HealthWrights: Workgroup for People's Health and Rights HealthWrights: Workgroup for People's Health and Rights HealthWrights: Workgroup for People's Health and Rights HealthWrights: Workgroup for People's Health and Rights Newsletters for the Sierra Madre
HealthWrights: Workgroup for People's Health and Rights HealthWrights: Workgroup for People's Health and Rights HealthWrights: Workgroup for People's Health and Rights HealthWrights: Workgroup for People's Health and Rights HealthWrights: Workgroup for People's Health and Rights Siluets of Disabled Kids
About Us How  You Can Help Projects David Werner Papers Links to Other Sites Contact Us
What's New! Publications Politics of Health Reading List Spanish Training Program Spanish Pages/ Páginas en Español Site Map



September, 1968

When I first came to the barrancas, I had no intention of taking part in political issues or getting involved in any village problems other than strictly medical ones. I did not wish to champion major changes in the way the people live. For I felt that in spite of the many hardships and inefficiency of labor there was still a great deal of beauty and
joy in the lives of the villagers. There was a simplicity and vitality derived from basic living which I wished to learn from rather than to modify. Now, after three years in the Sierra Madre, I feel essentially the same way. I have discovered, however, that "simplicity" can get very complex. In a community where the subsistence of many people is marginal, village problems and political issues can have a crucial bearing even on the health of the inhabitants. The more I have come to know and care for the villagers, the more I am moved to take action where I can on certain vital issues. In this way "Project Piaxtla" has become involved in activities which go well beyond my original intention of providing provisional medical aid, yet in the long run are just as important to physical health.

One such activity has been the initiation of a cooperative corn bank which offers the campesino or poor farmer some alternative to being exploited by the wealthy cattlemen and land barons. These land barons are the heirs of those who took the best farm-land from the Indians by force before the Mexican Revolution. Their families, although few in number, still claim possession of all the good bottom land along the Rio Verde near Ajoya. Resorting to "pay-offs" to government officials, intimidation of the poor farmers, and occasionally to murder, the land barons have successfully ignored the post-revolutionary laws requiring equitable redistribution of land. In effect, the Mexican Revolution has never reached Ajoya. The result is that the campesinos must either farm the steep, rapidly eroding mountainsides by the slash and burn method, or must labor for the land barons either as share cropping peons, or at a daily wage of 10 pesos (800. In either case, the campesino is held at such marginal subsistence that the health of his family is affected. He can rarely afford to eat more than corn, and sometimes beans. He cannot afford to buy meat, or milk for his children. If he succeeds in raising a few chickens, pigs, etc., he is often forced to sell or forfeit them to pay his ever-mounting debts to the wealthy land barons. I don't want to portray the land barons as evil. They are my friends, also, and within their families they are often kind, even gentle. But they have inherited along with their land -- which is not legally theirs -- the tradition of exploiting the poor campesinos at
every turn. Business is business. At harvest time the land barons buy corn from the need campesino at as low as 25 centavos per liter, then sell it back to him six months later at as high as 70 centavos to one peso per liter, forcing the campesino to sell any chickens and pigs he has been raising in the interim in order to buy back corn for planting. Or the land barons loan him corn, with a return of five liters for every two liters loaned. And if the campesino cannot pay on the set date, the land baron collects from him his burro, a hog, or sometimes even his house, although the object may be worth several tithes the debt. The campesino, even when robbed outright, has little effective recourse to law. To those with money, "justice" is easily purchased.

Hunger for the right kind of food is the most widespread physical hardship in the barrancas. The diet of the poor campesino consists of about 90% corn. Corn not only contains inadequate protein for human needs, but factors which inhibit efficient utilization of vitamins derived from other foods. In an attempt to offset the resultant
deficiencies I have in the last three years, provided hundreds of thousands of vitamin and iron pills and many hundreds of pounds of powdered milk. The benefits are often quite dramatic, but they are also ephemeral. There is no end of tile need in sight, nor can there be until the people achieve a better diet.

Theoretically, a wide range of agricultural improvements are possible which could help provide the campesino with more and better food. The bottom-lands could be irrigated and fertilized to give double or triple their present yield. Vegetables and cash crops could be planted. With monumental effort, sections of the steep mountainsides might even be terraced and made more fertile. But in reality, such improvements are still a long way away. The good bottom-land is all in the hands of the land barons, who have no need of making it produce more. And as for the steep mountainsides, the reply of Martin Reyes, the boy I brought to study in California last year, is typical. When asked by his school counselor if he didn't want to help his father improve a piece of land, he answered, "Oh, no! As soon as we got it improved, the rich would take it away from us!" Such events have frequently happened .

Until redistribution of the land is accomplished, therefore, or the extent of exploitation of the poor by the rich is curtailed, any proposals for significant agricultural improvements are unrealistic. The campesinos have repeatedly tried to organize. They have made repeated requests to the government to enforce the redistribution of land. But twice the leaders of the land reform efforts have been murdered, once in the nineteen thirties when the campesinos tried to organize an ejido (govt. sponsored cooperative community) and once two years ago, when the campesinos made efforts to recover use of some of the good bottom-land. Whenever government arbitrators
have come to enforce the land laws, they have been met by the land barons who, by padding their palms, have convinced them that no changes are necessary. The discouraged campesinos feel that there is not an official in the Mexican government who is not corrupt. However, there is new hope in Guillermo Ruiz Gómez, State Director of Work and Social Action. Unquestionably a man of high integrity, Don Guillermo learned of my medical project in the barrancas two years ago, and befriended me. When I and a young campesino explained to him the land
problem in Ajoya, he was outraged, and swore he would do something about it. Several months ago he got authorization from the governor to straighten things out ;n Ajoya. He arrived one Sunday in Ajoya with two land engineers, called a town meeting, and laid his cards on the table. He told the land barons that if they themselves equitably redistributed the land, they could claim parcels equal to those of the campesinos; if, however, they refused, the government would redistribute the land by force, and the land barons, who obtain ample income through their large cattle herds, would be given no farm land. The land barons verbally gave in, agreeing to sign a statement to that effect. When the engineers returned two weeks later with the statement drawn up, however, the land barons refused to sign. The engineers got angry, ripped the paper to shreds, and told the land barons they would pay for their insolence. They drove away, and the next day the land barons dispatched a messenger
requesting a new statement. The statement was delivered, signed by the land barons, and returned to the State Capital. Guillermo was delighted... But that was last spring . Summer came and with it the new planting season, the rich proceeded to oversee the bottom-lands as they always have, and the poor proceeded to burn and plant the steep mountainsides. 111o change has taken place. The last time I talked with Guillermo he sounded discouraged. He declined to discuss the matter, but said sadly, "These things take a long time." I rather suspect the land barons went over his head.

The corn bank I have started now at least lessens to a small extent the degree of exploitation of the poor. The corn bank has two functions . (1). It buys corn from campesinos at harvest time, and sells it back to them at planting time at virtually the same price. (2). It loans corn at planting time, to be returned at harvest time at very
low interest. It presently has storage cribs in Ajoya and Jocuixtita, and proposes to expand to other villages when the villagers cooperate by constructing storage areas. All accounting and exchange is conducted by village volunteers, so that eventually the corn bank can be completely turned over to the villagers .

The response of the campesinos to the corn bark has been overwhelming. For many of the sixty families it involves it has been a life-saver. My biggest regret is that my. own funds have been too limited to meet the demands. This summer I loaned out nearly 20,000 pounds of corn, which I went broke buying, and even so I only partially met the corn needs of the families I loaned to, in order that the benefits reach more people. Hopefully the bank can continue to grow.

In addition to the corn bank, I have opened a cooperative food store in the remote village of Jocuixtita, with the help of an especially conscientious villager, Daniel Reyes. The store also helps sidestep the exploitation of the rich by supplying staples such as rice, flour, sugar, salt, beans and soap on credit, to be paid, either in corn or cash, at harvest time. Purchasers who loaned burros for transport of supplies get reduced rates. The store has started off small, with only $250.00 worth of merchandise, which sold out the day the store opened. A drop in the bucket, perhaps .... but hopefully a seed in the soil.

The following outstanding events involving Project Piaxtla have taken place this past year:

Last November a team of three plastic surgeons from the Stanford Medical Center, led by Dr. Donald Laub, and accompanied by an anesthetist and two nurses came to Sinaloa to operate on some of my patients who desperately needed reconstructive surgery but could not. afford it. At the invitation of the Governor of Sinaloa and in cooperation with the State Health Department the procedures were performed at the Civil and Children's Hospitals. in the State Capital. Eighteen patients were operated, most of them with severe burn or birth deformities, especially cleft lips and palates. In addition to the patients whom I brought, others arrived from all over the State, more than eighty in all, many in urgent need of surgery. Most of these remained untreated because of insufficient time, yet the team, deeply moved by the extent of the need, determined to return to Sinaloa on a regular basis. The next visit was set for the end of April, and once again the Governor extended his invitation. This time a team often medical men from Stanford arrived in Culiacán. But unfortunately, word of the
project got back to Mexico City, stepping on the tender toes of national pride. One angry article in a Mexico City newspaper stated, "Either the Stanford people are crazy or... they think themselves to be in darkest Africa as Stanley knew it." "We Mexicans are not guinea pigs." An official order was dispatched from Mexico City forbidding the U.S. doctors to operate. To appease the disappointed people in Sinaloa, the federal government flew a team of plastic surgeons from Mexico City to Culiacán. Patients had gathered from hundreds of miles around. (I myself had driven 150 miles to Culiacán with 24 persons packed into my Jeep truck). The Mexican surgeons performed four operations . These were photographed and well publicized with articles acclaiming that "Mexico can take care of her own medical needs !" The Mexican surgical team then returned to Mexico City and the scores of untreated patients returned to their villages. Of the patients I brought, several children with severe cleft lips and palates, who could have been restored virtually to normal, must resign themselves to grow up not only with unsightly appearance, but virtually unable to speak. One young mother of seven, whose hand is crippled by scar contractures from a burn in early childhood, again has lost hope of having her hand made
functional. One little six year old boy with a congenital hernia will probably die of his condition before manhood. Etc... All because prosperous diplomats in Mexico
City would maintain their country's good image: "We don't need outside help." By the same token, Mexico has never allowed the Peace Corps. One sometimes questions the virtue of national pride.

We have not given up altogether, however. Dr. Laub from his end, and I from mine, have been working to reopen the doors which were closed upon us, and there is some hope in sight. The Government is completely behind us. Meanwhile I continue, as quietly as possible, with my work in the barrancas.

---The prospects for the pure water system in Ajoya have also had their ups and downs. For nearly two years I struggled to raise the 15,000 pesos ($1,200) which the village needed to contribute in order for the government to supply equipment and engineer the installation of the system. 1 used every device and ploy I could think of to get the wealthy land barons to contribute, but although they wanted the water, they argued that the poor campesinos should contribute the same amount as they should, or they quibbled among themselves about who should pay more, and in the long run they contributed almost nothing . It was not until last spring, when Mrs. Mary Kersliner of Cincinnati, Ohio offered to contribute half the cost if the villagers came up with the other half, that the land barons finally came through. With two representatives from Ajoya and the Municipal resident of San Ignacio, we drove to Culiacán and deposited the 15,000 pesos in a special account. Then we approached the Commission for Potable Water, which had promised to begin the project as soon as the money was raised. But the chief engineer shook his head. "I'm sorry," he said. "We had
government funds reserved to start 30 projects this year, but the money..." He shrugged his shoulders hopelessly..."You see this is election year, and all the politicians in office will soon leave their positions. The money reserved for water projects has gone elsewhere." He put his hands in his pockets. "Do you understand
me?" We understood only too well . "And when will you be able to begin the water project in Ajoya?" we asked. "After the new Government comes in," he replied, "in November." And so we are still waiting ! But at least the biggest hurdle has now been passed and the project 'is a sure thing . Ajoya is the first on the list when the Water Commission begins to function again. It is only a question of time.

---On the brighter side, things have been going fairly smoothly in the dispensaries in Ajoya and Verano. My dispensary in Ajoya has been moved to an old adobe house which I purchased for $200. The Reyes family, with ten children, now lives there, too, having been evicted from their old house because Remedios (the father) sided with the independent campesinos in the latest land controversy. The new dispensary consists of two small rooms, freshly whitewashed, with sky-lights composed of plastic roof tiles we cut in Palo Alto from the plastic windshields of old fighter planes and molded in an oven. A small generator now provides light for night time emergencies.

---We have now started a simple lab in Ajoya where we can do blood counts, hemoglobin test, urinalysis, and other basic clinical procedures. Chris Walker, the nineteen year old daughter of Dr. Murray Walker, the anesthetist who came with the Stanford team, was instrumental in setting up the lab. She apprenticed at the Stanford Medical Center in preparation for spending two months in Ajoya. She did a magnificent job.

---In October there will be a full-time addition to the staff of my dispensary in Ajoya: Robert Steiner, his wife Dorothy, and their 15 year old son Bob. Mr. Steiner has been working with L.A.M.P., an aid program in Mexicali. At present he is studying lab techniques at Stanford, and will expand and improve our lab in Ajoya. His own and his wife's activities in Ajoya will be completely volunteer. Their presence should allow me to spend more time in my upper dispensary at Verano, which is normally vacant when I am in Ajoya.

---Martin Reyes, the boy whom I brought a year ago to study in the United States, has proved his desire to learn. Even though he skipped from the fourth grade in Ajoya to the seventh grade taught in a new language, he had nearly a B average by the end of the year, and, according to his counselor, he had mastered more English more quickly than any other foreign student in the school’s history. Much credit goes to the family of Bob Graham with whom Martín stayed, and especially to Shirley Graham, who worked tirelessly with Martín when he was first learning his English. This summer Martín returned to Ajoya, where he organized and conducted two classes in English, won the respect of his students, and earned a wage above that of most grown men. This autumn Martin has eagerly returned to Kennedy Junior High School in Monta Vista, and is staying with the Prosser family of Cupertino. (By the way, if interested persons could help out with some of Martin's clothing needs, this would be a great help.)

---This year another boy from Ajoya, 14 year old Miguel Angel Mánjarrez has come to the United States to study. He is attending Terman Junior High School in Palo Alto. Miguel is staying with the family of Dr. Murray Walker. For the past year, Miguel has volunteered his services in my Ajoya dispensary, where he has learned to package medicine and write instructions, to give injections, take blood samples and do white cell, red cell, and differential counts under the microscope, to measure hemoglobin content, cleanse and dress wounds, and even pull teeth. He has aspirations of perhaps becoming a village dentist, for which the need is great. Life has been a bit tough for Miguel since he has been in Palo Alto, especially since, after his second day of
school, he fell from a rope swing and broke his arm. But he is courageous, and hopefully will do well.

Both Martín and Miguel long to get back to their families over the Christmas vacation.