Dr. Luis Castillo is a Mexican physician who worked with Partners In Health in Chiapas, Mexico, for his required year of medical service to a rural community. In this essay, he reflects on how the experience transformed his interest in service into a strong commitment to changing the world.
I had the good fortune of growing up around people who were motivated to improve the situations of local communities in need. Nevertheless, to be honest, I dedicated just 21 days of the year to helping marginalized communities through volunteer work with Catholic missions.
I stepped foot in Chiapas for the first time in my life, full of uncertainty and doubts, but with my spirit awakened and ready for new challenges.
In this way, I had only a passing interest in service when I learned about Compañeros En Salud, Partners In Health’s sister organization that works to improve the primary health care system in rural Chiapas, Mexico. My first encounter with them was mere coincidence. I found myself in the hallway of my hospital, during a pediatrics rotation, when one of my colleagues told me about the adventure that was waiting in Chiapas for my social service year.
I learned the details through the Internet and contacted the program directors—strangers who before long became my mentors. And before I knew it, I stepped foot in Chiapas for the first time in my life, full of uncertainty and doubts, but with my spirit awakened and ready for new challenges.
I was surprised by the ecological diversity, the incredible scenery, and the magic that enveloped the Sierra Madre Mountains. My colleagues—the other social service year physicians—were interesting people with inspiring stories, social consciousness, and a skilled, thoughtful approach to the titanic daily struggle we had decided to undertake.
I heard for the first time the name of the place where I would spend one year of my life: Laguna del Cofre, a tiny community about seven hours via public transportation from Chiapas’s largest city. The truth is I hadn’t the least idea of what awaited me. I searched on Google Maps without a single result, heightening the sense of adventure.
I arrived as a total stranger. At the beginning I didn’t even understand the language, a rural Spanish with a smattering of indigenous words, let alone the perception of time or the course of an illness. Most of the people measured less than five feet tall, with a thin build and brown skin, accompanied everywhere by a machete, a sack, and a gallon of “pozol,” a traditional beverage good for filling hungry stomachs.
The transition I had heard about so many times in medical school happened: I became a community doctor. The Mexican Ministry of Health and PIH/CES accompanied me and introduced me to the community. I felt responsibility and a host of emotions as I took charge of the health of children, young people, men, women, and the elderly.
I went to my new house. It was an old health center: a large room with faded colors, notable only for its humidity, dysfunctional bathroom, and brownouts that made it impossible to use electronics. I had the basics: a cot, a couple of photos of family and friends, and a heart ready to work.
Just then, Doña Caty approached me. A humble woman with a steady gaze and a warm greeting, she had a wrinkled face that suggested a life dedicated to sacrifice on behalf of the people she most loved. “Doctor, would you like to have a cup of coffee?” she asked. That cup of coffee, bitter as the night, opened the doors of her home to me. She introduced me to her 10 children, accompanied by her grandchildren. I should confess that it took me a bit of work to learn their names, but they became friends, my confidantes, support, inspiration, and family.
I had an epiphany. I discovered a world that was divided in two: between the haves and the have-nots.
I accepted the challenge.
Waking in the morning, I felt excited by the smoke of neighborhood chimneys that circled the sheet-metal roofs, the sounds of the animals, and the chill of the mountains. Each day I faced a different challenge related to the difficulties of a place where resources are limited. I learned about family dynamics in which domestic violence was the common denominator, human rights were an abstract concept, and the primary goal of every day was to simply survive. All this contributed to a cycle that made health interventions complicated and seem impossible.
This series of problems, some imposed by our Spanish colonist forebears, joined with a lack of access to basic health services to plague Laguna del Cofre. I came to understand the term “global health,” from my experiences in the field and the trainings offered by PIH/CES to supplement our clinical work.
I had an epiphany. I discovered a world that was divided in two: between the haves and the have-nots. To me, the deepest and most painful injuries that affect our society today are poverty and disease. And most importantly, I learned they are not conditions imposed by God, but instead depend on social forces—on all of us. I refuse to accept that the world has to be this way. I reject the justification that says we can’t do anything.
PIH/CES, as a model of excellence in the field of global health, has provided me the tools to nourish my courage to face social injustices and to act upon my desire to fight each morning against the systems that disadvantage the most marginalized people.
Of course we can break the cycle of poverty and disease. It doesn’t matter what resources we have on hand, we need only science, innovation, and strong advocacy to influence decision-makers in the government.
So it was in Laguna where I had my change of heart, where my desire turned into action. There, I found my calling. There, where the air changed the color of the houses. Where dreams are humbled. The place I had chosen, where I felt my hope reinforced to build a better world.