Friday, July 22, 2011

Thursday 22.7.11

Another great day on the fieldwork program. The day started with finalising our NGO interview schedule ready for Friday. The NGO group will be conducting an interview with Wuqu’ Kawoq (NGO who’s mission is to improve health care outcomes by strengthening Indigenous languages, culture and access to medical services). Our project is about looking at the viability of matching the organisation with another one which is called ‘Link for health’ who is involved in matching volunteer surgery teams from North America and the viability of this. So we have a detailed interview schedule ready for Friday.

We had lectures this morning about the Guatemalan health care system. This was great to have an overview of the tiered structure which again resources Biomedical interventions and health promotion/ traditional healing services based in the community appeared to be a ‘added benefit’ and hardly funded. Interesting cardio-obstructive pulmonary disease was the number 1 killer – presumably related to preventable occupational hazards including smoke exposure (cooking), pollution. After that came, HIV/AIDS, lower respiratory infection, violence (interesting factor on top of list) and then perinatal. We also were introduced to the political structure of Guatemala where we talked about the corruption in voting and also for whom is able to be elected. Also interestingly number 1 income for Guatemala is remittances from abroad.

I was well aware of the gap in discussion of Occupational concepts that had potential to be linked with Med anth concepts presented. Was there the possibility of Occupation overview and the OT voice to be included in the discussion on ‘Guatemalan social security institute’. How does occupation and employment relate to health care in Guatemalan context? What are the occupational health issues? How do peoples lifestyles and occupational choices link to health outcomes of indigenous people? How does cultural practises affect this? Frameworks around this?

And a dynamic discussion about the Rigoberta Menchu book. From the ethics of the David Stoll critique of the book not representing ‘truth’. This was my first exposure to the social science of Anthropology to discover and strive for ‘truth’ by uncovering accounts from different points of view. Another good point made was perhaps the frustration of indigenous people of not only being ‘under represented’ but being ‘misrepresented’ by Rigoberta’s story. The point was made that it is a testimonial (subjective version of a story ) vs an ethnography or a illness narrative. From my point of view the story has every right to be ‘illogical’ or represent a ‘collective memory’ given the traumatic history and experience. It has every right to exaggerate the truth given the horrors that a human being has had to suffer through. That is my OT ‘meaning and purpose’ and ‘therapeutic’ hat. But in terms of talking about responsibility of being ‘scholarly’ or ‘ethical’, Im not sure. But I definitely agree with the responsibility of anyone determined to ‘critique’ and pick apart someone else’s story especially with a trauma history is strange. I was also looking around and thought that the discussion would be truly enriched by the addition of local Guatemalan anth/ OT (or closest things to?) students who could join as part of a scholarship program. Wouldn’t half half be so great?! So many local people would really benefit and be empowered by discussion and critique on own health services and build collegial relationships with students from different health system experiences.

Also a final quote that stirred me with the ‘ethics’ workshop. “not everyone wants to be empowered”. I am not sure what this is getting at but I believe that most people would prefer power over non-power and perhaps the meaning is more about being ‘used to’ and authoritative approach to health care.

It is also quite interesting how the info about ‘mentality’ of Guatemalan people reflects the conversations I am having with my SPansih teacher. He appears to believe that things are ok in Guatemala just not wanting any more violence, blaming past troubles on the US intervention during Cold War and not wanting or caring about elections because it wont change anything. It is also that foreign concept I am learning about the power or drug cartels in central America. Which makes me wonder.. who buys these drugs and do they know or care how it is affecting other countries? What is the history of this trade? It has been going on for years I guess.

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