15-Year-Old Receives Surgery For Rare Tumor In Rural Mexico

PIH provides medical care, social support 

Posted on Apr 29, 2022

The pediatrics hospital in Tuxtla Gutiérrez, Chiapas.
The pediatrics hospital in Tuxtla Gutiérrez, Chiapas where Compañeros En Salud, as Partners In Health is known in Mexico, helps patients receive specialized care through the Right to Health Care program. Photo by Paola Rodriguez / Partners In Health.

It was early 2021 when 15-year-old Juan Carlos Pérez first arrived at the clinic in Soledad, a rural community in Chiapas, Mexico, with his mother, Anita Linda Escalante. But it was not the first trip the two had made in search of medical care—and answers.

Pérez’s symptoms had started out like a cold: a runny nose and phlegm. But weeks later, he began to notice a bad smell inside his nose. Escalante took him to private doctors across Chiapas, where he received allergy medication. But the discomfort did not go away.

Pérez and his mother live in Tapachula, Chiapas, very close to Mexico's border with Guatemala. Tapachula is the second largest city in Chiapas, after the capital, Tuxtla Gutiérrez, where advanced medical services are available, but difficult for most patients to access. Those challenges were not lost on Escalante, a single mother of four children, who had to take time off work, losing valuable income, and arrange for childcare as she accompanied her son to his medical appointments.

A couple of weeks later, Juan Carlos began to feel what he described as a "little ball" inside his nose, which obstructed air from flowing to his lungs. At private clinics, the doctors told Escalante that this bump was a tumor, but they did not know if it was malignant. To determine that, Pérez would need a biopsy. But his family did not have the resources to pay for this surgery.

About two months passed and the tumor inside Pérez’s nose kept growing, to the point of causing bleeding, intense headaches, and eventually blocking his nostril completely.

Desperate, Escalante looked for public hospitals, where the procedure would be available for free, but waiting lists were long. At private hospitals, the procedure would be expensive. Many hospitals also required a reference paper from a doctor in order to accept patients; but Escalante and her son didn’t have one. Each time, they were rejected.

"How is it possible that no clinic in these cities could attend us?" Escalante recalls thinking at the time.

There was nothing more they could do, she thought, but watch the tumor continue to grow.

It wasn't until a family member told her about Compañeros En Salud, as Partners In Health is known in Mexico, that Escalante began to feel hopeful. Without a second thought, she took Pérez and traveled five hours from Tapachula to Soledad, one of the rural communities where Compañeros En Salud supports a primary care clinic.

Juan Carlos Pérez stands with Dr. Alejandro Hernández, coordinator of Compañeros En Salud's Right to Health Care program, and his mother Anita Escalante. Photo courtesy of Alejandro Hernández.

Compañeros En Salud has worked in Mexico for more than a decade, supporting nine rural clinics, a birthing center, and a community hospital, as well as training the next generation of clinicians through the pasante program.

Dr. Emiliano Hersch, then a pasante (Spanish for first-year doctor) completing his year of service at the clinic, treated Pérez—for free. Hersch quickly determined that Pérez’s tumor was a nasopharyngeal angiofibroma: a rare type of tumor that most often affects young men, but is benign. If the tumor continued to grow, however, it could cause damage to Pérez’s ears, teeth, and nasal septum.

To ensure that care continued, Hersch connected Escalante and Pérez with Compañeros En Salud’s Right to Health Care program, which helps patients get referrals to advanced care at hospitals and connects them with social workers and community health workers to manage their cases. The program also provides funding for transportation, food, housing, and medical expenses, also known as “social support,” making care accessible to all patients, regardless of income level.

For Pérez, recovery, for the first time in months, felt within reach. Through Compañeros En Salud’s support, he met with a specialist at the pediatrics hospital in Tuxtla Gutiérrez. There, he learned he would need surgery to remove the tumor so that he could breathe normally. But, before that was possible, he would need an embolization.

Embolization is a common procedure for tumor removal in which some blood vessels are intentionally blocked. But the procedure requires surgical materials such as needles and microcatheters that are often expensive and difficult to obtain. If the materials aren't available from the Ministry of Health, hospitals in Chiapas often make the patients cover the costs. Pérez's family was unable to afford these expenses, so Compañeros En Salud paid the bill.

Months later, in June 2021, the long-awaited day arrived. With his mother and case workers from Compañeros En Salud by his side, Pérez underwent surgery. The tumor—that had spread to his face and begun to affect his teeth—was removed, setting him on the path to healing.

That journey continues to this day. Pérez continues to attend follow-up appointments at the pediatrics hospital with the support of Compañeros En Salud.

"We are very grateful because Compañeros En Salud has always been there, supporting us so we can move forward," says Escalante. “I know that it's not just Juanito and I, but many families whose lives are changed."

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