Where Surgery is Difficult: Overcoming Barriers to Access in Chiapas, Mexico

In rural Chiapas, Mexico, poor patients often struggle to access surgical care and other medical treatment, even though access is guaranteed by law under the Mexican constitution. This case examines an innovative approach developed by Compañeros en Salud to accompany patients from rural communities through the health care system. By walking with patients through each step of a complex system, the organization in turn gains insights to barriers that can be addressed in a more systemic fashion. The case also raises questions about scale and how lessons drawn from specific cases of accompaniment might be used to address systems problems. To receive the **Teaching Notes** for this case, please contact keoughschool@nd.edu.