A long day in Juárez

The above picture is taken from Scenic Drive here in El Paso, which I visited on Saturday night with some wonderful friends.  What struck me (probably because Tom pointed it out) most about the view was that El Paso and Ciudad Juárez appear to be one city.  Since it was Memorial Day weekend, the Wells Fargo building in downtown El Paso used its lights to make an American flag; however, that's the only building that I can even attempt to identify here.  As one of my favorite songs, Such Great Heights, says "Everything looks perfect from far away."  In this picture, we don't see poverty, violence, racism, sexism, or any type of injustice.  We just see light in the vast darkness of the desert.

Unfortunately, up close things don't look so perfect.  Real disparities exist across the little river, many of which I've only begun to start reflecting on.

I spent literally all day on Friday in Juárez.  The morning began at 7am when I crossed the Puente de las Americas.  Since there was almost no one else out that early, I took some pictures from the bridge:

The actual border

View from the top of the bridge (El Paso is to the right, Juárez is to the left, and the Rio Grande serves as the border)

After crossing into Juárez, I sat in the Parque Chamizal to wait for Goreti (one of my many helpers) to pick me up and drive me to the hospital.  An abuelita came and sat next to me and we ended up chatting for about 30 minutes.  When I told her that I am studying public health, she immediately whipped out a binder of newspaper clippings to show me that her cousin is the director of surgery at the general hospital in Juárez.  She told me that I needed to go directly to that hospital, introduce myself, and tell him that I want to shadow him so that I can learn about transplants.  She then proceeded to write down her name and phone number, along with his.  I couldn't help but smile, especially when halfway through the conversation she asked if I was American.  Her follow-up question, after I said yes, was if I was married.  I said no, to which she responded, "Be careful, then, that people don't rob you here in Mexico."  I wasn't quite sure how to interpret that series of dialogue, but I certainly appreciated her friendliness.

I spent the majority of my day at the public hospital.  There's nothing quite like driving up to a hospital and seeing lots of people waiting outside to be attended to.  I put on my roommate's white coat (thanks, Josie!) so that I could get ushered into the prenatal clinic where I would be working.  I had to correct several people who referred to me as "Doctora", but everyone official wears a uniform in the Mexican health care system and there's no color associated with "random Master's student doing temporary research."

When I met the resident who was assigned to my study for the day, I asked him how many patients we would be expecting and how things would go.  See, the original plan was that I would observe a prenatal care visit and then do an interview with the woman.  Each interview usually takes about 30-40 minutes, so I was hoping to observe about 3 visits and then do the corresponding 3 interviews, which would have taken me until about 2ish; thus, I told Goreti to return at 2:30.  To my surprise, the resident told me that he had invited 15 women to come to the hospital for interviews.  None of the women had prenatal care appointments; they were only coming for the study.  And they were all told to arrive at 8am.  Awesome.

I awkwardly smiled and then nervously sat down in the exam room that I was assigned to.  Luckily, only 5 of the women showed up for the study.  Two male nursing students (age 18) were given the job of my assistants; they called the women in from the waiting room and then they sat on the other side of the small room where I did the interviews to observe my qualitative study methods.  Two of the women I interviewed asked them to leave for privacy, which was nice for me, too.  During my last interview, they were horsing around and being super annoying...basically, they were acting like 18-year-old boys.  I kept shooting them death stares until they sat down quietly; I was definitely not in the mood for babysitting.

The interviews were rough.  I don't ever recommend that anyone do five 30-minute interviews in a row without a break, especially in one's non-native language.  (Of course the first woman I interviewed was a soft-spoken mumbler, too...I sure hope my recorder can correct for that when I work on transcribing tomorrow!)  Despite many pilot interviews in both Spanish and English, I didn't realize that some of my questions would be irrelevant to this particular population, so that was kind of frustrating.  Most significantly, evidently women in this particular hospital have no concept of epidurals.  They all thought I was crazy when asking about pain medication during labor and delivery; all five women responded to my inquiries with something along the lines of "Of course it's going to hurt...that's just how it is..."

The people who attend the public hospitals in Mexico are among the country's poorest.  The women I interviewed ranged from ages 15 to 17.  They were obviously not well-educated, especially in regards to childbirth.

I felt like I had little rapport with the women; I've grown quite accustomed to chatting with the women in my study before observing their prenatal care appointment as a way to break down some of the barriers between us.  But in this case, I was sitting behind a desk and wearing a white coat when they entered the room, which obviously added another layer of difference between the participants and myself.  When I tried to ask the women how they were and other pleasantries, they were rather short.  I don't blame them; they had come to the clinic and waited just to be interviewed by me, so they likely didn't want to waste time.  (I suspect that at least one of the women came with the hopes of having an additional doctor's visit, but that didn't happen.)

I powered through the 5 interviews, made arrangements with 3 of the women to observe their next prenatal care visits in a few weeks, and then realized it wasn't even noon yet.  So I sat in the waiting room of the clinic for a little while and then sat outside of the main hospital for the rest of the time before my ride was going to pick me up.  It was hot out and I felt absolutely exhausted.  I also couldn't stop thinking about the simple disparities between the bathrooms in the prenatal care clinic and the majority of bathrooms in El Paso.  Despite it being a very large clinic, the men's room was out of service and the ladies' room only had 1 out of 2 stalls functioning.  There was no toilet paper or soap to be found, and the stall door was broken so that it didn't actually close all the way.  Good thing my travels have taught me to carry tissues and Purell everywhere I go!

After Goreti picked me up from the hospital, we went to a mall so I could buy a super cheap Mexican cell phone (it cost less than US$15 and looks like it's from the year 2000).  Hopefully now I won't need to wait for rides there anymore!  Then I went to buy a water bottle but the man working at the stand was super rude.  I hadn't been able to exchange my US dollars for pesos, as that was our next stop on the way back to the bridge.  I asked the guy if he accepted US currency and he said yes, but then when I said I only had a $20, he said he couldn't make change.  That's fair, but when Goreti offered to just buy the water bottle (it cost 7 pesos, which is like 50 cents), the guy basically asked why on earth she'd buy something for me.  She told him that we were friends and verified the cost while she took out her wallet.  He looked at me, paused, and then said it was 8 pesos.  Goreti then proceeded to tell him he's racist and a terrible example of a Mexican.  She left the water on the counter and guided me to another store, where she bought a water bottle from a nice clerk.  Goreti then proceeded to apologize profusely for his behavior.  We talked about how there are bigots everywhere, but I realized that it was the first time that someone was outwardly rude to me for seemingly no other reason than the way I looked.  It happens all the time, especially to non-whites in the US, so I guess it's good for me to experience as a reminder of my privilege.

The icing on the cake for the day was that after I walked over the bridge back to the US (which is about a 10-15 minute walk) in the insane heat, I had to wait in line for an hour and a half to get through customs.  Oh, and there's no shade in the area.  I got quite sunburned, but at least the time standing in line gave me a chance to process my day before I went to the airport to pick up Anne...but that will be the subject of my next blog post!