MEXICO CITY — For two decades, a community hospital in Colorado sent a medical aid mission each year to a remote city in northeast Mexico, treating tens of thousands of low-income residents for free.
Dozens of U.S. doctors and dentists, backed up by even more nurses and technicians, would repair cleft palates, take out gall bladders, treat cataracts, fix abscessed teeth and fit people for custom hearing aids.
"We basically would take over the hospital and run it 24/7 for a week," said Rich Lopez, a former deputy mayor of Boulder.
But then the gangsters arrived. Mante, a city in a sugar cane-growing region of Tamaulipas state, fell victim to the violence roiling Mexico. Last year, for the first time since the early 1990s, the U.S. medical team stayed home. They stayed home this February, too.
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As Mexico battles narcotics and crime groups, U.S. medical and religious missions that for generations had come to build houses, tend the sick and conduct goodwill activities have been forced to retreat. The suspension of such missions has cast a terrible, unseen blow on hidden corners of Mexico. It's also been painful for Americans with a desire to help.
"The numbers have really dropped off in terms of people going to Mexico," said David Armstrong, director of operations for Mission Data International, a group in Arkansas that tracks foreign religious missions.
For U.S. citizens in the Southwest, taking part in a goodwill mission to Mexico used to be as easy as hopping on a chartered bus with like-minded people and tooling along highways for a few hours. Suspending the trips has, in some cases, brought anguish.
"You don't know how it hurts," said Tino Hernandez, director of the Austin Diocese Medical Mission in Texas, an outreach of the Roman Catholic Church. "It's going to have a huge impact, and the people who are suffering are the poor."
Hernandez used to organize teams of doctors, dentists, pharmacists and nurses to travel to areas of need in Jalisco and Coahuila, among other states.
"We were doing as many as three or four (missions) a year. We're right next door to Mexico, so we can drive," Hernandez said.
Now that the bishop has suspended missions to Mexico, Hernandez said, "the topic came up of possibly looking into the Philippines."
Few medical missions grew to the size or importance of the yearly Mante Medical Mission sponsored by the Boulder Community Hospital, that city's Rotary Club and its First Presbyterian Church.
"I can spin story after story of the miracles that these surgeries would accomplish," said Jean M. Bedell, a nurse who went on 20 annual missions to Mante.
Girls in Mante used to ridicule one teenager for her huge abdomen, Bedell said, until a Boulder gynecologist found that she had a non-malignant tumor and removed it.
As the years went by, the mission grew to more than 100 medical personnel, attending swelling numbers of patients. In recent years, the group filled a 40-foot trailer with operating room tables, anesthesia machines and disposable medical supplies to take with them and then leave in Mante. Organizers also arranged the donation of a used fire engine and ambulance.
"You can imagine what an enormous benefit that brought to our community. We estimate that more than 80,000 patients were treated over the course of those 20 years," said Dr. David Rodriguez Alvarado, a Mante physician whose father and aunt made the initial appeal at a Boulder church that set in motion the first mission in 1990.
Listening to that appeal in the congregation that day was David Gehant, chief executive of the 200-bed Boulder Community Hospital. He offered to speak with his doctors, leading to the medical missions.
Boulder medical personnel paid their own expenses to take part in the annual missions, working doggedly and returning a week later — exhausted.
"They would do more surgeries in a day than we ever do here in the United States," Lopez said, yet the hard work drew ample personal payoff.
"The doctors say, 'I get more thank you's in one week in Mexico than I do in a year here in Colorado,'" Lopez said. "So in terms of reward, we do a lot for them, but they do just as much for us."
Those who still lead volunteer missions to Mexico say they regularly draw sharp words of concern from relatives.
"Parents called us all kinds of names," said Howard Culbertson, a professor of world evangelism at Southern Nazarene University in Oklahoma who took 120 people recently to Coahuila state to help local churches in construction projects.
"Our numbers were about half of what they were before, and a lot of it is due to this hysteria," he added, referring to what he deemed alarmist media reports.
At least 50,000 people have died since late 2006, when center-right President Felipe Calderon came to office and launched an assault on drug traffickers.
The State Department this month expanded its warning to U.S. citizens to avoid traveling to all or parts of 14 of Mexico's 31 states. It advised against nonessential travel to the border states of Chihuahua, Coahuila and Tamaulipas, and the central state of Durango, and urged caution on trips to Baja California, Nuevo Leon and Sonora, also border states.
Organizers of missions have grown skittish as such warnings grow more dire.
"Every now and then, I'll talk to someone who says, 'I talked to the U.S. Embassy and they said that if you go, you better bring a body bag along,'" said Armstrong of Mission Data International. "In the media, it's just a blanket 'danger, danger, danger' everywhere."
But those who keep close tabs on the situation in Mante, for example, say the perils are real, even if the city seems "normal during daylight hours," as noted in a report from the Boulder-Mante Sister Cities Committee.
"A 5:00 p.m. curfew has pretty much shut down evening and nighttime activities. Weekly meetings, such as the Rotary Clubs in Mante, have been suspended. The military is fairly prominently in place and seeks to keep order as best they can," the report says.
Tamaulipas, which shares a 143-mile border with Texas, is one of Mexico's most homicidal states. It tallied 1,108 murders last year, 8.5 percent of Mexico's total homicides for 2011.
Lopez, of Boulder, said the Colorado medical team is hoping to return.
"We've told them that we'll be coming back down as soon as it's safe," he said.
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