WEBVTT - Mexico: Choosing the Economy Over Life

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<v Speaker 1>It's ninety degrees out and I'm covered in bug spray,

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<v Speaker 1>lying on the dirt floor of a hut with a

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<v Speaker 1>roof made of palms. A woman is pressing hard on

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<v Speaker 1>my stomach. She's telling me something is wrong. Look here, hey,

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<v Speaker 1>hap happy? The woman forcefully massaging my belly is She's

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<v Speaker 1>a a kind of traditional healer in the Yucatan region

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<v Speaker 1>of Mexico. Pregnant women come to her from nearby to

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<v Speaker 1>make sure that the whole childbirth experience is safe, kind

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<v Speaker 1>of like a duela. The massage she's giving me is

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<v Speaker 1>one of the sort of services she performs for her clients.

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<v Speaker 1>It does a bunch of things, including putting the baby

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<v Speaker 1>in a head down position for labor or calming the

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<v Speaker 1>client's nerves. Okay, that this massage, though it did not

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<v Speaker 1>exactly call my nerves while massaging me, tells me that

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<v Speaker 1>something of mine called isn't where it should be. This

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<v Speaker 1>probably isn't a body part you've ever heard of, but

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<v Speaker 1>in my own culture, here is an organ believed to

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<v Speaker 1>be found in your mid section. After you have a baby,

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<v Speaker 1>a time where your organs are really shifted around. You're

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<v Speaker 1>supposed to come back twelve days after delivery to get

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<v Speaker 1>a massage from someone like During that she makes sure

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<v Speaker 1>that your sto is where it should be and massages

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<v Speaker 1>it back into place if it isn't. The belief here,

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<v Speaker 1>though it isn't backed up by modern medicine, is that

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<v Speaker 1>with it out of place, you can experience back pain,

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<v Speaker 1>stomach issues, and anxiety. They believe you can pass along

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<v Speaker 1>some of those issues to your baby if you breastfeed too.

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<v Speaker 1>I'm way past that twelve day mark. How to baby

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<v Speaker 1>a year ago? So why am I hair exactly? I'm

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<v Speaker 1>Kelsey Butler, a reporter on Bloomberg's A Quality Team. When

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<v Speaker 1>I got pregnant in the middle of the pandemic, I

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<v Speaker 1>was living in New Jersey. The state was one of

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<v Speaker 1>the highest maternal mortality rates in the US, and the

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<v Speaker 1>numbers were the worst for women like me, who are black.

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<v Speaker 1>The death rate was made even scarier by the prospect

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<v Speaker 1>of getting COVID, which I knew made the chances of

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<v Speaker 1>complications for both me and my baby even higher. I

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<v Speaker 1>thankfully had a mostly complication free birth. My son turned

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<v Speaker 1>one last month, but it got me thinking about maternal health,

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<v Speaker 1>and when I started looking into it, I found an

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<v Speaker 1>even more shocking statistic, just a little bit south. For years,

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<v Speaker 1>maternal mortality had been improving in Mexico. Then the pandemic

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<v Speaker 1>hit and the rate for maternal deaths climbed over sixty.

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<v Speaker 1>So I jumped on a plane to Mexico to find

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<v Speaker 1>out what happened. Jobless claims coming in, I mean really

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<v Speaker 1>jumping from the week before, pretty brutal. Three point to

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<v Speaker 1>a million records. Six point six million Americans filed for

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<v Speaker 1>unemployment last week. Indian working women were the worst impacted

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<v Speaker 1>by the pandemic. If so divid like Umia, Well, now

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<v Speaker 1>to the billionaire boom. According to Bloomberg's super yacht charters

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<v Speaker 1>are up over three hut and a billionaire was created

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<v Speaker 1>every twenty six hours during this pandemic. It is time

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<v Speaker 1>for a wealth tax in America. Welcome back to the paycheck.

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<v Speaker 1>I'm Rebecca Greenfield. Among the many things that have determined

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<v Speaker 1>how a country has fared economically during the pandemic is

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<v Speaker 1>how government's decided to manage the virus that's off. Some

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<v Speaker 1>places opted for a COVID zero strategy, going to extreme

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<v Speaker 1>lengths to keep the virus out of their borders. Others

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<v Speaker 1>had more of a letter rip strategy, keeping the economy

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<v Speaker 1>and businesses open with little regard for the virus itself,

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<v Speaker 1>and many places where somewhere in between. Each approach comes

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<v Speaker 1>with costs, though some are much higher than others. Mexico

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<v Speaker 1>is a country that chose its economy over everything else.

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<v Speaker 1>A few months into the pandemic, the government slowly started

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<v Speaker 1>lifting restrictions. That's my colleague Andrea Navarro. She's a reporter

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<v Speaker 1>in Mexico City. We were one of the few places

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<v Speaker 1>in the world where we never really had any travel

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<v Speaker 1>restrictions of any kind. So things went back to normal

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<v Speaker 1>relatively quickly. Here Andrea usually covers Mexico's economy, but for

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<v Speaker 1>the last two and a half years she's been covering COVID.

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<v Speaker 1>She told me as early as before vaccines, Mexico is

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<v Speaker 1>open for business. To understand this approach, Andrea says, you

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<v Speaker 1>have to understand Mexico's president. Andrea's Manuel Lopez Obrador, who's

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<v Speaker 1>known more colloquially as Amlo. Amlo can be described as

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<v Speaker 1>a populist, and what that means is that he will

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<v Speaker 1>basically say and do anything that he says will be

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<v Speaker 1>popular with his base, which is very big. Am Lo

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<v Speaker 1>caters to Mexico's poorest people, many who work in the

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<v Speaker 1>informal and service economies, the people who run things like

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<v Speaker 1>street cards, and if they aren't allowed to operate or

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<v Speaker 1>all their customers are stuck in quarantine, they can't earn

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<v Speaker 1>a living, and unlike richer countries, Mexico didn't have the

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<v Speaker 1>money to just pay people to stay home. Plus, am

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<v Speaker 1>Low hates debt, so he basically let COVID run free

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<v Speaker 1>and the hopes that the economy would survive. Andrea says

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<v Speaker 1>the strategy allowed Mexico to keep a balanced budget. The

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<v Speaker 1>paso has also remained relatively stable, and there are no

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<v Speaker 1>worries about the country defaulting on its debt. But it

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<v Speaker 1>also had some nasty knock on effects, particularly on Mexico's

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<v Speaker 1>health care system. It's safe to say that the healthcare

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<v Speaker 1>system collapsed, Andrea says. During the worst wave, ambulances would

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<v Speaker 1>circle all night looking for empty hospital beds. So far,

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<v Speaker 1>Mexico has lost three people to COVID, which is high

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<v Speaker 1>enough on its own, but it lost another five hundred

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<v Speaker 1>thousand people to what are known as excess deaths, people

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<v Speaker 1>who shouldn't have died but couldn't get the care they

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<v Speaker 1>needed due to COVID, and among those were many pregnant

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<v Speaker 1>and childbearing women. Before the pandemic, Mexico's maternal mortality rate,

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<v Speaker 1>while still high, had been moving in the right direction.

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<v Speaker 1>Over two decades, it had dropped by half. The pandemic

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<v Speaker 1>erased most of those games. About two thousand women have

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<v Speaker 1>died in childbirth or soon after Mexico since the start

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<v Speaker 1>of the pandemic. My colleague Kelsey went down to Mexico

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<v Speaker 1>to investigate back to her for the story. I ended

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<v Speaker 1>up in Mexico after I heard the story of getting

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<v Speaker 1>Viejo Costito in January getting checked into a hospital in

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<v Speaker 1>Baja California to have her second baby. She was a healthy,

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<v Speaker 1>thirty one year old woman getting had a c section.

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<v Speaker 1>They're common generally speaking, but they're especially popular in Mexico,

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<v Speaker 1>which has one of the highest c section rates in

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<v Speaker 1>the world, and during the pandemic, the c section rate

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<v Speaker 1>jumped even higher. Hospitals were too maxed out and short

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<v Speaker 1>on time to let labor happen on its own. The

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<v Speaker 1>rates in the first year of the pandemic were more

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<v Speaker 1>than three times what the World Health Organization recommends. Because

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<v Speaker 1>c sections, though life saving and necessary in some cases,

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<v Speaker 1>carry greater risk of complications like infections or blood cloths

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<v Speaker 1>then giving birth the old fashioned way. It's also major

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<v Speaker 1>surgery and recovery is tougher to Just after gett in

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<v Speaker 1>c section, her family was sent home and told to

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<v Speaker 1>come back later. Everything seemed fine. They were told she

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<v Speaker 1>just needed some rust. But when Gatton's family returned, she

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<v Speaker 1>was dead. Her sister, Anna Maria Vaejo found her in

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<v Speaker 1>her hospital room. I talked to Anna on the phone

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<v Speaker 1>about this, which she described was heartbreaking. Anna says that

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<v Speaker 1>when she went to touch her sister, Gaydon was freezing.

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<v Speaker 1>Her arms dropped to her side, completely limp. It was

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<v Speaker 1>as if she had been dead for hours. The official

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<v Speaker 1>cause of death was listed as a hemorrhage or excessive bleeding,

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<v Speaker 1>one of the top causes from maternal death in Mexico

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<v Speaker 1>right now, just ahead of COVID. But Getton's family didn't

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<v Speaker 1>understand how things went so wrong. So quickly Anna told

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<v Speaker 1>me she asked the doctors how in the world that happened.

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<v Speaker 1>The family filed an official complaint, which triggered an autopsy,

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<v Speaker 1>but when her body was delivered to the medical examiner,

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<v Speaker 1>they were told they wouldn't be able to give the

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<v Speaker 1>family any answers because her organs were already removed from

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<v Speaker 1>her body. That's really odd. An official at the Medical

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<v Speaker 1>Examiner's office said it was the first time he had

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<v Speaker 1>seen something like that. The hospital, meanwhile, said it followed

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<v Speaker 1>protocol and removing Giddon's organs during its own autopsy. The

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<v Speaker 1>family wonders if doctors were trying to cover something up.

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<v Speaker 1>News outlets started picking up the story getting by that

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<v Speaker 1>is Eli. The story went viral locally. The pictures of

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<v Speaker 1>getting from her social media accounts put a face to

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<v Speaker 1>the brutal details. Women shared their own stories of mised appointments, negligence,

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<v Speaker 1>and bad treatment during their pregnancies. In February, people protested

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<v Speaker 1>in the streets. So that's almost gidding. We are all gidding.

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<v Speaker 1>Maternal mortality was already high in Mexico, but a perfect

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<v Speaker 1>storm of bad decisions made by the government during the

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<v Speaker 1>pandemic created a nightmare scenario for giving birth. The problem

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<v Speaker 1>started in the months before the pandemic. Mexico's President m

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<v Speaker 1>Low decided to overhaul the country's healthcare system to eventually

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<v Speaker 1>make it entirely free for everyone. Plar. The move couldn't

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<v Speaker 1>have come at a worse time. The news system wasn't

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<v Speaker 1>up and running, were fully funded. When the pandemic overwhelmed

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<v Speaker 1>Mexican hospitals, chaos ensued. There were drug shortages and not

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<v Speaker 1>enough hospital beds, and then one really bad decision made

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<v Speaker 1>it all worse. So when the pandemic started, there was

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<v Speaker 1>something called reconversion, hospital re conversion, and I think it

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<v Speaker 1>was not the best idea. That's Mina Mendez Dominguez, a

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<v Speaker 1>physician and researcher who studies maternal health in Mexico. She's

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<v Speaker 1>based in Mediva, a city of one point two million

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<v Speaker 1>people on Mexico's You've Got Them Peninsula. But I first

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<v Speaker 1>met her at a conference in New York in April.

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<v Speaker 1>Nina told me to deal with the influx of COVID patients,

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<v Speaker 1>the government decided to convert many big hospitals around the

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<v Speaker 1>country into COVID only facilities, meaning no one could be

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<v Speaker 1>treated for anything else, not heart attacks, not gunshot wounds,

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<v Speaker 1>not even childbirth. It was Nina and her colleagues research

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<v Speaker 1>that uncovered that first statistic that really shocked me, that

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<v Speaker 1>there had been a sixty jump in the maternal mortality

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<v Speaker 1>rate in Mexico during the pandemic. Other countries in Latin America,

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<v Speaker 1>like Brazil and Peru also had big jumps. Those COVID

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<v Speaker 1>only hospital conversions played a big part in the deaths.

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<v Speaker 1>She told me. What happened was that non essential medical

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<v Speaker 1>consultations were not available, but also nurses and oldest staff

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<v Speaker 1>were moved from certain hospitals to other hospitals. In other words,

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<v Speaker 1>even the hospitals that would see pregnant women were short

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<v Speaker 1>staffed because their staff had been sent to deal with COVID.

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<v Speaker 1>This led to a lot of problems for people with

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<v Speaker 1>all kinds of health emergencies, but it was particularly dangerous

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<v Speaker 1>for pregnant women, especially pregnant women who lived far away

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<v Speaker 1>from a hospital. Outside of the big cities, the only

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<v Speaker 1>nearby hospital or health clinic was reserved just for COVID patients.

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<v Speaker 1>In the remote region of you got done. Where I

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<v Speaker 1>saw someone in labor could be hours from the nearest

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<v Speaker 1>place that could deliver a baby or even do standard

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<v Speaker 1>pre and postnatal care. The first contact in rural areas

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<v Speaker 1>were not priority because they treat very small amount of people,

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<v Speaker 1>so then they stopped all the maternal consultations, and women

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<v Speaker 1>feared to travel to the urban areas and then go

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<v Speaker 1>to the hospital because they knew there were patients that

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<v Speaker 1>were sick over there already. Basically, pregnant women who already

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<v Speaker 1>lived far from medical care might now be even further

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<v Speaker 1>from somewhere that would treat them, and they also might

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<v Speaker 1>be scared to go there because there was more risk

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<v Speaker 1>of catching COVID. Henny Carrillo, a professor at Texas A

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<v Speaker 1>and M University who worked with Nina on the research,

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<v Speaker 1>put it bluntly, so what happened pregnant women did not

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<v Speaker 1>attend the routine checobs. All these decisions had a repel

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<v Speaker 1>effect henn He says not all paternal dates in Mexico

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<v Speaker 1>were directly related to COVID inflation, but rather to uncontrolled

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<v Speaker 1>conditions during pregnancy due to the limited hay care availability

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<v Speaker 1>that these women had to face. Nina told me about

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<v Speaker 1>one case while doing her research that's stuck with her.

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<v Speaker 1>She told me about a young woman who showed upbout

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<v Speaker 1>a remote hospital with a rare, life threatening pregnancy complication

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<v Speaker 1>called help syndrome. The first facility she went to didn't

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<v Speaker 1>catch it. By the time she got to the next

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<v Speaker 1>it was too late. She started bleeding internally and was

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<v Speaker 1>taken to surgery. The end result was tragic. She just

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<v Speaker 1>passed away, and it was so sad because her family

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<v Speaker 1>came after and she was already gone. It's these kinds

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<v Speaker 1>of cases that stick with Nina because they're part of

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<v Speaker 1>a common pattern unnecessary roadblocks that make it hard for

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<v Speaker 1>people to safely have babies. Emergencies were especially dangerous for

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<v Speaker 1>women in the thick of COVID because it took so

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<v Speaker 1>long for them to get to treatment and be seen

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<v Speaker 1>by doctors. It became so difficult for a woman, for

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<v Speaker 1>a pregnant woman to move from her house to find

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<v Speaker 1>medical attention that it ended up so bad. You get

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<v Speaker 1>done where Nina is based, so the highest level of

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<v Speaker 1>maternal deaths and more than a decade, it's a problem

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<v Speaker 1>that is leaving too many women behind. She says, pregnancy

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<v Speaker 1>should be a very positive experience. Bringing children to life

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<v Speaker 1>should be such an important event that we should all

0:16:10.240 --> 0:16:15.160
<v Speaker 1>enjoy this process and it should be equal for all

0:16:15.240 --> 0:16:19.040
<v Speaker 1>women in all the world. But at a virtual event

0:16:19.160 --> 0:16:24.480
<v Speaker 1>in February, Zoe Lejano, head of the Mexican Institute of

0:16:24.560 --> 0:16:29.560
<v Speaker 1>Social Security, said the country. Strategy had been quote very

0:16:29.800 --> 0:16:35.320
<v Speaker 1>very focused on hospital reconversion unquote, so that doctors wouldn't

0:16:35.360 --> 0:16:40.160
<v Speaker 1>be forced to decide which COVID patients lived and which died.

0:16:41.160 --> 0:16:45.400
<v Speaker 1>He went on to say, quote Mexico's model was growing

0:16:45.480 --> 0:16:50.320
<v Speaker 1>the capacity for care, so there were zero rejections unquote,

0:16:53.280 --> 0:16:56.880
<v Speaker 1>and barras or midwives are stepping in to fill some

0:16:57.000 --> 0:16:59.480
<v Speaker 1>of these gaps in a health care system they say

0:16:59.600 --> 0:17:04.200
<v Speaker 1>isn't working for women, but they can't fix everything. I

0:17:04.280 --> 0:17:07.080
<v Speaker 1>called one of these women who has been delivering babies

0:17:07.200 --> 0:17:12.240
<v Speaker 1>for over thirty years. Her name is Guada up She's

0:17:12.280 --> 0:17:16.640
<v Speaker 1>the president of the Association of Professional Midwives in Mexico City. Joe,

0:17:22.240 --> 0:17:24.920
<v Speaker 1>I have been delivering babies for more than thirty years

0:17:25.040 --> 0:17:29.360
<v Speaker 1>outside of hospital settings, in homes or in birthing centers,

0:17:29.880 --> 0:17:34.600
<v Speaker 1>under very strict protocols to ensure the security and safety

0:17:34.960 --> 0:17:39.480
<v Speaker 1>of both mother and baby. Told me she was afraid

0:17:39.520 --> 0:17:42.840
<v Speaker 1>to treat women early in the pandemic, leaving another gap

0:17:42.920 --> 0:17:46.160
<v Speaker 1>in the system for rural women. That wasn't the case

0:17:46.200 --> 0:17:49.520
<v Speaker 1>for Guada Lupe, who, during the height of COVID saw

0:17:49.840 --> 0:17:53.040
<v Speaker 1>double or triple the number of women she normally does.

0:17:53.880 --> 0:17:57.399
<v Speaker 1>That's because people either couldn't get care or we're scared

0:17:57.440 --> 0:18:03.040
<v Speaker 1>to go to traditional care facilities. See, so it was

0:18:03.200 --> 0:18:07.960
<v Speaker 1>very difficult imagine the situation running out of options and

0:18:08.320 --> 0:18:15.679
<v Speaker 1>filling on certain women began calling professional meadwifes. Now, she says, fortunately,

0:18:16.080 --> 0:18:19.240
<v Speaker 1>the maternal mortality numbers are in a much better place.

0:18:19.800 --> 0:18:22.920
<v Speaker 1>The latest government figures show the rate of maternal deaths

0:18:23.359 --> 0:18:26.879
<v Speaker 1>is at about thirty one for every one hundred thousand

0:18:26.960 --> 0:18:31.040
<v Speaker 1>babies born. That's down from fifty three deaths for every

0:18:31.119 --> 0:18:33.840
<v Speaker 1>one hundred thousand berths at the end of last year.

0:18:34.320 --> 0:18:36.800
<v Speaker 1>That's in large part because the chaos of the earliest

0:18:36.840 --> 0:18:40.440
<v Speaker 1>days of the pandemic and those hospital conversions are in

0:18:40.520 --> 0:18:43.680
<v Speaker 1>the past for now, but there's still work to do.

0:18:44.240 --> 0:18:47.600
<v Speaker 1>In two thousand, the country committed to decreasing the maternal

0:18:47.720 --> 0:18:51.680
<v Speaker 1>mortality rate to twenty two deaths for every one hundred

0:18:51.760 --> 0:18:55.440
<v Speaker 1>thousand live births. That's higher than many developed countries, but

0:18:55.600 --> 0:18:59.440
<v Speaker 1>lower than the United States rate right now. One way

0:18:59.520 --> 0:19:02.000
<v Speaker 1>to achieve eve that, Guada Lupe says, would be to

0:19:02.119 --> 0:19:09.320
<v Speaker 1>integrate midwives like herself into the health care system in Mexico.

0:19:11.480 --> 0:19:15.880
<v Speaker 1>We think that's what should happen here in Mexico. For starters,

0:19:16.320 --> 0:19:20.920
<v Speaker 1>they should insert professional midwives in the multidisciplinary team with

0:19:21.080 --> 0:19:24.240
<v Speaker 1>a budget to pay them well to stop treating them

0:19:24.560 --> 0:19:28.359
<v Speaker 1>in a denigrading way. There's evidence to back that up.

0:19:28.840 --> 0:19:32.280
<v Speaker 1>Researchers say addressing a shortage of global midwives would prevent

0:19:32.400 --> 0:19:36.960
<v Speaker 1>two and eighty thousand deaths per year by and the

0:19:37.040 --> 0:19:41.840
<v Speaker 1>World Health Organization recommends increasing education for midwives to reduce

0:19:41.960 --> 0:19:45.440
<v Speaker 1>maternal and infant deaths. Gualla Lupe says that there should

0:19:45.440 --> 0:19:48.720
<v Speaker 1>be more education for women about options outside the traditional

0:19:48.800 --> 0:19:52.080
<v Speaker 1>health care system to a system that is overwhelmed just

0:19:52.280 --> 0:19:54.840
<v Speaker 1>can't provide care to pregnant women the way they deserve.

0:19:57.480 --> 0:19:59.800
<v Speaker 1>Prenatal visit with an O B G y N that

0:20:00.040 --> 0:20:03.400
<v Speaker 1>has eighty women to see in a date, you can't

0:20:03.440 --> 0:20:06.320
<v Speaker 1>ask for quality of care, not even to give proper

0:20:06.400 --> 0:20:09.359
<v Speaker 1>advice or guidance. It's not that they don't want to,

0:20:09.720 --> 0:20:15.160
<v Speaker 1>it's that they can't. Right now, one thousand pregnant women

0:20:15.240 --> 0:20:20.159
<v Speaker 1>die each year in Mexico. Zoom out, and there are

0:20:20.280 --> 0:20:31.119
<v Speaker 1>three hundred thousand more around the world. One of the

0:20:31.240 --> 0:20:34.080
<v Speaker 1>lessons of the season for me has been that there's

0:20:34.200 --> 0:20:37.920
<v Speaker 1>no escaping the pain of the last two years. Some

0:20:38.080 --> 0:20:40.560
<v Speaker 1>places have felt that pain more than others, and in

0:20:40.640 --> 0:20:45.840
<v Speaker 1>more traumatic ways through unimaginable death tolls. But even countries

0:20:45.920 --> 0:20:49.560
<v Speaker 1>that manage the virus well couldn't fully insulate themselves from

0:20:49.600 --> 0:20:54.600
<v Speaker 1>the global shock of COVID. Next week, on The Paycheck,

0:20:54.840 --> 0:20:56.800
<v Speaker 1>we had to a place with one of the lowest

0:20:57.000 --> 0:20:59.840
<v Speaker 1>death rates in the world, where more and more people

0:21:00.280 --> 0:21:05.479
<v Speaker 1>are feeling economic pain. It strikes against the singaple pledge. Right.

0:21:05.520 --> 0:21:09.680
<v Speaker 1>We pledge ourselves to developer justin equal society. If we

0:21:09.880 --> 0:21:14.040
<v Speaker 1>don't hold that, then there's something problematic. Thanks for listening

0:21:14.080 --> 0:21:16.920
<v Speaker 1>to The Paycheck. If you like our show, please head

0:21:16.920 --> 0:21:19.280
<v Speaker 1>on over to Apple Podcasts or wherever you listen to

0:21:19.359 --> 0:21:23.480
<v Speaker 1>podcasts to rate, review and subscribe. This episode was hosted

0:21:23.560 --> 0:21:27.359
<v Speaker 1>by Me Rebecca Greenfield and reported by Kelsey Butler. It

0:21:27.480 --> 0:21:31.040
<v Speaker 1>was edited by Kristin V. Brown with help from Francesca Leavy,

0:21:31.280 --> 0:21:35.320
<v Speaker 1>Janet Paskin, Rocksheeta Sluja, and Me. We also had editing

0:21:35.359 --> 0:21:39.560
<v Speaker 1>help from Daniel Balby, Shelley Banjo, Gilda to Carly, Nicole Flato,

0:21:39.840 --> 0:21:43.959
<v Speaker 1>Elissa McDonald, and Kai Schultz. This episode was produced by

0:21:44.000 --> 0:21:48.120
<v Speaker 1>Gildada Carly and sound engineered by Matt kim Our original

0:21:48.200 --> 0:21:52.520
<v Speaker 1>music is by Leo Sidron. Special thanks to Magnus Hendrickson, McKinnon,

0:21:52.560 --> 0:21:57.040
<v Speaker 1>Da Kuyper, Margaret Sutherland, and Stacy Wong. The voice actor

0:21:57.160 --> 0:22:01.240
<v Speaker 1>you heard was Veronica Colloe. Francesca O Leevie is Bloomberg's

0:22:01.280 --> 0:22:06.560
<v Speaker 1>head of podcasts. See you next week. H