the weights are the mean of the actual
current population and the standard population both expressed in
proportions on a common basis of absolute size Source:
http://661027104/search?qcache:1qls-
gGu64YJ:statsoecdorg/glossary/detailasp3FID3D361922mortalityindex22
definitionhlenclientsafari
[29] Ibid, p 410
[30] Web page: CONAPO: wwwconapogobmx CD Table 1
[31] Baja California Sur State Government, V Informe de Gobierno 2003-2004
Lic Leonel
Cota Montaño, México 2004, pp 45-50
[32] Secretaría de Desarrollo Social SEDESOL,Programa Nacional de
Desarrollo Social 2001-2006 Superación de la pobreza: una tarea
contigo,1 edición, México 2001, p 25
[33] World Bank Website:
wwwworldbanckorg/depweb/spanish/modules/economicCD, p 6
[34] Baja California Sur State Government, Nuestro Gobierno, Abril de
2004Dirección Gral de Comunicación Social, Coord General de Proyectos
Especiales, La Paz 2003, p 8

[35] Interview given by Román Lucero Rosas, Presidente del Comisariado
Ejidal, Ejido Boca de la Sierra, October 15, 2004
[36] Interview given by Héctor Essau González Arvizu, Asesor Jurídico,
Ejido Cabo San Lucas, October 14, 2004
[37] Interview given by Enrique Avilés, Presidente del Comisariado Ejidal,
Ejido La Ribera, October 15, 2004
[38] Interview given by Ángel Salvador Ceseña Burgoin, Presidente del
Comisariado Ejidal, Ejido San José del Cabo, October 14, 2004
[39] Baja California Sur State Government, Compendio Estadístico 2001-2002,
Municipios de Baja California Sur, Cuadernos de Datos Básicos, Gob Est
BCS- Secretaría de Promoción y Desarrollo Económico, La Paz, Junio de 2003,
p 111
[40] El Sudcaliforniano Daily
paper with statewide circulation April 21,
2004
[41] Interview given by Antonio Avilés, Presidente del Comisariado Ejidal,
Ciudad de La Paz, October 5, 2004
[42] Interview given by José González, Presidente del Comisariado Ejidal,
Ejido Agua Amarga, October 5, 2004

[43] Interview given by Víctor Manuel Manzano Cosío, Presidente del
Comisariado Ejidal, Ejido El Sargento, Ciudad de La Paz, October 5, 2004
[44] Interview given by Rodrigo Márquez Arellano, Presidente del
Comisariado Ejidal, Ejido Melitón Albañez, October 7, 2004

[45] Interviewo given by Carlos Arévalo Rasso y Alfonso Durán Luján,
Presidente del Comisariado y Presidente del Consejo de Vigilancia,
respectivamente, Ejido Benito Juárez, October 9, 2004

[46] Interview given by Álvaro Zapien Castro, Presidente del Comisariado
Ejidal, Ejido Gustavo Díaz Ordaz, en La Paz, October 6, 2004
[47] Interview given by Manuel Aguilar Torres, Encargado Ejidal, Ejido
Emiliano Zapata 2, Poblado el Vizcaíno, October 8, 2004
[48] Interview given by Raúl Saldaña Alonso, Presidente del Comisariado
Ejidal, Ejido Emiliano Zapata 3, Poblado el Vizcaíno, October 9, 2004

[49] Interview given by Álvaro Padilla, Presidente del Comisariado
Ejidal,
Ejido Mulegé 20 de Noviembre, October 7, 2004

[50] Interview given by Rodrigo Martínez Zapíen, Presidente del Comisariado
Ejidal, Ejido San Ignacio, October 9, 2004
[51] Inteview given by Ángel López, Apoderado legal del Ejido, Ejido San
José de Gracia, Ciudad de La Paz, October 7, 2004

[52] Interview given by Marco Antonio Martínez Delgado, Presidente del
Comisariado Ejidal, Ejido San Javier, September 27, 2004

[53] Interview given by José Alfredo Murillo Murillo, Presidente del
Comisariado Ejidal, Ejido de Loreto, October 11, 2004

[54] Interview given by José Jesús Arvizu Higuera, Secretario del
Comisariado Ejidal, Ejido La Purísima, Poblado de San Isidro, September 24,
2004

[55] Interview given by Froylan Reyes Flores, Presidente del Comisariado
Ejidal, Ejido Ley Federal de Aguas 2, October 11, 2004

[56] Interview given by Luis Gracia Solorio y Tobías González, Presidente y
Secretario respectivamente, Ejido Ley Federal de Aguas 3, October 11, 2004
[57] Interview given by José Miguel Cano Lagunas, Presidente del
Comisariado Ejidal, Ejido Matancitas, Ciudad Constitución, October 13,
2004

[58] Interview given by Rodolfo Alcantar Juzaino, Presidente
del
Comisariado Ejidal, Ejido Tepentu, Ciudad Constitución, October 13, 2004

[59] Interview given by Federico Franco,Secretario del Comisariado Ejidal,
Ejido ley Federal de Aguas 4, October 12, 2004
[60] Interview given by Vidal Saldaña García, Presidente del Comisariado
Ejidal, Ley Federal de Aguas 5, October 12, 2004

[61] Interview given by Eleobardo Higuera, Presidente del Comisariado
Ejidal, Ejido Santo Domingo, October 10, 2004
[62] The NGOs and the projects they support are prioritized by criteria of
level of concern and urgency

Source:ukf-pcro.org