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September 1967

The series of journals titled "Report from the Sierra Madre" terminated with No. 4. However, many subscribers have shown so much interest in my continuing Mexican Project that I would like to keep them informed, if briefly, of my activities in the barrancas since the last Report came out in February.

1. In March, I took a group of eight Pacific High School students to "my" part of Sinaloa. As in 1965, the students made up first aid kits, sorted and repackaged sample medicines, and collected clothing and school supplies before the trip. We assembled a mule train in Ajoya, and made the rounds of the villages as far as Jocuixtita and Verano. The villagers were delighted to sea the students welcomed them into their homes, took them swimming, crawdad fishing, hunting, working and taught the girls how to prepare Mexican food. The students, in addition to studying various aspects of the village life, helped in the care of patients and the dispensing of medicines. We handled an average of over 30 patients a day. While the majority were afflicted with run of the mill ailments – nutritional deficiencies, flu, conjunctivitis, dysentery, minor injuries, we also encountered a number of severe conditions such as little Pancho, who chopped through the bone of his big toe with an axe, and Juan José who died of tetanus after a long struggle.

The students had the privilege of observing many beauties of village life, and closeness between members of a family, the resilience and good nature of the people, their bond to the soil and seasons. They were also exposed, however, to a harsh example of the violence and brutality which is also a part of village existence. The day after we left Jocuixtita, we were called back to that village to make repairs on Teófilo Martínez, the ‘comisario’ of Jocuixtita, in whose home they had dined two days before. The morning of the day we returned, Teófilo had gone out of the village to get firewood, and had been attacked by José Nuñez and his one-eyed son, Paco, together with Paco's two older sons. José Nuñez, the wealthiest man in Jocuixtita had been the comisario preceding Teófilo, but had been so unfair and corrupt that the people had petitioned to have him replaced by Teófilo. Although I had been told many unkind stories about José Nuñez, including how he had committed three brutal murders, I had hitherto witnessed only his good side. The students who had passed through Jocuixtita regarded him as a friend. For example, José had cleaned up his carbide miner’s lamp so that we could see to close the wound on the head of a girl who had been struck by a falling roof tile. He had also invited us to breakfast and had let us keep our animals in his corral. But friend or no, it was hard to forgive what he and his offspring had done to Teófilo. They had stabbed and gun whipped the little man repeatedly in the face and head. One slash had passed right through the bridge of his nose, from one side to the other; another had completely parted the lower portion of his nose and passed through into the upper portion of his mouth. We recoiled at the sight of him. Tinki Bock, who was with me at the time, kept exclaiming in dazed wonder, “How can one human being do that to another?” We spent three hours cleaning and sewing Teófilo’s face back together, then provided the family with medication and careful instructions, and continued on up to the arroyo to see a little boy we had treated for a severely infected dog-bite, three days before. Two days later, we passed again through Jocuixtita to see how Teófilo’s was doing, and did not see him again until eight days later, when his brother’s from Coyotitán carried him down from Jocuixtita to Ajoya, a distance about 25 miles. He was still weak, his eyes red from traumatic hemorrhaging, but the swelling had gone down and the wounds were healing nicely.

That night Teófilo disappeared from Ajoya, and it was not until several days later that we learned that the state police had arrested him and taken him to the jail in San Ignacio. It turned out that after so brutally beating Teófilo, José Nuñez had shot his own horse to incriminate Teófilo (the shot had been heard while Teófilo was being carried back to the village) and had then ridden to San Ignacio and placed charges against Teófilo, claiming that he had fired at José and struck his horse. The authorities did not trouble themselves to investigate the matter; they simply arrested the poor man on the richer man’s word. To get out of jail, Teófilo had to raise 2,400 pesos; 1,000 to the Presidente Municipal, 1,000 went to Nuñez as payment for the horse (an old horse, which at best was worth 400 pesos; I saw the old nag myself dead on the trail), and 400 pesos for the lawyers fees. Teófilo’s family managed to beg and borrow the money to get him out, but Teófilo, who was already in debt, remained a ruined man. His old house in Jocuixtita is on sale by his creditors, and he himself, still in fear of his life, with has fled to Sonora to live with relatives. As for José Nuñez, he though it wise to move with his family to the Arroyo Santiago, where he has bought the abandoned rancho of Chuy Alarcón, former leader of the Agridistas struggle for justice in Ajoya. On my last visit to the barrancas, José’s son, Paco came to me in Ajoya explaining that his father had developed a “strange sickness” – boils all over, and his whole body swollen. Paco asked me for medicines. I asked if José was still able to travel, and Paco said yes. I said that José would have to come in person for me to examine him if I were to provide medicines, and that I also wanted to talk with him about what happened to Teófilo. José Nuñez never came.

In spite of what appeared at first to be insurmountable obstacles, the sojourn of Dr. Rudolph Bock, eye surgeon from Palo Alto was a big success. Dr. Bock’s daughter, Tinki, and I returned to México in mid-May, two weeks before Dr. Bock scheduled arrival, to make preparations. We made final arrangements with Dr. Feliz of the Centro de Salud in San Ignacio for Dr. Bock to use the facilities of the health care center, and for Dr. Feliz assured us that everything was in order. Then, with assistance of Marco Antonio, a Mexican student from the University of Culiacán who had learned of my project and volunteered his assistance, we traversed about 150 miles of mountain trails, traveling on mule back from village to village. We made appointments for more than 200 patients before returning to Ajoya. Then, two days before Dr. Bock was due to arrive, we received a message from Dr. Feliz informing us that to practice in México Dr, Bock would have to obtain complete authorization from the state authorities! I was distraught. The last time I had been to see the Director of Health and Welfare in Culiacán, it had taken me 2 ½ days just to get an interview with him – and then he had refused to authorize anything, sating that the red tape was prohibitive. Nevertheless,
Tinki and I sat out in haste for Culiacán to beat our wings upon the bars. We went directly to the home of Guillermo Ruiz Gómez, the governor’s assistant who had offered me his assistance. Sr. Ruiz is surely a man with great influence, led up, and the royal carpet rolled out instead. Now, Dr. Bock’s visit was not only authorized, but applauded. Laudatory articles were published in various papers. The president of the Red Cross in Culiacán telegraphed to Dr. Bock his personal congratulations. Guillermo Ruiz Gómez visited San Ignacio, to pay his respects, and immediately following his visit even the local “Presidente Municipal” busied himself sending through personal messengers, letters of fatuous praise to both Dr. Bock and myself. (The same Presidente who tried to frame me with opium smuggling charges, a year ago.)

2. In spite of rather rustic facilities and unexpected complications, such as by a water failure and the accidental burning up of the operation gowns in our make-shift sterilizer, the eye operation – which were illuminated by a hand-held flashlight – went well. During his eight day visit, Dr. Bock examined over 260 patients and operated on fifty-five eyes. The majority of these operations were the removal of apterygial (opaque growth over the eye which gradually extend over the pupil, and if not operated upon, may lead to the obscuring of the vision and blindness.) Most miraculous, and among the most difficult of the operations which Dr. Bock performed were on the eyes of three persons who for up to six years had been completely blind with cataracts. One man in his sixties, named Beto, whom I had to lead by the hand over two miles of trail to where I could enter with my Jeep at Campanillas, had been blind for six years. When a few days after the operation, Rudy took off the bandages and put glasses over his eyes, Beto looked about and began to laugh with the uncontrolled wonder and delight of a child who wakes up to his first snow-storm. But unhappily, we could not give the same pleasure to all the blind patients who came to us with the hope of seeing again. The biggest disappointment for all however, was that blind Ramón, my host in Ajoya, proved to be a victim of glaucoma and has no hope of seeing again. Ramón took the news with apparent stoicism, but later, when he thought no one was looking, turned to the corner, weeping.

Glaucoma proved to be the biggest threat to eyesight in the villages, there being twelve incidents of blindness due to glaucoma. Rudy deplored the fact that this disease, so easily checked if caught in time, was so prevalent, and composed an article about it to be translated and published in the Sinaloan newspaper, in the hopes that it may stir up some action.

3. A week after the departure of Dr. Bock, Dr. Val Price–the pediatrician from Palo Alto who came to Ajoya a year ago–arrived on schedule with his wife and two of his children. During Dr. Price’s stay we had a number of very difficult cases, for which I was particularly thankful to have Dr. Prices’ knowledge and support. The most tragic case we had was that of a five-year-old girl with tetanus, contracted when her ears were pierced. Her father brought her to us in the night from Güillapa. Although I had given DPT inoculation in Güillapa, and had in fact inoculated all the brothers and sisters of thee little girl, she had somehow been missed. Val and I determined to rush the child to Mazatlan for hospital treatment, but as it turned out, we could have treated her as well or better in Ajoya. In México–even among the medical profession– there seems to be an incredible misconception about the contagiousness of tetanus. When Juan José died of tetanus in April, for example, nurses were sent to Ajoya from the Centro in a San Ignacio and inoculated only a handful of persons who had been in or near the house of the sick boy, as if it were contagious.
Similarly, when we took the little girl to the hospital civil in Mazatlan, she was at once hurried into an isolated corridor across from the morgue. It was a horrible place. The room was filthy, coated with dust, smeared with dried blood and excrement, the windows were broken, there was no light and the naked wires dangled from the ceiling. The hospital stored no tetanus anti-toxin, so Dr. Price and I hurried out to a pharmacy to buy some. At the hospital, we discovered that the authorities would let none of the nursing equipment into the room with the girl, not even a pair of scissors. We had to use a pocket knife to cut adhesive! When, after her arrival, the little girl nearly died of asphyxiation due to phlegm, her hospital attendant refused to use the suction aspirator because of the dread of tetanus. We did what we could to suck out the phlegm from her throat with a syringe and a piece of plastic tubing. In the night, we borrowed a kerosene lamp from the home of a friendly nurse. That same nurse also made arrangements for the Lion’s Club of Mazatlan to underwrite the cost of additional medicine, should the little girl survive beyond the first few days. Yet, she died shortly after noon of the next day. The nurses helped us sneak her body out of the hospital so that her sad father could at least return the child to its family for burial.

While Dr. Price and I were in the Hospital Civíl, we also paid a visit to a seven-year-old boy, who Dr. Bock and I had brought there with a broken thigh two weeks before. The boy’s leg was in traction and seemed to be doing alright, although he had developed a raging case of impetigo, which no one had bothered to treat. As little Ramón had no relatives with him, we provided the mother of another patient in the ward with phisohex to wash his face, and gave the boy a shot of penicillin. A week alter when I had occasion to return to Mazatlan, the youngster’s impetigo had completely cleared up. The traction device on his leg had slipped, however, his thigh had recontracted, and the bone had begun to knit in an overlapping and twisted position. I was told that the doctor had seen the boy shortly after the bone had slipped out of place, but instead of resetting the bone, had scolded the boy saying that by fidgeting, he had lost his chance at sound recovery. On seeing the leg, I at once telephoned the doctor, who came the next morning, looked at the twisted leg and told me not to worry; that young children were very adaptable and that little Ramón would in time be able to walk fairly well by affixing a block to the heel of his shoe. I pointed out that Ramón had never worn shoes in his life, and might never. The doctor shrugged, and said the boy would be alright. So! Through Guillermo Ruíz Gómez’s sister, who lived in Mazatlan, I contacted Guillermo about Ramón’s plight, and Guillermo at once made arrangements with the children’s hospital in Culiacan to have Ramón admitted. The next morning, we took Ramón out to the Hospital Civíl in Mazatlan, and transported him in my Jeep, 150 miles to Culiacan. There, at last, he got good treatment. His leg was immediately x-rayed. The following leg was re-broken and pinned. So now, although Ramón is still not over his ordeal (the pin will have to be removed in late September), at least he may have the comfort of knowing that when it is all over his leg should be just about as good as new. But what an effort!

4. Martín Reyes Mercado (whom his family thought was fifteen, but who turns out to be sixteen, now that we have checked his birth registration) is at present in California, seriously studying English in preparation for entry into Terman Junior High School this September. Arranging all of Martín’s papers was a hassle too prolonged and tedious to relate. It involved multiple visits to no fewer than sixteen different offices in three different cities, and nearly every office collected its fee, until the total expenditure was over 500 pesos. The visa itself was free.

The present plan is for Martín to spend one or two years in school in the states, and then return to Sinaloa to train to become a teacher in the villages. During the latter part of the summer, Martín has been staying with the family of Bob Graham and Shirley Graham in Monte Vista. Shirley, who had worked for several years with the language program of the Lark Foundation, had taken him on as a full-time student. Martín is learning eagerly and rapidly. He not only is learning English, but has already mastered the bicycle, has been studying math and has made many acute observations on American culture. Almost everyone who meets him, loves him, and all who spend time with him delight to see the old things we take for granted brought into fresh perspective through his new and wandering eyes. While Martín misses his family and the modest village food, he appears happy and astoundingly adaptable. He seems to have the knack of assimilating his new environment without being assimilated. He remains and promises to remain very much Martín.

5. In response to my request for help in the field of dentistry, Penny Brady of Santa Bárbara contacted her dentist friend, Chuck Renn, who has since taken great interest in my project, and on my last trip south, Chuck took the trouble to instruct me, briefly, in the basics of tooth extraction, including oral anesthesia. He also provided me with the basic tools and a text on oral surgery, and a goodly supply of disposable needles and carbocaine cartridges. When I got back to the villages, I began very proceeded on to firmer teeth. To date, I have extracted over sixty teeth. I have run into no major complications, although I have had occasional problems with root breakage, and have had to improvise makeshift elevators. On my last trip to California, I stopped in again at Santa Bárbara, and Chuck Renn arranged for me to observe tooth extraction in a nearby oral surgery clinic. The tooth surgeons and their nurses were particularly friendly, carefully answered my questions in the course of the extractions, and presented me with a set of elevators, the tools which I most needed.

What I can do gently, is still, of course, quite limited. I am unable to do any drilling and filling. I would be delighted if a dentist his services in the villages id only for a dew days. The dental needs and resultant suffering are enormous. One curious case recently, was the girl who had an ulcerous sore at the angle of her jaw, which Dr. Bock feared was scrophularia (tuberculosis). The ulcer which had had resisted all treatment for several months, cleared up completely after a rotten tooth was extracted. I am very grateful to Dr. Renn and his colleagues for affording me the chance to ameliorate at least some of the suffering due to infected teeth.

6. The prospects for a program for birth control in the villages has had some promising developments. Dr. Djerassi, who twice has arranged to have free medicines sent to me from Syntex of México, put me in touch with Dr. Jorge Martínez-Manatou, director of research from México’s social security program. Dr. Martínez-Manatou is one of the few persons in the circles of the Mexican government who is unequivocally in favor of his country taking some definite, positive measures in a national program of birth control. He became quite excited about my work and observations in the barrancas of Sinaloa, especially with the results of our censuses. (In addition to the census I took in Ajoya [see Report #4] two of the students took a poll in Bordontita in which the response of the people was even more strikingly in favor of birth control. Dr. Martínez-Manatou asked me to prepare a formal letter, in Spanish, explaining the population difficulty in the villages and the readiness of the people to accept birth control measures. He said he would personally present the letter to the national director of health and welfare in México City, and make a big push to have the government sanction of a pilot program of birth control in my region of Sinaloa. The letter has been in sent and the gears are in motion, but slowly. Whether or not the program will be OKd is still indefinite.

7. An increasing number of sources for medical supplies have been opening up. Dr. Martínez-Manatou said he would make efforts to secure donated medicines from some of the drug companies in México. Dr. Djerassi of Palo Alto arranged once again, for donations of cortico-steroids and antibiotic preparations from Syntex of México. My dispensaries were accepted as eligible recipients of medicines from the Direct Relief Foundation of Santa Bárbara, a non-profit organization which accumulates and sorts medical samples and surpluses from all over the country and awards them to volunteer medical organizations in foreign countries at handling costs of 25¢ per pound. (Although the relative quantities of the medicines are determined by the Foundation, and the chore of re-packaging is enormous, I have so far obtained some very good medicines in substantial quantities through the Foundation at costs far below what I would normally have to pay.) My dispensaries in Ajoya and Verano are at present fairly well stocked, except for some of the fastest moving items such as vitamins, aspirin, and worm medicine for which the need is as ubiquitous as the lack of diet and hygiene. So far I have dispenses more than 100,000 vitamin tablets. There does seem to be an increase in nutrition deficiency symptoms in my area. There is also an apparent decrease in infant and child mortality – which means the birth control program had better hurry up. (Martín’s mother is pregnant with her eleventh!)

8. My present plans are to remain in California until the latter part of September, long enough to see Martín started in school, and then to return to the villages.

In November, a team of four plastic surgeons, headed by Dr. Don Laub, Head of Plastic and Reconstructive Surgery at the Palo Alto Stanford Hospital will be driving to Sinaloa to operate on financially poor patients with cleft lip, and on congenital and burn deformities. It is still uncertain whether they will conduct their operations in the State Capital of Culiacán or in San Ignacio, but in either case, complete authorization has already been obtained, via my friend Guillermo Ruiz Gómez, with sanction from the governor and the Head of Health and Welfare for the State. As I did for Dr. Bock, I plan to make rounds of the villages, ahead of time to notify those who may benefit from operations.

During the time I am in the barrancas this Autumn, arrangements are being made for a group of Pacific High School students to come down and spend a month in the villages. This time, the primary objective will be to learn Spanish, although a great deal more should be learned incidentally. The plan is that each student will live, eat, sleep, work, and communicate as well as is he/she is able with the family he or she stays with. The students will, of course, be paying for their own food plus a little extra, so that the experience should be of advantage to them. The students who so choose will also have the chance to take turns helping me with my work in the dispensaries and other activities. If this experiment works well, it may be repeated in the Spring. My ulterior motive is that it also brings me a little salary, which is useful.

9. Until my return to Mexico in the latter part of September, I shall show slides on my project in the Sierra Madre and be available to speak to interested groups with the hope of encouraging further support for the continuance of my project.

I am, as ever, before my return to the villages, collecting needed items to take down; notable clothing, blankets, school supplies, children’s books in Spanish, medical supplies, powdered milk, funds, etc.

I would also like to solicit the help of a typist (or even a hunt-and-peckist with copious time and patience) to prepare stencils of a résumé of my Mexican project. These will be made available to those who have not had the advantage of the Reports, which long since ran out. Also, should anyone by some miracle have the equipment and time to rerun on a mimeo the stencils of my Reports from the Sierra Madre, it would be a tremendous help. I have many requests I have been unable to fill.

- - - - - -

The response to my “Further Request for Help” accompanying the 4th Report was quite good. I have been unable (or, more correctly, have neglected) to send personal thanks to all of the persons who have made, or are continuing to make contributions to my project, and until such time as I thank each of you personally, I hope that my thanks may be acceptable in this form.

I would like to give special thanks to Laurie Ann Lepoff, a senior high school student from Sunnyvale, California who came to Ajoya for the first part of summer and tutored Martín en English to give him a head start when he came to the US.

I also give special thanks to Ann Wilsnack and Joe Bonner of the Woodside High School Student Council for their enthusiasm in organizing a benefit dance to raise money for the project (specifically for medical and educational uses) and to Marianne Moore and Chris Jones, two of the students from Pacific High School who have been to the villages with me, for helping prepare the photographic exhibit and presenting the slide show at Woodside in conjunction with the benefit. The show netted $207.14 for the furtherance of the project in the Sierra Madre.