Tijuana Hospital--a Promise Unfulfilled

The General Hospital here was envisioned and built during an epoch when oil revenues made even the grandest projects seem obtainable in Mexico. The imposing, seven-story hospital was designed to revolutionize medical care here, replacing an antiquated, crowded facility and providing superior service for the mostly poor clients, who could afford no other hospital.

A group of enthusiastic young specialists was recruited, largely from Mexico City, to staff the government-run facility. Proud officials promised a spacious, eight-story hospital with state-of-the art equipment. Its 400-bed capacity would be sufficient to meet Tijuana’s needs for decades, authorities boasted.

Finally, it seemed, the politicians’ rhetoric would become reality and the boundless promises of the nation’s new-found wealth would filter down to the Tijuana residents who most needed relief.

Promises Unfulfilled

Four years after opening, though, the promises remain unfulfilled. At the hospital, shortages are so severe that doctors say they often don’t even have such basic material as scissors, sutures and surgical gowns, while high-technology equipment such as X-ray machines, heart monitors and respirators are often inoperative, outdated or nonexistent. Patients are at daily risk of their lives, and some have probably already died needlessly, doctors say. The hospital is badly under-utilized.

“The situation is critical; it’s grave,” said Dr. Alfonso Valenzuela, a pathologist who was among the enthusiastic young physicians who arrived from Mexico City four years ago. “We’re playing Russian roulette with patients’ lives. . . . This is a time bomb waiting to go off.”

Doctors have taken matters into their own hands, drastically reducing services and making their complaints public.

The hospital that was conceived with so much hope and optimism--too much, perhaps--now stands as a vivid, concrete-and-mortar symbol of the raised expectations af the Mexican oil boom and the dashed hopes of la crisis. It had the misfortune of opening in 1982, when oil was no longer king and Mexico was already plunging into its most severe economic crisis in half a century.

“Had the boom continued for six more years, this hospital could have been one of the best in the country,” lamented Dr. Gabriel E. Garcia, the assistant administrator.

Health Care Is Victim

Doctors and other observers say the carencias, or shortages, at the General Hospital here are symptomatic of those throughout Mexico, where officials attempting to cope with a burgeoning foreign debt have cut back expenditures in such areas as health and education. Tijuana’s troubled hospital, in effect, represents the raw edge of the Mexican economic crisis.

“Health care has become a low priority,” said Leo Chavez, a research associate at the Center for U.S.-Mexican Studies at the University of California, San Diego, who has studied border health issues.

During the oil boom, Chavez noted, there was a palpable optimism in Mexico that the new revenues would lead to vast improvements in health care, education and other areas, perhaps finally boosting Mexico into the developed world. “The crisis eroded that optimism,” Chavez said, “and health care is just one victim of that.”

Adding to the frustration at Tijuana’s General Hospital is the fact that the facility is situated less than 25 miles from the gleaming medical institutions of San Diego. The juxtaposition vividly underscores the contradictions that characterize the U.S-Mexico border region, a place where the Third World meets one of the world’s most developed nations.

“We recognize that this is a Third World country; we’re not looking for ultramodern equipment, luxury equipment like they have in San Diego,” said Valenzuela, who heads the doctors’ association at the hospital. “All we are asking for is basic equipment so that this can function like a real hospital. Now, it’s not a hospital. It’s a joke.”

Patients Suffer

The joke, unfortunately, is on the patients--mostly Tijuana’s poor and emergency cases who are brought here from throughout the city. Besides being severely ill-equipped for its current role, physicians say the hospital is utterly unprepared for any kind of major disaster, such as an earthquake, airplane crash or explosion. And Mexicans are not the only patients affected: In cases of serious vehicle accidents and other medical emergencies, Americans and other foreign visitors here are likely to be sent to the emergency room of the General Hospital.

“It’s a pathetic situation; it’s very critical,” said Dr. Gerardo Sela, chief radiologist. “There are times when all we can do is look at the natural evolution of illnesses without doing anything to stop it, because we don’t have the equipment. As a medical doctor, it’s very frustrating.”

So frustrating, in fact, that the 58 staff doctors have taken the unusual steps of cutting back on treatment and going fully public with their demands for new equipment and better maintenance--even purchasing advertisements in Mexican newspapers to warn citizens and dramatize their complaints. Government health officials have responded slowly, at times chiding the doctors for exaggerating the situation and making “unrealistic” and “stratospheric” demands at a time of economic crisis and fiscal austerity.

“The doctors have to understand the situation in which we live,” Dr. Diego Fernandez de Castro, federal health chief in Baja California, pointedly told the Mexican newspaper ABC.

Equipment Promised

However, last month federal officials visiting the facility acknowledged shortages and vowed to provide up to $170,000 in equipment before the end of the year. Meeting total needs would cost more than $1 million.