This is reprinted from Island Breeze Newspaper

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With the Easter Holiday or Semana Santa fast approaching and Spring is finally here, I wanted to talk about restaurants in San Miguel de Allende.
San Miguel de Allende has many wonderful restaurants. It is hard to list favorites because things change quickly.
Restaurants come and go, even good ones. So my goal isn’t to list my favorites, but WHY I like to dine in San Miguel de Allende.
If you have any favorites, PLEASE do tell and comment and tell us about them.

San Miguel de Allende’s restaurants are varied and numerous. One can find anything from German cuisine, Italian, Chinese, Indian, Thai to home style
Mexican cuisine. Like in any town, some are amazing, some are good and some are terrible! So I always ask people for a recommendation,
Usually a local gives the best advice.

My favorite part of eating in San Miguel de Allende, is walking down the street and finding a restaurant, tucked into a garden patio, with a fountain
and beautiful flowers everywhere. To sit back and drink a Cappuccino and enjoy a great breakfast and just relax. It is wonderful. Or to sit in an open garden and enjoy a plate of enchiladas and a great Margarita. ( Especially at the Hot Springs!!)

Life just doesn’t get much better.

Most of the better restaurants use purified water and ice and are careful with fruits and vegetables. You most likely won’t get Montezuma’s revenge, but be careful when eating off the street, just make sure everything is cooked.

With St. Patrick’s Day just ahead, an unusual musical mash-up has surfaced. Paddy Moloney and his legendary Irish group The Chieftains have joined forces with Ry Cooder and various guest artists on a new album called San Patricio — Spanish for St. Patrick.

The recording came out last Tuesday and commemorates a little-known connection between Mexicans and the Irish.
During the Mexican-American War of the 1840s
a group of disaffected Irish-American conscripts led by Capt. John Riley
crossed the border to fight with the Mexicans.
Riley put together a battalion named the “San Patricio,” men who had
deserted the U.S. Army and joined the Mexicans to fight on what he saw as the side of justice.

“They fought five very heroic, wonderful battles,” Moloney says. “I’m afraid the last one was at Churubusco,
which was the finisher-upper, as they say.”

The Chieftains’ album features a long list of guest artists, including narration by Irish-born actor Liam Neeson of a poem in tribute to the San Patricios.

Saint Patrick’s Day in San Miguel de Allende

March 17^th is Saint Patrick’s Day or Dia de San Patricio’s. It is an Irish/Celtic festival. It is celebrated by a parade through the city of San Miguel de Allende and highlights traditional Irish food and music.

In Mexico, Saint Patrick’s Day is also celebrated to honor Los San Patricios, The St. Patrick’s Battalion, who fought in the Mexican-American war of 1846-1848.

Who were these soldiers?

Batallón de San Patricio was a unit of 175 to several hundred immigrants (accounts vary) and expatriates of European descent. Most of the battalion’s members had deserted or defected from the U.S. Army. The Battalion was made up primarily of ethnic Irish and German Catholic immigrants, the battalion also included Canadians, English, French, Italians, Poles, Scots, Spaniards, Swiss, and native Mexicans, most of whom were also Roman Catholics. Disfranchised Americans were also in the ranks, including African Americans who had escaped from slavery in the American South.

Why did they defect to the Mexican Army?

The Mexican government offered incentives to foreigners who would enlist in its army: it granted them citizenship, paid higher wages than the U.S. Army and gave generous land grants. None of the members of the Saint Patrick’s Battalion, except for a few Americans, had yet become a U.S. citizen.

Numerous theories have been proposed as to their motives for desertion, including cultural alienation mistreatment of immigrant conscripts by nativist soldiers and senior officers, their not being allowed to attend Sunday Mass or to practice their religion freely, the incentive of higher wages and land grants starting at 320 acres offered by Mexico, and their witnessing poor conduct of U.S. troops following battle victories.

Some historians believed a primary motivation was shared religion with the Mexicans and sympathy for the Mexican cause, likely based on similarities between the situations in Mexico and Ireland.

The Treaty of Guadalupe

Outnumbered militarily and with many of its large cities occupied, Mexico could not defend itself and was also faced with internal divisions. It had little choice but to make peace on any terms.The Treaty of Guadalupe Hidalgo, signed on February 2, 1848,, ended the war and gave the U.S. undisputed control of Texas, established the U.S.-Mexican border of the Rio Grande River, and ceded to the United States the present-day states of California, Nevada, Utah, and parts of Colorado, Arizona, New Mexico, and Wyoming. In return Mexico received US $18,250,000 ($457,373,077 today)—less than half the amount the U.S. had attempted to offer Mexico for the land before the opening of hostilities—and the U.S. agreed to assume $3.25-million ($81,450,000 today) in debts that the Mexican government owed to U.S. citizens

After The war, The Trials, The Hangings…

After the war, The San Patricios were captured by the U.S. Army. They were treated and punished as traitors for desertion in time of war. In addition, they had been responsible for some of the toughest fighting (and the heaviest casualties) that the U.S. Army had faced. Seventy-two men were immediately charged with desertion by the Army.

Most of the convicted San Patricios were sentenced to death by hanging. The rationale was that they had entered Mexican military service following the declaration of war. Execution by hanging was in violation of the contemporary Articles of War, which stipulated that the penalty for desertion and/or defecting to the enemy during a time of war was death by firing squad, regardless of the circumstances.

Hanging was reserved only for spies (without uniform) and for “atrocities against civilians”, neither of which activities were among the charges brought against any members of the Saint Patrick’s Battalion. More than 9,000 U.S. soldiers deserted during the Mexican-American War, and only the San Patricios were punished by hanging.

Why are They Considered Heroes in Mexico?

A main reason for their hero status in Mexico is derived from their exemplary performance in the battlefield. The San Patricios ultimately suffered severe casualties at the famous battle at Churubusco, which is considered the Waterloo for the Mexican Army in this war. Mexican President Antonio Lopez de Santa Anna, who also commanded the armed forces, stated afterwards that if he had commanded a few hundred more men like the San Patricios, Mexico would have won that ill-famed battle.

While the brave soldiers of Saint Patrick’s Battalion are not particularly well-known outside Mexico, it is clear that their god-like status in Mexico is enough to compensate for the attention they failed to receive in other countries. There is still a fond memory of “Los Colorados” the red-headed Irishmen who gave their lives in the struggle for Mexican sovereignty.

There are Irish names in prominent places – if you can recognize them. There’s “O’Brien City,” for instance, better known as Ciudad Obregon in the northern state of Sonora. Alvaro Obregon (1880-1928) was a famous and admired Mexican soldier and statesman.

Today few towns in Mexico are without a street by the name. O’Brien became the Spanish “Obregon.”

Mexico and Ireland Recognize The San Patricio’s

There was a large celebration in 1983, which the Mexican government issued a commemorative plaque honoring Los San Patricios. A special mass was held, schoolchildren placed a wreath at the plaque, the Mexico City Symphony played the national anthems of both Ireland and Mexico.

In 1993, the Irish began honoring these soldiers with an annual celebration in Clifden County, Galway Ireland. This was John Riley’s hometown. John Riley was the leader of the Saint Patrick’s battalion.
View Documentary about The San Patricios

One of the most important considerations when choosing a place to retire to is access to good medical care.
San Miguel de Allende is  adequate when it comes to basic to moderate medical concerns. Though nearby are the cities
of Leon and Queretaro with state of the art facilities, so anyone with health challenges shouldn’t be worried about visiting
or living in San Miguel.

Below is a list of Doctors practicing in San Miguel de Allende, this is not an endorsement of any kind.
To view the entire list go to http://whatshotinsanmiguel.com/health-services/doctors

Dr. Jorge Alvarez de la Cadena
Internal Medicine, Cardiology
Address: Libramiento a Dolores Hidalgo #43, Suite 20
Borough: Colonia Mesa del Malanquin
Work Tel: +52- 415-152-2320, 512-2329, 152-2233
Mobile: 044-415-153-3131
Pager: 01-800-333-2223, Pin# 5241533131
Email: lilyjacs@unisono.net.mx
Languages: English and Spanish

Dr Roberto L. Maxwell
Internal Medicine, Emergency Medicine, Cardiopulmonary Medicine
Address: Calle Insurgentes #29 (between Hidalgo and Reloj)
Work Tel: +52-415-152-0247
Mobile: 044-415-100-3592
Email: casamaxwell@cybermatsa.com.mx
Languages: English and Spanish
Makes house calls

Dr. Salvador E. Quiroz
Internal Medicine and Nephrology
Address: Libramiento a Dolores Hidalgo #43, Suite 11
Work Tel: +52- 415-152-2233, 152-2320, 152-2545
Email: yolysalquiroz@prodigy.net.mx
Languages: English and Spanish
Makes house calls

Dr Cornelio A. Hoogesteger
General Medicine, Homeopathy
Address: Callejon de Publito #1-A (at corner of Reloj)
Work Tel:+52-415-152-1753
Home: +52-415-152-3519
Mobile: 044-415-100-4851
Email: krelius@prodigy.net.mx
Languages: Spanish, English, Dutch, and some German
Makes house calls

Dra. Liliana Hernandez
Ear, Nose and Throat
Address: Libramiento a Dolores Hidalgo #43, Suite 21
Borough: Colonia Mesa del Malanquin
Work Tel: +52-415-152-2329, 152-2320
Mobile: 044-415-103-5463
Email: lilyjacs@unisono.net.mx
Languages: English, Spanish, some French
Makes house calls

Dr Fidel G. Dobarganes
Orthopedics/Traumatology
Address: Libramiento a Dolores Hidalgo #43, Suite 2
Borough: Colonia Mesa Malanquin
Work Tel: +52-415-152-2233
Mobile: 442-281-0981
Email: fdobarganes@prodigy.net.mx
Languages: English and Spanish

Dra. Maria del Rocio Barrios
Obstetrics and Gynecology, Colposcopy
Address: Calzada de la Estacion #108
Borough: Colonia Centro
Work Tel: +52-415-152-4981
Home Tel: +52-415-152-7446
Email: lepanto@cybermatsa.com.mx
Languages: Some English and Spanish

Dr. Jose Diaz
General Surgery
Address: libramiento a Dolores Hidalgo #43, Suite 3
Borough: Colonia Mesa del Malanquin
Work Tel: +52-415-152-2233, 152-2320
Mobile: 044-415-151-7385
Email: hospitaldelafe@prodigy.net.mx
Languages: English and Spanish
Makes house calls

Dra. Blanca Elena Farias
Dermatologists
Address: Hernandez Macias #85 A
Borough: Centro
Tel: +52-415-152-2321, 415-152-4082

Dr. Juan Bosco Ruiz Padilla
Plastic Surgery
Address: Potranca #29
Borough: Frace Guadiana
Tel: +52-415152-2172

Dra. Angela E Nava Ortiz
Acupunture
Address: Canal #135-A
Borough: Centro
Tel: +52-415-152-8971
Mobile: 044-415-109-1808
Email: angelanava@yahoo.com.mx

Dr. Eduardo Lopez Saavedra
Acupuncture
Address: Ancha de San Antonio # 81
Borough: Ranta Alta, Centro
Tel: +52-415-150-0160
Mobile: 044-415-100-4812, 044415-101-6565

San Miguel de Allende has a wonderful reputation for being retirement haven for Americans.
One of the most important factors when looking for a good place to retire, is access to good medical care.
San Miguel de Allende has a lot to offer retirees plus it has one of the most forward thinking doctors living and working there,
Dr Haywood Hall.

Dr Haywood Hall started the PACEMD program and the MEDSPANISH program both of which are located in San Miguel de Allende.

Mesones 38 Int. 15 “Mesón de San José”, Col. Centro,
San Miguel de Allende, Guanajuato, México 37700
Tel./Fax: 01 (415) 152-7532

I came across an interesting paper that was written by Erica Smith, Michelle Hellums, and Callie Louis. In the paper they describe Dr Haywood’s experience that drove him to create the PACEMD Program (PanAmerican Collaborative Emergency Medicine Program)

” It all began in 1996 when a vacationing Dr. Hall happened upon a multiple vehicle accident in the dead of night on a stretch of highway somewhere between Juarez and Chihuahua.

Dr. Hall, a U.S. emergency physician, took in the scene with particular focus on the unconscious man experiencing acute agonal respiration. A hundred thoughts ricocheted in his mind: time of the essence; no sign of help; absence of equipment; legal liability without a recognized license; but, above all, his Hippocratic oath. A life was on the line. Minutes were precious. The fuse was lit.

Thirty minutes passed before an ambulance arrived with its sub-par equipment, outdated drugs, and woefully under-trained crew.  Dr. Hall sought and received from the police permission to intervene. He did his best with what he had. After stabilizing the patient, Dr. Hall addressed his otherwise-fatal tension pnuemathorax.  Dr. Hall decompressed the patient’s chest with an improvised chest tube fashioned from an old endotracheal tube and glove and intubated him with expired Valium and another ET tube.  This story had a satisfactory ending as the patient survived his ambulance ride to Chihuahua.

Dr. Hall later reflected on the experience. He recalled the sorry display of the response team that night and the likely outcome without his chance intervention.  How many other people in Latin America were dying due to grossly inadequate emergency response resulting from the lack medical of basic knowledge, skills and equipment?

The Epiphany

It so happened that this reflection intersected with Dr. Hall’s own reevaluation of his professional life. He was in his fifth year of practicing emergency medicine in the U.S. and was looking for new directions. After arriving in beautiful San Miguel de Allende, Dr. Hall’s reflection blossomed into an epiphany. His life goal would be impressive in scope: apply his extensive training to develop a comprehensive emergency medical program for the entire Spanish-speaking population in the Western Hemisphere.”

My Mexico Experience

I too had an experience with the emergency medical response in Mexico. While driving through Baja California, a  semi-truck  had flipped and the wife, who was a passenger, was ejected through the front window. She was unconscious but breathing and no apparent external injuries. Somebody had a radio and called for help (no cell service.) I sat and talked to her and held her hand for  over 2 hours ( the nearest city was about 2 hours away.) When the ambulance arrived it was a guy in a mechanics coveralls and no medical equipment with him at all, no oxygen, not even a gurney. He only had a large piece of foam. So we all lifted her onto the foam and into the ambulance. I was horrified and I prayed a lot for her. I drove much more carefully after that.

I applaud Dr Haywood Hall for his programs and continued work. I am humbled by his drive and perseverance.

To read more about what PACEMD is doing to improve emergency medical care in  San Miguel de Allende see previous post.

What is PACEMD Doing to Make San Miguel de Allende A “Safe Place”?

PACEMD has begun a “Safe San Miguel” program, with a goal of making San Miguel de Allende a standard throughout Mexico in community based Emergency Medical training and certification.

The Hospital General in conjunction with the  PACEMD program, has played an integral part in providing San Miguel de Allende with higher quality emergency medical care.

• Hospital General has the highest percentage of externally validated certified providers of any hospital in Mexico.

• Starting next month, Emergency medicine residents, from the United States, will help to develop a Chest Pain Center in the General Hospital.

• They are also teaching the staff, Medical English, so that they could better serve the US medical community.

• It is also routine for US providers to often have an advisory role at the hospital.

• PACEMD and Hospital General are also initiating an International Emergency Medicine Fellowship program whereby graduated emergency medicine specialists who are interested in international medicine can split their time between US hospital on the US Border and in our training and development program in Mexico. These fellowships are 2 years long.

• Dr Luis Vazquez , who is the acting director of the emergency department at the General Hospital is also the national coordinator for our center and all of its courses. He is also the Medical Director of the Red Cross. His wife Dr Lulu Tejeida (presently Medical Director for Hospice) helped  to develop the emergency nursing diploma course which has taught approximately 200 nurses in the state (beginning with San Miguel de Allende , of course!)

• PACEMD  has trained 7 physicians at the General Hospital emergency department in the Advanced Cardiac Life Support (ACLS) course and provided them certifications , as well as provided essentially all of the nursing staff with BASIC BLS Training. All but one of the Obstetrical staff is trained in the emergency obstetrics courses as well as many of the general physicians, who come in contact with obstetrical patients.

• Next month PACEMD  is rolling out a new Pre Hospital Trauma Life support program in San Miguel  (ATT) and have already provided Proteccion Civil and local Red Cross and bomberos with disaster certifications and with the American Heart Association Heart Saver courses.

• For the Red Cross, Transito,  Proteccion Civil and the Police,they are beginning to “train the Trainer” with the American Heart Association programs.

PACEMD is also installing two Public Access Defibrillators in the Jardin as well as in la Lucierniga. This is the first public Access Defibrillation program that we know of in Mexico (You see these devices in airports all over the US).

What Is PACEMD?

PACE is an institution of multinational cooperation and humanitarian, committed to the development of culture and dissemination of emergency medicine and its services, in response to the needs of the community and with international recognition.

The PACE program, based on the spirit of humanitarianism and professionalism in multinational emergency medicine, seeks to provide mechanisms for collaboration to develop and enhance the specialty of Emergency Medicine in Mexico and Latin America through programs that disseminate the culture of medicine Emergency.

The Continuous Update Program in Emergency (PACE) is a program designed to update physicians working in emergency rooms, emergency doctors, general practitioners, family physicians or other specialties related to emergency medicine, including also nurses and other health professionals involved in the process of care in medical emergencies.

PACE programs spread the culture, knowledge, service and training of emergency medicine.

And graduate courses are endorsed by the University of Guanajuato through the Faculty of Medicine of León, the Ministry of Labor and Social Welfare, The Medical College of Emergency State of Guanajuato (CMUEG) and the General Medical Council in order to give academic endorsement, all conducted and supervised by emergency medical specialists.

According to Dr Hall, (founder of PACEMD) “PACEMD has one of the most active (of about 15) American Heart Association Programs in the country.
We have 150 instructors operating out of 10 training sites around the republic. One of our training sites is the State Red Cross of Guanajuato where we provide externally validated training.

We have provided 11% of the training and certifications within Mexico (about3,000 last year) in courses such as the Basic and Advanced Cardiac Life Support and Pediatric Advanced Life Support programs. We have trained another 3,000 or so in CPR, All in Spanish. We have the only Advanced Life Support for Obstetrics Program in the country and have active contracts with the States of Oaxaca, Chiapas and Elsewhere, as well as with the Federal Health Ministry. In fact, we are part of the national strategy to decrease maternal mortality and the past Federal Director of Reproductive Health is national coordinator. We have trained almost 1000 people in the ALSO Program and are also training nurses, midwives and physicians in the Social Service year in the Basic Life Support for Obstetrics programs.
We also teach and certify in Pre Hospital Trauma courses, Disaster Life Support courses, Advanced Airways management and are one of the pioneers in Mexico in Emergency Ultrasound Training.
We also organize Emergency Medicine conferences and have brought Peru, Panama , Venezuela, and the Dominican Republic into the International Federation of Emergency Medicine.

We have had over 400 US doctors come for our MedSpanish Program , and receive CME Credit (and we are working on CEU Credits for nursing and
EMTs). These US Medical Providers learn Spanish in a medical context and spend 25 hours a week working along side local health care providers at
the General Hospital, and Red Cross and rural health brigades.

The Red Cross plans to develop a regional training center, based in part with our support of them as a training site for some basic Red Cross
courses. We are also working with the US National Registry of EMTs to provide their sought after certification in Spanish in Mexico.

We helped to pass legislation in Texas to provide for a Disaster training center in McAllen Texas that will service the border area (US and Mexico).”

Finally, there will be  a National PACEFEST in San Miguel this summer training providers and instructors in all ouf our disciplines as well as
hosting the International Federation of Emergency Medicine Symposium on resuscitation in the summer of 2011. We expect a few hundred worldleaders in emergency medicine to attend.

To learn more about The PACEMD program visit their website http://www.pacemd.org/

To learn more about Med Spanish go their website http://www.medspanish.com/

What are your health care options while living in San Miguel de Allende?

Most U.S. and Canadian health plans, do not cover any of your health care needs, while traveling to or living in Mexico.

Medicare Benefits Extended Into Mexico?

Yes it’s true! The US government has been approached by numerous expat groups such as the Puerto Vallarta based chapter of Democrats Abroad and the bipartisan group of American Citizens Abroad (ACA) with the intent of promoting, Medicare for expats, living abroad.

They argue that not only have these Medicare recipients paid into the fund over a lifetime, but the cost to the US taxpayers will be significantly reduced because rather than returning to the US for expensive and long term medical care, the majority of these expats will merely elect to have their medical care provided near their foreign residence at a fraction of the cost.

The newly appointed US Ambassador to Mexico, Carlos Pascual, has been following the current efforts to establish a demonstration project for the initiation of Medicare in Mexico as a pilot program. In fact, Ambassador Pascual recently accompanied President Obama to a North American Summit in Guadalajara where one of the topics covered was Medicare in Mexico as reported by the Guadalajara Reporter.

What are your options until then?

One option is International Health Insurance

International Health Insurance has many benefits.

1. It will cover you almost anywhere in the world
2. It will cover almost all of your medical expenses, emergency and otherwise. For example:

• inpatient treatment
• emergency medical evacuation & medical repatriation,
• repatriation of mortal remains
• life-saving organ transplants,
• outpatient physician & paramedical fees
• outpatient X-Ray, laboratory tests,
• prescribed drugs, vaccinations
• hospitalisation cash benefit,
• well child care
• day surgery/treatment
• psychiatric, drug & alcohol abuse
• pregnancy & childbirth, complications of pregnancy
• eyeglasses & contact lenses
• chronic diseases (including cancer, heart disease & HIV/Aids)
• preventative & general dental care, dental crowns, bridges, dentures & implants
• Non-Western & Alternative Medicine (including chiropractic, osteopathy & acupuncture, etc.)
• annual Health Checks
• Prescribed Medical Aids
• Death of Close Relative- In the event of the death of a close relative (spouse, parent, child, brother or sister)
  100% of costs of a round trip airline ticket to attend a funeral up to maximum US$5,000 per person.

Some of the cons of international health insurance:

You must purchase these plans before your 75^th Birthday. ( Note ; if you have purchased this plan before age 75, as long as you pay the premium you are covered.)

Most of these plans will not cover you while you are in the US. Make sure you have additional coverage, such as Medicare or travel insurance that covers you while in the US.

Some carriers have a network of hospitals and doctors. If you go to one of the network facilities, you don’t have to pay out of pocket. Otherwise, you pay up front, save your receipts and you are reimbursed.

Be sure to choose one that carries an “A” rating.

Also be sure to read the fine print in your applications for medical coverage. When speaking with a representative of the insurance company, they will tell you that certain procedures are covered, but sometimes fail to mention how much they will pay for a certain procedure. This can be a problem when you think you are fully covered, have the procedure completed only to find out that the insurance company will only pay X amount of dollars for said procedure when in fact the hospital charges 3 times that amount. This can leave you with a substantial bill.

Another option is Mexican Social Security or (IMSS)

The Mexican Institute of Social Security provides affordable health insurance for all residents of Mexico regardless of their nationality. If you have a valid FM-T, FM-3, or FM-2 visa, you can apply for enrollment. Enrollment can only be applied for during the months of January, most of February, July,  August. The cost is from $100- $300 dollars per person per year, depending on your age.  The application process can be intimidating so I recommend that you hire an agent to complete the paperwork for you. The cost is $50 to $75 USD. There is a questionaire requiring you to disclose any preexisitng conditions. Be truthful!!

• Two photocopies of your current passport and immigration documentation
• Copies of either your FM-2 or FM-3 (expatriate visas)
• Duplicate copies of your marriage license (if applicable)
• Two copies of a most recent utility or telephone bill in your name or a renter’s lease agreement in your name
• Three passport-type photographs

Once you are approved,  It can take about 6 to 9 months for coverage to be activated after acceptance. Once accepted, you are a life member as long as premiums are paid. You are assigned a primary care physician who will certify your health during a general exam.

If any further treatment is needed, your assigned physician will refer you to a specialist within the IMSS system.

Any treatment that you receive at the clinics or the hospitals, from general practitioners or specialists, will be covered completely by your IMSS insurance. If medication is prescribed, that medication will be free from the IMSS pharmacy within the hospital or clinic. If the medication is not available from IMSS, you may have to buy it yourself at a privately-owned farmacia (pharmacy). The cost of medicine at these pharmacies is relatively low.

Emergencies are covered immediately. There website in English is http://www.imss.gob.mx/english
IMSS has about 1500 clinics and 264 hospitals across Mexico.
If you can’t speak Spanish, either learn or be sure to take an interpretor with you.

Benefits of IMSS

For hospitalization, generally IMSS has superior equipment to that in private hospitals and clinics. Some surgeons with private practices work at IMSS,  a day or two a week.
Cost is a major advantage of availing oneself to IMSS. Another is the quality and extensiveness of the hospital’s surgical and related equipment. Since some physicians perform surgery through IMSS, coverage might be the way to go, using private doctors for diagnosis and treatment, and just hanging onto IMSS as a safeguard in the event of serious illness. Alternatively, one can enroll, use IMSS initially, and make one’s own assessment that first year.

Cons to IMSS

The downside of depending on IMSS for all your healthcare is that you have no control over the doctors or specialists that you see for your problems. Sometimes the wait to see a doctor or to receive medication can be  long. As a general rule, Mexicans tend to prefer private health care to the state-run system. More than 25% with IMSS pay for their medical expenses out of pocket. Be aware that the social security level of healthcare is not what you are used to in most industrialised countries, ie. using mayo jars for urine specimens, paper sheets not being changed between patients, overhearing private conversations. Costly and long-term treatments are often not covered by the system, so many Mexicans and most foreigners prefer to take out private health insurance as well if they can.

There exclusions based on pre-existing conditions (though some are waived after 2 years):

• Cancer
• Diabetes
• Liver Disease
• Heart Disease, previous arrhythmia, heart attack or valvular disease
• Lung Disease, chronic bronchitis or emphysema
• Neurological disease, stroke TIA’s, peripheral vascular disease
• Drug or alcohol addiction
• HIV or history of AIDS
• Psychiatric illness
• History of accident that requires continued treatment

In addition you cannot receive treatment within the 1^st year of receiving benefits for:

• Surgery for vein disorders
• Gyn surgery for any condition except cancer
• Lithotripsy for kidney stones
• Surgery for hernias, sinuses, nose, hemorrhoids, rectal fistulas, tonsils and adenoids or any operation that is considered “elective” rather than required

An additional option is private Mexican health insurance

Mexico has excellent private insurance companies, just like U.S. companies, though the costs are significantly less. Often times these companies are located on the hospital grounds. The rates vary, depending on your age and preexisting conditions. Note you cannot apply for a new private health insurance policy after your 65^th birthday. For more information contact informacion@gnp.com.mx or visit their website www.gnp.com.mx (Spanish only)

So what’s the bottom line?

In conclusion, one of the reasons Mexico always ranks high as a destination for people to retire, is their high quality health care system as well as their opt-in national insurance plan, IMSS. Most of the doctors and dentists have received at least part of their training in the U.S. or Europe and many go there for continued training. Also many U.S. and European Doctors train in Mexico, especially Guadalajara.

Most large to midsize cities have excellent hospitals. And one huge plus is that healthcare costs are at least half of what they are in the US and prescription drugs, manufactured in Mexico are about 50% less than the exact same drug found in the U.S.

It seems most expats, when they are sick,  pay for out of pocket to visit a private doctor. They use the IMSS for major illnesses or accidents and or they carry an International Health Insurance Policy. List of International Health Insurance Companies. To be safe, I would carry an international insurance policy and have the IMSS for back up. If you find the IMSS to adequate for your needs, then drop the International policy. Though if you want the option to be airlifted back to the US for any medical emergency then you can carry insunace for emergency medi-vac.

Anniversary of Mexican Revolution – 20th November

Mexican Revolution of 1910 and is celebrated, as an obligated day off, on the third Monday of November. On the day itself, 20th November, San Miguel de Allende along with the rest of Mexico will have parades similar to that of the Independence parade. In San Miguel de Allende, there will be people and colors on the streets, more than usual I mean. Sometimes, there are reenactments of selected events, sometimes a whole band of people dressed in and suited as revolutionaries. It is usually a cute treat for people who love children as parents dress up their children as revolutionary heroes and traditional dresses, complete with fake moustaches and huge sombreros as tribute to Emiliano Zapata and Pancho Villa. The history of Mexico, as all stories of the fight for freedom and independence, has been wrought with much violence and individual greed. It is the spirit of the people that prevails and it is fitting that the locals celebrate their local heroes. Popular history remembers the revolution as a progressive movement that ended an oppressive dictatorship and, returned power and land to the Mexican people. The Mexican Revolution was born out of a dissatisfaction against the political elite and the dictator, Porfirio Diaz. Although his economic policies favored commercial progress and Mexican produce, the benefits were spread only among members of the most privileged sectors, especially large landowners and industrial capitalists. By 1910, 85% of the land belonged to ‘Mexico’ but less than 1% of it to the people itself. The peasants were landless and jobless, and suffered daily from hunger and poverty. So, while the country enjoyed economic prosperity, there were dissatisfaction among the middle classes and hatred amongst the poorest groups in society. The Mexican Revolution of 1910 helped shape contemporary Mexico. It was not however a one time fight. It consisted of a series of revolutions and internal conflicts between various political leaders and military personnel between 1910 and 1920. There were huge numbers of fights and riots. After more than 30 years in power, Diaz had called for elections in 1910 but made a mockery of democracy when he imprisoned his most powerful opponent, Francisco Madero, who was a supporter of agrarian reforms, supporting of the peasantry and the principle of non-reappointment. Diaz won the election through fraud. The protests and peasant insurrection however, did not allow the old dictator to remain in power any longer and he chose exile in France. The hopes of Mexicans though were not realized as Madero was unable to maintain order. His assassination in 1913, shook the country and sparked a torrent of passionate and bloody power struggle that lasted several years…but that is another story. From the armies of peasants of the 1910 Mexican Revolution, emerged great military leaders, Francisco “Pancho” Villa and Emiliano Zapata. They are heroes of the Mexican people. It is because of theirs as well as the people’s struggle that a new constitution that enacted public control of natural resources,made education free and compulsory and the formation of labour unions was drafted in 1917, aiming to help and protect the people. Hence, the revolution lasted from 1910 to roughly 1917.

Emiliano Zapata is the Mexican rebel leader who said “It is better to die on your feet than to live on your knees.” A former sharecropper, he organized and led peasants during the battles of the Mexican Revolution, joining forces with Pancho Villa and others to fight the government of Porfirio Diaz. Zapata supported agrarian reform and land redistribution; his rallying cry was “Land and freedom!” Though Diaz was defeated, Zapata continued to resist subsequent government leaders as they were viewed as incompetent and did not realize the hopes and dreams of the Mexican people. He was ambushed and shot by Mexican troops in 1919. Zapata remains to this day a folk hero in Mexico.

It is said that Pancho Villa was a brutal modern-day version of Robin Hood. He is a hero to some and a villain to others. Born a peasant, Doroteo Arango was on the run from the law from an early age. According to legend, he shot to death a wealthy landowner who had raped his sister. He fled into the mountains and then joined a bandit gang led by Francisco “Pancho” Villa. When that Villa was killed, Arango took over his name and his gang. In 1910 the new Villa and his men joined the revolt against Mexican dictator Porfirio Diaz and fought alongside Emiliano Zapata. The revolution succeeded, but a few years later shifting alliances made Villa an outlaw again. Over the next decade, he went back and forth the U.S.-Mexico border, robbing and rustling cattle to survive, with armies from both sides unable to capture him. Villa’s sympathy for peasants and his early battles against the corrupt Diaz regime made him popular with Mexico’s poor, and his exploits were heavily publicized in the U.S. and around the world. In 1920, Villa accepted a deal with a new Mexican government, laying down his arms in exchange for thousands of acres of land in Durango. He was assassinated three years later, though his killers were never captured.

Day of the Dead in San Miguel de Allende

It has been a week of remembrance here in San Miguel de Allende. The people of San Miguel, as well as all of Mexico, have been preparing offerings for their departed family members, relatives, friends, as well as public figures, loved celebrities and artists. They celebrated the Day of the Dead or Dia de los Muertos, as it is called in Mexico. They place offerings, usually in the form of foods on altars. In San Miguel de Allende, these alters can be found in homes, public areas and buildings, like the public library (Biblioteca Publica), the police station and the radio station.

The Mexicans are amazing. It seems like they dance to everything, even death. Death is not to be feared. Here in San Miguel de Allende, I have learned that they celebrate death, even count it as a festive day. They still hold on to the ancient traditional belief of the Aztecs.  When one dies, his spirit continues to live in Mictlán.  Here all souls reside after leaving life on earth. It is said that Mictlán is not a dark or scary place, but one that is quiet and pleasant where souls rest before they continue on their journey to heaven or Tlalocan. In order to make this journey, the souls need food and water for sustenance, candles and or the bright yellow flowers to light the way, coins to pay the ferryman to get them across the river to Mictlan and a thorny staff to drive away the devil. Hence, the tradition of offering these items. There is also another version where the souls stay in Mictlán till they can come and visit their loved ones back on earth. The offerings and decorations, mentioned above, are the departed’s favorite foods, so that when their spirit comes home to visit, to share the banquet, they will enjoy themselves and then leave happily to heaven.

Before the arrival of the Spaniards, the Day of the Dead was celebrated in August and coincided with the end of the agricultural harvest of corn, squash, chickpeas and beans. The bounty of the harvest was an intregal part of the offerings given to the dead. With the coming of Catholicism, the day was turned into an act of mourning and prayer, so that the dead could rest in peace. The indigenous tradition though was stronger and has been combined with Catholic rituals. Hence, Dia de los Muertos has become a carnival of smells, tastes and loves in which the living and the dead co-exist together for a day. Families play together with their deceased loved ones, hosting banquets on colorful alters. This eases the pain of loosing a loved one with the belief that the soul is whole and well, in the Land of the Dead. Thereby making Dia de lo Muertos a celebration full of joy and color during the day mixed with silences of night.

The Day of the Dead is actually held over 2 days: November 1st, is All Saints Day or Dia de Todos los Santos. This day is for those who led exemplary lives as well as for deceased children. November 2nd is Day of the Dead or Dia de los Muertos. This day is for all departed loved ones. The festivities as one is collectively known as Dia de los Muertos or Day of the Dead, in San Miguel de Allende and all of Mexico.

Although altars vary from one place to another, there are several basic elements present in all. According to tradition, every altar must have 7 levels, which represents the 7 levels that souls must pass through to finally rest in peace. The day before, the altar must be swept with herbs, moving east, west, north and south, the direction of the 4 winds.  A good altar has to have all the levels. The highest and smallest level is the center of the altar, where a photo of the loved one is usually placed.

The seventh level is the last and largest level which is on the ground. This part holds firewood, coal, a brazier or three stones used to make a hearth, water and a cross made of ashes or salt. The middle levels hold the loved one’s favorite foods and other items—a doll for a child or a guitar for a guitar player, for instance. Additionally, a humorous poem about famous people is added.  Each level has to be covered with a white cloth or colored paper. All colors, except black can be used. Black is not used, as it represents sadness and darkness, which is not in accordance with the celebrations. The typical colors used are purple, green, yellow and orange. The 4 elements of nature must be present on the altar: earth, represented by the foods; wind, represented by a light moving object such as the colored and design-cut china paper with images of death in endless forms and shapes, placed on doors and hung from wall to wall; water, represented by a glass, vase or bottle of water for the soul to quench its thirst after and for the journey; and fire, represented by candles that serves as light against the darkness of death, to illuminate the path of the deceased.

The bright yellow flowers, xempaxúchil, or marigolds, also act like the candles, guiding the souls home and is used everywhere, in homes, on altars, in gardens as well as the Jardin Principal in San Miguel de Allende.

Another very popular tradition is the Pan de Muertos. To me, it signifies the coming of the day as it is sold everywhere. Every bakery sells it, even Starbucks, complete with hot chocolate! Another popular custom is to exchange calaveritas, or sugar skulls, between living friends and family

Among the foods often placed on altars are rice, pollo en mole (chicken in mole sauce), pozole (traditional Mexican corn soup), tamales (steamed, stuffed cornmeal dough), beans, corn-on-the-cob, tortillas, coffee, fruit juice, water, traditional drinks such as atole (a creamy drink made of water sugar and rice, wheat or oat flour), tepache (a fermented pineapple drink) and pulque (fermented maguey sap) and aguardiente (sugar cane brandy), beer, cigarettes, tejocotes (a seasonal native fruit), sugar cane, peanuts and Mexican candies like charamusca, a sort of taffy, garapiñado, candy-coated peanuts, and sugar skulls. A friend of mine, who is a local of San Miguel de Allende, actually tested the belief that the spirits who come to the banquet are said to consume the essence of the food, so if you tasted the food, after the appointed time they were to visit, it would have no flavor. He tasted some of the food at the altar the very next day and found that indeed, there were no smell nor flavor to any of the foods there.

Over time, more traditions were added, such as visiting cemeteries and dining on the tombs of departed family and friends. It is believed that the spirits take part in the festivities. Another custom is for family and friends to get together at the grave-site. They and clean and decorate it.  They have picnics and tell stories about the departed.  Some people even hire bands from northern Mexico or Mariachis to provide entertainment.

So you see, rather than it being a sad day for the dead, Dia de los Muertos, is a very cheerful and colorful event. The Mexicans treat death with humor. For instance, “the Grim Reaper,” is referred to irreverently as calaca (‘skeleton’), huesuda (“bones”), dientona (“toothy”) and flaca (“skinny”). For dying itself, Mexicans use playful expressions such as petatearse, estirar la pata (literally, “stretch your foot out”) and pelarse (slang for “take off”). These playful twist of words find their way into verses and sayings that make light of kicking the bucket.

I believe, for the people of San Miguel de Allende and all of Mexico, The Day of the Dead, Dia de los Muertos is a celebration of life.