The Pluma Hidalgo clinic

In October 2004, Doctors Outreach Clinics selected a first site: Pluma Hidalgo. Situated in the Sierra Madre Sur of the southern state of Oaxaca, Mexico, Pluma Hidalgo is a district that is composed of 93 hamlets, Pluma Hidalgo proper being the largest of them, with a population of nearly 900. Pluma is situated in the high coffee-growing region of the state, and its local economy has been tied to coffee for the better part of a century.

Oaxaca is a unique state, culturally and ethnically. It is one of Mexico’s poorest states in both economic and health terms. It is typically one of the three states with the highest rates of morbidity and mortality, especially when it comes to women and children.
Many of its 3.3 million people have an indigenous language as theirprimary language. Interestingly, many of the health care indicators cutalong ethnic and linguistic lines, with those speaking little or noSpanish having poorer health care outcomes than their Spanish-speakingneighbors. Nearly one third of its population emigrates and immigratesto northern Mexico and the US every year. This itinerant population hasre-defined Oaxaca’s economy, demographics, and health care concerns.

An integral part of the DOCS approach is close collaboration with the host community: forming mutually supportive bonds of trust, collaboration and shared commitment. The partnership between DOCS and the host government is additionally vital. In the case of Pluma, DOCS has been successfully building a strong relationship with the Oaxacan government, the Mexican Ministry of Health, regional hospitals, the State University of Oaxaca (Benito Juarez) and the social security system, IMSS (Instituto Mexicano de Seguro Social). Each of these parties helps to ensure the mutual success of this endeavor.