Mass General Brigham's Center of Expertise in Global and Community Health



Enhancing clinical care in rural Mexico part 2

Sunrise over Soledad

In my final weeks working in Chiapas, Mexico with Companeros en Salud (CES), I was stationed in two communities - Laguna del Cofre and Soledad. Laguna is one of the highest elevation mountain communities that CES serves, and it's also one of the biggest and most remote. Because of the large size of the community, clinic hours often started early and ran late. The Pasante did not turn patients away. As the other Pasantes I worked with, she was similarly skilled both in creative improvisation to provide appropriate medical care - we constructed an asthma inhaler spacer out of a plastic water bottle - but also in integrating herself as a trusted and valued member of the community.

It was here that I was also able to learn much more about the various stages of coffee processing from one of the local roasters, who provided a detailed explanation of coffee processing one morning before we began in clinic. Prior to my time in Chiapas, I'd pictured the coffee that we buy from the large franchise chains in the US as coming from large ranches in whatever country the coffee was being sourced from. It wasn't until living in Chiapas that I saw how all of these villagers were largely growing coffee to sell to large coffee retailers in the US. The villagers pool their coffee together in co-ops to try and negotiate for better deals. Though they drink coffee all the time, it's generally the worst quality coffee, because it's what can't be sold to the foreign markets that pay the highest price.



Stages of coffee bean processing



In my final week in Chiapas, I was working in the community of Soledad, a beautiful village built on mountainsides of striking red clay earth. Soledad was similarly one of the more remote communities that CES served. There, I stayed in the spare room of an incredibly friendly and generous family. The father of that family had recently left to try and cross over into the US. The percent of young men who planned to travel to the US for work was striking, though most were adamant that they wanted to return to Mexico to be reunited with their families. Husbands and wives would go weeks without being able to talk to each other - either because they didn't have the funds to communicate, or often the husband was moving from one job to the next in the US. After working and saving money, many planned to return to their home communities and use that money to increase their family's standing in the social hierarchy there - buy a better store, build a nicer house, or have a little more land to grow coffee.