“Most people do not know how the emergency response system functions in the Lake Chapala area, and many are completely confused and unprepared when a serious emergency arises,” says Chapala Red Cross medical director Sam Thelin. Expatriate residents often face legal, cultural and language barriers that aggravate the situation, the doctor says. “However the emergency response system worked in your home country, it is probably different here.”
As guest speaker at the March meeting of Cruz Roja International Volunteers (CRIVC), Thelin offered valuable tips to minimize troubles in coping with a health crisis, along with an outline of the obligatory protocol established by Jalisco’s Emergency Medical Attention Service (SAMU) system.
- Everyone needs to have a plan. In weighing your options, take into account factors such as insurance coverage and financial circumstances, and the roles your personal physician, family and third parties may play.
- Make sure that anyone who may have to make decisions in case you become incapacitated fully understands your wishes and has pertinent information to deal with the situation. Keeping copies of an “En Caso de Emergencia” contact list next to the phone, in your wallet and inside the car glove compartment can be vital in these instances.
- Cruz Roja and Chapala’s Clinica Municipal handle most local medical emergencies. The main ambulance service provider for both home calls and auto accidents is Cruz Roja, with three units based in Chapala and one other at the Ajijic sub-station manned 24 hours a day by Emergency Medical Technicians (EMTs).
- To call Cruz Roja for help it is best to dial (376) 765-2308 rather than the more indirect route through the 065 hotline. If there is no answer, it is because the line is busy. Just call back. An English-speaking staff member is usually available. Explain the nature of the problem as concisely as possible. Be prepared to give the street address and useful directions such as nearby landmarks or cross streets to pinpoint the location. Make sure your house number clearly marked and illuminated.
- In a typical ambulance call the EMT first responders will first evaluate the patient’s condition. If the problem cannot be resolved on site, the patient has two alternatives at this point: either go in the ambulance for attention at the Cruz Roja clinic or, if the patient or his/her personal physician know that hospitalization is required, arrange for independent transport to a private hospital in Guadalajara. Keep in mind that private hospitals will want proof of capacity to pay for care prior to admittance.
- Whether the patient arrives by ambulance, private vehicle or walks in, Cruz Roja staff will provide whatever medical services are within the clinic’s capacity. However, specialized attention – such as emergency surgery and advanced laboratory or image (CAT scan, MRI) exams – is not available there. When a higher level of treatment is required, the patient or person acting on his/her behalf must decide where to go next.
- Persons who have commercial medical insurance or the means to pay expenses usually opt for private hospital care, lining up their own mode of transportation. The patient can also sign a release and go straight to a government- affiliated hospital by personal transportation or taxi.
- Ambulance transport to the Hospital Civil and other government-subsidized facilities is not an immediate option because it is illegal without permission channeled through SAMU. There are more people needing “free” emergency care than there are doctors and hospitals to treat them. SAMU determines who gets permission based on need and ability to benefit.
- Those with IMMS and similar government insurance get permission fast because there are simply more hospitals. IMSS operates seven major hospitals in Guadalajara. Patients without insurance and those who use Seguro Popular are usually sent to one of the two Civil Hospitals, and space is limited. Patients who would die without rapid attention, and who will probably live after treatment, are put at the top of the list. Non-emergencies and patients with chronic conditions who would probably die even with rapid treatment, go near the bottom. Everyone else falls somewhere in between. Depending on the severity of a candidate’s condition and how many new patients make the top of the list in the meantime, the waiting time could be hours, days or even weeks.
Dr. Sam Thelin will delve further into this topic at the next CRIVC meeting, set for Wednesday, April 10, 2 p.m., in the Gazebo of the Lake Chapala Society.