Only the living can prepare for dying
By Linda Sorin

Lecture: Hospice San Miguel
Living and Dying in San Miguel
Mon, Sept 24, 5pm 
Teatro Santa Ana 
Biblioteca Pública
Insurgentes 25
50 pesos

A standing-room-only crowd attended the first public presentation by Hospice San Miguel. The presentation will be repeated on Monday, September 24, due to overwhelming public response.

Following is a summary of the information from the September 5 program. In the near future this information also will be available at Hospice San Miguel’s website.

Dr. Roberto Maxwell, Hospice San Miguel’s medical director, spoke about the importance of choosing a physician and developing a relationship with that physician prior to experiencing any medical necessity. Dr. Maxwell cited several instances in which he had been called to the emergency room for someone who had not been his patient after the person had suffered a stroke or a serious heart attack and was unable to communicate. As the physician he had no knowledge of the individual’s wishes concerning Do Not Resuscitate orders or other health care directives, nor did he have information concerning emergency contacts.

In Mexico, a death certificate can only be signed by a physician. A physician may not be willing to sign a death certificate for a patient who s/he did not know and for whom s/he did not know the cause of death. To avoid these situations it is important to develop a relationship with a physician while you can still make your wishes known.

Dr. Maxwell stressed the importance of choosing your physician carefully and making sure your needs and wishes are understood. He suggested a checklist of questions to help with your decision making. These include:

Where did you receive your medical training?

If I need to be admitted to a hospital, where do you admit your patients?

Do you keep medical records? In what languages?

If I have a cardiac emergency, where will I be referred?

Will you communicate with my doctor in the US by phone or email?

Do you make house calls?

In the event of an emergency, which emergency room should I use?

Who shall I call in the event of an emergency?

Will you cover me 24/7 if I’m in the hospital?

Can I call you in the middle of the night, on weekends and holidays? 

How should I get from my house to the hospital?

If I can’t be treated locally, which hospital do you use?

If I need to go to the States for my care, do you have access to air and ground transportation?

In addition, Dr. Maxwell suggested providing information to your doctor concerning your medications, medical history, health care directives and emergency contacts. Your Advanced Directives should include information about who will take care of your final medical bills, as well as the names and contact information for two or three people you have entrusted to make medical decisions for you in the event that you are unable to do so. One suggestion was to see a Mexican notary to make a Living Will. However, Dr. Maxwell doesn’t require notarized information if he is receiving it from a patient in his care with whom he has developed a relationship. 

Since hospitals require payment up front, it is important that someone know where you have cash in your home or have access to your bank account or credit card.

US consular agent Ed Clancy urged US citizens to register with his office. If a US citizen dies the next of kin is called by the US Embassy in Mexico City within 48 hours of the death. The Embassy needs the contact information from you so that they know who should be contacted. In the event someone is ill and needs help, the US Privacy Act requires that the Consular Office have written permission from you to contact anyone on your behalf. 

In the case of a suspicious death, the Ministerio Publico’s Office is called and the US consular agent secures the house of the deceased. There will always be an autopsy and the estate will be secured, whether or not the death is mysterious. Forms in the Consular Office can be completed to give permission to your designees to enter the premises. In the event of the death of a US citizen, the following must be brought to the Consular Office: deceased’s passport, Social Security number and a death certificate. 

The most difficult cases for the Consular Office are when someone is incapacitated. It was recommended, in the event that you are incapacitated, that someone have Power of Attorney to access your bank account(s) to pay your medical or final expenses. Ed suggested having all important documents, clearly marked, in a location known to family members, your attorney, executor, and/or friends. 

If someone has no family here, it was suggested that they obtain information from and join the 24 Hour Association, who will make all burial or cremation arrangements (for a fee) according to your wishes.

There was discussion about bringing medications in to Mexico. All controlled substances require a prescription in the name of the person carrying the medications. If someone is bringing controlled substances over the border for you, they must have a prescription in their own name. Some of the mail services will allow you to ship in medications, but they charge a fee and duty. It’s best to check with each service individually for their policies. One suggestion was to go to Laredo, or some other nearby city and buy a 90-day supply of all medications that you take.

There is a Social Security Office in Mexico City. A representative comes to San Miguel twice a year. If you would like an appointment to discuss your benefits or to have other questions answered, call Ed Clancy to request an appointment.

In this age of information when so much of our communications and our finances are conducted electronically, it’s important to know how to handle your email, bank and investment accounts in the event that you are incapacitated or die. Charles Miller, a freelance computer consultant who has worked in the information technology industry for more than 20 years and who writes the weekly “Computer Corner” column in Atención shared some useful information with the audience. 

Miller recommended writing down all of your passwords somewhere and informing your heirs, executors, attorney or whoever is appropriate of their whereabouts. Email accounts are terminated due to inactivity after a certain period of time. If you want someone to have access to your email account and your address book, make sure they have your password. If you have email that you want saved, speak to a computer person regarding what you want saved and how. If you are incapacitated, you could have someone use the Auto Respond feature to say that as of a certain date you will no longer be receiving emails.

Find out what is going to be needed to change transmittal of your electronic information to paper or to your heirs or your designee. If you have a PayPal account, make sure that it is listed as one of your assets if deposits are made to it. Always be conscious of naming and archiving documents in a way that they will be obvious to your heirs or other appropriate persons.

Do your homework, get your personal, medical and financial lives in order and you can kick back and enjoy all the wonderful things that San Miguel has to offer.

The Hospice San Miguel office is located in Colonia Lejona at Manuel Rocha 35. For more information, or to volunteer, call 154-4287 or visit www.hospicesma.org. 

CASA 25th anniversary celebration huge success!
By Barbara Erickson

CASA Hospital and Center celebrated its 25th anniversary and the renovation of the CASA Hospital with great fanfare and fun on August 5. The festivities began at 11am with a ribbon cutting and invitation to everyone to tour the hospital.

 Sanmiguelenses were treated to refreshments, broad smiles, and presentations for hard work and excellent service. The local San Miguel business community provided the financial support for the festive celebration.

Visitors enjoyed seeing the brand new water birthing room with state-of-the-art water birthing tub and family area. The newly refurbished patient consultation rooms, which all look out to the lovely patio, are spacious and friendly.

Doctors, patients, board members, staff, friends and family members were excited and happy to applaud the 25 years of community service provided by CASA and to celebrate not only these accomplishments but to enjoy the renovations as well.

CASA Hospital has a new administrator who plans to enhance the already capable medical team and bring extra support to the midwifery cooperative. A childbirth advocate has relocated here to round out the CASA team.

Many in the community are not aware that doctors at CASA offer many health services in addition to the work of the midwives. The hospital team includes not only physicians and midwives but dentists, podiatrists and chemists, many of whom have worked at CASA for 18 years or more. Medical services are provided on a sliding scale, and CASA Hospital served over 9,400 patients last year alone.

In addition to the renovations at the hospital, CASA Center has been repainted and looks beautiful. If you have not had the opportunity to visit the CASA Center at Santa Julia 15, you might consider taking an afternoon to visit. You will find the daycare center a delight, with over 90 youngsters busy with their daily routine. Perhaps the theatre team will be rehearsing, the midwifery students could be taking classes, or the peer-to-peer counselors will be planning for their next visit to the campo. The counselors provided sex education to 5,680 students and family planning to 3,475 people last year. CASA graduated the eighth generation of midwives in July, and many are already working in their rural communities, making a difference the CASA way. The CASA center is a beehive of activity directed at the most pressing problems in Mexico—(M)working in poor, underserved communities to deliver health and human rights education. 

The CASA staff want to extend the fun of the 25th anniversary celebration and invite you to visit! To see what CASA is up to, call Ana Peña at 154-6060 for a tour.


Breaking News: CASA has received an invitation to participate in the CGI Annual Meeting in New York by Hillary Freudenthal, Deputy Chair of Global Health at the Clinton Global Initiative (CGI; www.clintonglobalinitiative.org ).

CGI was started in 2005 by former President Bill Clinton as a non-partisan catalyst for action, bringing together a community of global leaders to devise and implement innovative solutions to some of the most pressing global challenges. A distinctive feature of CGI is that every participant is asked to make a commitment to act in one of the issue areas highlighted at the conference. Commitments must meet three criteria: They must be new, specific and measurable. Although the membership of CGI is primarily business and government leaders, they also extend a very limited number of complimentary invitations to NGOs around the world that are doing exemplary work.

Independence the theme for Mujeres en Cambio
By Roger Hind

Luncheon
Mujeres en Cambio Luncheon
Thurs, Sept 27, 2–(N)4 pm
The Party Pavilion at Patsy’s Place
200 pesos, for sale at Casa de Papel

One of the characteristics that distinguishes the young women receiving Mujeres en Cambio scholarships is independence. They show independence of spirit by daring to dream of a better future through education.

 They display independence of character by visualizing a different kind of life from that of their friends, parents or siblings. They display independence of thought and action by committing themselves to obtaining a superior education. Their goal is to increase their eventual level of independence beyond that of the typical young woman, both intellectually and financially.

For example, we recently followed up on a student, Aricela, who had not been collecting her scholarship. Her teacher told us that Aricela was still attending school and still getting excellent grades. We also learned that her father had found work and that the family wanted another student to have the chance that had been given to Aricela. Now that’s independence!

In a similar vein, Mujeres en Cambio and several other generous supporters of our cause sponsored Jessica Hanson for a second summer internship in the community of Agustin Gonzales. Jessica is a languages student—(M)on track for a Fulbright scholarship—(M)who graduated from Pacific Lutheran University in Tacoma, WA, in May. Agustin Gonzales, on the road to Guanajuato, is the home of the Mujeres en Cambio rug hook project (see http://charlottebell.com/rughookproject/). We also support many students at the schools there. For two years running, Jessica lived in the village during her summer vacation and ran a literacy program and English classes.

I attended this year’s graduation ceremony in early August. It began in a typically Mexican way. We gathered at the junior high school where Jessica had been allocated a room for her classes and where the students’ projects were on display. But Jessica found that while the head teacher had given her the keys to the room, she did not have the key to the gate to the school grounds! Family and friends of the students picked up their pots of food, refrescos and a huge chocolate cake and, accompanied by assorted dogs we all walked across the highway to the community center. There on the porch we set up for the ceremony, borrowing a table and chairs from a nearby neighbor.

As is the norm for Mexican fiestas, all ages were represented from babes in arms to great grandparents. While the refreshments were laid out and the youngsters shrieked and ran around the playground equipment, the students nervously reviewed their notes and practiced their pronunciation. When the ceremony began, I was moved by the incredible sense of community pride in the young people—(M)all young women apart from two brave young men—(M)who stood and acted out their creative pieces in English. Shy, hesitant, but nevertheless determined to succeed, each child was a star for a few minutes. The sense of achievement (and relief!) after each presentation shone on the students’ faces. What an incredible example of our motto in action—(M)making a difference in young Mexican women’s lives. May the changes we are fostering in this village and around San Miguel contribute to the fortunes and independence of this wonderful country!

Mujeres en Cambio provides scholarships to more than 150 young women recommended by their school principals from the ranchos around San Miguel. To maintain their scholarships, students must maintain good grades (the grade average of our students is 9.5). High school students receive approximately US$275 per annum. Many of our students graduate from high school and continue on to college, technical school or university. We support these students with a larger annual scholarship of approximately US$1,000.

Mujeres en Cambio is an entirely volunteer-run organization. We rely on the generosity of our supporters to raise the US$75,000 needed each year to operate our program. One of the ways we raise funds is by holding monthly events.

We are delighted that on September 27 we will once again be hosted by Patsy Dubois at her beautiful country property near Atotonilco. Patsy’s idea to base the lunch on Mexican Independence Day prompted my thoughts for this article. Lunch will be served in the brand new “Party Pavilion at Patsy’s Place” which will be decked out in Independence Day colors. Patsy will serve chiles en nogada accompanied by an array of vegetables and salads. Dessert and coffee will also be served, and there will be a cash bar with soft drinks, beer, wine and margaritas.

Patsy, repeating her incredible generosity of last year, will donate 100 percent of ticket and bar sales to our scholarship fund.

Come along, enjoy great company (men and women both welcome!) and beautiful surroundings, and learn more about our activities.

Tickets are 200 pesos and are on sale now at Casa de Papel, Mesones 57A (the China Palace Building). Please note that entry to the lunch is by advance purchase ticket. There are only 100 tickets and they always sell out quickly. Remember, no tickets will be sold on the day of the event.

To keep our costs low and therefore maximize the benefit of this fund raiser, we will be carpooling to and from Patsy’s Place. Those needing a ride should be at Calle Cardo, opposite St Paul’s church, at 1:10pm on September 27. Those offering a ride should be there between 1:15pm and 1:25pm to pick up passengers. If you can help with car pooling please let us know when you purchase your ticket. Directions to Patsy’s Place are printed on the back of the tickets; you may also ask for a map when you purchase your ticket.

For more information, visit our website, mujeresencambio.com or call Roger at 154-6552. (Note that no reservations can be taken). Take a sneak peak at why this trip to Patsy’s Place will be a very special experience by visiting patsydubois.com.

What’s happening in Mexico City
By Jim Johnston

The summer doldrums are over and cultural life in the big city is back in full swing. Here are a few noteworthy events.

The Compañia Nacional de Danza will present the ballet Romeo y Julieta at the Palacio de Bellas Artes on September 20, 23, 25, 27 and 30. The music by Sergei Prokofiev is one of the greatest ballet scores of all time.

German cabaret singer Ute Lemper, known for her interpretations of the music of Kurt Weill, will perform at Bellas Artes for one night only, September 26.

Tickets for these events are available at the Bellas Artes box office or through www.ticketmaster.com.mx

The Spanish singer known by the single name Martirio will bring her fabulous mix of jazz and flamenco to the Lunario of the Auditorio Nacional on September 28 and 29. If you don’t know her, you should. Tickets are available at the box office or through Ticketmaster.

Serious classical music fans should visit the website www.musicaunam.net to see the list of upcoming events in the Conciertos Internacionales series, featuring musicians such as famed Bach-interpreter Angela Hewitt.

If you are missing Oaxaca these days, the show Presencia de Oaxaca en México might help fill the gap. Crafts, food and more will be on sale until September 16 at the Galerías de las Estrellas, Marina Nacional and Circuito Interior Melchor Ocampo.

Another show featuring contemporary artists from Oaxaca is on display at the Museum of Natural History in Chapultepec Park for the next six months. The theme of the show is reflected in its melifluous Nahuatl title Xhua Shela Nhaban Chechho which translates to “Corn is Our Life.”

To find out what else is happening in the art world, check the listings in Centro magazine, available at most newsstands and at Sanborn’s. They are the clearest and most complete I have found. Another good source is the website www.arte-mexico.com/. For general listings of cultural events (movies, theater, etc.) buy a copy of Tiempo Libre magazine, a weekly that comes out on Thursdays.

If you have already visited the popular museums recommended by most guide books, try the Laboratorio de Arte Alameda (Dr. Mora 7 at the west end of the Alameda) for the latest in video art or the new Museo del Estanquillo (Isabel la Católica 26 at the corner of 5 de Mayo) with its great views from the top floor café.

A new (and free) English-language monthly paper now being published is aimed at the expatriate community throughout Mexico. Inside Mexico contains feature articles, news items and practical tips for foreigners living here. The paper is distributed in more than 20 locations around San Miguel, or you can read it online (www.insidemex.com) where you can subscribe (also free) to have it sent each month to your e-mail address.

Jim Johnston, a 10-year resident of San Miguel, now lives in Mexico City. His first book, Mexico City: An Opinionated Guide for the Curious Traveler, was published in 2006.