Adela Maria Gutierrez fell ill on April 1 with what she thought was a bad cold. She tried aspirin and antibiotics, bed rest and moist towels, but nothing brought down her soaring fever, reduced her aches and pains, or boosted her energy level.
It would be eight days before Gutierrez went to Oaxaca’s general hospital, where she arrived listless and barely able to breathe, her extremities blue from a lack of oxygen. That delay in getting expert help may explain why Gutierrez, 39, a mother of daughters ages 10, 17 and 20, became Mexico’s first death from a new, virulent strain of influenza A (H1N1). It may also explain why Mexico’s death toll from the virus is higher than anyplace else’s.
Epidemiologists are still puzzled by the virus, its origins and its modes of transmission. But they agree that prompt medical attention is crucial to treating it. That has been where Mexico, which the World Health Organization said Thursday had 97 confirmed cases and seven deaths, lags far behind.
“People wait too long to go to doctors,” said Dr. Marcelo Nogera, undersecretary of health for Oaxaca state. “That’s a problem here in Mexico. If we can treat a disease like this early, we can stay ahead.”
There may well be other factors to explain why patients in Mexico like Gutierrez, whose medical records show a desperate, belated scramble by a team of doctors to keep her alive, are dying at what appears to be a higher rate than swine flu patients elsewhere. Mexicans may have been hit by a different, deadlier strain of the flu, or it may have infected more people who had other health problems, researchers speculate.
But one important factor may be the eclectic approach to health care in Mexico, where large numbers of people self-prescribe antibiotics, swear by homeopathic medicine, or seek out mysterious vitamin injections. For many, only when all else fails do they go to a doctor.
“I think it has to do with the culture, the idiosyncrasies of Mexicans,” said Dr. Nicolas Padilla, an epidemiologist at the University of Guanajuato. “The idea is that I don’t go to the doctor until I feel very bad.”
But there are logistical reasons, as well, that compel Mexicans to steer clear of hospitals. At overcrowded public facilities, they complain, they are often turned away, treated by indifferent doctors or made to wait endlessly.