“This,” says Fernando, his heavy 24-carat gold crucifix falling out of the front of his cheap Hawaiian shirt, “is where life starts again for America’s old people.” Over a thumping dance beat and the hot smoke of Mexican cigarettes, the elixir of life has been rediscovered in the Bar Olympico.
Welcome to Algodones, a dusty medical mecca for America’s senior citizens. They come across the border to one of the most dangerous countries in the world, where those desperate to escape will risk their lives to beat the barbed wire, shotgun-toting
border patrols, spotlights and a 20ft fence for a new life in the US. But slowly padding the other way, from Arizona, in bleach-white trainers, with blue rinses and gold-framed glasses, is another set of refugees – escapees from the US’s overburdened medical system. They are America’s senior citizens, and they cross the border at the rate of 10,000 a day, tripling the population of Los Algodones in just a few hours.
They come to a town full of dusty streets and bar-hopping prostitutes, where there are more dentists per square foot than in any other place on Earth. And where, in the space of just four blocks, you can get a new smile with the latest dental technology for a few hundred dollars, a new pair of optician-honed glasses for less than the price of a bottle of Tequila, botox injections for 5 a shot and a year-long supply of medication for a third of the price you would pay in the US.
Millions of senior citizens from all over the world have crossed the scarcely manned border, and within a few short feet face the garish purple two-storey building that the locals call Viagraland – a huge pharmaceutical emporium containing every modern drug known to man. Outside, raffish young Mexican men in wraparound Oakley shades hawk drugs, boasting that they can sell them cheaper than in the 22 pharmacies in town.
Their wares include Celebrex, a prescription pain reliever, for 64.99 (compared with about 225 at US pharmacies), the antidepressant Prozac at 17.50 (about 65 in the US), and the heart medicine Atenolol at 3.85 (about 50 in the US). And, of course, Viagra, which is 2 a pill.
Yet all this has brought controversy in the US. And indeed war has broken out between senior citizens and the multi-billion-dollar pharmaceutical companies upon whom they are forced to depend to keep them alive. Medicare, the post-retirement national health programme, is seriously overloaded, and senior citizens have to pay for prescription drugs, dental care and glasses. And the costs are prohibitive – just to treat high cholesterol and high blood pressure can cost 285 a month.
A survey of seniors in eight states by the Kaiser Family Foundation and the Commonwealth Fund found that nearly a quarter of them skipped medicines or did not fill out their prescriptions because of cost. Many have to choose whether to eat or take their medication. That is why millions cross the border each day to Mexico or Canada, where prescription drugs are far cheaper. Medicines are cheaper there because they are not price-fixed by the big US drug companies, which have to market their drugs in Mexico at a price Mexicans can afford – and this is regulated by the government, not the drug companies.
“People are scared,” says David Gross of the American Association of Retired Persons, which has 35 million members. “There are some great drugs on the market that can save lives, but people can’t afford to take them. It’s like showing a hungry person a plate of food and saying they can’t have any. We know, for example, people are prescribed hypertension drugs and they don’t take them because they can’t afford to, which leads to an increased risk of heart attack.”
But the big drug companies and the Food and Drug Administration, a regulatory body controlling the safety of food and drugs, are clamping down fiercely. Leading the charge is drugs giant GlaxoSmithKline, which has threatened to cut off any pharmacy selling cheap drugs to American citizens. And the FDA is lobbying Congress hard to stop people bringing in drugs, which is illegal – although small amounts are still tolerated.
“They may well be buying counterfeit products in substandard facilities, which the FDA has not inspected,” says a spokesperson. “We have heard of pesticides getting into medicines, or different medicines being made in the same place, which is dangerous. We would advise people not to do this.”
None of this seems to matter to those who come to Algodones. They are known as the ‘snowbirds’ – retired US senior citizens who follow the sun, marking off each state visited on the sides of their huge Winnebagos or recreational vehicles in the manner of Second World War fighter pilots – which, indeed, some of them were. In the winter months, they leave the frozen states in the north for the sunbelt states in the south.
Algodones is jammed between October and April, after which it is deserted. Every day, the snowbirds spend 100 each at the bustling pharmacies, doctors and dentists that are contained in four short blocks.
Sitting in the hot Mexican sunshine, swatting at flies, is 72-year-old Kenneth Leech, who is waiting for his wife to have a crown done at the dentist’s surgery opposite. In a brown striped shirt and polyester slacks, he clutches a fistful of dog-eared cards bearing the names of various pharmaceuticals. Twice a year for nine or ten years, he and his wife have made the long trip down from Washington State to Algodones to stock up on drugs, get their teeth fixed and buy glasses.
Leech estimates that he saves 800 over three months of buying Verapan, for his high blood pressure, and Warafina, a blood-thinner for his heart fibrillation. “In the US, they look after you if you’re poor or if you’re really rich. If you are in between, you are in trouble. This place is a life-saver.”
Which is more by accident than design, according to the founding father of Algodones, dentist Dr Magana. In the heart of the purple-painted Viagraland, he has an expansive marbled office with scented air-conditioning and cream leather sofas. A wiry, birdlike man with a big moustache and a Rolex, he sits at a marble desk that resembles a throne. Official-looking pieces of paper in gold-edged frames cover the wall behind him – evidence of his medical qualifications.
“I,” he says, grandly, “was the first dentist in Algodones.” He trained in Mexico City but spotted an opportunity treating wealthy American patients in Algodones. He built his practice less than 100 yards from the border so that Americans afraid of Mexico’s deadly reputation could scurry in and out again in a few seconds.
Back then, Algodones, which means cotton, was a dirty little agricultural border town consisting mainly of brothels and bars for the local cotton workers. They all laughed at Dr Magana’s grand surgery, but in a few years, snowbirds that were over the border in Yuma, Arizona, for the equable climate in the winter months heard about it and started to descend in their droves. He charges 450 for a crown, 500 for dentures, root canal surgery is 250 a molar – all roughly half the price of similar treatments in the US. He now sees 40 patients a day and has a plastic surgeon, too.
Dr Magana became a rich man overnight, and he promptly bought 15 pure-bred Arab horses, a ranch and a sports car. But this ostentation does not go down well in a country where the daily wage is 4 an hour, and he was kidnapped a few years ago. After two weeks he was released, and it is rumoured that he paid his kidnappers 3m to be released. When I ask him about his kidnapping, he cuts our interview short and tells me to come back tomorrow, before adding: “I certify all the other dentists here.”
Following Dr Magana’s lead, there are now 280 doctors and dentists in Algodones, and a further 28 dental labs working round the clock to supply the dentists with dentures, bridges and crowns. In Algodones and its surrounding villages, men can make 100 a day training as lab technicians.
Dale Franson, 62, and his wife, Barbara, 57, have driven down from Washington State in their 32ft Airbus. This is their sixth trip to Algodones. Barbara has had two crowns and four fillings done, all for 450 – saving her, she estimates, 1,500 on US prices. She is delighted with the work. “We come every year now,” she says. “The dental work is superb. I also come for treatment for a heart attack I had ten years ago.”
She has been having chelation therapy, a treatment that suffuses the body with ethylene diamine tetra-acetic acid to remove harmful metals such as lead, mercury and cadmium. In Algodones, there is a medical freedom and treatments are available here that are not so common in the US. Chelation is used against the hardening of the arteries, and sometimes in preparation for heart bypass surgery. But it is controversial, and groups such as the National Council for Health Fraud declare it unethical and useless. Patients, conversely, declare it a life-saver.
Dr Magana’s brother-in-law, Dr Jesus Medina, runs a chelation centre. “They say that I am a quack,” he says without prompting. “But I don’t care. The American doctors say this will blow up your kidneys or will kill you. That’s lies.” He throws his hands up in the air, making a whistling noise with this teeth. Dr Medina has secured an ‘experimental licence’ for 20,000 from the Mexican authorities.
Upstairs from his crisp, white consulting room, cheap armchairs line the walls. Above them, drips hang from hooks and tubes lead into the arms of elderly patients who gaze at magazines while liquid is fed into their bodies.
He takes us around and introduces us, messiah-like, to his patients, who praise the benefits of chelation with the zeal of the newly converted. Andy Anderson, 81, moved to Yuma from California when his arthritis and arterial blockages became so bad that only the desert heat was a balm. He had a 76% blockage to his carotid arteries, and was operated on the left side. But rather than have more surgery, he opted for chelation. So far, he has had 43 treatments at 50 a time. “I didn’t tell my doctor I was coming down here,” he says. “But so far my blockages have been reduced to 20%. It works. American doctors just want to make money out of surgery.”
Many here haven’t told their doctors back home, but they attest to the life-saving qualities of Dr Medina, who puffs his chest out proudly. They clamour to tell me their stories. “I can feel my toes now,” says one. “My heart was blocked and I needed a bypass, now I don’t,” shouts another.
Yet Dr Medina is not the only one using unusual methods. Down a shady path off Avenue A is the cramped surgery of doctor Curt Maxwell, a New Zealand expatriate. A chiropractor, he practises prolotherapy, a controversial treatment for arthritis and joint pain that injects local anaesthetic into the joints. “There is more medical freedom here in Mexico,” he says. “Everything in the western world is controlled by the drug companies, who are making billions selling pills and anti-inflammatories. You see, it’s a big scam – outright quackery.”
Outside is Earl Bach from Washington State, with his wife, Erika. He has had back problems ever since he dive-bombed a Japanese machine gun position during the Second World War. “This is the last hope,” he says, holding hands with his wife. Both now live in Yuma for six months of the year and come to Algodones every week to stock up on drugs.
The couple both used to have dental work done, until Erika got some poor-quality crowns, which then had to be redone in the US. Hers, however, is a rare story, and almost everyone had nothing but positive things to say about Algodones and the treatments available.
Bill Bernard is editor and publisher of the Los Algodones Times, a feisty weekly newspaper for snowbirds in the area. He has been living in Yuma, Arizona, for 12 years. “I have never heard of a bad experience,” he says. “People are dying, and Algodones has never been more important.”
This is a view shared by Sandra Cochran, owner of one of the town’s many pharmacies. “We are saving people’s lives,” she says. She is a member of the Cochran family, which virtually runs the town. Her grandfather, George Cochran, was an Irish immigrant who married a Mexican woman, and his progeny are the most influential in the town. Some are doctors, some pharmacists, and they have a long tradition of being elected as mayor and running the police force.
Jorge Cochran is the current mayor of the town. His office is above the police station, opposite the Bar Olympico and the hotel above, which is the town’s busiest brothel. “My job is to protect the tourists,” he says, squarely. And in sharp contrast to a lot of Mexico, Algodones feels completely safe. “If any bad people come here, we find them and send them away,” he adds with a smile. No one wants to spoil business.
The visitors arrive in their droves at seven or eight in the morning. Then there is the mass exodus before 5pm, with a queue that stretches for hundreds of metres as people wait in the hot sunshine to go through customs. The town continues to sprawl and pump with new economy. In recent months, specialists have moved in: there is now a dermatologist who gives cut-price botox treatment, and a gynaecologist, as well as various hi-tech medical labs.
All this is to the embarrassment of the FDA and the drug companies, which are constantly trying to find ways to halt the flow of ‘pill tourists’. Daniel Hancz is the pharmacist for the Health Authority Law Enforcement Task Force, a multi-agency group dedicated to tackling the sale of illegal pharmaceuticals in California. It was formed after two people died from taking medication that had come from Mexico. He says, however, that probably the greatest risk is that the drugs bought in Algodones are placebos. “We’ve tested drugs that were meant to treat cancer or anaemia, particularly steroids, and they don’t contain the active ingredient. People could be buying this stuff thinking they are saving a few dollars, but what they buy is not doing what it should, which could be very dangerous for them.”
But as the best Mexican dental and medical talent continues to emigrate up to the little border town, the inducements are too large to be ignored. In fact, many are reporting a significant increase in the numbers of Europeans coming for dental work and cheap glasses.
It’s 8pm, and outside the bar the town is deserted – a ghost town. Until tomorrow. Over the street, in Bar Olympico, a smokey hub of activity for the Mexicans, Fernando, one of the many street-stall owners, rubs his hands in glee. “This time next year,” he says, “I will be a millionaire.” And he’s probably right.
