Via NY Transfer News Collective * All the News that Doesn't Fit DOCTORS OF THE WORLD OBSERVER REPORTS BACK FROM CHIAPAS by Toby Mailman for NY Transfer February 10, 1994 Ramona Bailly, a pediatrician and a member of Doctors of the World (DOW), a New York-based, non-profit human rights organization, travelled from January 15 - 26 through Chiapas, Mexico as an observer representing DOW, mainly to see what the status of health care for the people in the region was after the military intervention following the uprising on January 1 by the Zapatista National Liberation Army (EZLN). In a talk given on February 9 at the offices of Doctors of the World Dr. Bailly reported on some of the human rights abuses she saw or heard about, in addition to the lack and even prevention of medical care. Dr. Bailly was told by residents one of the areas she visited that some 300 bodies were brought to a fair grounds run by the military. Forty-eight bodies were autopsied and buried in a paupers' cemetery without being identified. By Mexican law, photos are supposed to be taken before, during and after the autopsies, and the photos and fingerprints of the bodies are supposed to be made public, so that they can be identified. The Government refused to make the information public. The fates of the remaining 252 bodies was unknown, and hundreds of families may never know what happened to family members who have disappeared. Reporters who were able to get a look at the bodies gathered at the fair grounds said they were all definitely indigenous people. The assumption is that they were executed by the military and that these executions are being covered up by the government. In a cemetery next to a hospital which had been occupied by the military for ten days a number of bodies had been quickly buried, and not by family members. They were dug up by the government Attorney General's Office and given autopsies. Independent international observers were not allowed to watch the autopsies. Dr. Bailly for some reason was not stopped as she walked around the cemetery, where she was able to observe bullets being removed from the backs of some of the bodies. Her lack of training in that field, however, prevented her to make further observations. She described the members of the Attorney General's office who were performing the autopsies as "the bad guys," and said the people truly feared them. Observing the situation of refugees in Mexico, Dr. Bailly said the Guatemalan refugees, who are for the most part being cared for under the auspices of the U.N., were doing alright. However, Mexican refugees who were displaced for a variety of reasons following the January uprisings, including military bombings, and who were being cared for by the military and the Mexican Red Cross, did not far as well. In one refugee site which held about 300 people military doctors were giving examinations in public, sure to have their military photographers on hand. The three military doctors said they did not need any assistance from the oberving foreign doctors. At another refugee site organized by a farm cooperative, which also held 300 people, conditions were much better. Committees were organized to see to people's needs, and there was even a recreation area for children. In Ocosingo the military was seen distributing food, or shoes, or clothing. However, the recipients were all Mestizos, none of them were indigenous people. In order to get the food the people needed to show identification, which is bureaucratically almost impossible to obtain. Witnesses told Dr. Bailly that in one rural town the military harassed the population. In another 33 people were tortured and taken away. The residents were told to stay in their homes or they would be bombed. Although the official death toll during the uprising and military repression is in the hundreds, testimony from people living in Chiapas indicates that during a ten-day period when no outsiders were allowed to enter the area, deaths in Chiapas at the hands of the military really reached the thousands. On January 2 a hospital in Ocosingo was closed down by the military for 10 days. According to reports from patients in the hospital, all male visitors were shot or disappeared by the military, allegedly suspected of being members of the EZLN. On January 3 a guard at an archaeological site was shot in the chest and the military would not allow him to obtain medical attention. He died after three days. In the town of Altamirano the only medical attention the indigenous people get is from the small, St. Vincent de Paul-run San Carlos Hospital. Personnel at the hospital, including nine doctors, have in the past received death threats and it has long been suspected by the government of supporting insurgency because it serves the indigenous population. It has been made clear that the hospital will serve anyone who needs the care, but, according to Dr. Bailly, the non-indigenous townspeople do not want to receive medical treatment at the same place the indigenous people receive their treatment, since that would mean they would be treated as equals. When the military came into the area after the EZLN they patrolled the San Carlos Hospital wards, and harassed and threatened the staff. The head lab technician was tortured and taken to Tuxtla. Fortunately a lawyer was able to get him released eventually. Patients were not allowed by the military to enter the hospital. The hospital normally runs a very good community outreach health care program, going into the rural indigenous communities. The military would not allow the nuns who work at the hospital to continue their work in the communities. With the presence of foreigners the situation has improved somewhat. Mdecins du Monde has sent a doctor to work in the San Carlos Hospital for six months, and Doctors of the World has sent a doctor for 3 months, who sends back regular reports. After 3 months the situation will be reassessed. Meanwhile, there are thousands of people displaced by the military intervention who are in precarious condition. The question that no one can answer now is what will happen to them when they go back to their homes. At any time during the next six months, until the end of June, Mexico has the option to pull out of the North American Free Trade Agreement (NAFTA). It is not clear what effect this may have on the government and the military's treatment of the indigenous people in Chiapas, or on other peoples in Mexico as the new spirit of rebellion and demand for change spreads. # # # FOR IMMEDIATE RELEASE - February 8, 1994 CONTACT: Dr. Ramona Bailly Member, Executive Committee Board of Directors Doctors of the World Steven Segal Executive Director Doctors of the World (212)529-1556 (212)529-1571 (Fax) ESSENTIAL HEALTH SERVICES JEOPARDIZED BY STRIFE IN CHIAPAS, MEXICO. INTIMIDATION AND ISOLATION LEAVE INDIGENOUS PEOPLES FEARFUL OF SEEKING NEEDED CARE. DOCTORS OF THE WORLD PLACES AMERICAN PHYSICIAN IN ALTAMIRANO HOSPITAL. Unremarked in much of the reporting about the Zapatista revolt in Chiapas, Mexico, is the effect of the Government's response to the uprising on the availability and delivery of medical services to the region's population. A fact-finding mission conducted jointly by Doctors of the World (DOW), a New York-based non-profit international human rights organization, and Mdecins du Monde (MDM), DOW's French counterpart, documented intimidation and isolation that still prohibits people form seeking and receiving health care. Further, systemic, gross inadequacies surfaced in both the level of health care services and the delivery channels for those services. Representing DOW on the mission was Ramona Bailly, MD, MPH, Pediatric Emergency Room attending physician at Bronx Lebanon Hospital, Bronx, New York. Bailly spoke with victims and witnesses of violence, Zapatistas and health care providers in San Crist"bal de las Casas, Altamirano, Ocosingo and the countryside. The mission established its base at San Carlos Hospital, serving Altamirano, a municipality of 60,000 people living in 600 communities in the mountainous area southeast of San Crist"bal de las Casas. Reports confirmed Mexican Armed Forces (MAF) human rights abuses, targeting particularly the indigenous population. Since the outbreak of the revolt, delivery of health services at San Carlos Hospital and within the pueblos [small towns] has been seriously disrupted. - Of the hospital's nine doctors, all Altamirano locals, seven have fled in fear. - Deliveries of fuel and other supplies often were stopped. Hospital staff were routinely intercepted when attempting to maintain the facility's water supply or gather wood for cooking. - The hospital was not included in the MAF's water delivery to Altamirano inhabitants prior to the arrival of international human rights representatives. At the request of the Sisters of St. Vincent at San Carlos Hospital, and responding to the state of medical urgency witnessed by the mission, on 1 February DOW placed a volunteer American physician - Glen Fennelly, Pediatric Infectious Diseases Fellow at the Albert Einstein College of Medicine, Bronx, New York - at San Carlos Hospital, Altamirano. Dr. Fennelly joins Dr. Marie Soulard, an MDM volunteer; both work at the hospital and conduct consultations in surrounding villages. Their presence, with others on site as observers, is considered essential to allow continuity in providing medical services and offering some protection for local health workers. The doctors are seeing approximately 100 people each day. Since the cease-fire, the Government Secretariat of Health has dispatched teams in the jungle, fully equipped with vaccines, various antibiotics and other necessary materials as well as vehicles suited for travel into the countryside. Fennelly and Soulard have been readily accepted as members of the medical teams making daily forays. While this Government action is welcome - even necessary to gain access for the expatriates in some villages - it has been sporadic. After arriving in Altamirano on 27 January, they abruptly left on 2 February without explanation. As unexpectedly, Government Department of Health teams returned three days later and resumed work in tandem with the DOW and MDM doctors without comment. Regarding medicines an medical supplies, Bailly highlighted the hospital's desperate need for these items in her mission diary. Fennelly also observes that availability of mediation and supplies seem to be tied to the presence of Government Secretariat of Health staff. There is great concern for regular, dependable delivery of an adequate quantity of these essential supplies. Fennelly's 5 February report from the field: - While there has been no sign of true emergencies, there is a tremendous disease burden, including tuberculosis, parasitosis and malnutrition. Evidence of a woefully inadequate health care delivery system is everywhere. - People in most of the villages visited hadn't had contact with any health care workers since the end of December. Several local health care promoters have fled. - Members of the Government teams are encouraging people to visit the hospital; nonetheless, there is still tremendous fear of travelling to San Carlos hospital. At the hospital, where the usual patient population averaged 55 before the MAF began its patrols, ten count is now fewer than twenty. Typically busy out- patient clinics are quite. - Additional international personnel have arrived in Altamirano, primarily as observers. Coincidentally, two supervisors from the Government teams visited the evening of 4 February, giving every sign of welcoming the expatriates. Doctors of the World and Mdecins du Monde plan to maintain their services - and physical presence - Chiapas through April. Doctors of the World-US is a non-sectarian medical relief organization operating worldwide, with headquarters in New York City. DOW is the autonomous affiliate of Mdecins du Monde, Paris, which currently has more than six hundred health professionals in field assignments in forty countries. DOW has developed, staffed and funded programs around the world, including Kosovo, the former Yugoslavial; Moraz n, El Salvador; St. Petersburg, Russia, and in the streets of New York City. # # # +----------------------------------------------------------------+ + 212-675-9690 NY TRANSFER NEWS COLLECTIVE 212-675-9663 + + Since 1985: Information for the Rest of Us + + e-mail: nyt@blythe.org info: info@blythe.org +