Cholera menace returns to Mexico: Poor hygiene underlies a serious outbreak of the disease, reports Phil Davison from Mexico City

AT THE state paediatric hospital in Mexico City's humble La Villa barrio, the medical advice and drawings on the walls are simple, indeed childlike. The aim is to get the message across to the district's poverty-stricken and often illiterate population that cholera is back and can kill.

Health officials say there have been more than 6,000 cases of cholera in Mexico this year and 108 deaths. The La Villa district has been among the worst hit in the capital of 20-odd million souls. Given Mexico's still-backward water supply system and poor hygiene, the recurrence of the disease that appeared to have died out in the Fifties poses a serious threat.

'Boil water before drinking it,' says one warning in the La Villa hospital lobby, beneath a crayon drawing of a steaming saucepan. 'Wash your vegetables with water and soap,' says another, a tip unlikely to do much for the flavour of salads. The warnings reflect public service ads on radio and television telling Mexicans not to eat their beloved tacos from street stands or anything fried in the fritangas (frying pans) of millions of taco stands around the country.

It's rather like asking an Englishman to give up his cup of tea in his local cafe. Not surprisingly, the warnings are going largely unheeded and the taco stands seem as busy as ever.

Indeed, right outside the door of the paediatric hospital, and catering specifically for its visitors and employees, is a typical, yellow-canopied taco stand. Here, the warnings on the hospital's walls are blatantly ignored by the grey-haired taco lady and clients peckish after queuing for hours to have their children treated for whatever ailment, in some cases cholera symptoms.

It is the usual system. The lady has a single pink bucket of water to clean her half-dozen plastic plates. After each client, she wipes the plate with a cloth dampened from the bucket which she may well use all day without changing the water. She stuffs each taco by hand and the client eats them the same way.

Dr Robles Rivero of the La Villa hospital said he had treated 30 cholera cases last month, 22 of them children, but that none had died. Dr Rivero believes Mexico has the disease under control. But he is a state employee and echoes the government line. Others are not so sure.

Most Mexicans do boil their water for drinking. But they tend to get their liquid intake from soft drinks. Foreign residents often filter water several times as well as boiling it, in an effort to avoid diseases such as the dreaded Montezuma's Revenge - a form of diarrhoea alluding to an Indian emperor's mythical curse on foreign conquerors - or ubiquitous parasites.

A recent Health Ministry study revealed that no less than 80 per cent of the food served up on the streets of the capital contained fecal bacteria. In many backward areas, particularly on the outskirts where Indian and other peasants arrive daily seeking work and squatting in any free space they can find, the toilet is the nearest relatively private spot. Fecal bacteria is part of the city air and 80 per cent of residents were recently reported to suffer from some form of parasite. Locals build up anti-bodies. Foreign visitors often suffer more.

'In areas where there are no toilet facilities, people should cover their excrement with lime or earth,' the Health Ministry recently advised.

The Health Minister, Jesus Kumate, admitted last week that the Rio Suchiate, which runs along the Mexico-Guatemala border, was contaminated. Indicating that the contamination also threatened the nearby former British colony of Belize, he said that country, Guatemala and Mexico would hold regular meetings to discuss the problem.

It was on the banks of the Suchiate river that the first Mexican cholera case was discovered in June 1991. The authorities fear Central American refugees, who flock across the river on rafts or the inner tubes of lorry tyres as part of their long, illegal odyssey towards the United States, may have helped carry cholera north.

The issue hit the headlines recently when Argentina banned its citizens from returning from Mexico with jugs of 'miracle water' from a village in the Mexican state of Queretaro. Word had spread throughout Latin America that the water from a well in the village of Tlacote could cure anything from epilepsy to cancer or Aids. Argentine travel agents arranged package tours to Tlacote from Buenos Aires, with 17 gallons of 'miracle water' per person guaranteed. Several Aids and cancer victims were among those to make the pilgrimage.

But the Argentine government, as well as that of Uruguay, feared the water could be cholera-contaminated and barred returning pilgrims from bringing in the jugs. Some were coming with several dozen jugs each. When refused permission to bring it in, they staged a sit-in at the Ezeiza international airport in Buenos Aires, finally forcing a partial backdown by the government. It promised to examine the water and allow it in if it was not contaminated.

The owner of the 'miracle' well, Jesus Chahin, vehemently denied it was cholera-contaminated. On the contrary, it may be able to cure the disease, he told a visiting reporter. He and his dog were jointly responsible for discovering its 'healing qualities,' he said. His dog had been dying until it lapped up water from the well and staged a miraculous return to health. The water also cured a back injury he had been suffering from through a faulty golf swing, Mr Chahin said.

(Photograph omitted)

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