Orlando Sentinel (Sunday)

‘Dumb deaths’ inside Mexico’s broken hospitals

- By Natalie Kitroeff and Paulina Villegas The New York Times New confirmed cases per day, globally

The senseless deaths torment doctors and nurses the most: The man who died because an inexperien­ced nurse unplugged his ventilator. The patient who died from septic shock because no one monitored his vital signs. The people whose breathing tubes clogged after being abandoned in their hospital beds for hours on end.

In Mexico, it’s not just the coronaviru­s that is claiming lives. The country’s broken health system is killing people as well.

Years of neglect had already hobbled Mexico’s health care system, leaving it dangerousl­y short of doctors, nurses and equipment to fight a virus that has overwhelme­d far richer nations.

Now, the pandemic is making matters much worse, sickening more than 11,000 Mexican health workers — one of the highest rates in the world — and depleting already thin ranks in hospitals. Some hospitals have lost half their staff to illness and absenteeis­m. Others are running low on basic equipment, like heart monitors.

The shortages have had devastatin­g consequenc­es for patients, according to interviews with health workers across the country. Several doctors and nurses recounted dozens of preventabl­e deaths in hospitals — the result of neglect or mistakes that never should have happened.

“We have had many of what we call ‘dumb deaths,’ ” said Pablo Villaseñor, a doctor at the General Hospital in Tijuana, the center of an outbreak. “It’s not the virus that is killing them. It’s the lack of proper care.”

Patients die because they’re given the wrong medication­s, or the wrong dose, health workers say. The protective gloves at some hospitals are so old that they crack once slipped on, nurses say. People are often not sedated properly, then wake up and yank out their own breathing tubes, hospital employees say.

Adriana de la Cruz, a nurse at Dr. Belisario Domínguez hospital in southeast Mexico City, said the overstretc­hed and often undertrain­ed workforce has made glaring errors — at great cost.

“People have died because of a lack of medical attention and because of negligence,” de la Cruz said.

The Mexican government spends less on health care as a percent of its economy than most countries in the Western Hemisphere, according to the World Bank, and President Andrés Manuel López Obrador presided over spending cuts even after acknowledg­ing his country had 200,000 fewer health care workers than it needed.

When the epidemic hit Mexico in March, many hospitals sent front-line workers to confront the deluge of cases without any is one of the city designated hospitals for COVD-19 patients.

Coronaviru­s cases worldwide protective equipment or training. Many nurses say they were forced to buy face shields and goggles themselves.

The fallout has been severe. About 1 in 5 confirmed cases in Mexico are health workers — a greater share

107,740 New cases as of May 29 than in the United Italy or China.

Mexico’s outbreak is growing quickly and shows no signs of slowing. Reported cases and deaths have risen every week for the last couple of months, hitting Mexico City and

States,

Baja California, which includes Tijuana, particular­ly hard.

“Administra­tion after administra­tion gave lip service to the issue of health, but it never showed up as a priority in the budget,” Judith Méndez, an analyst at the Economic and Budgetary Research Center, said of Mexico’s successive government­s.

The Mexican government did not respond to repeated requests for comment. Local health ministers in Baja California and Mexico City also declined to comment.

Patients have filed thousands of complaints with the country’s human rights commission about negligence in hospitals in recent years. And the quality of care only diminished further after hospital workers in Mexico endured some of the nation’s first coronaviru­s outbreaks.

Many countries have struggled with doctors and nurses falling ill, but in Mexico the problem is particular­ly bad.

“If health getting sick workers are at this rate, bottom line is you risk not having a health workforce to look after people,” said Howard Catton, the chief executive of the Internatio­nal Council of Nurses.

De la Cruz, the nurse in Mexico City, said her hospital initially instructed employees not to wear masks around a patient until the person tested positive for coronaviru­s.

“You waited three or four days to see if the patient tested positive, and in the meantime you got infected,” said de la Cruz, who noted that 80 of her colleagues have gotten sick.

Some hospitals did prepare early for the virus. In Monterrey, doctors said protocols to shield workers were put in place months ago. Rodolfo Ruiz, an infectious disease specialist, says he feels protected at his public hospital in Mexicali, even as hospital beds fill up.

But the missteps in some of the hardest hit cities have brought overrun hospitals to a breaking point, workers say. Doctors and nurses have staged protests outside their hospitals in at least a dozen states, according to local news reports. Some doctors and nurses have refused to treat coronaviru­s patients.

Rosario Luna, a nurse at the José María Morelos and Pavón hospital in Mexico City, described treating COVID-19 patients with broken heart monitors and faulty suction machines.

Doctors and nurses say that many errors inside hospitals are never investigat­ed, in part because overtaxed health workers are unlikely to lodge complaints against their own colleagues.

At Dr. Carlos Mac Gregor hospital in Mexico City, Berenice Andrade, a doctor, said one internist quit because of the lack of personnel and that only one doctor watched over 54 patients during the weekends.

“It makes the care we offer very deficient,” said Andrade.

 ?? MEGHAN DHALIWAL/THE NEW YORK TIMES ?? Dr. Carlos Mac Gregor Hospital in Mexico City
MEGHAN DHALIWAL/THE NEW YORK TIMES Dr. Carlos Mac Gregor Hospital in Mexico City

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