Mauricio Ramos has developed a system in Mexico to extend professional medical assistance to HIV/AIDS patients and their relatives within their own homes.
The New Idea
Mauricio Ramos is enabling family members to become the primary resource in home-based care of AIDS patients in Mexico, where a tradition of close family structures gives relatives the potential to be more capable care givers than overcrowded and underfunded hospitals. Mauricio has found that at least one family member, although he or she may be fearful or uninformed, is generally willing to learn the basic medical and interpersonal skills needed to care for the patient. By properly training these relatives, he is reducing the financial strain of medical costs on the family and increasing the number of patients for whom every medical professional can provide care.
Together, Mexico and Brazil account for 70 percent of the spread of the HIV/AIDS pandemic in Latin America (UNAIDS Statistics), and the disease places severe economic demands on Mexico's National Health System. The cases of AIDS diagnosed in Mexico by 1992 totaled 12,292, with as many as 30 times that number thought to exist; by 1996 the official figure had risen to 30,674, based on incomplete sampling, still a small fraction of incidence on the ground. In response to the implications, the Mexican government has launched wide education prevention campaigns, which have been particularly successful in reducing the risk of transmission through blood transfusions. Entire hospital wings have been set aside for the medical care of terminally ill AIDS patients. But Mexican medical institutions are trying to assist an increasing number of people with an ever-shrinking budget. Even were the spread of AIDS successfully abated, the National Health System would still not be able to provide adequate care for all infected individuals from the time their symptoms become visible.
As a result of the economic pressures, many AIDS patients, particularly the poor, are being cared for and dying at home. They do not have the option of continuous hospital care and have only their families for support. But because of the stigma still attached to AIDS and a lack of medical training, their family members are often more terrified than helpful.
Mauricio has formed The Mexican Foundation for the Battle Against AIDS. Working through his organization, he has organized a team of 70 physicians, nurses, chemists, psychologist, dentists and priests–many of whom are volunteers and some of whom are themselves HIV-positive–who provide domiciliary assistance to AIDS patients and training to their relatives. Working with specially trained nurses for approximately ten two-hour weekly visits, families learn how to take the patient's vital signs; administer medications and apply injections; treat wounds, hemorrhages and ulcers; clean and move the patient; and care for his or her nutritional and dietary needs. In cases where patients do not have the constant support of a family member, Foundation volunteers step in to take charge of grocery shopping and other needs.
Psychologists provide intensive counseling for patients and their relatives, combating the families' prejudices and misconceptions surrounding the disease and teaching them to provide emotional support for their affected relative. They are available should a crisis arise, and they offer support for mourning; they help the entire family accept and cope with the disease. The Foundation also offers spiritual guidance through volunteer priests and ministers, and legal assistance for victims and their families.
Working with several international and government agencies, Mauricio is taking steps to introduce his assistance program into the National Health System. This would alleviate the overcrowding in public hospitals, increase the scope of assistance provided by understaffed institutions and reduce the per-patient cost of assisting AIDS victims. To further disseminate his idea, he is developing a model specifically for rural communities, writing a nontechnical manual on domiciliary health care, creating a training program for trainers, working with Mexican universities to create an academic degree for Volunteers Specialized in the Assistance of AIDS Patients and cooperating with other nongovernmental organizations and social groups interested in replicating his program throughout Mexico. Ultimately, Mauricio plans to spread his program throughout Central and South America and to apply his integrated home-based approach to the treatment of other health problems in addition to AIDS.
From a very young age, Mauricio has been interested in helping others. As a freshman in high school, for example, he organized his friends to collect old toys, which he then distributed among less privileged children.
Having studied psychology at a private university in Guadalajara, Mauricio became determined to use his knowledge to serve the public. He started working on AIDS projects in 1986, at a time when there was no psychological support for those who had been diagnosed as HIV positive. In 1987, he created the first Mexican support group for infected individuals.
Mauricio helped create a training program and manual for counseling on the prevention of AIDS and has given courses on AIDS prevention throughout Mexico and Latin America. Since 1991, he has also worked with the National Director of Epidemiology to promote HIV testing and psychological support for those being tested.