By Manuel Roig-Franzia
Washington Post Foreign Service
Friday, August 18, 2006
MEXICO CITY Silent figures filled every plastic seat under the dim fluorescent lights. Two men slumped on the tile floor in the corner, heads buried in their knees. A rattly cough was the only sound.
It was 7 a.m. in Xoco Hospital, where uninsured Mexicans pay for medical services, quite literally, with blood.
Bernaben Ruiz, a 23-year-old busboy, rubbed his red-rimmed eyes and studied the little prick mark at the crook of his right arm.
"It wasn't so bad," he said.
The little bag of blood Ruiz had just given up would pay for the Caesarean section that made his friend a father, and it was part of an elemental ritual of life here. In Mexico, patients who have no health insurance or who are covered by bare-bones government plans are required to recruit two to six blood donors -- friends, relatives, even total strangers -- in order to receive free or discounted medical care.
It is an obligation accepted matter-of-factly. Nearly half of the population had no health insurance in 2005, and almost everyone -- except for the estimated 5 percent of the population that can afford deluxe private insurance -- can readily spool off a list of surgeries that their blood has made possible.
At Xoco Hospital, the minutes passed in drowsy silence. The clock said 7:45 a.m., and Ruiz was still waiting for his post-donation consultation.
It was so quiet that no one could miss the weeping that soon grew into great, belly-heaving sobs just down the hall. A hushed semicircle formed around a man in a baseball cap, a man overwrought with grief.
"Please," the man said, "I beg your support."
Carlos Reyes had brought friends to Xoco to give pints of blood following the car accident that crumpled his father's body. But that didn't seem important anymore. A man in a white coat had told him his father was gone. All Reyes could think about now was the money he needed to take his father home to be buried in Cuernavaca, 55 miles south of Mexico City.
A small woman stepped toward Reyes and handed him a coin. "Bless you," he said.
By 8 a.m., the long corridor could no longer hold the dozens of blood donors who shouldered in alongside patients awaiting orthopedic examinations and plaster casts.
José Alvarez, a window installer with droopy eyelids and thick forearms, fingered the slip of paper that told him his place was at the back of the line -- way at the back. Number 45, he said dejectedly, and slumped against the wall.
Alvarez knows Xoco well. He radiates health. His family doesn't.
Alvarez had previously given blood to pay for both of his brothers' kidney surgeries and for some procedure that his brother-in-law needed but that Alvarez never quite understood. Somewhere in between there was a cousin who hit him up for half a pint, too. On this day, he was here for his sister's heart surgery.
"If you can help, it's good," he said.
At 8:20 a.m., a man with a crew cut -- his face contorted in an angry grimace -- hobbled up on crutches, trailed by two police officers. The women next to Alvarez whispered and pointed.
"Prisoner," one of them said.
With nothing to do -- no magazine rack or television, no radio or newspaper stand -- the prisoner's arrival qualified as entertainment, or at least a welcome distraction. The blood donors cast quick glances at the prisoner, who languidly examined an X-ray of his shattered knee.
A woman behind the orthopedics counter called out a name and the policemen shuffled their prisoner through a door. The donors resumed staring at the floor, resigned to the endless wait after 15 minutes of diversion. Many had been here since 6 a.m.
Across the corridor, Cristian David Reyes Trujillo and Raúl Morales were getting acquainted. They had met for the first time the day before, the day a doctor told Morales that his wife would need an emergency Caesarean section to give birth to their second child.
The announcement put Morales in a fix. His wife has rare O-negative blood, and he had to find someone with matching blood.
In some places, this might have been a daunting task. But in Mexico, where the World Bank estimates half the population lives below the poverty line, a person's blood type is essentially common knowledge. It's the sort of thing that gets talked about at sidewalk taco stands and, thankfully for Morales, at bars.
Morales's aunt is a regular at a bar near her home and she just happened to know that her favorite bartender -- Reyes Trujillo -- had O-negative blood. She made the introduction, and Reyes Trujillo agreed without hesitation. Someday, he figured, he might need the same.
At 9 a.m., a woman in a white nurse's uniform asked Reyes, "Are you the one with O-negative?"
"Oh, yes," he said, straightening up.
She pointed down the hall. Reyes Trujillo thought he might finally get this over with, but he was wrong. He was just waiting in a different place now.
A door swung open at 9:20 a.m., and a woman darted into the hallway carrying an armload of sloshing blood pouches pressed to her chest.
"Dum, duh, dum," Reyes Trujillo hummed, affecting the ominous tone of a B-movie thriller.
The door slammed shut and Reyes Trujillo slouched back into a chair.
"How much longer do you think this will take?" he asked.
More than an hour later, at 10:30 a.m., Reyes Trujillo asked the same question.
Morales glanced sheepishly at his new friend. Then he shrugged his shoulders.
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