Quality medical care can be hard to find in rural Mexico
Dr Alejandra Rodríguez of Logimedex reports on a case that required careful identification of the right medical facility for the patient’s treatment, and coordination with the military to organise flight logistics
In Mexico, there is significant variation between the healthcare options available throughout the country. In addition to this, the openness of private hospitals to work with insurers or third parties exists only in large hospital centres or in private hospital chains. One of the biggest challenges in small cities and rural areas of the country is to find health centres with the necessary equipment and medical services.
In November 2021, Logimedex received a request to verify that the facilities of the health centre treating a 79-year-old female of Danish origin in Tehuantepec, Oaxaca were appropriate for the diagnosis of a probable ischaemic-type cerebrovascular event. We knew right away that it was very likely that the conditions of the health centre were not adequate, and that the patient could be transferred to another local hospital with similar limitations. We contacted the health centre before the local transfer happened and confirmed that this was indeed the case.
After evaluating the appropriateness of the facilities, we notified our client, and immediately offered to transfer the patient to a hospital with the proper infrastructure to guarantee the timely and correct treatment and recovery of the patient. We established direct communication with one of the best private hospitals in Mexico and Latin America, which is within our network, to guarantee their availability to receive the patient, since at this point the patient needed carotid angiogram, a skull MRI, Holter monitoring, echocardiogram, and evaluation by an advanced cardiology service. The hospital confirmed they were prepared and awaiting the arrival of the patient. We immediately arranged an air ambulance and assessed the logistics of transferring the patient from Tehuantepec to Mexico City. Unfortunately, we then discovered that there was no airport close to the patient, which made our mission more difficult.
Managing the air ambulance transportation with the National Army’s help
After continuing with our local investigations, we found that there was a military air base in Ixtepec, Oaxaca, which is 30-minute drive from the patient. Hand in hand with one of our trusted air ambulance partners, we were able to contact the air base to request permission to land and take off from the base to evacuate the patient. The chances of the landing permission being granted were minimal, but due to a team effort and great communication with the authorities, permission was granted. By this time, all the preparations for the transfer had been made, the necessary Covid tests required for the flight were carried out, the documentation of the passengers was sent to the military base and the admission of the patient in the specialty health centre was arranged.
The chances of the landing permission being granted were minimal, but due to a team effort and great communication with the authorities, permission was granted
Road to clinical recovery
The patient was transferred without any complications during the flight. She landed in Mexico City and was transferred by ground ambulance to the hospital. Upon arrival, the patient was placed in the intensive care unit, a central venous catheter was placed, she was assessed by internal medicine, neurology and cardiology services, and the MRI was performed. These confirmed the suspected diagnosis of cerebralvascular event, which was affecting the parietal lobe; additionally, a carotid artery ultrasound demonstrated 92 per cent obstruction of the artery due to atherosclerosis. Immediately, the medical team started treatment with antiplatelets, statins and antihypertensive medication, and the patient quickly started to respond and began recovering partial mobility of her limbs.
Transfer to Denmark
After eight days of hospitalisation and improvement of symptoms, the patient was discharged to continue her complementary treatment in her native country, and the proper logistics of transportation from the hospital to Denmark were carried out.
The cooperation of all the parties involved made this important mission possible so that a patient who was in an area that was difficult to access could be treated in a timely manner in one of the best private hospitals in Latin America.