Looking out at the villages lining the mountains of Chiapas.


PIH is officially launching its newest sister project in a rural, mountainous region of Chiapas, one of Mexico’s poorest states. The new organization is called Compañeros En Salud (CES), which translates as “friends in health.” 

Map of Mexico

Chiapas is Mexico's southernmost state.

Beginning February 1, 2012, CES staff and recent graduates of Mexico’s top medical school, Tecnológico de Monterrey, will begin providing high-quality health care in an area encompassing thousands of people in nearly a dozen isolated communities. The physicians will be based in two rural government medical facilities that have been underutilized and understaffed. 

As with other PIH projects around the world, CES is partnering with local communities and the regional government in order to strengthen Chiapas’s public health system. “This approach is based on what we’ve learned from local people through several years of operating a mobile clinic unit in these isolated towns,” said Project Coordinator Lindsay Palazuelos. “Our goal is that community members will be involved in raising standards in every aspect of their health care.”


Listening to local communities, building customized health systems

While CES is a new entity on paper, PIH has a long history in Mexico’s southernmost state. Since 1989, PIH has partnered with the Chiapas-based nonprofit EAPSEC – Equipo de Apoyo en Salud y Educación Comunitaria, Spanish for “Team for the Support of Community Health and Education” – with the aim of organizing communities to improve health care and the determinants of health.

Shuttered clinic in Chiapas

One of the previously shuttered government-built clinics that CES will staff, supply and reopen.

For two decades PIH accompanied that organization with clinical and program staff, financial support, and strategic planning. Working together, the organizations staffed a mobile health unit and trained dozens of community health workers

CES will focus on providing medical care and training, while PIH will also continue supporting EAPSEC as it concentrates on programs in food security, women’s empowerment, and access to credit. PIH has long recognized the intimate connection between socioeconomics and health. The best health care does little good if a patient goes home to a makeshift home or lacks access to food and clean water.

PIH’s work in Mexico is made possible by a generous donation from Green Mountain Coffee Roasters, which donates a percentage of its profits to helping develop the communities where it sources coffee. This year Green Mountain will fund projects through roughly 1,200 nonprofit organizations throughout Latin America and beyond.


A region blessed with riches, but desperately poor

Despite being home to world-class organic coffee farms and incredible biodiversity, the people of Chiapas are largely marginalized. Too many households still lack electricity and water. Schools are inadequate and illiteracy rates high. Unsurprisingly, access to health care also lags behind needs, meaning that too many people suffer from preventable or treatable conditions.

By working with local communities and hiring and training a team of local community health workers, CES will take key steps towards establishing a sustainable public health system.



Attracting physicians to rural Chiapas, expanding partnership opportunities

PIH's Dr. Hugo Flores Navarro

CES's Drs. Dan Palazuelos and Hugo Flores Navarro.

“In rural areas, attracting medical staff is a key challenge that we wanted to find innovative ways to address,” said CES’s Dr. Hugo Flores. A central component of the new organization’s strategy aims to address this problem.

When medical students graduate in Mexico, they enter a one year required social service assignment before receiving their medical license. Too often residents spend this year with little mentorship or guidance in underequipped rural clinics. For many, the experience can feel discouraging.

CES aims to transform the social service year into a meaningful training experience that helps build the next generation of social medicine physicians. CES is partnering with Brigham and Women’s hospital residents to provide a unique package of training and support that includes global health seminars, supervision on site, and supplementary supplies, that has already attracted many interested medical students and recent graduates from Mexico’s top universities, including Tecnológico de Monterrey.

These measures help ensure that physicians have the tools needed to provide high-quality care in poor communities.

The CES core team possesses several years of experience working in Chiapas. Dr. Palazuelos began work in the area as a Doris and Howard Hiatt Global Health Equity and Internal Medicine resident at Brigham and Women’s Hospital in 2005, and helped launch the mobile health unit in 2007. Ms. Palazuelos began as coordinator in 2008, and Dr. Flores began serving patients in the area in early 2010.