Mexico’s Seguro Popular—A model of inefficiency–prescription at last!

pills

So, holding my breath that the lab results would be in, we went back on February 14.  Results were only given from 9-10 in the morning, so there wasn’t any need to arrive at dawn or determine who I needed to form up behind.  The line started forming right about 9 and moved along rapidly.  My paper was marked especial (special) so the clerk had to go to a different file for my results, but it didn’t take more than a few minutes and voila! There they were.

Since Dr. J said I should come and see him after the results were in, I asked the clerk how I should go about it.  She said that I should go to Archivos, but I told her that Dr. J said I should make the appointment without going to Archivos.  She said that his office was down the hall in Consulting Room 5 and that I should go there and ask.  So I did.  I stopped at the nurse’s table and told them I wanted to see Dr. J.  The nurse said he was in today but that he was using Consulting Room 9.  I asked if there was some sort of list I needed to be on and she said no.  So I went there and parked my butt in the seat directly in front of the door.

I waited there maybe 5 minutes, then thought that perhaps I needed to do something else, so I went to Archivos and asked.  The lady there gave me a blue ficha and told me to go to the nurse’s desk.  The nurse at the nurse’s desk sent me back to the nurse’s table.  I handed my blue ficha over and the nurse wrote my name on the list, and then checked my weight, height and blood pressure.  This time I felt I was on track.  She sent me back to Consulting Room 9 to wait.  I was #4.

I went out to tell my husband how I was progressing.  He didn’t want to stay, but since I was already there, I wanted to see if I could make this my final trip for the permanent prescription and not lose another day of work.  So I went back to the waiting area and spent some time studying my TSH results.  Everything was within normal range with my taking 1 pill a day, so that seemed promising.  The blood samples had been sent to the hospital in Leon and back.

Dr. J began seeing patients at 10 a.m.  I was called at 10:40.  Meanwhile, I spent some time talking with an elderly lady who also wanted to see Dr. J about her family member who was just admitted into urgencias (emergency room).  I told her it might be prudent to get a ficha from Archivos, which she went and did.

I sat down and Dr. J remembered my case.  I expect gringa patients are far and few between, so I stand out a bit. He looked over the results and agreed that I needed to keep taking one pill a day.  He gave me a prescription for 2 boxes of 100 pills each and explained that I would need to come back every 6 months for a new TSH blood workup.  That didn’t surprise me any, but I had to restrain a sigh.  He told me to go to Archivos and make an appointment for 6 months, then go to the lab and make an appointment for 6 months, then go to the pharmacy for the pills.

I thanked him and left the consulting room planning on doing just that to find Archivos were closed.  I went to the lab and found a line out the whazoo.  I went to the pharmacy and got my voucher for the pills.  They didn’t have the pills in stock of course, but I could get it from another pharmacy with this voucher.

I went back outside and told my husband how things were going.  We agreed that it would be better if he came another day to make the appointments and pick up the medicine.  It was just too much for now.

All’s well that ends well, since now I will be able to get the blood test, doctor consultation and medication free for the 3 years we have Seguro Popular.  I can’t imagine going through this process if I were really ill though. I’d more than likely die in the waiting room, but maybe that’s the point.

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Mexico’s Seguro Popular—A model of inefficiency–second blood draw

Medical Services Sign uid 758158

I returned for the new blood draw on Monday February 3rd, the observed holiday for February 5th Constitution Day.  My husband waited outside again since the lab was close to the doors and he didn’t wish to aggravate the security guard.  I arrived and asked who the last person to arrive had been and made note of her purple scarf so that I would know who to fall in line behind.  The light to the office turned on at 7:45 but it was a ruse.  The clerk didn’t start getting down to business until 8:30.  Blood draws began at 8:40 with children under 5 at the head of the line.  I was 6th  or 7th in line, right behind purple scarf.  There were several attempts at line jumping and I had to scold a lady who tried to butt in front of me.  I knew I was behind purple scarf and the lady behind me knew she had arrived after me, so we weren’t giving any ground.  Annoyed, the interloper pranced to the end of the line.

I presented the cita (appointment) paper to the lab technician and she said that my results would be ready in 22 days. She gave me another appointment paper, this time without stickers, and I went back to the chairs and sat down near the lab door so that I could hear when my name was called since by now there was quite a crowd.  The security guard came through to check that everyone that was there had a reason to be there and wasn’t just loafing.  He shooed one or two out, however the rest just discretely passed the appointment paper from one to the other so that it looked like both had an appointment.   He also tried to straighten out the bola (ball) of people that had accumulated at the head of the line, even went as far as raising his voice, but line jumpers were still rampant.

Around 9:00, it was finally my turn.  The nurse only took one vial of blood and told me to come back in 15 days for my results.  She told me to go back to the desk and have her mark the date on my paper.  So I went back to the desk and she told me to come on February 14 for my results.  Hmm, that didn’t seem like 15 days from February 3, but hey, what do I know?

My husband didn’t mind the wait so much this time since around 8 a.m. volunteers came around and gave arroz con leche and bolillo to those waiting outside.  Wish they would do that every time I had to come!

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Our Family Hobby

Welcome to the April 2014 Carnival of Natural Parenting: Parenting Fears

This post was written for inclusion in the monthly Carnival of Natural Parenting hosted by Code Name: Mama and Hobo Mama. This month our participants have shared stories and wisdom about family pastimes.

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A family hobby? Us? We are so busy in our day to day lives that we don’t often have time for leisure activities like travel or bungee jumping or arts and crafts. But we spend time together as a family and we enjoy the time we spend together as a family. So what do we do together as a family? Our daily discussions, activities and lives are centered around our animals. Animal husbandry is our hobby.

We play around with animal husbandry, not in the Wikipedia definition of Animal husbandry as “the management and care of farm animals by humans for profit,” since we certainly do not realize a profit, but more as the now obsolete meaning of the word husbandry as a “steward” of a household. We are definitely stewards.

Since moving to Mexico, we have been involved in purchasing, raising, caring, breeding, healing, feeding, selling, butchering and sometimes burying all sorts of animals.

Afternoons will often find us settled on the back steps watching some aviary antics.

Mrs. Macho setting on the eggs.

Mrs. Macho setting on the eggs.

We have been host to domesticated pigeons escaped from the tiro de pichon (shooting range) and watched them raise generations of babies in the eves of our animal area. Eventually Mrs. Macho moved on when we had to change the roof slant, but it was fascinating to watch the love and care both Mr. and Mrs. Macho took by sitting on the eggs and feeding the ugliest little broods. We enjoyed watching the babies growth and their first practice flaps and then rejoiced as they left the nest one by one.

Golondrices are small, native quail.

Golondrices are small, native quail.

We have also had golondrices, which are a small native quail. We noticed most how the little guys would come to greet us at feeding time, even pecking at our shoelaces when we were slow to acknowledge them, hopping up and hooting just like in the cartoons.

Chicken hierarchy

Chicken hierarchy

Of course, our mini-homestead has chickens and chicken culture is amazing. Their socialization and hierarchy is as intense as any telenovela (soap opera). We have watched young roosters make their first macho challenges to the current head mucky-muck. We watched as Henny Penny gave up the will to live when the love of her life was no longer there. We chuckled at Jovencita’s attempts to adopt every single chick hatched and shook our heads at the poor mothering done by Hilda. We were horrified in the pecking death of Gringa, for the crime of being different from the others. And we are on hand to cluck over the newest batch of hatchlings. (See Why did the chicken cross the road?)

These goats are less than a week old and already playing bump heads!

These goats are less than a week old and already playing bump heads!

One of our daily activities is taking the goats out to forage. Some days this is a run for your money if Duchess or Twiddledee get it into their heads to head for the hills. Most days, it’s a relaxing afternoon under the mesquite watching the antics of the goat kinder (kindergarten) as they play king of the rock or a rousing game of bump heads. We have even had kids that wanted nothing more than to sit in your lap, although this tends to be a bit cumbersome as they grow. (See Separating the sheep and the goats)

Beauty getting saddled up.

Beauty getting saddled up.

Sunday afternoons will often find us spending time with our hoofed animals, which currently includes Fiona the donkey, Beauty the yegua (mare) and Shadow her colt. It is not unheard of for us to take a family ride up and past La Yacata and back, sometimes further. We have even been known to have donkey races just for fun. (See Donkey Races, A horse is a horse or not, Beauty’s Babies)

Smile for the camera now kitty!

Smile for the camera now kitty!

I must not forget to include our long list of puppies and kitties that have come into our lives, sometimes for an extended period, sometimes for just a few days. Their personalities, travisuras (naughtiness) or amiableness, have made them such a pleasure to come home to. Currently we are hosting 2 dogs, Hershey and Chokis and one cat, Little Miss Licorice Stick, otherwise known as Licky. (See 101 perritos)

Whether we have been strictly observers or had a hand in their daily lives, we have enjoyed our foray into animal husbandry. We have come to know that animals are sentient beings and that our actions and attitudes towards them affect their lives, sometimes drastically. Ahh, a hobby with moral value. What more could anyone ask for?

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Carnival of Natural Parenting -- Hobo Mama and Code Name: MamaVisit Code Name: Mama and Hobo Mama to find out how you can participate in the next Carnival of Natural Parenting!

Please take time to read the submissions by the other carnival participants:

  • 8 Reasons to Go Camping with Your Kids — The weather is warmer, and it is time to think about taking a break. As you plan your family vacation, Mandy of Living Peacefully with Children, guest posting at Natural Parents Network, explains why you should consider hitting the trails with your kids.
  • Crafty Cohorts — Kellie at Our Mindful Life enjoys crafting with her kids, and the skills they are learning.
  • 10 Hobbies For Families With Young Children — Jennifer at Hybrid Rasta Mama knows that finding hobbies families can do together (with young children in tow) isn’t always the easiest of feats. She has compiled a list of 10 family friendly hobbies that children of all ages can enjoy and that won’t break the bank!
  • Helping Himawari — Sophelia’s family at Sophelia’s Adventures in Japan share a passion for helping when a dog is abandoned at the nearby elementary school.
  • The ‘Art’ of Having FunMarija Smits shares some thoughts on family art and fun.
  • How we made our own Family Day — Lauren at Hobo Mama shares how her family celebrates the best day of the week, a chance for connection and adventure and endless possibilities: Family Day!
  • Our Family Hobby — Survivor talks about how animal husbandry has become her family’s favorite hobby at Surviving Mexico Adventures and Disasters.
  • Sowing the Seeds of Passions — Christy at Eco Journey In The Burbs wonders if her interests, and her husband’s, will shape her children’s passions as they mature.
  • Harry Potter Potions Party — One of the best activities Dionna at Code Name: Mama has ever done with her family has been a Harry Potter Potions Party. She is sharing the resources she used to create their potion recipes, the ingredients and tools they experimented with, and the recipes themselves. Feel free to use and adapt for your own budding wizards and witches!
  • Pastimes Have Passed Me By — Kati at The Best Things takes a new perspective on projects that never get done.
  • Food as a cultural experience for preschoolers — Nathalie at Kampuchea Crossings finds that food is a good way to engage her preschoolers on a journey of cultural discovery.
  • 10 Reasons I Love Thrifting With My ChildrenThat Mama Gretchen has always enjoyed shopping, but with a growing family she’s become more frugal and thus, her little ones are now in tow on her thrift store adventures.
  • Pastime with Family vs Family Pastime — You can share lots of pastimes with your family, but Jorje of Momma Jorje discovered a family pastime was much more pleasant for sharing.

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Mexico’s Seguro Popular—A model of inefficiency–Dr. J.

dr j

So January 27 arrived and we got to the Regional at 6:30.  My husband had to stay outside again. I asked in the waiting area who had been the last to arrive and took note, so that when we lined up, I would know who I was after.  While I waited, I listened to the other people waiting tell stories of having to arrive at 4 a.m. at the clinic to get in line or buying a ficha (number) from someone who had arrived earlier.  I distinctly remembered seeing a sign at the front door that said that fichas (numbers) were not for sale…but hey, who am I to begrudge someone 20 pesos for their time?

When the appropriate personnel arrived, we were instructed to line up according to our order of arrival.  This was a surprise to some of the people waiting and there was a bit of shoving to get the line straightened up.  I was 5th or 6th in line, however those who were waiting with children were giving the first few spaces.  When it was my turn, I handed the attendant the sheet Dr. Viejita (Old Lady) had given me and in return she gave me a paper with the date I should return for results and 4 stickers with my name on them.  It didn’t take too long for them to call my name and take 2 vials of blood and I was out by 7:15 a.m.  I must have looked like a pro because no less than 3 women asked me what the procedure was for the lab while I waited and I explained.

My results were supposed to be ready the next day, so I sent my husband to pick them up.  He had time at 1 p.m. and drove out to the hospital; however the lab only gives results from 9-10 a.m. and 3-4 p.m. and no other time, so he had to make 2 trips.  I looked over the results and didn’t see the TSH results, but I thought maybe it had a different abbreviation in Spanish.  Silly me.

Although my appointment for January 30 was at 9 a.m., my husband insisted we needed to go early.  So we did.  This time we entered separately, with each of us carrying some paperwork in order to slip past the security guard.  Archivos (archives) didn’t open until 7:20 and I ended up being about 20th in line.  When I arrived at the glass partition, I handed the clerk the copy of our seguro (insurance) policy, a copy of my curp (Mexican social security number), a copy of my new residency card (See Residency at last), a copy of a proof residency which usually is a water or electric bill but in our case came in the form of a letter from Super Prez asserting that we lived in La Yacata, and the pink appointment book.  She returned the pink card to me and gave me a blue laminated ficha (number).

I went to check in at the nurse’s station, but was told I needed to check in at the second nurse’s station, which really was just a folding table, 2 chairs and a scale.  So I marched down there and had my height, weight and blood pressure checked.  I understand that my weight and blood pressure might vary, but just not sure why my height might change drastically since the last appointment, but it didn’t cost me anything to stand and be measured again.  The nurse took my ficha (number) and wrote my name down, but couldn’t tell me what consultoria (consulting room) I would be in.  I sat down to wait.

As the crowd thickened, the nurses were questioned repeatedly about when the doctor would arrive to begin consultations.  The harried nurses responded with the startling truth that the doctors did not have set schedules.  When a doctor was finished with his or her rounds in the hospital, then and only then, would he or she report to the consultation area.  This might be around 9 a.m. or might not.  Not encouraging news.

With the press of people in the waiting area and the rising sun, the waiting room became stuffy and hot.  My husband began to get cranky.  I think I have mentioned before that he is not a patient man.  He was ready to leave and make the appointment for another day.  As I had already lost the morning’s work, I didn’t want to reschedule and pleaded with him to be patient just a little longer.  Finally, at 10 a.m. my name was called along with 3 or 4 other women’s and we were told to go over to the consulting room next to x-rays which was in another wing of the hospital.  We did.  It was closer to the front door and therefore much cooler and we sat down to wait.  Dr. J arrived but we had to wait while he went to hunt down a typewriter for his office.

A woman much like my now deceased mother-in-law tried to bully her way into the consulting room, but Dr. J was having none of that and frowned her into her chair again. I was ficha #2, so I was in before you could say Jack Robinson, comparatively, and seated before the doctor.

Dr. J was much younger than Dr. Viejita.  I would estimate he was in his early 30s, with wispy light brown hair and an failing attempt at a moustache. He was recently married as evidence by the shiny new golden wedding band on his finger. He was wearing a surgical mask, which made it difficult for me to hear him since he was so soft spoken, but I did my best.  He asked why I was there and I again explained I needed a permanent prescription for hypothyroidism.  He asked about surgeries, if I had ever received a blood transfusion, if I had diabetes or high blood pressure, all which seemed to be relevant questions to my health issue at hand. He examined my throat for possible goiter, had me raise my arms to check for trembling, which is a sign for too much thyroid hormone and then sat down again to look at my lab results.  And surprise, surprise, there were no TSH results to be found.  So he gave me a new blood work order and sent me back to the lab to schedule the test.  He told me after I got the results, I should come back and see him directly and not to go through Archivos.  He was there Monday thru Friday.  Okie Dokie.

So I went back out to my waiting husband and told him I needed to schedule a new lab.  He was annoyed, but since we had come this far, we might as well keep going.  I queued up and made an appointment.  Since the following Monday was Constitution Day, the labs wouldn’t open until 8 a.m.  That was fine since there would be no school that day and I wouldn’t miss any work.

When I retold this adventure to my sister-in-law, she remarked that at least it was a free service.  However, I pointed out that the gas and time and money lost from cancelled classes hardly made this free and she had to agree.

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Mexico’s Seguro Popular—A model of inefficiency–Dr. Viejita

 

dr viejitaSo we went to the Regional in Uriangato, which is the hospital where my mother-in-law died.  My husband had gone the day before to inquire about the procedure and was told by the pharmacy that I needed to make an appointment with archivos (archives) first to open a file.  Archivos (archives) opens at 7 and it’s on a first come, first serve basis. Therefore we were up at the crack of dawn so that we could take animals out to pasture and drive to Uriangato.  It is about a 30 minute trip by moto, but seems much, much longer in the frigid early morning.  We arrived at 6 a.m.

The security guard on duty would not let my husband in, so I took the paperwork and queued up.  The clerk arrived at 7:15 and started processing appointments.  I was about the 10th in line, so it was about 7:40 when I reached the desk.  I explained my situation and showed her my papers.  She looked them over and told me that it was the responsibility of the clinic that gave me the prescription to continue giving me the medication and that if they wanted to send me here, they needed to give me a referral.  Well, they hadn’t and she knew that, so she went ahead and gave me an appointment with a general practitioner anyway.

I checked in at the nurse’s station and had my height, weight and blood pressure checked and returned to my seat.

I was #3, but as the doctor doesn’t begin seeing patients until 9 a.m., I had to wait.  Meanwhile, my long-suffering husband was shivering in the cold.  After 9, he suddenly appeared in the waiting room.  He had waited until the guards had changed, then asked permission to use the bathroom, which was on the other end of the hall where the consulting offices were.  He did use the bathroom, but instead of returning outside, he headed down the hall to see where I was.  By this time, there were so many people, one more wasn’t noticed.

So 9:30 came and it was finally my turn.  I was shown into a small consulting office and sat down in a chair next to a tiny space heater.  The female doctor was at least 80 years old and was extremely disconcerted that I was not Mexican.  She asked me several times if I could understand her questions and each time I assured her I did.  I explained what it was that I wanted.  She then said I would have to be referred to a specialist.  She pulled up her Olympia typewriter and started in on the referral.  She asked where I lived, but didn’t understand me, so I handed her the policy which had our address on it.  Then she asked about my age, place of birth, religion, age that I began menstruating, age that I married, if I had my son vaginally or by c-section (she even mimed this one for me in case I didn’t understand her meaning), and if I lived permanently in México or was just here for a visit.  I answered her questions, but tried to explain again that I had hypothyroidism and told her that I had had preeclampsia and pregnancy-induced hypertension, but she made no note of those issues.  I told her about surgeries I had as well, but again, nothing written down.  She apparently made a mistake on the form, so she pulled the sheet out of the typewriter and started again.

I waited.  When she had finished I showed her the prescription that I had been given at the clinic and told her I needed a refill.  She looked it over and said that she would write a prescription and that I would need some blood work too.  That seemed reasonable, since in the States, I would periodically go for TSH level blood tests.  I thought perhaps she had understood my problem after all. Silly me.

I was there about an hour while she filled out these forms.  She made no attempt to examine me and when we were finished she asked if I felt I had been treated fairly.  I suppose I had.

So then, I went back to archivos (archives) to schedule an appointment with a specialist.  There the clerk gave me pink appointment booklet and scheduled the appointment with Dr. J for January 30 at 9 a.m.  Then I went to the lab desk to schedule an appointment for the blood draw.  That was set up for January 27 at 7 a.m.  Finally, I went to the pharmacy to fill the prescription, but they didn’t have the medicine there.  Since I was already late for work, I didn’t have time to hunt down some other pharmacy.  I sent my husband later in the day to find the referral pharmacy and get the prescription filled.

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Mexico’s Seguro Popular—A model of inefficiency–Getting Started

CAISES in Moroleón

CAISES in Moroleón

I have hypothyroidism which was diagnosed shortly after the birth of my son.  It’s a chronic condition that requires a pill each and every day.  A box of these pills costs $400 pesos and lasts about 2 months.  Sometimes we don’t have the $400 pesos and I do without.  A long period of doing without means that I become over-emotional, weepy and exhausted.

My husband decided that we needed to find a way for me to get my pills and applied for Seguro Popular, the Mexican version of Medicare.  We qualified, despite the fact that I am only a Mexican resident, because my husband has been out of work for the last 3 or 4 years and the fact that we live in La Yacata without electricity, water or sewage.  However, in order to get the all-important policy paper, we had to provide a comprobante de domicilio (proof of residency) in the form of a water or electric bill.  On other occasions, we have borrowed a bill and claimed we were renting at the address on the bill.   We were tired of doing this and therefore solicited a letter bajo protesta decir la verdad (under oath to tell the truth) from SuperPrez saying that we were living in La Yacata without utilities.  Thankfully, the office accepted it as adequate proof and we went for our initial family consult at the hospitalito (clinic).

The reason there isn't a line at 9 a.m. is because everyone knows they must arrive at 4 a.m. to get a number!

The reason there isn’t a line at 9 a.m. is because everyone knows they must arrive at 4 a.m. to get a number!

We arrived well before 8 a.m. which was good since it took 40 minutes for the staff to determine which module La Yacata belonged to.  Finally they decided that we should be assigned to module 5, which was only open in the afternoon.   Since we were already there, and a little peeved, the nurse on duty said that she would do our consults that morning, so we waited.  Our examination consisted of each of us being weighed and measured, a blood pressure and diabetes check and a health questionnaire about vaccinations, illnesses and surgeries.  I explained that I needed to take levotiroxina, but that I had run out of pills.  The nurse had a doctor write a prescription for me, but the pharmacy at the clinic didn’t carry that medicine.  My husband went to another clinic, but they wouldn’t give him the medicine because the doctor had written a prescription for 2 boxes and they said they never give 2 boxes.  So my husband returned to the first clinic for another prescription for a single box and then back to the second clinic for the medicine.  It took all day but I got a box with 100 pills.

The nurse told me that when I ran out, I would need to come in again for a full examination to get a prescription refill.  So that’s what I tried to do.  We arrived before 8 a.m. for a ficha (number) for module #5 but were told that all the fichas (numbers) had already been given.  The nurse said we could come back at 2 p.m. to see if the doctor had time to see us after all the people with fichas (numbers) had been attended to.  So we did.  And we waited.  Then another nurse told us that we would need to go to the Regional (regional hospital) in Uriangato to get a receta permenente (permanent prescription) since my condition was chronic.  It would have been nice to know that before we wasted the entire day.

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Reconstructing the Facts

This is the intersection where the accident occurred.

This is the intersection where the accident occurred.

Before my father-in-law’s case could proceed to the higher court in Celaya, a mandatory reconstrución de hechos (reenactment) had to be held.  This required all participants, witnesses, lawyers, la juez (the judge) and a neutral perito (sort of like a detective) to be present.  This was scheduled December 27, the Friday after Christmas, at 9 a.m. in the morning.

As it turns out, in a rare weather fluke, it happened to be raining that morning, something that is far from common in December.  Since it had not been raining the day of the accident, the judge suspended the proceedings.  This angered many of the witnesses, since they had lost a day’s work and would lose a second day’s work for the rescheduled event.   Although it was a valid point, if the judge really was concerned about mimicking as close as possible the actual scene, she would have rescheduled this for mid-May.

Be that as it may, the proceeding was rescheduled for January 2, which was the Thursday after New Year’s.  We made arrangements for my husband to take his father to the courthouse and my son to help his aunt in the Tortilleria.  Unfortunately, we had in mind for some reason that January 2 was the Friday after New Year’s and so when my sister-in-called to say that we had been mistaken in the day, there was pure pandemonium.  I had already left for my classes and had taken my son’s phone with me to charge at the school.  So there was no phone in La Yacata for me to call to tell them of the mix-up.  I still had 30 minutes before the students were due to arrive, so I raced to La Yacata on my moto and arrived beeping at the house. When I explained the situation, my husband jumped on his moto and headed for the courthouse and my son hopped up behind me to go to the tortilleria.

When I dropped my son off, I glared at my sister-in-law and demanded to know why she hadn’t called sooner!  I then zoomed back to the school just in time for my first class of the day.

My husband was able to meet up with my father-in-law before the whole crew went out to the scene of the accident and therefore provided some moral support.  He said that the lawyer remarked that since all the witnesses said different things, winning the case would be canijo (difficult), but he was going to continue.  The alternative is a murder conviction and jail time for my father-in-law and that just isn’t right.

So the next step is to wait for the court case to be called in Celaya and see what there is to be seen.

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