Hospital Systems Around the World
I have been in Mexico, working at the Hospital de la Mujer now for 3 weeks. They have been very kind and accommodating to me, letting me talk to patients, staff, the quality department, taking me on tours of the state hospitals IMSS, ISSSTE.
Allowing me to sit in on urogynecological surgeries, granting me access to state tax information, strategic planning, organizational structure.
Giving me info on pay structure, infection control data on hospital acquired infections, adverse events, teaching tools, policies, and procedures.
I have been able to attend meetings between the hospital and the schools in which they are reinitiating programs (after COVID) that put medical students in the community to provide primary care screenings and preventive care.
I’ve been to training on bioethics, family planning, and urogenital problems and infections.
One thing I didn’t expect was the disempowerment of being in a city of 800,000 people with a level 4 restriction on travel with the state department, and trying to respect my school’s conditions that I only go to and from work with my preceptor. Also, trying to respect my preceptor’s wishes that I not rent a taxi, or a car, or even walk outside of our small gated and guarded neighborhood. He said, “What will I tell Salvador if something happens to you?” Salvador is his nephew, my friend, who brought me the news that there was an internship possibility for me here.
So, I don’t have access to a car. I can’t walk to the store. I didn’t have cash for the first 10 days. My phone hasn’t worked since I got here and I can’t just go get a new sim card the way I normally would if I was anywhere else. I feel like a child. It’s incredibly uncomfortable. We have run out of toilet paper a few times at the house and I have no resources for that (not to mention, the cleaning lady took my stash of stand-by toilet paper that I’ve been saving from the pay toilets. Not cool–but she didn’t know). And yes, I know. I have everything I need and these are first world problems.
All that aside, I have learned a ton about this system. There are a lot of differences, but also a lot of similarities.
- obviously the safety level is different here. There are guards in front of gated communities, as well as in all of the hospitals. This is a huge change for somebody who doesn’t always lock her doors and can jump on a bike outside of my house and ride for 50 miles without fear if I want. I have felt like a bit like a caged animal.
- infrastructure is different here. We are unable to drink the water from the faucet–public health issue for sure.
- They have wifi on the hospital campus. My hospital in the states does not.
- They are very open and transparent about so much. I’m pretty sure that if I wanted to bring a Mexican student to work for 5 weeks that my hospital would say, absolutely not.
- The people here in the hospital have been incredibly accommodating and kind. If there is a seminar to attend, or a surgery to see, or a resource they know I will be interested in, they make sure I get it. I feel like the people where I work are so crushed with their work, and so unaccustomed to accommodating others that they would not be so kind.
- Free health care. Also, a private option.
- Free education ($50 a year at the state university) with the ability to get scholarships.
- Mexico has ACCESS TO ABORTION IN CASES OF RAPE OR INCEST OR THE RISK OF MORTALITY OF THE MOTHER.
- Disciplinary measures with Michoacan state employees are similar to those for Federal employees. If an employee here has an alcohol problem, for instance, they remove the employee from patient care and get them treatment.
- People dedicated to what they do. Very caring.
- Corruption in political systems. Bureaucracy that is resistant to change and improvements.
- Cultures of fear and politics in systems.
- Racism (according to the people I talk to)
- Really great programs and educational materials and difficulty getting that information out to the people in rural areas and implementing them in the systems that exist.
- Not enough resources making it to the most poor in our societies.
I’ll talk about my internship work in another post because it’s just too much to put in here. But it’s been pretty great to have time to work on these things, with these people, in this place.
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