Sick and Alone in Mexico

I doubt many of us are really prepared for the serious medical emergency while we are traveling. No matter how well prepared or how seasoned a traveler, when the doctors say “surgery,” you quake inside.

One Saturday evening in my second week on Oaxaca, I became doubled up with intestinal cramps and pain that lasted all night. It let up a bit and so I waited till Monday to go to the doctor. He listened to my symptoms and said “amoeba.” I took the prescribed meds and nothing changed. The pain was acute.

I found another doctor who again treated me for amoeba, and still there was no change. Now it was getting worrisome, and I was getting scared. After a series of tested, including a colonoscopy which could not be finished because of severe and infected blockage, my doctor started mention “surgery.”

This is when the alone part of traveling alone became an issue. First, of course, alone is not the way to be for a medical emergency, especially one that takes you into the finer workings of a foreign medical system. You need someone to talk to and to go to the doctor’s with you, because in the circumstances, your judgement may not really be the best. Hand holding is called for, and someone to talk you off the ledge of extreme fear. Someone soothing who will both let you cry and talk you out of weeping.

Second, in many countries, including Mexico, you are expected to have someone at the hospital with you, and someone to care for you post-operation. Of course everyone back home is working, or if they aren’t, like say a young adult grandson, they don’t have a passport. I checked in with everyone. I got lots of sympathy and concern and apologies for not being available, but it isn’t the same and doesn’t help you with the practicalities of recovery.

So here I was alone and afraid. Between the pain fear, I was crying a lot. A neighbor helped me some with diagnostic appointments, which was helpful, but I didn’t really know her. I sure could not ask her to help me through the whole process.

But it ended up not being necessary to have help this time. My condition started improving, which seems to have had something to do with the total cleansing necessary for the aborted colonoscopy. Between the colonoscopy and a cat scan a few days later, I had started healing. It was then that the doctor told me he had been convinced it was cancer, but it wasn’t, and I was healing well.

This, of course, has been a learning experience. I guess the most important consideration is whether or not you are comfortable having surgery in a developing country. If my cat scan had shown the same condition that the colonoscopy did, then for sure they would have wanted to operate pretty immediately. To go to the US for the surgery, where I have no established relationship with a doctor or medical system, would have postponed things for too long. But everyone was encouraging me to do just that. My doctor assured me that the surgeon here was excellent, and I have been assured by many that the hospital is very good.

Insurance is another issue. For me, at least. I travel “bareback,” meaning I have no medical insurance except for Medicare in the US. Self insuring is good for doctor’s visits and such, but surgery is a different story. My doctor told me the whole thing would be under $2000 US. I have set aside savings with exactly this eventuality in mind. Fortunately all of the testing and the doctor’s visits came to under $300.

I was extremely lucky. First and foremost because I found a doctor who had trained in the US, and who had grown up there. He has practiced in Oaxaca for over 20 years, so he is totally integrated, and integral to, the local medical establishment. His English is spoken with no accent and he understands the needs of American patients. In case you find yourself needing a doctor in Oaxaca, his name is Alberto Zamacona, and most call him Doctor Z.

I was lucky beyond what I every could have expected by having recovered without having surgery. For that I am grateful both to the ministrations of my doctor, and to my excellent immune system. I have been stunned by my recovery.

So, that was my month in Oaxaca. Now I have a couple of weeks left to enjoy the beautiful city and get acquainted with more than the medical system.

Leaning Towards Mexico

There is really no deciding where it is best to spend the rest of one´s life. It is all done with some bittersweet hope and trepidation. I´ve been too many places and have seen and experienced too much disappointment after having earnest confidence. I´ve read the stories of others whose hearts were broken by a place they fell in love with. Perhaps that is part of the reason I have been looking for so long, and have been mostly crest fallen at what I´ve seen.

But Mexico. In the last 14 years I have been in Mexico more time than in the US. I have worked there, a bit, and slept there a lot. I´ve invested in land there, only to be ripped off by my partner/good friend; a real soul crushing experience. I have few romantic delusions about Mexico. I am currently reading Under the Volcano, which should banish what remains of my fantasies. I think if I stay in Mexico, it will be a measured decision.

I landed back in Mexico City a couple of weeks ago, from Lima, Peru, and it didn´t take long to remember why it has always been my first and last choice. Why hadn´t I just decided that long ago? First, I am very concerned that I won´t qualify for residency with my very limited resources, besides, I still had exploring to do. The issue of financial requirements scares me. If I can´t get residency here, then I am back to the start in terms of finding a place. For a variety of reasons that I will try to  cover in another post, I was not satisfied with the options in South America.

I am set on Mexico for now. I have contacted an attorney, and I hope they can help me sort out the residency visa. Now is a good time to do this, as the dollar is at an all time high vs. the Peso, so at least it seems like I have more money than I do.

What is it about Mexico? That is the ephemeral aspect to choosing a place. I can give lots of practical reasons; I am learning the language, it is close to the US, I love the food and the culture, yada yada. But it comes down to walking the streets of Mexico City and feeling a part of it, and yet totally foreign. It gives me the psychic space I personally need while allowing and inviting me to be part of it.

If I stay, I will try to spend a lot of time in Mexico City. I imagine I will need to settle some place less costly, but I love the city. Here are some photos from the recent visit:

First, there is the architecture, the very bones of the City. The Cathedral is actually built upon the Aztec bones of old Tenochtitlan, upon and with the stones of the old empire. The architecture spans centuries and tells the history of the city. I think now the powers that be understand the importance of this and will protect it.

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Cathedral built atop Aztec Temple

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Bellas Artes

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Random building across from my hotel room

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Down a side street from the zocolo

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The Cathredal

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Abandoned building on the Alameda

And the food! My favorite two countries for street food are Thailand and Mexico. I really cannot decide between the two, but ranking Mexico with Thailand in terms of food says a lot. The food is cheap and plentiful, and of course, muy rico.

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And cool, stylish, joyful street life. Mexicans live hard and party harder.

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So, hopefully, it will be Mexico.

 

 

False Confidence

My Spanish language skills suck. I mean, really, really suck. I’ve traveled a lot in Mexico and my poor, but I thought improving, Spanish got me by. I really hadn’t factored in the strength of Spanglish on both sides of the Mexico/US border. I am recognizing how much Spanglish holds its own amongst the MexAmericanos. We fill in the gaps for each other and transactions are fairly simple. Mexican Spanish is slow and well enunciated, which helps also.

Today I went out to buy a sim card for my cell phone. The original purchase of the phone and of a sim card and minutes in Durango, Mexico, was no real problem. Here there was a deep wall of incomprehension on both sides. It took about 30 minutes and a lot of kindness on the part of the young women selling the cards for me to succeed. But what I learned is that I need some real Spanish classes pronto. Imediatamente. Fast.

My second day in Medellin has been stressful. I woke to construction at 7 AM, after lingering over a book till 1 AM. I’m still exhausted from the trip. My good friend in Miami told me on Tuesday to not lose patience or heart with the challenges of living in South America. I sort of laughed it off and said I had lived for 14 years in Asia, yada yada. No, this is different. My false bravado has come up against a real challenge.  It’s these times, with exhaustion, a new environment and a simple rudimentary grasp of the language that one has to dig deep and find courage. Or at least not wimp out.

If it weren’t for the internet and that connection with friends, and for my blog contacts, well, I suppose I would carry on, but it would be more difficult. I don’t want to find myself in an expat barrio, so now I have to soldier on.

Thanks for listening!

Best Places to Retire Chart

I slagged on International Living recently because of its hype and its eager promotion of dubious products, but it often does have some useful information if you can get past the promos. Here is a chart that outlines the best places to retire based on a number of variables.

Global-Retirement-Index

From International Living website

Read across the top to find the ones that concern you, don’t just look at the aggregate best score. I find that some of the variables aren’t a concern to me, or aren’t equally ranked with the others, and some other variables aren’t included. I notice that language isn’t included, and that is very important to me, for example.

If it weren’t for health care, climate and language (not in their variables) I would strongly favor Cambodia.

Mexico measures high on most everything, but the financial requirements are relatively high (I’ve covered this elsewhere, but as an example, you can retire in most of the other countries on a pension of $1200 US or less, and it is over $1500 and some measurable assets for Mexico).

Ecuador looks good for most everything, and my only serious hesitations are political stability and the fact that the currency is the US dollar. Ecuador continues to be a strong contender.

Air fares and travel costs are also not on the graph.The countries in Asia may be better choices for Australians due to their close proximity. On the other hand, North Americans will find Latin America close and convenient, and cheap for return travel. For example, you can fly from Medellin to Miami return for less that $350 US. A return flight from most any place in Asia is $1200 on a good day. On a pension that is a huge difference.

The above chart is a great starting point for checking out the options. Please send me any question you have on the topic and I’ll be glad to research it for you.

 

Deportees

I’ve written about visa laws. Sometimes we forget that by retiring abroad we are immigrants. We have to meet the laws the same way migrants to our own countries do. Check the laws and be sure to stay legal. As the article shows, getting deported at 70 is possible. Personally, this sounds quite disruptive and painful. Not only can U.S. citizens get deported from Mexico, they do. Repatriated, deported and extradited Americans account for more than 2,000 cases a year, or five a day on average. Sometimes more.‘I got deported from Mexico!’ Country expels hundreds of U.S. citizens every year | Fox News Latino

Source: ‘I got deported from Mexico!’ Country expels hundreds of U.S. citizens every year | Fox News Latino

The (White) Elephant in the Room

I’ve spent the last couple of years researching retiring abroad. There are lots of websites and blogs devoted to the topic, but I haven’t seen any yet (they may exist) that deal with the fact that most of us expats from the west retiring in (non-white) developing countries are white. And, obviously, of a certain age. This simple fact deserves a lot of attention and discussion, and definitely, at a minimum, awareness on the part of those of us who are migrating to these countries.

What is it like living as an ethnic minority in Asia? This is where I’ve spent most of the last 13 years. It should be humbling., after all, we stand out, get stared at, and sometimes jeered. But, in most cases, our cultural dominance precedes us via the presence of westerners, especially military, and the media. Developing countries mostly want to develop to be like the west on one hand, and resent it for lots of historically appropriate reasons. Westerners enter a complicated situation when they expatriate.

There’s nothing neutral about arriving where you are a minority. That should be the humbling part. Imagine being an immigrant or refugee arriving in Europe or America, with all of the attendant issues: language, attitudes, culture, etc.. Yet when we arrive as travelers, we’re welcomed.

For the week or two holiday, it can be fairly easy to feel that you’re entirely welcomed. After all, you’re “contributing to the economy” and “respecting the culture”. The airports, hotels, restaurants and cultural events all welcome you and your dollars/Euros. Occasionally a tourist has a bad experience, but in the main the experience is pretty much structured and guaranteed to be welcoming and positive.

When you are going to stay a while. and you pay attention, the complexities should become more apparent. It’s naive to think that everyone likes and welcomes us, and that our presence is an unmitigated positive for the locals. If you are going to live in a new community, there are huge adjustments to make. We think about this in our own country, but with moving to a new country, somehow it seems a different matter.

Historic Impact of Westerners

Westerners have been arriving in non-European countries for hundreds of years. Since the 15th century, most of this has been as colonizing empires. One of the first steps of moving to a developing country should be to gain an understanding of the history, politics, economics and culture. To move to Vietnam, for instances, without knowing your own nation’s history with Vietnam, leaves you unprepared for understanding the country.

We sometimes blithely think that the past is the past and, well, we’re good people and we should be accepted as such. A man who lost his father, his family and his village to the American War in Vietnam is still burdened with his painful past. Now he sees development that isn’t benefiting his country or his community proportionally. War has been replaced by sweatshops, traffic and McDonalds. The thread that binds these is forms of colonialism. The country of Vietnam suffers from generations of birth defects from Agent Orange. The past is not gone, it’s the lived reality.

Yet, in truth, we are mostly welcomed and treated well. That takes character and forgiveness. It also takes the perspective of thousands of years of history and overcoming adversaries and the past. In a way, we aren’t so important, the Chinese loom larger. But we can experience occasional resentments and slights.

It’s good to remember, or learn, that the history we have learned in our schools is partial and culturally biased. This is true everywhere. We may think we are entering places that have received “liberation” or at least the largesse of aid, from our countries. The perceived reality of the locals will be different.

Western Impacts Today

Today when we arrive en mass in a country, such as Thailand or Ecuador, we have our own negative and positive impacts. We contribute to the economy, but in uneven ways; some benefit, a lot, often most, don’t.

Western intervention in economies and governments is ongoing. Whether it is positive or not is up for debate, that the neoliberal global economy has entered the smallest villages and enclaves of the world is not. When we arrive as expats or retirees these days, we are part of a global flux of peoples, no different in some ways than the Latin Americans entering the US, or the Syrians entering Europe. We are leaving a place that doesn’t meet our needs for a place that we believe does.

When we arrive, we cause inflation and housing shortages. When foreign enclaves form in developing countries we create rich ghettos that distort prices and cultures. Locals who live in these areas are soon displaced as McDonalds and Starbucks replace local family restaurants, and supermarkets aimed at western tastes displace small tiendas and markets. Tastes themselves are changed as westernization is to a lot of people considered a good thing, and McDonalds represents that.

Some of this is caused by what we consider largesse.  A good example is local transportation. The cost of a rickshaw in Chittagong around a foreign university is much higher than in more traditional neighborhoods. I couldn’t in good conscience pay the tiny amount a Bangladeshi pays. My rationalization is that if I am making so much more than the locals, I should try to spend it locally. Knowing that I was contributing to a problem, I was also trying to solve a problem. My high wages I paid to my rickshaw driver allowed him to move himself and his family back to the countryside, which is a big improvement for them. But this has unintended consequences that I recognize.

Western culture and values are easily acquired, especially among the young who have been so influenced by the media. In traditional societies this means changes that aren’t always welcome.

Conclusion

This is a dense and contested issue. I look forward to the thoughts of others on it. My conclusion is that we as expats need to be humble, respectful and aware when we move abroad. Often I read people maligning the locals, or condescending to them. Almost all cultures outside of the west are more ancient and developed than our own. They have their own dignity and collective meaning. There is a lot which can be learned by us.

When we do arrive eager to learn the language and local ways and sometimes feel rebuffed, try to remember that we are not just well-intentioned individuals, we are part of a historic movement of peoples that has not always been good for these countries.

We are the elephants in the room, and it is time we talked about it.

 

 

 

Latin America

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http://www.gilgordon.com/resources/samerica.htm

It’s huge, and covers a continent and then some. I’ll be traveling around Latin America next year and checking out potential retirement spots. Fortunately in the 21st century a lot of the leg work can be done online. This I’ve been doing for the last couple of years.

I have criteria I’ve been rather loosely applying as I’ve been researching. Concern for affordable health insurance and health care has risen on my list, but the basics remain the same, and the bottom line is being able to live on my Social Security of $1300 a month (plus whatever extra income I can generate).

Here is my current short list:

Mexico

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 http://www.trllavk.tk/map-of-mexico/

Mexico meets a lot of my criteria. Unfortunately, there are rather high financial requirements for a permanent visa, and legal status is required for the national health plan. There are other plusses and minuses, and I’ll be spending time there and filing a full report.

Guatemala

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http://www.infoplease.com/atlas/centralamerica.html

Guatemala has risen on my personal list because the visa financial requirements are quite doable, there is good quality affordable health care, and it’s close to Mexico and the US.. Antigua and Lake Atitlan seem to be two favorite spots due to their climate and beauty. Guatemala City may be getting better, but it has a reputation for danger.I plan to spend some time in Guatemala.

Nicaragua

This is another country with low entrance and residency barriers. The health care is reportedly good and affordable. The cost of living is cheap, and they are some beautiful locations. It hasn’t risen to a must visit yet, but I am paying attention.

Panama

Panama offers the best package for retirees. The communities that meet my criteria in terms of climate and size tend to be more expensive than Nicaragua, Guatemala and Mexico. The medical care is reputed to be excellent. Panama City is a cosmopolitan city, with a challenging climate. Like Nicaragua, I am still researching Panama, and it does have a lot to offer.

Columbia

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http://www.infoplease.com/atlas/country/colombia.html

I met someone recently who convinced me that Columbia would be an excellent choice. The visa requirements are quite reasonable. There is very good health care and a national health plan. The cost of living is low, there are great beaches and old colonial towns and cities. Medellin gets good reviews, though it is a big city and I am not convinced that it is as safe as it is lauded these days. I do plan to visit and check it out.

Ecuador

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http://www.infoplease.com/atlas/country/ecuador.html

There are many publications these days that rate potential expat retirement locations. The income requirements for a visa are quite reasonable. Cuenca Ecuador often tops these lists. In the mountains, it has a springlike climate. There are a lot of expats living in this colonial city. Health care is both excellent and affordable, with a national health plan available to legal residents for about $80 a month. Personally, I am not so keen on the “lots of expats” part of it, and will probably be more interested in places where there is a smaller presence of us. I’ll be checking out Ecuador and will be reporting back.

Next time I’ll go through the map and talk about what places I’ve ruled out and why. Maybe something will move up to my short list, and something else may fall off. I can’t wait to get started!