Health In The Guatemalan Highlands

Students and health practitioners traveling abroad seek insightful and relevant background material to orient them to the new environment. This volume on Guatemala provides historical, political, and cultural background for contemporary health care challenges, especially related to poverty. Combining the personal insights of the authors and Guatemalan medical personnel with a broader discussion of the uniquely Guatemalan context, it is an essential guide for anyone heading to Guatemala to do health care-related work.

This book examines medical systems and institutions in three K'iche' Maya communities to reveal the conflicts between indigenous medical care and the Guatemalan biomedical system. It shows the necessity of cultural understanding if poor people are to have access to medicine that combines the best of both local tradition and international biomedicine.

"In the early to mid-twentieth century, the governments of Ecuador and Guatemala sought to expand Western medicine within their countries, with the goals of addressing endemic diseases and improving infant and maternal health. These efforts often clashed with indigenous medical practices, particularly in the rural highlands. Drawing on extensive, original archival research, historian David Carey Jr. shows that indigenous populations embraced a syncretic approach to health, combining traditional and new practices. At times, the governments of both nations encouraged--or at least allowed--such a synthesis, yet they also attacked indigenous lifeways, going so far as to criminalize native medical practitioners and to conduct medical experiments on indigenous people without consent. Health in the Highlands traces the experiences of curanderos, midwives, bonesetters, witches, doctors, and nurses--and the indigenous people they served. Carey interrogates the relationship between 'progressive' public health policy and indigenous well-being, offering lessons from the past that remain relevant in the present. Our best way forward, this history suggests, may be a compassionate syncretism that joins indigenous approaches to healing with science and a pursuit of environmental and social justice"--

An unsettling exploration of the hidden power dynamics of global health, seen through the lens of childhood diarrhea and its treatment within the Guatemalan context. Deaths from childhood diarrhea seem preposterous in high-income countries. Yet, for children under five years old in the rest of the world, diarrhea is the third highest cause of mortality. Despite a glut of prevention and treatment programming spanning more than forty years, this least glamorous of global health ills remains a critical problem. In Underbelly, Rachel Hall-Clifford takes a hard look at the pathways of global health funding and development policies and the outcomes they deliver for recipient individuals and communities. Drawing on fifteen years of ethnographic research in highland Guatemala, Hall-Clifford focuses on the provision of primary health care services as a critical exemplar of how global health and development programs fall short. Guatemala has a fragmented health system, the author explains, that guarantees health as a human right but also suffers from systemic racism, inadequate health services and access to those services, community distrust from a legacy of harm and violence, and a demeaning paternalism. Bringing together the discourses of global health and medical anthropology, Underbelly explores the ways in which global health—its actors, structures, and systems—perpetuates the challenges it purports to fix: this is the underbelly. Hall-Clifford argues that global health programs, conceived in offices distant from the places in which they are delivered, often have unintended consequences and contribute to pluralistic and exclusionary health systems that mirror neoliberal economies. She argues that if we are to fix this entrenched crisis of health inequity, we must use the immense resources of global health to center local communities as drivers of change. With a foreword written by Waleska López Canu, an Indigenous Maya medical director, and an afterword by Arthur Kleinman, renowned expert in global health, this book underscores the importance of looking deeper into what seems on its surface incontrovertibly “good” to understand the more complex realities on the ground and in people’s lives.

This textbook is the new edition of Purnell's famous Transcultural Health Care, based on the Purnell twelve-step model and theory of cultural competence. This textbook, an extended version of the recently published Handbook, focuses on specific populations and provides the most recent research and evidence in the field. This new updated edition discusses individual competences and evidence-based practices as well as international standards, organizational cultural competence, and perspectives on health care in a global context. The individual chapters present selected populations, offering a balance of collectivistic and individualistic cultures. Featuring a uniquely comprehensive assessment guide, it is the only book that provides a complete profile of a population group across clinical practice settings. Further, it includes a personal understanding of the traditions and customs of society, offering all health professionals a unique perspective on the implications for patient care.