Medical Tijuana: Healthcare Entrepreneurship in a Border City
I arrived in Tijuana in the summer of 2000 with three other Sustainable Cities doctoral students for a one-month residency. We worked on an innovative city park project administered by El Colegio de la Frontera Norte, our host institution. Ecoparque, an innovative wastewater reclamation facility perched on a hillside, offered a fine view of the redeveloped tourist district, Zona Rio. Yet I was hardly tempted to stroll its wide boulevards punctuated by didactic monuments. Instead, every day I grabbed a taxi to Zona Centro, the historic center of Tijuana. Though the monumental planning of Zona Rio seemed forlorn in its emptiness, Zona Centro percolated with energy. Immediately, I noticed the concentration of healthcare facilities in Zona Centro.
While clinicas are abundant in Los Angeles, they remain relatively decentralized. In Zona Centro, however, providers cluster tightly to remain accessible to clients arriving from throughout the city by taxi. But there also exists US-based demand for affordable health care, and so providers choose to locate near to the crossing to service clients traveling from the United States. Though clinicas are sometimes located near the colonias which surround Tijuana, Zona Centro remains the preferred location for healthcare providers.
From colonias near and far, people converge in Zona Centro via those ubiquitous Country Squire station wagon taxis recycled from Southern California suburban family service. They buy clothes and daily necessities from the work-a-day shops, food stands, and bakeries, and they gather together in the city’s main plaza on Sundays.
In the confines of Zona Centro, however, competition should thin the ranks of providers, yet large and small they jockey for advantage by using various strategies to attract business. Providers, in fact, may not even be physicians; the designation “doctor” is perhaps more culturally than legally defined in this healthcare landscape – a situation far different from that in Los Angeles. Zona Centro is urban; there is centrality and vitality. While back in Los Angeles, only Broadway can claim the sort of spirit and Brownian motion that characterizes Zona Centro.
Documenting this urban pastiche of doctors, dentists, homeopaths, optometrists, hypnotists, and faith healers of every kind (including tarot card readers), and the radiologists, laboratories, and pharmacies which support them, is the first phase in an ongoing study of transnational entrepreneurship in a border city.
Doctoral Student in Urban Planning
The work in this exhibit was made possible by generous support from the Sustainable Cities Doctoral Fellows Program. The exhibit itself was supported by the Office of the Dean of the School of Policy, Planning and Development. Special thanks to Professor Martin Krieger for his encouragement and boundless enthusiasm for the medium of photodocumentation.