From Xico

DIF: Integrated Family Development in Mexico, and Swine Flu Especially Here in Our Area

You can see the bright pink and lime green offices of DIF http://www.difver.gob.mx in most pueblos of any size at all.  The acronm stands for Sistema Nacional para e Desarrollo Integral de la Familia, or the Comprehensive Development of the Family.  It offers all kinds of services from food, more in hard times, to mammograms to activities for us old people to issuing cards for seniors to get discounts, to sports, to psychological counseling and health education, some devoted to specific problems like leukemia and assistance for people without state insurance who need heart surgery.  It offers programs for kids and teenagers.  It’s kind of like a community center in the US, except this is a government organization. It’s very visible. It doesn’t seem to suffer for its government connection, and it is tied closely to local communities.  This is the place in Coatepec where citizens are supposed to bring their cooking oil. 

DIF is also a dispenser of sage advice on A/H1N1 prevention measures.  Here’s a poster they share from the Ministry of Health on hand washing:

 

We haven't heard of anyone in our area yet who has had swine flu.  In the country at large, 2431 new cases have been reported in the last 48 hours.  Thus far, altogether 41,920 people have been infected and 260 have died from it.  Mexico has a population of roughly 106 million people. 

In looking at the epidemiology of those who've died in Mexico, it's reported in (I thik the October 1 issue of El Processo that 22.5% of the 193 people who'd died as of October 1 in Guadalajara, 22.5% were cigarette addicts. It's a bit hard to find a quantitative definition of addiction, but the Mayo Clinic says that you can tell if you are dependent if quitting causes withdrawal symptoms.  In Mexico, somewhere between 12% and 15% of the population are considered addicts, less than the mortality rate from the A/H1N1 flu, at least in Guadalajara, indicating perhaps a link between lungs compromised by smoking in particular and the severe pulmonary complications of the flu.  The article pointed out that most people who died had serious secondary problems from heart disease to other pulmonary disorders.

Flu In Veracruz State | Ruminations of an Expatriate

Expatriate Ruminations has information I don't on the flu in Veracruz here:
Flu In Veracruz State | Ruminations of an Expatriate.

Follow his links up and down for more information.  What remains of interest is the death toll in the original centers where flu was concentrated, though the flu itself has not proven to be the deadly plague feared.

Influenza in Mexico: La Gloria after Its Fifteen Minutes of Fame

A reminder: You can click on the pictures to see them bigger.

We drove into La Gloria down a fairly smooth road from the main road to Perote.  We knew where to turn because there was a bright new sign saying, La Gloria, 9 km.  I suspect this was new so reporters could find their way.  When we drove down the road, it didn't occur to me that it had been widened and smoothed It was a dirt road) for the hubbub that grew over it being thought of as "Ground Zero" of the flu epidemic because of the presence of the litte boy who was the first diagnosed case, but I think it must have been. There were remnants of road-making materials still lying on one side.  Jim thought perhaps they were there to repair damage when the rains came...roads suffer terribly in the heavy downpours.

Here is a picture Jim took when we arrived at La Gloria.

There were no reporters, no cameras, no media vans.  But there was a bit of crowd at the center.  Still present were public health trucks and a mobile kitchen from the state.  I suspect these mobile kitchens are normally used for disasters.

Jim's photos of the outside and inside of the mobile kitchen.

I'm not sure how long the government had been providing these delicious-smelling meals, but I know it hadn't been longer than La Gloria's presence in the world news.  I talked to a government representative who said indeed it was because of all that La Gloria had had to endure with being at the center of attention.  Another woman said the government had never done it before.  At least the trucks were there longer than the press.  In the picture below, you can see people eating and lining up to eat.  We were invited to join in.  We felt it would be odd to do it.  We weren't of the community. I guess I can't really explain our feelings, but it felt a bit like it would be cheating. 

Below is a picture of the clinic on the main street in La Gloria. Granjas Carroll says it provides all health services for the community.

Perhaps part of the rejuvenation of La Gloria's appearance for the press (by the government of the state) was repainting (or painting) these statements on the sides of the elementary school buildings. 
(Jim's picture)

The values statement says  that within the relationship among the director, teachers, support people, students and parents there ought to exist respect, tolerance, trust, responsibility, solidarity and fairness. While there is huge room for improvement in Mexican public schools (as there is in many countries, including the US), there is a striking difference between the US and Mexico.  In the latter, responsibilities to family and community are stressed.  Achievement is linked to doing well for family and community, not for oneself.  Meeting these responsibilities seems ever-more elusive in times when people are forced to leave both to make a living.

(In addition to Mission and Values statements, on another wall there is a Vision statement: shades of Total Quality Improvement to which my clinic and I were subjected in the 1980s.)

In the park in front of the school, the main park, this sign hung.  It shows the municipality of Perote including La Gloria and highlights all the road improvements the state government lays claim to. (Jim's picture) Notice it looks like the two most important towns in the area are Perote and La Gloria.

Now I have to add that one shouldn't be too cynical.  Roads are being improved/constructed all over the state, including at the entrance to our own colonia.  Texas does this, too, but on a much grander scale.  No two lane roads for Texas!

We walked through the downtown and beyond.  Three women joined us and asked who we were.  We explained.  They were eager to share information about La Gloria: not about Las Granjas Carroll anymore, but they wanted us to know that half the working population had to go to Mexico City to work -- they stay there during the week and come home on weekends, and that many were in the US.  There was little work to be found in La Gloria.

We had noticed some towers toward the end of the street.  They turned out to be towers of a ruined hacienda.  We all walked towards it, the sand still blowing around us.  

The next post: The Hacienda and a bit more.

Influenza in Mexico: La Gloria´s Fifteen Minutes of Fame

First of all here is a link to an excellent post on the La Gloria-Granjas Carroll connecton on an excellent blog called Intersections by a Mexican-American-Mexican(?), Daniel Hernandez, in Mexico City.  You'll find links within it to more information about the La Gloria-Granjas Carroll connection.

Jim and I took a trip to La Gloria last week  going by way of Ixhuacán de los Reyes and Los Altos.  Before I write about that, here are some segments sometimes loosely translated (sometimes just paraphrased) from an article in La Jornada which I found via a link on Intersections  which describes La Gloria's fifteen minutes of fame:

By Andrés Timoteo Morales, correspondent.

In only eight days, La Gloria was transformed from a neglected, semidesert pueblo into a community allive with streets being paved, the little parke being rehabbed with paint and decorative plants, and even a cafe....

In fact...a week ago Wikipedia opened a site on La Gloria and had thousands of hits from all over the world....

The bonanza arrived at the puebla with the national international press....more than fifty representatives from, among other places, the US, France, Qatar, China, Brasil, Corea, Japan, the UK, Germany, Spain and Venezuela, attracted by the reports of the origin of ...A/H1N1 and because it was the home of Edgar Hernandez, "patient zero" of the infection.....

Dozens of state and municipal workers made La Gloria the center of their rehab operations starting on April 29....and they hung a huge map marking the location of the pueblo. 

They smoothed the road whic led to Perote, the center of the municipality.  The government of the state, according to Silvia Dominguez, the secretary of Social Development and the Environment of the state, said they invested five million pesos in public works in addition to resources for health and food.

The communities which benefited from the fame of La gloria are Xaltepec, El Carmen, Totalco, Guadalupe Victoria and Zayaleta.  At all the towns, trucs loaded with construction materials, provisions, and mobile health units from the Secretary of Health.

"We have more than thirty people who come daily to work at La Gloria, said Dominguez, the secreatary, and he continued, adding that all this sudden activity was not due to the flu outrage, but because all the works were pat of the progam of public works for the state for 2009.  Not a peso nor an action have been improvized." (This last is a direct translation)

To this figure, is added the personnel of the community kitchens, three mobile health units, and pollsters/interviewers who enroll the  inhabitants in various social programs of the state.

We are from La Gloria, nthing more, and now the whole world knows us, said some of the oldest.  Some of them told anecdotes about interviews they gave to CNN, Televisión Española and even Al-Jazeera

....

The first sign posted for the media to see was this one (taken from La Jornada):

However, it seems that the mayor of Perote ordered more signs to hang at the main accesses to La Gloria.  These are what we saw:

 

Next: Our visit to La Gloria, after the fifteen minutes of fame.

Flu in Mexico -- IF it did start in La Gloria, it could easily have spread to Mexico City

In a previous post, it was mentioned that finally Fidel Herrera Beltrán might be calling in some truly independent investigators to look into The Situation at Granja Carroll and La Gloria to see if it might be at all possible to track the flu there still.  Numerous questions mean that it is impossible to rule it out including the rather unusual outbreak which affected a quarter of the population in March and earlier of this year. Apparently half the working population of La Gloria works in Mexico City during the week, returning home on weekends.  (Many others have migrated to the states -- where in the States? When?)  Given that people can be contagious with the flu for days before they exhibit symptoms (if indeed they do exhibit notable symptoms), it seems quite possible that these workers may have brought the flu to the Mexico City.  Is this being investigated?

Flu in Mexico: The Tip of the Iceberg

An excellent and very important piece of investigative journalism by Laura Carlsen here at Americas MexicoBlog 

Among the points:

• FINALLY Fidel Herrera Beltrán, governor of the State of Veracruz, says he will order an independent investigation of the possible connection of the flu outbreak in La Gloria and Granjas Carroll.  Carlsen got this information from, of all places, Al Jazeera English, not a Mexican or US news source.
• Carlsen describes international failure, not just Mexican, to deal with early signs of a significant problem.
• She addresses in detail the terrible potential of factory farms to spread disease, especially by means of uncovered lagoons and contaminaation of local  water sources.
• She describes how the priorities were geared to protect the corporation of Las Granjas Carroll, owned jointly by Smithfield Foods and Agroindustrias Unidas de Mexico, before the well-being of the people of La Gloria, or indeed of Mexico and the world.
• She describes the inadequacies of Mexico's public health system and reveals that Mexico, in response to  the economic aspects of the crisis is planning to CUT funding to IMSS, the major provider of healthcare in the country.
• She shows how research continues to be geared to showing that Granjas Carroll is "innocent," not to answering the question, how did this epidemic start?
• She talks about the swine-human connection and how critical it is.
• She reveals that the vaccine production racket is already in gear, and that the first company at the starting gate is one that is under investigation in a number of countries.
• She discusses (what I and many others know) how difficult it is to get any real information on the subject in Mexico, particularly as it relates to agroinustrial practices.
• She addresses the failure of oversight on all international levels.
• She raises critical issues relating to NAFTA and "the centrality of foreign investment in Mexico [which] creates a climate where transnational corporations with large investments can exercise coercive power over government agencies on all levels."
• She condemns the Obama administration for its dreadful narrow focus on  police/military/hardware assistance to Mexico in place of the actions which really might mitigate the control of organized crime AND the public health threats.  
• She describes the damage that a profit-driven system of medicine and vaccine production essentially ignores public health interests.

You need to read the article.

I would like to add that as in the case of global warming, in which the problem is undeniably real, but attention to which blinds us to other very serious environmental problem, the agroindustry-disease connection is very real, but it shouldn't blind us to other very serious problems presented by these companies, from dangerous overuse of antibiotics to loss of jobs to pollution of soil, air and water, to hideous mistreatment of animals to loss of income for local areas.

Flu in Mexico: Mexico's Handling ... muy impresionante

In the Washington Post you can read about Mexico's response to diagnosis of the flu: a story filled with high drama. It was wonderful and swift. Mexico is a country with an abundance of very smart, very talented people.

Origin of Flu anywhere: Stolen from Agenda Veracruz

Agenda Veracruz is a blog of political opinion mostly addressing issues here in our state, often in the context of national politicsandissues.  It is in Spanish. 

And here is how swine (flu) originated....

Flu in Mexico: Contradictions

From La Jornada, May 8, 2009 My translation
The Federal Commission for Protection against Public Health Risks (Cofepris--Spanish acronym) only verified that there were no sick pigs in Granjas Carroll and the community. The public health visit was limited to La Gloria months after the outbreak. The report contains data which contradict that reported by the National Water Commission.
 by Ángeles Cruz Martínez
At the end of April, two months after the flu outbreak that affected 25 percent of the inhabitants of La Gloria in Perote, Veracruz, and six days after a public health emergency was declared in the country because of the epidemic of A/H1N1 flu, the Federal Commission for Protection against Public Health Risks (Cofepris) completed a public health verification which was limited to confirming that there were no sick pigs either in Granja Carroll or in La Gloria.
Miguel Ángel Toscano, head of the Commission, participated yesterday in a press conference at the Health Department (Ssa--Spanish acronym) in which he described the state of the epidemic in the country. He also recounted the activities which supervisors of Cofepris undertook both in the town and in the pig plant, but without making any reference to the complaints which the inhabitants of La Gloria have made over the years about public health risks because of environmental contamination.
This past March 1, one of the 1,200 case of A/H1N1 confirmed at this point was recorded in La Gloria. In La Gloria, one of the unusual outbreaks of influenza between February and March of this year also occurred, in which 25% of the inhabitants were affected.
Discontented citizens at that time expressed their fear that the viral infections were related to the contamination generated at Granja Carroll; however, nobody paid attention to them. The epidemiological outbreak ended, and it wasn't until this past April 23 when Ssa confirmed that one of the tests taken in La Gloria on April 23 and sent to Canada for testing came back positive for the new virus.
The discontent of the Veracruzanos [La Gloria is in the state of Veracruz] sharpened when they found out that A/H1N1 had a genetic component of swine origin Yesterday in his presentation, Toscano highlighted the basic public health measures and public health promotion which the government of Veracruz had undertaken, such as the distribution of [colloidal silver, 5 kilograms of hyperclorito of calcium], chlorination of fifty water tanks, and 100 kilograms of lime and the [encalamiento-- lime treatment)?] of foci of infection.** Then Toscano proceeded to recount the visit to Granja Carrol, located eight kilometers from La Gloria. According to Toscano, the company manages garbage well. It is taken away by specialized contracting businesses. The management of [pig] corpses is by means of composting mixed with straw and dirt in installations with concrete walls and a mesh roof to avoid bird, rodent and insect infestations. In addition, he said the mortality rate at the granja is maintained below the average of the sector. From October 2008 to March 2009 it varied between 2.1 and 2.9 percent, where as the average in pig farms is between 3.1 and 3. percent. He also referred to the operational conditions of the granja which, he said, included measures maintaining a high level of biosecurity such as a mesh fence surrounding the whole installation, programs of weed and pest control, disinfection and sanitization of materials which enter the farm and keeping food containers closed, among other measures.
According to Toscano -- and in contradiction to that which the National Water Commission reported in respect to the existence of underground filtration of fecal wastes--, the oxidation lagoons in which the solid wastes are captured are constructed in three layers of compaction withclay and a special sealant which prevents filtering into the subsoil. * Granjas Carroll is a company that is jointly owned by Smithfield Foods of the US and Agroindustrias Unidaswith 16 pig factories in the states of Veracruz and Puebla, all, I think, in the areas of the Valley of Perote and the Valley of Guadalupe Victoria. It's worth taking a tour through their website.* Granja Carroll or granja Carroll refers to the factory nearest to La Gloria. ** I am not scientifically-minded enough to translate these terms correctly to English since I'm not sure what they'd be in English.

Mexican flu: What Mexicans think about it and the government's effortsB

Below is my translation of Consulta Mitokvsky's summary of their survey.

Human flu in Mexico

National Telephone Survey

This survey was completed by Consulta Mitovsky.  Full results at www.consulta.com.mx

IMPACT

In general terms, the mood of the country is negative for all items evaluated.  It is considered that present conditions are worse or equally bad compared to last year.  85% of the national population thinks tat economic conditions are worse than last year; regarding health, 70% think so, 70% think security is worse and 62% think political conditions are worse.

In spite of the negative perception of the situation across the country, President Felipe Calderón receives a high rating, with 70% approval given by Mexicans who have residential telephone service, though without doubt this reflects the mood of the country in general.

All the attention  paid to the news is monopolized by the flu epidemic which the country is presently living through.  84% of the population mentions this matter as the principal event of the past week, and they also mention aspects of the event.

Once the events arising from the epidemic and the suspension of classes in the whole country are mentioned, practically everyone says they are interested.

When the suspension of all levels of education is referred to, the largest proportion think this was decreed by the Secretary of Health (39%) although they also mention the President of the Republic as important in some way (30%).

THE INFORMATION

The principal preventive measures Mexicans have currently taken have been to use mouth covers (25%), not to go in the street (24%), to wash hands well (18%), to follow the recommendations of the authorities (9%) and to avoid public places (6%).

In spite of the magnitude of the medical emergency, 94% of citizens say they don’t directly know anyone directly who is sick eith the flu, while 75% say that they don’t know of anyone with the flu in their circle of close neighbors or friends.

In spite of the seriousness of the symptoms, 87% of the citizens think that if anyone becomes sick now, it is quite certain that they can be cured of the illness.  In the cases in which people died from influenza, the majority of citizens (65%) that this occurred because the victims didn’t get help in time and not because they did not receive attention from public health authorities.

Without doubt,  a positive element of all the coverage has been that it has put clearly in people’s minds  (94%) the information about where to go in case someone in their family or a neighbor shows signs of the illness . Also, a very high percentage of citizens say they know the symptoms which would permit them to identify the illness (94%).

THE AUTHORITIES          

When asked about the suspension of classes and the cancellation of events, 75% of the national population with telephone service thinks that the measures are called for;  that 11% of the population thinks that stronger measures should be taken.  Meanwhile,  45% of those interviewed think that information is being hidden.

It is mainly thought that the actions of the authorities in this medical emergency have been efficient (72%) and that it has not been exaggerated (69%), and it’s also thought that for the most part, the measures have been timely (65%).  Opinions are divided about whether the information received has been incomplete (44.%) or complete (39.2%) [NOTE: the figures in the Spanish version of this report are incomplete.  I took the figures from the actual survey.]

Among different levels of authorities people have been involved with, citizens grade positively the federal government in general and Felipe Calderón in particular (65%), next the Secretary of Health (63%), and in the case of local authorities, people grade their actions positively (58%) as well.

THE EFFECT

Without doubt, these actions have had a significant effect on daily activities.  80% of those questioned had a family member who stopped going to school, 32% cancelled plans during this time, 16% cancelled trips and in 22% of the cases, a family member stayed home from work.

LOS MEDIOS

Television is the preferred medium by a long shot for following the evolution of this epidemic according to 85% of those interviewed.  A distant second is radio (7%) and third, conversations with friends and family members (2%)