For Immediate Release
Mexico City, Mexico — A breakthrough report was released today detailing the devastating impact that the region's ongoing, low-intensity conflict has had on the health and human rights of Chiapas' civilians. "Excluded People, Eroded Communities: Realizing the Right to Health in Chiapas, Mexico," based on research which took place over fourteen months in 2000-1 and was supplemented with more recent information, was a joint project between CCESC -DDS (Center for Training in Ecology and Health for Campesinos — Right to Health Defense Group), ECOSUR (The College of the Southern Border), and Physicians for Human Rights (PHR). The household survey is the first comprehensive population-based study to take place in the conflict zone-yielding alarming data on maternal mortality, child health (particularly rates of malnutrition and vaccination coverage), the number of people infected with pulmonary tuberculosis, as well as the overall availability of health services to the population and socio-demographic indicators.
"The candidates for President should use this election to start a national dialogue about how Mexico will address the health crisis afflicting indigenous communities like Chiapas," said Marcos Arana Cedeño, director of CCESC-DDS. "As the study conclusively shows, the people of these areas cannot wait another six years to be able to access the healthcare they need now."
Among the key findings was that the overall rate of malnutrition, according to the height-for-age index, a commonly used methodology to determine rates of stunted growth, was an alarming 54.7%, which is among the highest found in any study within the country — placing the area studied among some of the most underdeveloped countries in the world. The gross estimated rate of maternal mortality was 607 per 100,000 live births, a number at least seven times higher than that calculated by the health sector for Chiapas and for the whole country.
In the forty-six studied communities, pulmonary tuberculosis was detected in 29 people, of whom only 13, or fewer than half, had been identified by health services and were being treated. The unadjusted overall rate of pulmonary TB for the population, taking into account estimated total inhabitants, was at least 85.3 per 100,000 and 161.2 for those age 15 and older, almost three times the rate reported for the entire state of Chiapas. In the conflict zone, 23% of the children have not completed their vaccination schemes, a number far higher than the official figures, which is under 5%. This disturbingly low coverage is attributable to many factors, including lack of knowledge about the importance of vaccinations, lack of access to health services, and distrust towards government health services for conflict-related reasons.
In cases of self-reported illness within the last month, three out of every ten persons did not seek any health care (government or other), while six out of every ten sought government-provided health care. As to the reasons for not using government health facilities, members of opposition communities most often mentioned lack of medicines and problems related to the conflict, such as receiving treatment only if certain conditional demands were met, or being denied treatment all together. People in pro-government communities repeatedly noted their distrust of services as well as the lack of care and transportation. In divided communities, economic constraints on using any health service were most often mentioned.
"The disintegration of basic social services in Chiapas, especially healthcare, shows the dire effect Mexico's national policies can have on entire sectors of the population when indigenous people have no say in the decisions that directly affect them most," said Héctor Javier Sánchez Pérez, Professor at ECOSUR. "All candidates for the Presidency must commit, if elected, to finally and fully implement the San Andres Accords," added Professor Sánchez Perez. "Implementing San Andrés will help ensure that the indigenous communities of Chiapas are granted autonomy they need to build social services that can appropriately serve their communities. Permission to build local healthcare centers in Chiapas should be granted immediately as part of the Accords' implementation."
The report's findings suggest that during the first six years of the conflict between government aligned forces and the EZLN (Zapatista Army for National Liberation)-1994 to 2000-profound divisions arose within and among hundreds of communities in Chiapas, which had previously been distinguished for their high level of social cohesion and organization. The politicization of social services offered by the government and the civil resistance of EZLN supporting communities are two of the key factors, among many, that have caused the people of Chiapas' health status to dramatically decline.
"The people of Chiapas and all of Mexico's indigenous groups have a fundamental right to health-and the government of Mexico has systematically undermined the health of indigenous people," stated Alicia Yamin, JD, MPH, Director of Research at PHR. "The findings of this study clearly show the link between years of human rights abuses and Chiapas' ongoing public health emergency. The basic health indicators for the region place Chiapas among the ranks of some of the most impoverished in the world."
In the forty-six communities studied, information was obtained from 17,931 individuals in 2,997 households: 1,477 households (49.2%) from pro-government communities, 256 (8.6%) from opposition communities, and 1,264 (42.2%) from divided communities (496 pro-government, 168 opposition, and 600 of undetermined political affiliation).
ECOSUR, The College of the Southern Border, is a multidisciplinary public research and post-graduate educational institution, which focuses on development and cross-border issues on the southern border of Mexico. Its programs are oriented towards the generation of scientific knowledge, training human resources, and the design of techniques and strategies that contribute to sustainable development.
CCESC-DDS (Center for Training in Ecology and Health for Campesinos) was created in 1985 to support the work of physicians and researchers during the humanitarian emergency that followed the eruption of the Chichonal volcano, and to attend to the health needs of Guatemalan refugees and internally displaced populations. The Right to Health Defense Group merged with CCESC more recently. In 2005, CCESC received the Sasakawa Award at the World Health Assembly for its more than 20 years of work on behalf of the indigenous communities of Chiapas.
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.