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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.

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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.

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