Mexican Charity Assists Women on Both Sides of the Border

On a recent sunny warm day near the border between the United States and Mexico,

about a dozen Hispanic women gather on the back patio of a house in a neighborhood of low-income residents. The women, whose husbands are away at work, are attending a gathering of a “community bank” that is operated by a Mexican charity called FEMAP — the Spanish acronym for the Mexican Federation of Health and Community Development.

In some ways, this community bank resembles others operated by FEMAP in Mexico and by other nonprofit organizations in poor areas around the world. The women each get an initial low-interest loan of $100 and, over 27 months, gradually borrow more and more money while they take courses on such topics as accounting, marketing, and building self-esteem. By the end of the course, the women have saved and spent enough money to start their own small businesses by obtaining or making such things as candies, candles, food, and vases to sell to neighbors and friends.

But this community bank is strikingly different because it upends a stereotype widely held north of the border: that philanthropy is a one-way street heading straight from the United States to Mexico. This gathering of women is one of a series that is being staged by the Mexican-based FEMAP across the border — but on the United States side, in a New Mexican suburb of El Paso.

“We have a lot to learn from Mexico,” says Adair Margo, founder of the FEMAP Foundation, an El Paso organization that raises money to help pay for projects run by FEMAP, which is based in Ciudad Juárez. “We started the foundation eight years ago to help people on the other side of the border, but they turned around and helped us.”

Says Mary Martinez, a foundation staff member: “The border is not a separate place. We breathe the same air, we drink the same water. We are connected economically completely. There is no way around it. We all have to help each other.”

A Much-Needed Hospital

The community banks are one of several programs operated by the Mexican Federation of Health and Community Development, a private organization founded in 1973 by a woman from Juárez, Guadalupe de la Vega, who says she saw an urgent need to provide health care and other support to poor women in her country.

Nearly 30 years after its creation, FEMAP is a major presence in Mexico’s nonprofit world and widely praised on both sides of the border. Laura Bush, the U.S. first lady, embraced the organization during her husband’s terms as Texas governor, visiting the group’s programs and serving on its honorary advisory board, a position she still holds. Marta Sahagún Fox, Mexico’s first lady, has also expressed support for the organization’s work.

FEMAP’s most visible project is its 100-bed, 82-doctor Hospital de la Familia and clinic for women that is located in Juárez, just steps from an international bridge linking the city with El Paso. The facility emphasizes the primary, maternal, child, adolescent, and reproductive health care that is needed in a country and city facing a chronic shortage of medical providers.

Although most of the hospital’s patients are from Mexico, 13,000 residents of the United States chose to cross the border last year to obtain affordable care at the Juárez hospital.

FEMAP has traditionally received 60 percent of its income and support from the sale of services and supplies, mostly at the hospital and clinics it operates. An additional 25 percent has come from donations it receives from foundations and donors in other countries; 12 percent from revenue generated by more than 40 affiliates; and less than 5 percent from the Mexican government. FEMAP’s overall budget in Juárez last year was about $6-million.

At its hospital and clinics, FEMAP believes that the majority of the poor people it serves can and should pay for services rendered. The organization says that about 70 percent of its clients pay all or part of the cost of care, while the remaining 30 percent, “the poorest of the poor,” are treated for free.

FEMAP’s executive director, Enrique Suarez, says the hospital works to keep its budget in the black by watching its costs carefully and being excruciatingly efficient — its doctors, for example, see an average of 4.5 patients each hour. The facility also focuses on treating a large number of patients — it provided 600,000 medical services last year to about 220,000 people — and counts on the sheer volume of its work to generate revenue to cover its operating costs. “We are always fighting the misconception that if you serve the poor you cannot survive as an institution,” says Dr. Suarez. “It’s a very tough balancing act, and you have to work 10 times harder than people at other hospitals to make it work. But it’s a matter of being efficient, without stopping being a humanist.”

Range of Programs

Over the years, FEMAP has also created a nursing school and now operates programs that educate prostitutes and others about the prevention of AIDS. The charity also works to improve environmental health and sanitation and helps run a program to keep young people away from gangs, drugs, and violence, all of which are prevalent along the border.

But Mrs. de la Vega says that the “heart and soul” of FEMAP is found in its 6,500 volunteer health workers who live and work in the poorest communities throughout Mexico. Those volunteers, mostly women, give fellow Mexicans in their own neighborhoods basic health education, birth-control information, and contraceptives. “They change the world of people from despair to hope,” says Mrs. de la Vega.

Mrs. de la Vega, whose husband is a well-known Mexican businessman, says she was moved to start her organization nearly 30 years ago after reading a shocking newspaper article. The report heaped scorn on a depressed mother of nine, pregnant with a tenth child, who had tried to stab herself to death because she was so poor that she could not provide food or health care for her family. The woman, whose husband had left for the United States, nearly died, and was eventually jailed.

“The newspaper and everybody else was calling her a ‘human hyena,’” says Mrs. de la Vega. “But she was a victim of a society that could not give her what she really needed. I knew we had to do something to help people in her situation in life.”

With her own money, Mrs. de la Vega started a family-planning clinic to provide poor women with education and information on maternal and child health care and vaccinations.

Over the years, FEMAP has received key support from a variety of grant makers in the United States. FEMAP has also obtained money from corporations that operate plants along the border, such as Johnson & Johnson and the Eaton Corporation. Mrs. de la Vega says she is deeply grateful for all that foundations have done to help her causes. But she says she is frustrated that she has not been able to generate the level of donations required to expand her work the way she thinks is needed.

She believes that some grant makers may turn down her requests because her organization is no longer brand new or in danger of failing. “Maybe you have to be small and weak for them to want to come in and pick you up,” she says. “I would like to ask them, Where in the continuum from failure to success do we have to stop in order to get more help?”

Mrs. de la Vega says that if U.S. foundations want to help build a strong nonprofit community across the border, they must help ensure that the charities already set up in Mexico remain strong. “Laura Bush told me that if you see something that is working well, you have to promote it. We all must do that.”