Tijuana Doctors ÔÇÿDropping Like FliesÔÇÖ and Free Trade Gets Blame

In the border town of Tijuana, factories are working full tilt to pump out masks, protective gear and ventilator parts as global demand surges because of the coronavirus. And yet, locals say hospitals are desperately short of it all.

Mexico is the eighth-largest supplier of medical devices in the world, but much of it is shipped abroad. International trade rules, an aggressive scramble by wealthier nations to stock up and what critics call a lack of planning on Mexico’s part have drained the nation’s health system of supplies it will need to fight the pandemic.

It’s proving a deadly mix as cases start climbing in Tijuana, a medical-device making hub in Latin America.

Baja California state Governor Jaime Bonilla warned that doctors there are “dropping like flies” and threatened to shut down a ventilator-parts factory if it couldn’t find a way to bypass trade rules and supply nearby clinics. Videos on Twitter show health care workers lining up around town as they hunt for their own protective gear.

“The medical equipment producers don’t have anything for us,” said Faustino Ruvalcaba, a doctor in Tijuana who spent three decades working for the national health system known as IMSS before retiring. “All the output that occurs here isn’t for here -- it’s for everywhere else.”

Asking Trump for Help

Ruvalcaba has taken it upon himself to hunt for supplies in San Diego and said he’s close to reaching a deal with a distributor for 1,000 medical-grade masks to help former colleagues. It’s not so different from what President Andres Manuel Lopez Obrador is doing. After repeatedly downplaying the seriousness of the disease up until late last month, Lopez Obrador personally asked Donald Trump for ventilators in a call.

“He said he’d do everything possible,” Lopez Obrador said on Tuesday. “This week, they may tell us if they can help.”

Tijuana’s experience could provide a glimpse at what’s to come elsewhere in Latin America, where the regional response has been scatter-shot and, at times, counter-productive.

Bodies started appearing in the streets of Guayaquil after the Ecuadorian port city was caught off guard by the speed and breadth of an outbreak that went undetected until it was too late. Manaus, Brazil’s manufacturing hub, is also quickly turning into a hot spot for infections. Throughout the region, a shortage of testing that dwarfs what other nations have experienced is making it hard even to gauge the extent of the problem.

Baja California, where Tijuana is located, says it has 515 confirmed cases and 57 deaths. The federal government says there are 5,847 cases nationwide and 449 fatalities, but Mexico’s testing rate is among the lowest in the region and the country itself has estimated that the true number is about eight times that amount.

Neglect

Governor Bonilla and national health officials have sparred publicly, with Bonilla accusing the social security system of “neglect” after an outbreak among hospital workers. Mexico’s Social Security Institute, or IMSS, denied a lack of personal protection equipment and said that only four workers have been infected at the Tijuana clinic hardest hit by the spread.

Bonilla last week warned Smiths Medical, a U.K.-based supplier of ventilator components to the U.S., to start diverting some of its product to the local market or he’d deem the business non-essential -- meaning he’d legally be allowed to shut it down. Bonilla said Sunday that Smiths agreed to help.

But it’ll be no easy switch, according to Luis Hernandez, head of the Association of the Maquiladora Industry of Tijuana, including dozens of companies that produce hundreds of thousands of different types of medical components. International trade rules mean Smiths will have to ship supplies from abroad, rather than the local plant, he said.

A call to Smiths Medical wasn’t answered, and attempts to reach a company official through the Tijuana industry association weren’t successful.

Most of the companies manufacturing medical supplies in Tijuana fall under Mexico’s maquiladora program, which means they benefit from tax breaks in exchange for assembling goods that must be exported.

Mexico has acknowledged that it continued sending supplies like face masks to China in February, only to have to buy some back at a higher cost. Government officials argue that they couldn’t stop companies from selling abroad without declaring a national emergency, which it couldn’t do because it didn’t yet have any cases. Diplomatically, not filling those orders would have hurt the nation’s ties abroad.

“The irony is a reflection of Mexico’s uneven position in the current global order,” said Carlos Bravo, a political scientist at Mexico City’s Center for Economic Research & Teaching.

Now, Mexico is backtracking in trying to stock up as the global death toll from the coronavirus tops 138,000. That’s pushing Mexico’s government into unknown corners of the medical-supply market, with at least one contract fueling concern over its legitimacy.

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