A roiling white cloud of ash, gas, water vapor and superheated rock spewed from the cone of Popocatepetl high above the village of Xalitzintla, whose residents said they were awakened by a window-rattling series of eruptions. Mexico’s National Disaster Prevention Center said that a string of eruptions had ended in the early morning, then started up again at 5:05 a.m., with at least 12 in two hours.

“Up on the mountain, it feels incredible,” said Aaron Sanchez Ocelotl, 45, who was in his turf grass fields when the eruptions happened. “It sounds like the roaring of the sea.”

The white cone of Popo, as most call the mountain, is an iconic backdrop to Mexico City’s skyline on clear days, but its 40 miles distance means even a moderately large eruption is unlikely to do more than dump ash on one of the world’s largest metropolitan areas. It’s a different matter for the villages on the flanks of the volcano, where the quiet of the corn fields and fruit orchards was pervaded by the volcano’s spooky roaring.

“Everyone needs to take this seriously. This buzzing, this roaring isn’t normal,” said Gregorio Fuentes Casquera, the assistant mayor of Xalitzintla, a village of 2,600 people about seven miles from the summit. He said the town had prepared 50 buses and was sending out its six-member police forces to alert people to be ready to evacuate.

He said he believed about half the populace would be willing to evacuate, while the rest would want to stay.

Dozens of women lined up in Xalitzintla’s main square to get free face masks and bottles of water. Health authorities were giving out 10 masks and 10 bottles of water to each family, and the surgical-style masks, intended to filter out the fine ash released by the volcano, were becoming common among the town’s students, who are required to wear them in school. Few adults wore them.

“Right now we’re not scared. When it’s scary is at night, when it’s putting out lava,” said Nancy Agustin Inclan, 14, as she removed her mask and took a break outside the gate of the town’s middle school.

President Felipe Calderon said live on national television that authorities are keeping open roads around the mountain, preparing emergency shelters and making sure residents know the latest information about a potential eruption.

Stéphanie Villedrouin, will meet with the Director of Fonatur, Alejandro Enrique Carrillo. The Fonatur (Fondo Nacional de Fomento del Turismo) is a public body, directly under the Ministry of Tourism which is responsible for development of tourism in Mexico.

The experience of Fonatur in the establishment of an eco-friendly tourism and the integration of the community around tourism sites, makes of this organism a preferred partner for the Ministry of Tourism of Haiti in the elaboration of its Development Plan of tourism poles.

A group of Haitian businessmen and businesswomen of the private tourism sector (ATH-Tourism Association of Haiti) will accompany the Minister to make the analysis of the Mexican experience and develop a similar plan of tourism development for Haiti.

The fact that the parents were President Obama and the first lady, Michelle Obama, and that the teenager was their daughter Malia, thrilled Mexican tourism officials, who are trying to redefine the country’s image as it has struggled with drug violence.

“It’s a compliment that the daughter of President Obama and her friends have decided to live the experience of Oaxaca,” said José Zorrilla, the state secretary for tourism and economic development, slipping into promotion mode.

Each updated travel advisory from the United States State Department is painted as an affront here. Especially galling to Mexicans was the spring break warning issued by the Texas Department of Public Safety suggesting that Texans avoid Mexico altogether.

Plenty of Americans are ignoring the government warnings. Last year, Mexico reported a record year for foreign visitors, 22.67 million, and most of them were American.

Malia, 13, attends Sidwell Friends School in Washington, which has been organizing trips to Oaxaca for years, said Ellis Turner, the associate head of school, who pointed out that there was no State Department travel warning for Oaxaca.

Although the White House asked English-language media to remove articles about the visit from their Web sites this week, the visit was never a secret in Mexico. “The reality is that Oaxaca isn’t that big and it isn’t that easy to hide 10 girls and that security,” said Mr. Zorrilla, the tourism official.

On Monday, the group sat down for lunch at Terranova, a family restaurant behind the porticos lining Oaxaca’s central plaza. The headwaiter, José Victoria, said they ordered bottles of water, vanilla milkshakes, pizza and spaghetti. Malia opted for cheese quesadillas, which he said she ordered in Spanish.

Along with their work at the orphanage, which Mr. Turner did not identify, the teenagers trooped through all the tourist spots in Oaxaca, a handsome colonial city set in a blue-green valley steeped in pre-Columbian culture. They toured Zapotec archaeological sites and visited nearby villages famous for producing black pottery and fantastical wood carvings called alebrijes.

But what the group is most likely to take back may not be a souvenir but the memory of a strong earthquake that prompted the White House to lift its news blackout, acknowledge Malia’s trip and assure everybody that she was safe.

The spot has seen a dip in business since State Farm left town last summer, but locals keep it bustling. Those who love this place say it’s got the best burrito, fresh salsa, and great margaritas! Tonayan pulled in 34 percent of the vote in this week’s poll.

Looking back at his 40 years in the restaurant industry, Tonayan’s Isidro Velasco says there’s one reason he is where he is today: hard work. He stood perched against the kitchen door on a recent day, and surveyed his restaurant. Patrons sipped margaritas at the bar. A couple at a table near the window in the back of the restaurant crunched tortilla chips with housemade salsa.

The lunch rush just finished; it’s the quiet hour right before dinner begins.

“Today was a good day, business has been picking up,” Velasco says.

Velasco, 59, moved to Los Angeles from Jalisco, Mexico in 1972, when he was 18. A year later he would travel to San Francisco, in search of a new way of life.

“I decided when I was five years old that I wanted to move to America, to start a family,” he says.

Velasco started small. He became a dishwasher; then a bus boy, a server, bartender and manager. He was promoted to cook at Sizzler, and ran front of the house operations at Celia’s Mexican Restaurant in San Rafael. Then he ventured out — and started a new spot in Petaluma called Velasco’s with his sister-in-law. He’s modest when asked about how he went from a boy with a dream to a small business owner.

“I just knew what I wanted, and got it,” he says.

Velasco’s work ethic is one that follows him to this day. He’s up early, and closes the restaurant every night with his wife of 22 years, Laura. Rarely is there a week when the two aren’t there all seven days.

The two came Rohnert Park in 2006. Velasco said they saw it as an opportunity to branch out. Since, the couple has been working to keep the restaurant up despite the soured economy. They recently opened up a full bar and started hosting karaoke Friday and Saturday nights to stay fresh.

He’s in the back most of the time; she’s out front. No doubt, anyone who’s eaten at Tonayan has witnessed Laura’s stellar service.  She often wears a smile, and hardly stops moving.

Today, the same factors driving growth in medical travel to other destinations – rising medical and health insurance costs – favor Mexico’s medical tourism outlook, while expanding the opportunities for U.S. travel agents.

But for Mexico there are challenges. Once poised for a boom, Mexico’s medical travel sector has slowed in those regions hard-hit by drug violence. Other regions have fared better, especially those with high-profile tourist destinations.

In the first of a two-part series, Travel Market Report provides an overview of Mexico’s medical tourism offering and the consumer market. Part two will examine the impact of security concerns on medical travel to Mexico.

Large U.S. market
With their large Spanish-speaking populations, U.S. border states have traditionally supplied the largest contingent of medical tourists to Mexico.

A 2009 study by UCLA’s Center for Health Policy Research found that each year almost 1 million people from California alone venture south of the border for medical, dental or prescription drug services in Mexico.

The study, which appeared in the journal Medical Care, cited the rising cost of care in the U.S. and lack of insurance as the two main reasons for travel into Mexico.

Fraction of the cost
The cost savings for U.S. medical travelers are huge, since prices of popular procedures in Mexico are often a fraction of what they are in the U.S.

For instance, a knee replacement that would cost $50,000 in the U.S. costs just $12,000 in Mexico, according to the nonprofit Medical Tourism Association. Other examples: dental implants are $1,800 in Mexico, compared to $2,800 in the U.S., and a facelift costs $4,900, compared to $15,000, according to the association.

Canadians go too
Canadians travel to Mexico as well, but not necessarily for the cost savings.

“Canadians go to Mexico because procedures they have to wait years for in Canada can be performed with no waiting period in Mexico,” said Patrick Osio, vice president and co-founder of the Baja California Medical Tourism Association.

Mexico’s expanded offering
In recent years, Mexico’s options for medical tourists have expanded beyond border clinics to cities such as Monterrey, Mexico City and Guadalajara.

A number of Mexican hospitals now boast prestigious international accreditations or affiliations with top American institutions such as the Mayo Clinic.

“Cities such as Monterrey made strategic efforts to position themselves as medical tourism destinations. And, they have some excellent hospitals,” said David Vequist, Ph.D., founder and director of the Center for Medical Tourism Research in San Antonio, Texas.

Medical facilities have U.S. ties
Some Mexican hospital chains are managed by American corporations. Others are owned by U.S.-based companies.

One example is Angeles Health International, a U.S. subsidiary of Mexico’s largest private hospital network, was formed specifically to attract American tourists to certain facilities.

Six Angeles Health facilities cater to American patients, offering dental and vision correction procedures, as well as bariatric, orthopedic, cardiac and cosmetic surgeries.

Medical tourism in resort areas
One area of growth for Mexico’s medical tourism is its resort destinations. “Places like Cancun or Cabo have developed the so-called vanity procedures – as opposed to cities such as Monterrey where you go for heart surgery,” Osio said.

Hotel chains in resort destinations also have paired with local hospitals to promote medical tourism programs.

Among them is Casa Velas Hotel Boutique in Puerto Vallarta, which markets medical tourism packages and bills itself as a “medical and health retreat,” complete with medical attention and organic meals.

Casa Velas partners with nearby Amerimed Hospital, where guests can arrange for “advanced elective procedures,” such as facelifts, tummy tucks, nose jobs, liposuction, breast reduction, gastric bypasses and cosmetic dentistry.

It takes a lot to prepare for the coming of the pope and the 3 million people the host Archdiocese of Leon says he is expected to draw. Facades must be spiffed; campgrounds must be sprayed for dengue-bearing mosquitoes.

The visit of Pope Benedict XVI, his first to Spanish-speaking Latin America, begins in just a week in Mexico’s central state of Guanajuato, where he will spend three days and give an outdoor Mass for some 300,000 people before heading to Cuba on March 26.

In the Bicentennial Park in nearby Silao, hammers and heavy equipment pound out the contours of a massive stage large enough for a Madonna concert. The religious order of the Capuchin Poor Clares in San Isidro is making 150,000 Frisbee-sized hosts for the Mass, though it won’t require vats of wine. While the masses eat bread, only the officiates will sip a mere 2.5 gallons (10 liters) of consecrated wine on stage.

Maria de la Luz Yepez of nearby San Francisco del Rincon is overseeing the stitching and stretching of faux suede and velvet on three artisanal sombreros that will be given to Benedict. Each took three weeks to decorate by hand. One has an embroidered face of Benedict inside the cap and features a map of Mexico on the brim. Another shows the Virgin of Guadalupe, Mexico’s patron saint.

She said the whole community, a suburb home to tennis shoe factories and makers of the black, spangled sombreros sold in airports and tourist stalls, wants to chip in.

“Even to make the boxes to pack the sombreros,” said Yepez, whose 55-year-old family business, Sombreros Salazar Yepez, made the signature Mexican hats for popes Paul VI and John Paul II as well. “They want the sombrero to carry a little bit of everyone here in San Francisco.”

The Popemobile landed weeks ago, courtesy of an Alitalia flight, so it will be ready for the pontiff. The church’s preparations include giving the 85-year-old pope a slow morning after arrival “to get over jet lag,” said the Rev. Federico Lomardi, Vatican spokesman.

When he ventures out, he’ll find cities that have put on a shine.

The 60-foot (20-meter) Christ the King monument overlooking the city of Guanajuato was smothered in scaffolding as part of a two-month restoration. The church is taking advantage of the fact that the federal government is helping out with the bill, polishing the bronze and replacing some of the statue’s weathered plates.

Benedict is rumored to be doing a helicopter flyover of the statue at 7,800 feet (2,600 meters) above sea level before the Mass and turn on special lighting of the monument from Leon that Sunday night.

The city of Guanajuato is repairing and repainting some 200 buildings the pope will pass on his way to meet President Felipe Calderon in the historic city center, where he will give a blessing in the colonial Plaza de la Paz. A team of 20 workers, funded by private donations and city money, is scrubbing graffiti as well.

Mexico’s presidential guard service is amassing thousands of officers, though Calderon’s office won’t give a total for security reasons. More than 3,000 will patrol Leon, according to city officials.

The agency did announce it will cut off cell phone service for about 10 minutes in the area around the pope’s convoy as it passes, said Leon city press spokesman Jesus Montano.

“They always do this for heads of state,” Montano said.

Mexican government officials insist major tourist destinations are safe and that travel warnings from the federal government and the Texas Department of Public Safety are unnecessarily alarming.

Nonetheless, from the beaches and nightlife, to the stories of shootouts, carjackings and kidnappings; for many students going to Mexico for Spring Break is no longer such an easy decision.

“Yeah, I wouldn’t want to put myself in that position,” said one University of Houston student.

“We’ve thought about it, and we’re just prepared to cover our tracks and lay low, I guess,” student Turner Harris said.

The U.S. Department of State issued travel warnings for 18 different places in Mexico. These warnings involve the violence associated with warring drug cartels in border towns, interior states and desolate stretches of roads between major cities. These numbers are up from last year’s travel warnings. Both the State Department and Texas Department of Public Safety even punctuated this year’s travel warnings with statistics showing the numbers of Americans murdered in Mexico jumped from 35 in 2007 to 120 in 2011.

Students Local 2 spoke with at the University of Houston are taking these warnings to heart. Dresdynn Warnell is heading to South Padre Island for Spring Break, but said her plans no longer include hopping the border to party in Matamoros.

“(I’m) still in Texas, so my mom, my parents, won’t worry so much,” said Warnell.

“I did think about it, but the violence is really not where I’m going to be,” said Harris, whose planning a canoe trip down the Rio Grande River.

None of the travel warnings include the major tourist spots like Cancun or Cabo San Lucas. The state department did warn tourists to “exercise caution and stay within tourist areas” in Acapulco, Zihuatanejo and Ixtapa.

“The security levels in Acapulco have plummeted,” said Mason Wilder, an intelligence analyst for ASI Global, a Houston-based company specializing in security, as well as kidnap and ransom services for international travelers. “It’s really turned from a vacation friendly destination to almost a drug cartel war zone.”

The city of Puerto Vallarta is also not listed by the U.S. government as a danger zone, even though last month 22 cruise line passengers were robbed at gunpoint while on their way to a nature hike.

The state department’s advisories do warn travelers to stay in the heavily populated tourists zones of these cities, urging tourists to not go off the beaten path, especially at night.

Also, U.S. government officials warn travelers to not project even the slightest appearance of wealth. Wilder said an under-reported crime in Mexico is a so-called “express kidnapping.” Wilder said this generally happens when tourist are conned into taking a ride in an unmarked cab.

“(They’ll) steal all their valuables and take them to several ATMs to make them withdraw their daily limit,” said Wilder.

“We are overjoyed that Mexico has broken our longstanding record with regard to international visitation,” said Rodolfo Lopez-Negrete, Chief Operating Officer of the Mexico Tourism Board, “these figures clearly demonstrate that the bold diversification strategy we have implemented, promoting a broad tourism offering and targeting an expanded breed of global consumer, is succeeding.”

Following efforts to attract a more diverse cohort of tourists from a range of international markets, Mexico saw in a significant increase in visitor numbers compared to 2010 from Brazil (66 percent), Russia (55 percent), China (30 percent), Colombia (23.2 percent), Italy (13 percent), Australia (13 percent) United Kingdom (11.6 percent), France (10 percent), Japan (9.3 percent) and Canada (7 percent).

Mexico remains the most popular international destination for U.S. tourists. The economic environment in the U.S. translated to fewer Americans traveling abroad in 2011; according to the Department of Commerce international air travel from the U.S. declined 4.1 percent in 2011.  Mexico, however increased its market share in the US from 14.1 to 15 percent.

However, it is a fair bet to say that few would have predicted a forecast of 52 million visitors to the country in 2012, as recently announced by the Mexico Tourism Board.

The bold prediction comes on the back of a strong winter break season for the country’s accommodation sector, with hotels throughout the country’s tourism hotspots reporting significant increases in occupancy compared to the previous year’s winter break.

SECTUR, the Mexican Ministry of Tourism, also reported that the number of air arrivals in December 2011 had risen 13 per cent over the same month in 2010 as a record 1.07 million international tourists visited the country.

Leading growth in visitor numbers were year-on-year increases from Argentina (21.4 per cent), France (12.4 per cent) and Italy (10.5 per cent) as well as traditional markets the United States (10.6 per cent) and Canada (9.1 per cent).

“We envisage that 2012 will be a record-breaking year for Mexico in terms of tourism numbers,” Mexico Tourism Board chief operating officer Rodolfo Lopez-Negrete remarked.

“Mexico’s tourism industry is undergoing a stunning transformation – based on a bold strategy of diversification – focused on promoting a broader range of tourism aimed at attracting a new breed of global consumer.”

I recently sat down with tourism secretary Gloria Guevara to ask her just that. Appointed in 2010, Guevara inherited what most would view as an overwhelming and even insurmountable set of issues, all of which were beyond her control. In recent years, Mexico, a country where tourism accounts for 13% of its GDP, has been linked with every imaginable issue that would deter travelers: crime, violence, drugs, terrorism, health concerns, and so on. Compounding those woes has been the economic crisis in the US which represents an overwhelming majority of the Mexico’s travel market.

Riding the elevators up to Secretary Guevara’s Mexico City office, I kept asking myself, “The challenges facing Mexico are so extraordinary, how can she succeed in reshaping the world’s perspective of her country as a travel destination?” But after spending just a few moments, I got my answer.

As we discussed the future of Mexico’s tourism industry, I was both inspired and astounded by a leadership style that enabled Guevara to view even the most difficult circumstances as roadblocks rather than walls. “The measure of a leader is often tested during a crisis. And those leaders who can engage directly, but still maintain their sense of perspective, are the ones that will help the organization survive,” says Guevara.

While the situation in Mexico can certainly be described as a crisis, travel to the country is on the rise and well-positioned for future growth.  Here’s why Guevara is succeeding in how the world views travel to Mexico and why she may just be able to take Mexico from the tenth most visited destination to one of the world’s top five by 2018.