Puppets tug at the young at heart
By Atención staff, April 5, 2007

In San Miguel de Allende one can find many music and film festivals and plentiful exhibits of the plastic arts, but there are relatively few cultural activities designed for the young people who live and visit here.

For this reason, the San Miguel Puppet Festival, founded in 2003, continues this year free, and in the streets. All productions will be performed in front of the Parroquia and a few in the corridors of the Bellas Artes building. According to organizer Monica Hoth, the goal is to preserve the art of puppetry so that children of the 21st century can come to know, appreciate and enjoy this ancient theatrical art.

Beginning in the 19th century, puppets were generally relegated to the realm of childhood. Nowadays, with children spending increasing amounts of time in front of the television and lack other options for entertainment, they devote less time to playing and creativity.

Some experts believe that this phenomenon is responsible for the erosion of childhood traditions. The games and toys that help bring about intellectual, emotional and even spiritual growth are in danger of extinction, taken over by commercial interests that generate a mass culture promoting violence and consumerism to the detriment of more traditional family values and society at large.

For more than three centuries San Miguel de Allende has been privileged to be home to several important puppetry companies. In records dating back to 1730, inquisitorial proceedings were directed at a puppeteer named Antonio Farrfán. The Sacred Office of Mexico recorded that the puppeteer’s skills and operations created foul smoke and that some of his performances were hardly Christian and led to superstition. For his theatrical efforts the poor Farrfán was jailed.

In the early 20th century the renowned Compañía Nacional de Autómatas Hermanos Rosete Aranda passed through San Miguel. Don Donato Almanza, a prestigious artisan of sacred images, became enchanted by the marionettes and, along with his apprentice, José Rodríguez, began constructing his own puppets.

In 1968, Linda and John Keogh, Canadian puppeteers and pioneers in the field of television animation, came to San Miguel. They set up a puppet workshop in el Centro Cultural “El Nigromante” (Bellas Artes) and presented several works by the celebrated Spanish author Federico García Lorca in the Teatro Ángela Peralta.

The group of shadow puppets “Athanor,” formed by María de Céspedes and Claudio Kermaría, among others, established itself in San Miguel in 1974. In 1983 and 1985 they organized the very successful National Festivals of Puppets in San Miguel.

Since 1999, Monica Hoth has taught the puppet theater workshop at Bellas Artes.

In 2003, the Festival of Puppets San Miguel de Allende was organized under the auspices of the Mexican Association of Hotel and Motel Owners of San Miguel de Allende, A.C., and Bellas Artes. These two groups also directed the festival in 2004, with the added support of the Coordinator of Tourism of the State of Guanajuato the National Chamber of the Restaurant Industry.


Puppets festival in San Miguel

All shows are free



Monday, April 9, 
6pm, Jardín
The well: 

A day in the life of little Emiliano, a worm who goes late to school. On his way, he passes by a well and the echo surprises him. Emiliano gets into the well and explores it and finishes playing with it. But Fogón, the most envious dragon in the region, says that that well is his, and will not allows anybody to get close to it. With braveness and shrewdness, Emiliano will defeat Fogón and will finally become a butterfly. 



Tuesday, April 10 
6pm, Jardín
Kasper and the crocodile:

Traditional German tale, with antique German puppets



Wednesday, April 11 
6pm, Jardín 
The fairy and the woodcutter

A woodcutter goes to the city in search of fortune. He is captured and sent to jail. There he finds a fairy who helps him change his fate, and release the kingdom from the wicked king.



Thursday, April 12
6pm, Jardín
The Red Little Devil 

A little boy has to face many unfortunate events accompanied by a good little devil. The little devil saves the child from sorrow and sadness by making the ultimate sacrifice. However the little devil is rewarded for his good acts. 

This story provides a wonderful lesson about friendship and strength of character.



Friday, April 13 
5pm, Bellas Artes corridors
Yorinda and Yoringuel 

A brief and beautiful fairy tale, influenced by Waldorf philosophy



6pm, Jardín
Trapped within puppets

While digging a hole to escape from jail, two convicts find a bag with various objects that magically come to life when touched. The two prisoners forget about their purpose as they enter a realm of fun and joy. 



Saturday, April 14
5pm, Bellas Artes corridors
Yorinda and Yoringuel 

A brief and beautiful fairy tale, influenced by Waldorf philosophy



6pm, Jardín
The re-Creation

A minstrel tells the story of the creation, the birth of life, of each star, each planet, and the different species and man. 



Sunday, April 15
6pm, Jardín
El Yeitotol:

Legend says that Yeitotol is a big and beautiful bird with velvet feathers, that appears on the highest hill of the world, every one thousand years. Only a fortunate few can reach it… whoever returns with one of its feathers will receive a gift upon their return.

El Yeitotol is an example of the values necessary to instill to children, in order to preserve this world and not to wait another thousand years to see it again. 

Feed the Hungry’s English program at Los Ricos de Abajo: The meaning of privilege
By Dianne Walta Hart

The dust settles around our SUVs as we pull up to the chain link fence. Behind it, on a barren hill in Central Mexico, are two buildings that for a moment look deserted. Then we spot a child running to the outhouse.

Moments later, a few children in blue uniforms leave their classrooms and start down the hill, shading their eyes from the mid-day sun as they wind their way carefully over the rocky soil. When they reach the gate, they crank it open and greet us with quick smiles, a tentative “Hello,” and a careful “How are you?” They pick up the school supplies with one hand, reach out to hold their teachers’ hands with the other, and begin the dusty trek back up the school. 

We are part of the contingent of Feed the Hungry’s teachers arriving for the twice-weekly English classes at the Naciones Unidas Los Ricos de Abajo elementary school, a half-hour from San Miguel de Allende. 

Contrary to many US elementary classrooms of today that utilize tables for small groups, these students are squeezed into half of the brick-walled classroom and sit in tiny desks, all right next to each other in rows. The children are small, with fine features that some authorities say resemble those of the Otomís who settled in this area of Mexico hundreds of years ago. 

In the first and second grade classroom, Manuela and Francisco immediately take advantage of the substitute English teacher. They stand on their desks—not on the seats, but on the desks. Big smiles on their faces, just waiting for the teacher to tell them in some language to sit down.

Manuela, as tiny as she is, is almost 9. When Lucha, the school director, found out last year that Manuela was working in a factory, she reported it to authorities who promptly removed her. Now Manuela is a bright star—if mischievous—in the first grade. 

In the third and fourth grade room, the class steams with energy as the teacher puts them through the hoops. The pedagogy behind the English program is TPR—Total Physical Response—where the target language is internalized through the body by physically engaging students in their language learning. Where’s your head, arm, knee, foot? Point to the color green. Repeat after me. Where’s the red? And their pronunciation of red comes out like “rrrrrrred.”

To teach clothing items, the teacher pulls out t-shirts, hats, belts, and skirts from her suitcase. What’s this? “A sheeeerrt.” What’s this? For a moment, the students are bewildered. Skirt, shirt, aren’t they the same? But they catch on. “A skeeerrt.” 

Some students are older than one would expect, and former mischief-maker Gregorio now turned into teacher’s helper, is almost 12, having been held back for not being able to read. English is new, though, and maybe by packing up the teacher’s supplies at the end of the day he can succeed.

In the fifth and sixth grade room, the students are fascinated and wonder what this teacher will do next. They watch as she dances, zips back and forth across the front of the room, and calls out commands when the students least expect them. 

Sunny? The teacher makes a big circle with her hands. Raining? She utters a gulp, gulp sound, moves her hands to indicate rain drops, and then turns into a female rendition of Gene Kelly as she runs across the front of the room with a pretend umbrella. 

Then she adds more words. “Is it sunny?,” she asks and they answer, “It is sunny” and imitate her big sun. Raining? They move their hands like raindrops and say, “It is raining.” And cold? They hug their sides and shiver. “It is cold.”

One of the students who clearly enjoys this the most is Luis Gustavo. Bright as he is, he has a problem with his father.

As often as the classroom teacher has talked with the father, he is unrelenting in his decision to control his many children, one as intelligent as the next, by not allowing them to continue their education. Like his siblings ahead of him, Luis Gustavo will stop at the sixth grade and join his brothers looking for work as bricklayers’ helpers. 

Equally disconcerting is that Luis Gustavo’s father prevents his family from taking advantage of a government program called Oportunidades that provides money if parents keep their children in school. To qualify, parents have to send their children for yearly medical exams and have someone in the family clean the rancho’s streets, tasks forbidden by the father. 

The School

Lucha, the school’s director, motions for me to follow her and get out of the sun. “Let’s sit where there’s some shade and a breeze.” We sit down on the low wall under the school’s portico, our backs to the small homes that cascade down the rocky slopes. A short confident woman in a burgundy business suit, she touches my arm to make a point, treats the children with affection, and when I asked her how many people lived in Los Ricos, she takes the number of her students, figures out how many are in their families, throws in some grandparents and great grandparents, and comes up with the number 350. 

Since Feed the Hungry’s kitchen started making lunch for her students over two years ago, Lucha has seen a difference in the children: they have more energy, more desire to learn in class, aren’t sick as often, and don’t faint standing in line as they used to. 

And now the topper: Feed the Hungry has singled the school out for a pilot program to expose the students to English. “It’s a gift,” she says, and adds, “Just look at what San Miguel employers always say: ‘a little English is required.’ I tell the parents that we are a privileged school.”

I look around and think that privilege probably isn’t the first word that would pop into anyone’s mind. No copy machines, no front office, no mailboxes, no telephone, not even any adult-sized chairs. The school has three buildings: one an individual classroom and another with three classrooms—the third functioning as a storage room for teaching supplies and, in the hope that water for bathrooms will someday arrive, uninstalled toilets—and a one-room kindergarten building farther up the hill. In January, an icy blast often sweeps over the hilltop and the classrooms become like ice boxes.

Life isn’t easy in Los Ricos and neither is getting to school. This year Lucha has been getting a ride with a fellow teacher, but for the first 17 years, she took a bus from San Miguel to a highway gas station and then walked an hour, an effort that she says has made her so strong that she never gets even so much as a cough. 

Along the route to school, she has encountered snakes and packs of dogs, one terrifyingly large with 35 dogs. Her biggest challenge, though, has been crossing the Río Laja, which is usually dry during the winter months. She says that at the juncture of a privately-owned vehicle-size bridge and the Río Laja is the Ruta de Independencia that Father Miguel Hidalgo took when he marched from Atotonilco to San Miguel in September of 1810. I don’t know how Hidalgo got across, but Lucha usually crosses via a pedestrian bridge built in 1985, the only other option being considerably longer on the other side of Los Ricos. 

However, the high water from the rains of 2004 and 2005 washed out the bridge, forcing Lucha to cross on horseback, in plastic tubs or, with a backpack full of dry clothes, by wading across. When the water was too high for any of those methods, Lucha had only one option: a high-wire act across the remaining cables—one foot after the other on the narrow lower cable and both hands on the upper one. It took the government two years to repair the bridge, requiring Lucha to get to and from work that way for months. 

Needing to work hard doesn’t stop with just getting to school, starting a school has its challenges, too. To open a public school in Mexico, a creative combination has to come together: parents who want a school, someone who owns the land and is willing to donate it, someone to pay for the construction materials, people to do the actual building, and sometimes parents willing to pay part of the teachers’ salaries. Then the application goes to the government.

In the case of the Los Ricos de Abajo School, the Ejido los Torres donated the land; then members of the religious community of the nearby Monasterio de Nuestra Senora de la Soledad raised funds from other religious groups in the US and Canada (thereby naming the school Naciones Unidas) and hired workers for the construction of the main building. The people of Los Ricos helped however they could. The government built a second building and, fortunately, picked up the tab for the teachers’ salaries. 

The school opened in 1986 with 43 students, a number that has now reached 70. Attitudes toward education have changed in the rancho and every Thursday afternoon, a teacher from Mexico’s National Institute for Adult Education comes to the school to give a general class to 8 women. Lucha remembers that when she first came to Los Ricos, most parents could not write their names. Now, out of the 34 families with children in the school, only 2 cannot, and, to the parents’ surprise and pleasure, their children are now studying a second language.

That’s certainly privilege, as defined in Los Ricos de Abajo.

María de la Luz (Lucha) Jiménez is the school’s director and teacher of the 1st and 2nd grades, José Pedro Ramírez Jacinto teaches the 3rd and 4th grades, and Roberto Amaguer Aguayo the 5th and 6th. They provided much of the information for this article. The English teachers are Chad Payne, Mary Murrell, and Jackie Donnelly. The names of the children have been changed. 


History of Feed the Hungry’s English Program

Michael and Helen Chadwick, the donors who sponsor the kitchen at the Los Ricos de Abajo School, asked if there might be a way to enrich the educational opportunities. After careful consideration and discussions with the school’s director and teachers, Feed the Hungry concluded that English classes would serve that purpose since the school’s faculty and the people of Los Ricos want the students to have a better chance of getting jobs. The language program was developed with the assistance of experts who have donated their time and skills. Volunteer teachers have an orientation, in-service training, detailed lesson plans, and materials to use with the children. Classes are taught twice a week for one hour after the regular school day. Feed the Hungry is considering expanding the classes to other schools when the 2007 school year begins. Requirements to participate in the teaching program consist of having some background in education, liking children, and wanting to learn more about the Mexican culture. Some S
panish is helpful but not required. Feed the Hungry can be found at www.feedthehungrysma.org /



WISH LIST

A wish list of supplies for the students in the elementary school at Los Ricos de Abajo includes:

· 70 copies of bilingual dictionaries, age appropriate

· Small CD players and a laptop computer

· Construction paper, scissors, and art supplies

· Books in English, age appropriate

· Bookshelves, small tables, and chairs

· Games like bingo, ABC, etc. 



If you are interested in participating in the program, either by teaching or donating supplies, please send an email to Mary Murrell at mmurrell@sprynet.com.

The wonder of science for the naturally curious
By Deborah Whitehouse

Imagine a school science project that challenges you to develop criteria about what makes the best kind of bubble gum. Is it the long-lasting flavor? The biggest bubble? Or the loudest pop?

This is one of the experiments in this year’s Science Camp San Miguel that prods students to come up with quantifiable data to support their observations. Do you count the number of chews until the gum loses its flavor? Do you stand at a distance to observe the loudness of pop in competing brands?

How do you measure a bubble gum bubble? Making learning fun is the unwritten mission of this year’s Science Camp where students teach themselves about life by learning to make scientific observations. Science Camp is the brain child of San Miguel residents Rita DeBrito and Alicia Rivero and it begins its second season as one of the most creative learning experiences for children offered in the US or Mexico this summer.

When I first met Rita DeBrito she was an inspired leader and powerful force in the world of education, working to influence and uplift elementary education in a profound way. As a bilingual elementary school teacher in New York City she stood very much at odds with the Board of Education defending her right to teach children creatively. Didactic textbook approaches to learning had left both her and her students bored and frustrated. Determined not to teach language as grammar, she reached for a new way to inspire both English and Spanish speaking children to learn. Rita soon realized that all kids like the sciences and she embraced the idea of using the content and context of science as a basis for learning in all subjects including language, reading, writing, and math. “I let them lead me,” she said. “Kids like science. They like animals. They are naturally curious. When you respect them as individual thinkers they learn to respect themselves and their own decisions.”

Rita’s learning campaign stretched far beyond her classroom. As a National Board Certified Teacher (NBPTS) and board member she was soon instructing other teachers in her method at a number of schools including Columbia University, Hunter College, Bank Street College of Education and New York University. Her travels took her to many cities including Washington, DC where she was invited to one of Al Gore’s “Town Meetings” as an education expert. Teaching children by day and teachers by night, Rita soon met like-minded Alicia Rivero at a seminar she was giving at Columbia University. 

Alicia’s inspiration for education took off while teaching children in Costa Rica, and blossomed as a Head Start teacher in the States. Teaching at a magnet school in Brooklyn and consulting for education nonprofits continued to feed her passion to support the learning process.

She and Rita were a natural team. By allowing children to be responsible for high-level learning, that which is motivated by the students themselves, they developed a style that now flourishes in San Miguel.

Today Rita and Alicia’s teaching philosophies are alive and well in Science Camp San Miguel. By creating a community of 8-12 year old kids from all over the US and Mexico, children whose lives might not otherwise intersect are given both the educational opportunity and the social opportunity to learn from and embrace each other’s likenesses and differences. Science Camp is a unique program of inquiry-based learning in an environment where children can practice observation and study, learning how to narrow their variables when creating experiments and then come to conclusions. This summer students are not only encouraged to think for themselves, but will select their own curriculum. The students lead the way—their individual needs and interests determine their direction. 

Much of the learning in Science Camp is centered on caring for and observing animals. This transcends language because animals provide the emotional motivation to learn by choice rather than by rote. “We find animals… spiders, snakes, a baby bat, lizards, butterflies, centipedes, and create environments in which they can live,” said Alicia. “The duck pond is its own environment. We feed the animals and observe them, and then let them go back to the wild at the end of camp. Do meal worms like to eat sugar or salt? We put out both and watch what happens. Which do they go for? Which makes them recoil? Each student has a fact book for recording a log of his or her observations.” Other activities at Science Camp include a paper airplane experiment in aerodynamics, a chocolate chip cookie experiment, an introduction to magnetism and the compass, map making, and more.

So what’s happening with Science Camp this year? It has taken on a life of its own and is growing in leaps and bounds! Last year’s success has fostered a whole new process of expansion with partners like El Charco del Ingenio, the botanical garden, offering nature study walks. The new camp program schedule has been extended by an additional hour each day and by an additional week through August 3, making a total of 4 weeks this summer.

The camp needs resources. Their ambition is to raise US$4,800 this year to cover materials and school supplies, lunches, snacks, trips, and support staff. A wish list for books on amazon.com (see below) enables a giver to order pre-selected books online and deliver them to the camp or put it in the camp’s mailbox. In addition to books, Science Camp also needs digital cameras, ink cartridges, photo paper, printers, laptop computers, benches, tables, and 10-gallon fish tanks. Volunteers with expert knowledge such as birders, naturalists, astronomers, microbiologists and others are invited to share their knowledge with students as guest teachers. 

Fundraising to create partial and full scholarships is ongoing this year to support students who otherwise would not have the opportunity to attend. Rita stresses that these scholarships are not handouts; they are earned by demonstrating an eagerness to learn. What is gained is a unique educational experience. The camp’s goal is to have 50 percent of its students partially or fully funded this year. US$150 covers one student for one week. A number of sponsored events, including a concert in May at El Topo Viejo and films at the Cinemateca, will contribute proceeds for new scholarships. A science fair for kids at La Biblioteca in early June will bring more awareness of Science Camp to the general public and provide additional opportunities to contribute. 

Alicia and Rita’s future vision for Science Camp San Miguel further expands the camp’s learning potential by continuing to partner with organizations like El Charco del Ingenio and La Biblioteca. Although the focus now is to provide opportunities for children of cross-cultural and cross-economic backgrounds to attend camp, their inspiration is for the camp to become a more community based experience. Alicia and Rita’s dream is to create a wonderful science center with a lab where local teachers as well as students would be welcome. Education is not about obedience or conformity,” Rita says. “It’s about opening minds.” 

If you’d like to donate a book you’ll find their wish list at amazon.com. Simply go to “find gifts” and enter sciencecampsma@gmail.com to access their wish list. You can deliver the book yourself or put it in their mailbox at La Conexión #413A.

Science Camp will be held July 9–August 3. Visit their website at www.sciencecampsanmiguel.com  for more information.

Botanical artists visit El Charco
By Alice Tangerini, Debbie Blankert and Marcia DeWitt

Our group of 12 botanical artists from the Washington, DC area traveled to San Miguel de Allende in March and took a two-hour tour of El Charco del Ingenio Botanical Garden. After the tour, we set aside time for sketching the plants.

Mario Mendoza, sub-director of the garden, was our tour guide, showing us the collections and focusing on the endangered species of cacti. We sketched the cacti for possible inclusion in a travelling show to be presented by the American Society of Botanical Artists called “Losing Paradise: Endangered Plant Species Here and Around the World,” scheduled to open May, 2008. 

All of the artists were students or teachers in a certificate program in botanical art from the Corcoran School of Art.

Nine of the group had been brought together by Leslie Exton of the Corcoran Gallery of Art in DC, who curated a show last year by these same illustrators, based on the flora Lewis and Clark identified during their explorations in 1804-1806.

Sketching the plants outdoors was pleasant, but the experience came with insects and very bright sunlight and required some dexterity to get close to the diminutive specimens, some much smaller than a thimble.

The artists took many photos in order to continue their work back in Washington, DC. We hope paintings of endangered plants will help make the public aware of the need to preserve these special plants.

Local San Miguel botanical artists indicated they would like to collaborate with us on teaching future classes in botanical art at El Charco.

All three authors are members of the American Society of Botanical Artists.

Benefit Art / Fashion Show
For Casa Hogar Santa Julia Don Bosco, A.C.

Sat, April 7, 4–7pm La Carpa, Fabrica la Aurora 100 pesos Art and fashion for the girls

At “Afternoon Delight,” attendees will have the opportunity to view religious (it will be the day before Easter!) and secular art from Chris Doolin, Jenny Norman, Genny Claro, Mujeres Trabajando Juntas, Fran Schiavo, Alfonso Alarcon, Jim McDermott, Maria Isabel Ayala and Dawn Gaskill, to name a few. 

All of this will be set to music by the Santa Julia choir and violinist Libby Clemens. Amplifying the featured style show with descriptions of the one-of-a-kind designs is popular speaker John Barham, and in case that’s not enough, participants can sip and crunch to their hearts’ delights on La Carpa’s gourmet wines and foods.

Through this event, the amazing Dominican Madres, who care for the girls of Santa Julia, hope to raise enough funds to buy the girls the clothes and shoes they need during the year.

Tickets to “Afternoon” Delight may be purchased in advance at the Biblioteca, Border Crossings, La Conexión, and Olvera Real Estate (Mesones 56).

Emergency medicine 101
By Haywood Hall, MD

An effective Emergency Medical System is not just an ambulance. It is the people who work to support the “chain of survival” from the time first aid is rendered, through the ambulance, the emergency departments and the stabilization and transfer to higher levels of care where appropriate.

Pre-hospital care in San Miguel is basically at the volunteer “first responder” level. The Red Cross (and the Bomberos) do extraordinarily well with what they have. They are essentially an all-volunteer force. They (the volunteers) have some training and some are even EMTs. The issue is one of having professional (i.e., paid) EMS personnel to ensure consistent quality and to provide a framework to advance the system.

As far as Hospital de la Fe is concerned, the issue is that any ER with a low volume (maybe 10 a day) cannot be well “tuned” enough to provide consistent emergency care. There are numerous reports of patients arriving there and not having a physician to greet them on arrival. That does not happen at the General Hospital. However, de la Fe is where private medicine is, and the best specialists in town have their offices and practices there. The inpatient care will, by definition, be more comfortable than at the General Hospital on Reloj. The new General Hospital, however, is opening in the near future and they have considered the possibility of a degree of private service (meaning that your private physician may have privileges there).

If I were in a major accident, I would go to the General Hospital and take my chances, because they have staff present at all times and can call in back-up (including the private doctors). From a US-standard point of view, the qualifications of the ER staff at either hospital is about as minimal as can be. Some of them have certified in a 2-day trauma course (ATLS) and a two-day cardiac care course (ACLS), but not all of them.

If I was having a heart attack, the best cardiac care would probably be at de la Fe—if Dr. De la Cadena or Dr Maxwell were on site, which is not always the case.

The solution has at least two focus areas which I will outline here.

We need better pre-hospital care—it can make a difference in many critical cases. This means professionalizing the Red Cross (i.e., salaries and training). Support the Red Cross (and Bomberos) with donations and resources to specifically support salaries and training.

For emergency care, we need to be sure that the doctors and nurses have the highest possible level of training, and they too are dedicated to professionalizing the emergency department. The ideal is to have an Emergency Medicine Specialist (residency-trained) as a Department Director (as is the case in Dolores Hidalgo and has been the case in Celaya), who will also provide some degree of medical control over ambulance services. There are eight Emergency Specialists in all of Guanajuato State, a few in the General Hospital in Dolores Hidalgo, but none who work in San Miguel (although two Mexican emergency specialists live here).

An emergency system is not simply “meeting your doctor at the hospital,” either. There are times when your doctor won’t be available and things will need to happen automatically, starting in the pre-hospital setting, in order to save lives.

An important mention should be made about evacuation insurance: It has its place, but is not the solution. You may have insurance that entitles you to care in the United States (and may even already pay for evacuation—check and see). In general, I recommend it. Realize however, that no medical evacuation service (ground or air) will transfer a patient that has not been stabilized. This requires, in critical cases, that the right thing has been done in the ambulance, in the emergency department and by the attending physicians. They will look for any excuse not to send an expensive plane and if you are “unstable,” they will pocket the change. You can’t buy evacuation insurance as a substitute for an expert local emergency care!

Let’s learn the language of emergency medicine: An Emergency Medicine Specialist is residency-trained. There are 3,000 of them in Mexico, 8 in the State of Guanajuato and none working clinically in San Miguel.

An Emergency Physician could possibly be the aforementioned specialist, but is more likely a general physician, lacking specialty training. This physician probably, but not always, has ACLS and ATLS certification.

A nurse who practices primarily in the ER and has received additional training in emergency care is an Emergency Nurse. In 2005, the hospital General Director, Dr. Vidargas, asked the PACE program to train the hospital nurses in emergency care and since then there are dedicated nurses in the ER. We also trained a nurse from Hospital de la Fe. Dr Vidargas deserves a lot of credit for this far-sighted move. 

A First Responder is an emergency responder with about 50 hours of training, while an Emergency Medical Technician (EMT-B / TUM I) has about 100 hours of emergency care training for ambulance crews (paid or volunteer). Our EMTs are not paid.

In the US there are also EMT Intermediates (EMT-I / TUM II) who have a couple hundred additional hours of training. We have none here. And finally, an EMT-P (Paramedic / TUM III) has up to 1,000 hours of training. There may be 300 true Paramedics in all of Mexico and none in Guanajuato that we know of. 

As Dr Bob Suter said in San Miguel at the PACE summit on February 25, what we need here is the best possible emergency care (pre-hospital and hospital) so we can stabilize and transfer patients appropriately. Anything that is not a true emergency can wait. You can fly home for anything else. As the past President of the American College of Emergency Physicians and the past President of the International Federation of Emergency Medicine, he knows. For more information on emergency care, and other health care issues, please visit www.pacemed.org, www.medspanish.com and www.ashoka.org. 

Haywood Hall, MD FACEP is an emergency and community health physician, as well as an ACEP Ambassador to Mexico and an Ashoka Fellow.