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Seminar on Migration and Health. Secretaria de Salud. Health Problems at the Southern Border. Jaime Mier y Terán Suárez, MD. Guatemala, October 18, 2004. CONTENTS. I. CONTEXT. SOUTH-SOUTHEAST REGION 29’701,894 Inhabitants. Puebla 5’480,844 hab. 1,149 Km Border. Veracruz
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Seminar on Migration and Health Secretaria de Salud Health Problems at the Southern Border Jaime Mier y Terán Suárez, MD Guatemala, October 18, 2004
SOUTH-SOUTHEAST REGION 29’701,894 Inhabitants. Puebla 5’480,844 hab 1,149 Km Border Veracruz 7’274,772 hab Yucatán 1’784,267 hab Tabasco 2’045,537 hab Q. Roo 1’053,084 hab Guerrero 3’249,559 hab Campeche 763,037 hab Oaxaca 3’693,497 hab Chiapas 4’357,301 hab BORDER REGION 8’218,959 Source: CONAPO Proj. 2004 The Southern Border
90% of Mexican petroleum • Malaria • HIV/AIDS • Tuberculosis THE WORLD’S MOST COMPLEX BORDER • SOUTH-SOUTHEAST REGION • 38.7% natural water availability* • Illegal Migration THE WORLD’S MOST COMPLEX BORDER The country’s agricultural basis • High violence ratios *Includes Southern Border and Yucatán Peninsula
QUINTANA ROO CAMPECHE TABASCO CHIAPAS DETENTIONS IN THE BORDER STATES OF THE REGION Source: INM. estadísticas de aseguramientos 2003 y 2004* (incluye solo Enero-Julio)
1% 1% 1% 2% 17% 43% 35% Guatemala Honduras El Salvador Nicaragua Ecuador Brasil otros DETENTIONS IN THE COUNTRY BY ORIGIN 2003
CAMPECHE CHIAPAS QUINTANA ROO TABASCO VERACRUZ TAMAULIPAS OAXACA GUERRERO PUEBLA IMPACT
PERCENTAGES OF MARINALIZED POPULATION BY ENTITY AND REGION SOUTH-SOUTHEAST, 2000 Entities with the lowest percentage of population in locations with a high and very high marginalization Percentage of population in locations with high and very high marginalization South-Southeast Percentages Percentages Source: CONAPO, Índice de marginación, 2000
LIFE EXPECTANCY BY ENTITY AND REGION SOUTH-SOUTHEAST, 2000 AÑOS AÑOS Entities with highest life expectancy South-Southeast Source: Estimates CONAPO.
HEALTH RISKS AND PROBLEMS Epidemic Outbreaks Threats
CASES IN THE SOUTH-SOUTHEAST REGION MALARIA 84.57% comes from the region 89.7% comes from the region DENGUE FEVER Fuente: SUIVE semana 35, 2004. Fuente: SUIVE semana 35, 2004.
MALARIA OUTBREAK IN GUAYACAN 2004* CONTROL OPERATION DIAGNOSIS OPERATION Fuente: Informe Semanal del ISP *Hasta la Sem. 39
HEALTH EXPENSES AS PERCENTAGE OF GDP 2002 Source: www.conacorg.mx SALUD MEXICO 2002, ANEXOS ESTADISTICOS (COUNTRY AND SOUTH-SOUTHEAST REGION)
HEALTH INFRASTRUCTURE INDICATOR OF BEDS TO BE INCLUDED IN CENSUS PUBLIC SECTOR PHYSICIANS BY FEDERATIVE ENTITY Fuente: Salud México 2003 * Camas por 1000 hab. Fuente: Salud México 2003 * Médicos del Sector Público por 1000 hab.
MOBILE POPULATIONS IN SOUTH-SOUTHEAST THE PROBLEM MANAGEMENT ASPECTS 1.- THE GROUP OF SOUTH-SOUTH EAST SECRETARIES 2.- BORDER HEALTH COMMISSION MX - GUATEMALA 3.- OPERATIVE COORDINATION TABASCO - GUATEMALA 4.- CONAGO 74,951INSURED PEOPLE IN THE COUNTRY IN 2003 Source: INM. estadísticas de aseguramientos 2003
DR. ALVARO EMILIO ARCEO ORTIZ SECRETARIO DE SALUD DR. DAGOBERTO GARCIA GARCIA SECRETARIO DE SALUD Campeche Quintana Roo DR. ANGEL R. ESTRADA AREVALO SECRETARIO DE SALUD Chiapas DR. JAIME MIER Y TERAN SUAREZ SECRETARIO DE SALUD Tabasco DRA. VERONICA MUÑOZ PARRA SECRETARIA DE SALUD Guerrero DRA. MAURO LOYO VARELA SECRETARIO DE SALUD DR. FELIPE GAMAS CASAS SECRETARIO DE SALUD Veracruz Oaxaca DR. JESUS LORENZO AARUN RAME SECRETARIO DE SALUD DR. JOSE A. PEREYRA CARCAÑO SECRETARIO DE SALUD Puebla Yucatán SOUTH-SOUTHEAST GROUP – HEALTH CHAPTER NATIONAL REPRESENTATIVES Dr. Roberto Tapia Conyer.- Subsecretario de Prevención y Protección a la Salud Dr. Enrique Ruelas Barajas.- Subsecretario de Innovación y Calidad Dr. Rodolfo Rojas Rubí.- Secretario Técnico del C.N.S Dr. Oscar Velázquez Monroy.- Director General del C.E.N.A.V.E. MEMBERS
PROGRESS • Epidemiological Surveillance Projects • (Proposal by Subsecretariat for • Prevention and Health) 2. Projects Proyecto Contra Riesgos Sanitarios Del Plan Puebla Panamá (Propuesta de la COFEPRIS) 3. Proyecto Regional de Infraestructura (Propuesta de las Secretarías de Salud del Sur - Sureste)
BACKGROUND Guatemala México • Agreement betweenGovernments of Guatemala and México to establish: BORDER HEALTH COMMISSION MEXICO - GUATEMALA • By the Mexican Government • By the Government of Guatemala Lic. Luis Ernesto Derbez Secretario de Relaciones Exteriores Lic. Edgar Armando Gutiérrez Girón Ministro de Relaciones Exteriores Guatemala, May 12, 2003
RESPONSIBILITIES OF THE COMMISSION • Diagnoses, projects, and studies on Public Health needs at the South Southeast Border. 2. Action programs on epidemiologic surveillance, risk protection and medical care. 3. Management support and financing.
THE COMMISSION PENDIENTE
Las Flores, Petén 15/jun/2004 Villahermosa., Tabasco. 29/jul/2004 MEETINGS OF AUTHORITIES TABASCO, MEXICO – PETÉN, GUATEMALA.
. Guayacán, Guatemala 29/jun/2004 OPERATIVE STAFF MEETINGS Civilian sanitary representatives and social representatives.
C O N A G O A NEW MANAGEMENT PERSPECTIVE AND A NEW SPACE At the XVIII Ordinary Meeting of the National Conference of Governors that was held in Valle de Bravo, State of Mexico, on July 9, 2004, the proposal of the Governor of the State of Chiapas to organize a Forum to discuss the topic of a Comprehensive Migratory Policy for the Southern Border was approved.
FORUM ON INTEGRAL MIGRATION POLICY FOR THE SOUTHERN BORDER WORK SESSIONS San Cristobal de las Casas; Chiapas 09/agos/04 1.-Diagnosis table 2.-International Migration 3.-Security at the Border 4.-Economic Development Villahermosa, Tabasco (13/agos/04) 5.-Health 6.-Social Development 7.-Cultural Development FORO DE GOBERNADORES SOBRE DESARROLLO INTEGRAL DE LA FRONTERA SUR Villahermosa, Tabasco (Oct 13/04)
GENERAL CONCLUSIONS The growing incidence of illnesses that were under effective control and that occur as a result of the intense movement of migrants. Joint solutions of the 3 Government levels and active participation of Civilian and Sanitary Authorities from Central America. To integrate the Health Support perspectives in the Border Commission Mexico - Guatemala Pending
Thank you Mexico’s future lies in the South-Southeast region due to its natural wealth. . Daniel Cosío Villegas