By Warner, Keith Douglass OFM, PhD
About 21 percent of Mexico's population lives in rural areas, according to the World Bank, yet only 2.3 percent of the country's 259,000 practicing physicians work there. That may seem like an insurmountable problem to some, but to Haywood Hall, MD, a high-school-dropout-turned-emergency-physician, it was a perfect opportunity to found PACE MD, a program that aims to enhance health care delivery in Mexico.
Mexico's fragmented health system with substantial but often poorly coordinated resources was crying out for someone to teach rural Mexican physicians, all of whom were fully qualified by their formal education but lacked practical training in emergency medicine. Enter Dr. Hall, who also recognized that many of the country's first responders would benefit from emergency medicine training.
PACE MD, started in 2002, weaves together disparate players and processes to foster a more responsive health system, save lives, provide better care, and establish a more inclusive health care system. Working closely with local partners such as the Red Cross, PACE MD organizes advanced training workshops across the range of Mexico's health care providers and institutions, linking emergency medicine to public health. The organization has trained some 30,000 health care providers in emergency cardiac care and obstetrics over the past 15 years.
I had the privilege of seeing PACE MD in action this past July during a PACE MD co-sponsored Advanced Life Support for Obstetrics (ALSO) workshop. PACE MD extended its reach to two students from Santa Clara University's Miller Center for Social Entrepreneurship, where I am the director of education and research. One day in the town square, PACE MD and its partners provided training to hundreds of ordinary citizens in the fundamentals of first aid. Four stations provided hands-on training, including effective responses for a person suffering a heart attack and for an infant who has stopped breathing. The trainers all regarded Dr. Hall with great respect, admiring his vision and leadership, which made me proud of the Miller Center's association with him and PACE MD.
PACE MD also started a program — PACE Corps — that complements medical students' classroom learning with practical fieldwork. This program is designed in the spirit of the Miller Center's Global Social Benefit Institute fellowship, in which Santa Clara University undergraduates conduct field research with social enterprises in developing countries. Last year, PACE Corps medical student volunteers spent several weeks in Chiapas, one of the poorest states in Mexico, providing ALSO training for nurses and midwives.
Jesus “Chuy” Noguez Vega, currently in his last year of medical school, had his PACE Corps presentations translated from Spanish into two indigenous languages so that they would be more widely understood. Many of the midwives on the front lines in poor communities work far from clinics and hospitals, and he was able to provide training to help these health care workers. Mr. Vega said he shares Dr. Hall's vision of using social entrepreneurship to transform the nation's health care system and dreams of following in Dr. Hall's footsteps.
PACE MD's efforts to transform health care systems go well beyond its training workshops. The training programs bring together all the elements of emergency health care: transit police, firefighters, paramedics, midwives, nurses, and doctors. The participants learn skills and develop a common vocabulary. As these individuals collaborate on more sophisticated outreach and clinical projects, a continuum of emergency health care becomes possible. That triggers social change shifting the status quo from fragmentation toward coordination, an excellent example of how social entrepreneurial action can advance a more just and inclusive health care system.
Emergency physicians and nurses are generous with their time, sharing their expertise in volunteer activities, including medical missions to the developing world. PACE MD relies on physicians trained in ALSO to provide training, build local capacity for emergency health care, and foster a more integrated emergency health care system. If you want to volunteer your services internationally, contact Dr. Hall at Haywood.Hall@Centro-PACE.org. Read more about the program at https://www.pacemd.org/en/about-us.
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