November 2001 Letter from Chiapas
by Dr. Linnea Capps

Dear friends of DGH,

Some of the optimism that many felt at the beginning of this year has dissipated. Almost exactly a year ago Vicente Fox was elected president of Mexico, defeating the PRI (the Institutional Revolutionary Party) for the first time in 70 years.

Fox had campaigned promising to resolve the conflict in Chiapas very rapidly and he did introduce into the Mexican Congress a law related to the right to autonomy of indigenous communities. This proposed law was based on the San Andres Accords signed by the Zapatistas and the previous PRI government. Former President Zedillo never brought the proposal before the legislature as the government promised it would do at the time of the signing of the accords. It was considered a sign of hope that the Congress was finally considering the proposal. A large number of Zapatista supporters walked from Chiapas to Mexico City and their leaders were given the opportunity to speak before the Congress. However, when the vote finally came, the law that was passed was significantly different from the original proposal. Indigenous groups from all parts of Mexico denounced the new law as falling far short of what had been expected, especially in the areas of communal land ownership and autonomy in choosing community leaders. Fox has since made statements essentially saying he has done what he promised, a law was passed, and he has to go on to more pressing problems for Mexico.

Meanwhile, little has changed for the people in the communities. Few if any troops have actually been removed from Chiapas. Many communities feel intimidated and threatened. The PRI is still a major political presence and there is great political polarization at the level of the communities. There have been a number of violent incidents and some political murders. In addition, some communities have expelled families who don't belong to the PRI.

The work of Hospital San Carlos continues and the atmosphere in Altamirano is quite calm at the moment. There is still an obvious presence of a couple of different police forces and of the Army, but the display of force is less menacing-looking. Another bright spot for foreigners is that the low level of vigilance by immigration authorities has not changed.

DGH volunteers have continued to participate in the clinical work of the hospital and DGH continues to support the hospital's community health work. We are currently supporting the salary of the Mexican physician who is in charge of the community health program and providing a small amount of material support for the work of the health promoters in the isolated communities where he is training health promoters.

All the promoters are volunteers and receive no compensation. Small amounts of money from DGH have helped them buy supplies to build a small community clinic, and buy a diesel generator to supply electricity to the clinic. They are also in the process of building a dormitory so it is easier to house promoters when they come for courses.

I have visited the community where the clinic is located and a couple of others during my visits to Chiapas this year. Most of the communities are quite isolated geographically, an hour or more from the main roads walking on narrow muddy trails. The communities are very small-15 to 30 families. They are part of an "autonomous municipality" and consider themselves to be in resistance meaning that they accept no assistance of any kind from the Mexican government. They have their own schools and want to have their own health system as much as possible.

Most of the people, including the promoters are very poor. The areas where they live are very mountainous and most of their houses have dirt floors and are made of mud packed over frames of bamboo. Their tin roofs are the only parts that are brought from the outside. Most of the communities have no electricity or running water. The people are subsistence farmers and most grow coffee to earn what little cash they can. (This has become much more difficult as the price of coffee has fallen dramatically in the past year.)

It has been very interesting to talk to the health promoters about their plans for their communities. (Unfortunately it is much harder to talk to women in the communities since very few speak Spanish). Some at least seem to have resigned themselves to a very long political struggle. During my most recent visit, I asked one of them what he thought of the Fox government and the debate over the new law relating to indigenous autonomy. He said he didn't think about it very much, that he felt his community was able to run itself autonomously already and was optimistic that things would continue to get better.

It remains hard to see how this will be resolved--the communities are very poor and can't really pay by themselves for things like water systems, better housing, health care, etc. Change will be very slow and some of the communities will remain outside the mainstream of Mexican society. However, they are determined not to go back to what they see as the subjugation they experienced before the Zapatista uprising.

Another interesting observation is that several people, including some of the auxiliary nurses in the hospital and people in these isolated communities have asked me how things are in the United States (these are mostly people with little formal education who don't know much geography or politics outside Mexico). In spite of all their own problems and their isolation, they know that a lot of people were killed and asked me how I felt about it. The Mexican doctor who runs the community health project spoke about it in a meeting we had in the community we visited. He and I talked about how large numbers of innocent people died in New York, but also how many innocent people are dying now in Afghanistan and that there are people in the US and elsewhere who oppose the continued bombing there. I had brought a news article about it and all those who could read Spanish took turns reading it.

I feel very privileged to be trusted enough to work with these people who have so many reasons to be suspicious of outsiders. I think this is a reinforcement of our philosophy of liberation medicine and a tribute to the physician who is coordinating and to all the DGH volunteers who have supported our community work.