conflict of indigenous peoples health

The Conflict of Indigenous Peoples Health Care in Guatemala: Towards a New

Pluralism

Walter Randolph Adams and John P. Hawkins, Eds.

2007 Health Care In Maya Guatemala: Confronting Medical Pluralism in a

Developing Country . Norman, OK: University of Oklahoma Press.

ISBN: 978-0-8061-3859-6

Pages: 268

Illustrations, Tables, Glossary, Index

Indigenous peoples around the world are at the center of many

conflicts: natural resource management, intellectual property rights,

sovereignty, identity, and health care to name just a few. In each

country, and among each indigenous group, these conflicts differ.

Adding to the complexity of each idiosyncratic conflict is the

continued encroachment of non-indigenous (primarily Western) cultural

practices, exacerbating specific situations for each indigenous group.

The country and indigenous people of Guatemala are no exception to

this mix - or emerging pluralism - of the old and the new, indigenous

and non-indigenous, ancient and modern. Health Care in Maya Guatemala

, the newly published book from the University of Oklahoma Press and

edited by Walter Randolph Adams and John P. Hawkins highlights this

contemporary dance of conflicts by specifically examining health care

among the indigenous Maya peoples.

Covering a range of issues effecting the indigenous Maya peoples of

Guatemala - specifically three neighboring K'iche' Maya communities in

the central west highlands - the book offers Central American specific

examples of cultural, institutional, and behavioral health care

perspectives. Further, the editors have made sure to include several

chapters on specific aspects of the nature and treatment of various

conditions, such as midwives, childbirth, development, dentistry, and

depression. As such, the book is well rounded and encompassing, making

it accessible to specialists, applied researchers, and interested or

concerned individuals. Furthermore, because the chapters come from

several years of field school programs held for advanced

undergraduates, this book is an excellent text for medical

anthropology courses.

Much of the importance in the book, however, resides in the unique

contribution to the larger medical and anthropological fields that it

makes. For example, the book provides important indigenous

perspectives to the Complementary and Alternative Medicine (CAM)

debate. Here in the West we are enthralled with indigenous forms of

medicine, methods of healing (including the body, mind, and spirit),

biopharmacy, and anything alternative to the mainstream medical world.

Health Care in Maya Guatemala , however, comes from the other

perspective - that of the indigenous Maya peoples and their

perspectives on Western versus traditional health care practices.

Rather then framing its arguments in terms of the West cannibalizing

Guatemalan Maya indigenous medical knowledge, it examines why

indigenous people in Guatemala are neglecting their own ethnomedical

knowledge (which works quite well), and instead willingly adopting

many aspects of Western medicine.

Through the use of short-term participant observation, informal

interviews, and other standard anthropological methods, the process of

this adoption are intricately captured. Not only are the shortcomings

of Western medicine in a culture that has a different understanding of

the patient/client role clearly documented, but so are the attractions

and perceived powers of Western pharmaceutical medicine discussed. By

focusing on three neighboring K'iche' Maya communities in the central

west highlands chapters within Health Care in Maya Guatemala argue

that the process of medical pluralism - the mishmash of indigenous and

Western medical practices - is currently the norm in Guatemala and

much of the rest of Central America. Not only is it the norm to a

large extent, but it is not necessarily that bad.

Beginning as early as the 1950s, the influx of Western medicine has

had an influence on the indigenous Maya of southern Mexico and

northern Guatemala (Adams 1952, Paul 1955). The process and methods of

this influence has not always been the same, and the editors and their

students have teased out several of the unique characteristics of this

plurality. For example, the Maya medical term yab'ilal is used to

describe a "disease for everyone" and k'oqob'al is used to describe

when "someone is making you sick." As a result of these indigenous

categories, Western biomedicine has had more of an influence on

diseases placed in the yab'ilal category, while those changes brought

about by Catholic and Protestant missionaries have effected k'oqob'al

diseases. That is, Western medicine's fixation on microbial and

pathogenic types of diseases has resulted in its influence on

"diseases for everyone" while more Western based psychological or

mental diseases have impacted k'oqob'al diseases.

Another component of this medical pluralism is that indigenous healers

often do not know unlimited amounts of ethnobotanical knowledge as

they are often romantically framed in the West. Rather, as the

chapters in this book document, many indigenous medical practitioners

(in this case comadronas [midwives], curanderas [healers], hueseras

[bonesetters], and cura los ojos [eye doctors]) often know only a

handful to several dozen plants that have medicinal properties.

Furthermore, most are self-taught with only a minimal amount of

training. However, as discussed via first-person interviews many have

experienced what has come to be known in the anthropological

literature as "the call." Several other aspects of the medical

pluralism found among the indigenous Maya are also documented, adding

to the books overall reach and value.

In general Health Care in Maya Guatemala attempts to reverse the trend

found not only in Guatemala, but in much of the medical research

dealing with indigenous peoples; that of focusing on behavioral,

quantitative, and mechanistic research projects. Rather, this book

returns to a more anthropological, qualitative, and applied research

and scholarship agenda. Part of this is the overarching theme of

giving something back to the Maya. This is done not only by the

publication of the book and its extensive use of indigenous linguistic

terms, but also by focusing on a very useful and applied topic: health

and the useful applications to promote health.

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Citations

Adams, Richard N. 1952. Un analisis de las creencias y practicas

medicas en un pueblo indigena de Guatemala. Guatemala: Editorial del

Ministerio de Educacion Publica.

Paul, Benjamin D. 1955. Health, Culture and Community: Case Studies of

Public Reactions to Health Programs. New York: Russell Sage

Foundation.