Dear friends of DGH,

Mexico has gone through some inportant political changes in the past year. There have been some very visible changes since the new government led by Vicente Fox and the PAN party won the presidency from the PRI in 71 years. The new governor of Chiapas, Pablo Salazar is also from the PAN but ran for office representing a very broad coalition that included almost all of the opposition parties including the left-of-center party, the PRD.

The new governor is clearly an improvement over the previous PRI governor. His public statements indicate an openness to real dialogue with the Zapatistas and a willingness to confront the PRI and the paramilitary forces. PRI legislators in the state assembly are doing everything possible to sabotage his efforts.

Fox had boasted before the election that he could end the conflict in Chiapas in 15 minutes and he has made some fairly rapid changes in the posture of the military. As of my visit in December and January, he had dismantled 3 of the 7 permanent military checkpoints in various parts of the state. One of these was in Cuxulja, the one closest to Altamirano. This was done with great fanfare, including burning buildings, furniture and papers in the presence of a contingent of ambassadors from several Latin American countries. Whether this turns out to be more than cosmetic is not clear yet. Most reports indicate that no troops have actually been removed from the state and Fox has now stated that he will not take down any more checkpoints until the EZLN has demonstrated their "willingness for dialogue."

What appears to be a true change of direction for the new government has been immigration policies. Immediately on taking office on December 1, the government of Fox moved quickly to remove many restrictions on the travel of foreigners in Chiapas. Several foreign nuns and priests who had been without immigration documents for as long a 5 years were quickly restored to legal status. In addition, several foreigners who were expelled from the country during the past several years have been told that there are no longer any restrictions on their return to Mexico. The immigration post in Ocosingo looks completely deserted and the one in Altamirano seems to staffed only occasionally.

DGH continues to work with Hospital San Carlos. The work of the hospital continues at the same pace. The outpatient clinic saw over 15,000 visits in the year 2000 and there were 2798 inpatient admissions. Several DGH volunteers, including medical students participated in work at the hospital during the past year.

DGH also supports some of the community health work of the hospital. Physicians associated with the hospital oversee a program to work with health promoters in several communities. Over the last 8-9 months work has begun in a new area in 29 small, very isolated communities. Many of the communities are several hours walk from the nearest highway.

A Mexican physician who joined the community health team at the beginning of 2000, started with almost nothing and began to train a group of about 25 health promoters from these communities. He goes every month for 2 days of training with them. He also began to train dental promoters. In addition, he went with the promoters and supervised them giving vaccines in 9 of the communities (the others are still in the process of being organized). He has also helped them with the logistics of building a "casa de salud" in the community that is the center of the municipality. This was accomplished with almost no outside funding; the funds came from small contributions (20 pesos per family per month) from all the communities in the municipality and the promoters did all the construction work. Funds from DGH that were designated for expenses helped to buy a diesel generator (none of the communities has electricity).

DGH has also helped to find financial support for the training of health promoters and appropriate technology promoters in another group of communities in the area of the hospital. During the past year these promoters have begun building dry fertilizing latrines and Lorena stoves (which use much less wood, create much less smoke and are much safer for children to be around). In addition, this year there will be a special workshop for women and support from a technical team from Guatemala so that they can learn to make ceramic pieces that are necessary for the construction of the stoves. These pieces have had to be imported from Guatemala until now.

These community programs are the heart of what we see as our work in Chiapas. We hope to support a system of prevention and community-based primary care that will be sustainable. Our most important contribution is education and technical support for the promoters. We plan to continue the project during 2001 by both supporting the salary of the Mexican physician and with the occasional work of DGH volunteers.