Mexican, Canadian Hospitals in Learning Partnership

Four Mexican hospitals that serve disadvantaged populations are exchanging knowledge and improving the health services they provide thanks to a partnership sponsored in part by Health Canada and the Pan American Health Organization (PAHO).

The Oaxaca Children's Hospital in Oaxaca and the Fray Antonio Alcalde Public Hospital in Guadalajara, Jalisco, have exchanged health professionals and on-site visits with the Children's Hospital of Eastern Ontario (CHEO), in Ottawa, Canada, during the past two years, and as far back as 1997 in the case of Oaxaca.

More recently, two more hospitals—the Madre y Niño Guerrerense Hospital and the Madre y Niño Indígena Guerrerense Hospital, both in Guerrero state—have joined the partnership with support from PAHO and Health Canada.

Physicians and nurses from Oaxaca Children's Hospital have traveled to Canada to observe practices and receive training at CHEO in areas including emergency services, infectious diseases, neonatology, pediatric endoscopy, scheduling and organization of surgery, viral respiratory infections, genetics, rehabilitation, and research. Canadians have also traveled to Mexico in professional exchanges and to provide training on-site.

"The Ottawa visits helped us to study and assimilate a model for the movement of patients and showed the importance of establishing a strong relationship between the patient, the patient's family, and the services offered," said Dinorath Díaz Rojas, chief of surgery at the Oaxaca hospital. "This contact not only improves overall functioning but also the quality of relationships."

The partnership has helped Fray Antonio Alcalde Public Hospital improve its diagnostic procedures, particularly for viral respiratory infections, which put some 500 children in the hospital each year. CHEO provided Fray Antonio Alcalde's staff with training in immunofluorescence, a laboratory technique that permits rapid and accurate virus detection and differentiation. With more accurate diagnosis, patients can be assigned to different rooms and appropriate treatment regimens, resulting in better care. Moreover, knowing which illnesses are viral and which are bacterial has led to more rational use of antibiotics, saving money and preventing the growth of antibiotic resistance.

Canadian nurses and physicians from CHEO have also benefited from the partnership. Small groups have traveled to Oaxaca to study more effective, efficient, and affordable ways of delivering health services in low-resource settings and to fine-tune train-the-trainers techniques.

Kathryn Suh, an infectious disease expert at CHEO, said the experience has been uniquely rewarding. "It is highly motivating and educational to be able to get to know colleagues from other countries who are facing the same challenges, listen to what they are doing to address them, and learn how the current collaboration can be most useful in offering practical solutions. This is our best reward, and when you feel rewarded, you work better."

The Mexican hospitals in the Canadian partnership serve some of the country's most disadvantaged groups.Guerrero state has the third-highest maternal mortality rate in Mexico, at 281 deaths per 100,000 live births. In Oaxaca state, nearly half the population is indigenous, 76 percent lives at or below the poverty line, and infant mortality is 36 percent higher than the national average.

Even Jalisco's Fray Antonio Alcalde Public Hospital, a large and well-established teaching hospital, serves a largely disadvantaged clientele. "We see the poorest of the poor— the ones who do not have health insurance of any kind," said Carlos Rivera, a specialist on the hospital's infectious disease team.

Sofía Caballero Martínez, head of the Madre y Niño Indígena Guerrerense Hospital, is looking forward to training for her staff under an agreement signed late last year.

"We hope to be able to train our staff in a diversity of subjects, including nosocomia infections and management of the newborn. The opportunities for training in our area are few, and specialized professionals often do not want to be transferred here.That is why it is so critical to be able to provide real incentives for those who are already here to learn new skills," she said.

Raúl López Roque, head of Madre y Niño Guerrerense Hospital, has similar hopes. "Our hospital is going to benefit from this international experience, and we hope in turn to share it with others. We look forward to the opportunity to improve the quality of care, diminish the number of births by caesarean section and tap into this international channel for training our technical and administrative staff."

PAHO and Health Canada have provided funding and technical support for the Canada-Mexico partnership since 2006 and are hoping to expand the program to include new partners, both hospitals and donors.