A New Project and a New City!

Well, flexibility is a virtue. As I mentioned in an earlier post, when I first arrived here in Mexico, I found out that the funds had not come through for the project I was scheduled to work on. So my professor and I decided that I would work on doing background reading and learning in preparation while we waited for the funds. Now, a month later, it has become clearer that perhaps the funds will not come through during my time here. For that reason, my professor and I have agreed that it will be best for me to find another project.

Luckily enough, when we decided that, I already was aware of a project being put into action that wonderfully matched my interests and ethics. When I had visited friends from Allentown in Tepotzlan, I decided to take advantage to our proximity to the National Institute of Public Health of Mexico (INSP) and try to arrange a visit there. At the time, my main interest was just to see what the Institute was like and to learn about current projects in the field of public health. I e-mailed some researchers to request a meeting, and the next morning I was in Cuernavaca at the Institute shaking their hands. One of the researchers I met with was Dr. René Leyva Flores. He told me about various facets of a research project he’s been working on related to HIV/AIDS in mobile populations (including migrants) in Central America. I was incredibly impressed by the scope and foresight of the project, as well as its orientation towards action.

Beginning in 1999, the INSP responded to what they saw as a need to understand the relationship between Central American migrants and their risks of acquiring HIV/AIDS during their migration. Many studies have shown that there is a clear link between migration and the spread of HIV/AIDS. Mobile, migrating populations of people generally experience conditions of social and economic vulnerability which serve to increase their risk of contracting HIV. To confront this issue, the INSP developed partnerships with other institutions throughout Central America, and together they began a comprehensive study of the HIV/AIDS situation in 11 transit centers in Central America. Throughout the centers, clear links found between local conditions (such as the presence of gangs, corruption, lack of financial resources of migrants, physical and mental stress, risk of sexual violence, and the flow of drugs) and increased vulnerability of mobile populations in the area to beatings, muggings, extortion, rape, sex work for money, drug use, and other forms of violence, all of which contribute to an increased risk of contracting HIV. Area-specific information was gathered and reported for each transit center.

Using the information gained from this initial evaluation, the project partners have begun designing comprehensive, collaborative, and integrative models of attention for HIV/AIDS care in the transit centers. These models respond to the identified needs and conditions in each specific locale. In Chiapas, one of these models has just begun operation in the city of Tapachula.

It is generally agreed upon that the situation for transmigrants is particularly harsh in areas like Tapachula in the southern border region of Mexico. Here, the threats listed above are amplified, and compounded by increased vulnerability in the face of increased immigration enforcement and corruption of local law enforcement agents. Increased risk among mobile populations here also spill over into the local population. The epidemiological effects of increased HIV/AIDS risk among the populations in the city are evident – Tapachula has the highest rate of HIV/AIDS cases in all of Chiapas and one of the fastest rates in all of Mexico. Responding to the information gained from the study of HIV/AIDS vulnerability and risk in Tapachula, the model of attention here involves prevention efforts directed toward migrants, sex workers, and other mobile populations; HIV testing; humanitarian aid; medical care; and psychological and emotional support. It also involves the collaboration of key local agencies, including the Secretary of Health, the local Public Health Jurisdiction, and a migrant shelter, the Casa del Migrante.

A key component to the execution of this project will be monitoring and evaluating its effectiveness and success, learning from its short-comings, and fine-tuning different aspects of the model it proposes. This evaluation will not only help to ensure the highest quality model of care in Tapachula, but will allow the INSP to share a successful model and with other transit centers participating in the Central American collaboration, with the idea that the model or aspects of the model could be reproduced in these other locations. The model of attention can also be shared with the academic and public health community, to increase global knowledge about strategies of providing HIV/AIDS attention to mobile population.

As I already mentioned, I was very impressed by this project, and excited about what it could mean for the development of successful HIV/AIDS prevention and attention for migrants in Mexico, an effort that I believe needs to be undertaken in order to fight for migrants’ human rights to safety and health. Therefore, when I began to seriously search for new projects, I contacted Dr. Leyva to see if he would accept me as a research assistant on the project. Fortunately, he agreed, and we have begun to iron out a plan for my participation on the project. Currently, I will be involved primarily in the monitoring and evaluation component of the project. I will collaborate with the implementation and research team in Tapachula, including INSP employees and the partner agencies. Following the protocol that details the proposed model of attention to HIV/AIDS, I will monitor the participation of the different partner groups. I will evaluate progress at the local level using a combination of qualitative and quantitative research methods. For example, surveys will be employed with migrants in the Casa del Migrante and more in-depth interviews will be conducted in partnership with a local sociologist with immigrant sex workers in Tapachula. Informed by the results gained from these research methods, I will work collaboratively with local actors and the primary investigator to suggest any necessary changes to the model of attention.

One down-side to my participation on this project is that it means that I will have to move to a new city. I really love living in San Cristobal and have been able to establish a nice social network here. It will therefore be tough to uproot and move seven hours away. Nevertheless, buses run between the two cities frequently and are relatively cheap, so I plan to continue visiting friends in San Cristobal every month or so. Overall, I’m very excited about the move and the work on the Tapachula project. As I get settled and my work progresses, I make an effort to share key learnings regarding the project with you all through this web-site. All the best, Juliana