The Struggle for Health in Chiapas

USAID head Rajiv Shah explains his agency's effort to integrate development and emergency intervention while emphasizing public-private partnerships in long-term development programs.

Tuberculosis, one of the world's deadliest diseases, has long been forgotten by most Americans, but it is re-emerging in a new, virulent form around the world.

OUTSIDE the main hospital in San Cristóbal de las Casas, women in traditional multicoloured garb queue up to see a doctor. Many are pregnant or carry infants on their backs. One expectant mother says she fears there will not be a bed for her when she enters labour—all too common in the overcrowded hospital. Tales of deaths from hypertension, haemorrhage or infection during or after giving birth are common in the second city of the state of Chiapas. In a nearby village, one doctor recalls a woman whose journey took so long that she died on the street outside his clinic.

Efforts to control tuberculosis and multidrug-resistant forms of the disease face extra hurdles in Mexico's poorer states. Samuel Loewenberg reports from Chiapas, southern Mexico. The village of Los Chorros lies in a lush valley reached by a dirt track at the end of a mountain road that winds past brick and wooden huts with thatched roofs, and terraced agricultural fields (see webvideo). At the top of a small hill is a yellow concrete building with a corrugated metal roof.