During the s, s and early s,various intercultural health proposals and actions emerged in most Latin American countries. These initiatives had two basic objectives: This paper analyzes the reasons for the limited impact and, in Historia de iztapalapa yahoo dating cases, failure of such intercultural health initiatives. Concepts, processes and uses of interculturality emerged in Latin America in the s and developed particularly throughout the s and s.
The proponents of interculturality sought to defend and empower ethnic groups and question the dominant classes that excluded, subordinated and discriminated these social actors.
These concepts and objectives, which were driven by ethnic movements and, above all, their more or less organic intellectuals, were also promoted within the field of health by professionals working in programs designed to expand access to health care among these marginalized groups implemented by institutions such as the National Indigenous Institute Instituto Nacional Indigenista — INI 1 1.
Instituto Mexicano del Seguro Social; It is important to stress however that these intercultural health initiatives were Historia de iztapalapa yahoo dating and organized by these institutions and intellectuals rather than the ethic movements themselves. A number of different and sometimes divergent intercultural health initiatives emerged as a result of this process, some of which had a common objective: Based on these objectives, this article initially some of the key factors that have limited or constrained the development of intercultural initiatives and then goes on to analyze some of the methodological orientations frequently used by purveyors of this approach.
In this way, the article attempts to find an explanation for the limited success, or veritable failure, of several Historia de iztapalapa yahoo dating the main intercultural health initiatives developed in Mexico. From the outset, it is important to stress that intercultural processes are permanent and have historical depth.
That is to say, they are a normal part of everyday life, not a recent or occasional phenomenon or exceptional processes that needs Historia de iztapalapa yahoo dating be constructed: What has happened is that the government staff, health professionals and intellectuals responsible for promoting intercultural health did not take existing interculturality into account, but rather attempted to create spaces and organizations that they thought would encourage the use of traditional medicine.
However, the lack of demand from the indigenous population for the services provided by hospitals and intercultural health centers shows that this did not happen, and traditional healer organizations have all but disappeared over a period of less than ten years 5 5. Chamanismo, poder, resistencia en Cuetzalan, Sierra Norte de Puebla [tesis].
This fact does not deny the Historia de iztapalapa yahoo dating and frequent need to promote change processes from outside the community, be it through government staff, health professionals and intellectuals, or NGOs and political groups.
However, for this to happen it is necessary to understand the main constraints to realizing these goals and the social forces that support and oppose these processes. It Historia de iztapalapa yahoo dating also necessary to understand the level of acceptance, interest and rejection and, above all, agency of the respective individuals and groups upon which interculturalists want to push change and recognize that these groups Historia de iztapalapa yahoo dating a range of resources at their disposal to pursue the objectives of change over time.
Initiatives similar to those promoted by interculturalists in the s and shad already been developed in previous decades, above all by INI 4 4. However, the results and experiences of these interventions were not taken into account by those who promoted the new intercultural initiatives.
As with the policies implemented andgoals were defined and actions developed from outside the communities and not based on their specific demands: Possibly one of the longest-running and most interesting intercultural health initiatives is the training and control of parteras traditional midwives which aimed to reduce maternal and infant mortality rates and, it should be stressed, particularly birth rates.
During the s, parteras were trained to sterilize traditional birthing instruments and keep the birth environment clean, refer more complicated cases to official health services, and promote the use of birth control and certain allopathic drugs.
These elements became part of the core knowledge of parteras 10 Therefore, to a certain extent, the intercultural health initiatives developed during the s and s Historia de iztapalapa yahoo dating be said to be a continuation of previously developed actions, although with slightly different objectives: The new intercultural health initiatives focused on the second aspect, seeking especially to validate, legitimize and promote traditional medicine and, in particular, traditional healers.
A second limitation of this approach was the assumption that social actors are homogeneous and in certain cases monolithic. Thus, indigenous peoples are regarded by authors such as Bonfill 12 Moreover, the interculturalists did not take into account the increasing differences within ethnic communities associated with religion, gender, political orientation, level of education, power and age groups. This statement does not deny that they were, and continue to be, utilized; rather it recognizes that they are used both to promote intercultural negotiation and incompatibilities between Indigenous Peoples and the dominant society.
Furthermore, the interculturalists that social groups, including ethnic groups, are characterized by change and not by permanence. Indigenous youth are no longer interested in being traditional healers, although they are interested in being health agents. In other words, the interculturalists disregarded not only the various types of differences and inequalities that exist between indigenous groups, but also the changes occurring within them.
This happened despite evidence that this had been occurring in several indigenous communities across the country since the s. Ediciones de la Casa Chata; Ministerio de Salud; It is worth remembering that the actual government institutions responsible for promoting intercultural health directly contributed to the reduction in the number of traditional healers, especially in the sands.
For example, both the INI and health sector organizations trained traditional healers exclusively to use herbal therapies, excluding all mention of witchcraft and magic 17 The proponents of intercultural health also failed to consider Historia de iztapalapa yahoo dating relations of solidarity and cooperation interact simultaneously with relations of conflict and violence in ethnic groups. Numerous Historia de iztapalapa yahoo dating and cooperation organizations exist in these groups together with relationships characterized by envy, blood feuds and witchcraft.
The interculturalists tended to emphasize relations of cooperation, failing to mention relations of conflict and division, including those between traditional healers who tried to organize associations that, however, were later dissolved.
One key aspect that they did not consider as a constraint to achieving the goals of harmony and respect that they promoted between indigenous and nonindigenous people was violence at macro and micro level that continues to the present day in Mexico. They disregarded structural violence, violence generated by organized crime, and gender violence. These omissions are almost incomprehensible given that Mexico has the highest homicide rate in the world.
Possibly one of the main omissions of the interculturalists was, Historia de iztapalapa yahoo dating continues to be, the issue of racism. Most importantly, they omitted or made only minimal references to this issue, knowing the role it played in the relationships between health service providers and the indigenous population.
This omission is in fact a characteristic of our anthropology, which ignores racism in all the fields that it studies. For example, ethnographic studies do not describe racism or the relationships between health professionals and indigenous patients 18 Although federal and certain state intercultural health programs do address racism, it is generally dealt with at a superficial level.
Finally, interculturalists fail to fully acknowledge the role biomedicine and the health sector as one of the main constraints on intercultural initiatives, despite its continual expansion and tendency toward growing monopolization of health care.
This can be observed in the application of official norms that directly affect the work of traditional healers. In the case of parterasthese regulations exclude them from labor, limiting their activities to sobadas massageshealth education focusing on birth control and referral of pregnant women Historia de iztapalapa yahoo dating medical services, meaning that in only 1.
Entre la normatividad y las instituciones de salud. In this respect, one of the main omissions was, and continues to be, the failure to register and analyze the increasing penetration of biomedical products and concepts into everyday life, including the work of traditional healers. This penetration and appropriation involves intercultural processes that are ignored, meaning that organizations and proponents of intercultural "Historia de iztapalapa yahoo dating" disregard some of the main aspects of this penetration because they have nothing to do with their own goals.
But these aspects influence how groups, particularly women, deal with their illnesses, and it would be interesting to observe how these groups integrate traditional medicine with biomedical products in treating, alleviating and resolving their health problems 20 Press I, tradition e adaptation.
Life in a modern yucatan maya village. It is also important to recognize the growing medicalisation of traditional healers, managed by themselves as a professional survival strategy. Recent studies have also documented the practically exclusive "Historia de iztapalapa yahoo dating" of allopathic drugs and ownership of pharmacies by traditional healers in their own communities 25 However, the medicalisation of traditional healers dates back further than this.
For example, training programs for parteras and people who know how to administer injections inyectadoras have been developed in some states since the s 15 El hombre toma el control. This process has involved a number of developments, including the implementation of government and NGO training programs since the s for health promoters, many of whom became local curadores who treated all kinds of illnesses with allopathic "Historia de iztapalapa yahoo dating." For these and other reasons, it can be said that the interculturalists did not adopt the pragmatism of Health Ministry that includes and excludes traditional healers according to its needs and objectives or the human resources at its disposal: The recognition of the constraints imposed by the set of processes outlined above, particularly those involving biomedicine and the health sector, should have led the interculturalists to question the national and international groups and social forces that favored, facilitated, distorted, hindered or opposed intercultural health initiatives.
Furthermore, they should have observed the real interests and powers behind the different social forces and their interest in intercultural health and the sectors they look to support. Despite this, they did not see these factors as constraints on intercultural health or take into account the complementary use of biomedicine and traditional medicine among the indigenous population or the penetration of
Historia de iztapalapa yahoo dating products and concepts into indigenous customs and traditions and practices of traditional healers.
To the contrary, they treated interculturality as if it was a recent process and something that should be induced in communities, as if they it did not develop from their own activities and needs. The ahistorical perspective of the interculturalists was influenced by various Historia de iztapalapa yahoo dating that are both ideological and theoretical.
The former allows one to think in terms of identity, cosmovision and difference, particularly for who were to legitimize the rights of Indigenous Peoples. However, it should be stressed that, beyond these attempts to legitimize, a significant portion of intercultural health Historia de iztapalapa yahoo dating, as well as ethnographic studies conducted by anthropologists, tended to exclude the growing use of biomedicine by ethnic groups because of these objectives.
As a result, they generated an image that did not reflect reality. Furthermore, they excluded mortality — although in contrast they sometimes talked a lot about death — providing detailed descriptions of the work of parterasshamans and herbal healers, but without
Historia de iztapalapa yahoo dating data and statistics about the causes of death in communities. I would like to stress that the fact that I am outlying these processes does not mean that I Historia de iztapalapa yahoo dating not "Historia de iztapalapa yahoo dating" the
Historia de iztapalapa yahoo dating, good intentions and the huge amount of work done by various interculturalists, as well as the partial achievements made by these interventions.
However, in addition to not considering the various social and economic forces outlined above, the interculturalists disregarded numerous aspects of the daily lives of Indigenous Peoples when designing and implementing intercultural policies.
There are two particular aspects that I observed in various small and medium-sized communities in different contexts throughout Mexico between andand that should have been incorporated into intercultural health initiatives.
Many also seemed to be more interested in the diplomas and certificates they received from the workshops than in the learning itself. Furthermore, there was competition and conflict between traditional healers that was reflected in appointment and treatment prices and traditional healers tended to be more critical of other traditional healers than biomedicine 6 6.
Entre la duda y la esperanza: The second aspect regards one of the most decisive factors in terms of interculturality at the microsocial level: Self-care processes can serve as an important guide to understanding interculturality in a health context and to design possible interventions in this field, particularly since self-care among these groups is a necessary part of social and biological reproduction processes.
Furthermore, this practice depends on the agency of individuals and microgroups, which goes beyond the existence of actors who promoteinterculturality 20 Malaria y leishmaniasis en Ecuador.
Self-care shows us that interculturality is a standard process
Historia de iztapalapa yahoo dating the behaviors and daily lives of the different micro groups, particularly among families. That is why we propose that intercultural health initiatives should focus on self-care processes, rather than traditional healers and their cosmovisions as promoted by the government staff, professionals and intellectuals who have promoted interculturality in Mexico; not only because self-care practices promote interculturality as a standard routine process or due to possible efficacy, but Historia de iztapalapa yahoo dating, while traditional healers may be declining or disappearing, traditional knowledge will remain, at least for sometime, through self-care.
The inclusion of these and other aspects of interculturality is necessary because, despite their importance, they are generally excluded from the objectives, theoretical and ideological frameworks and, above all, from the institutional, professional and academic interventions aimed at the harmonious, symmetric and tolerant promotion of intercultural health based on traditional healers. It could be argued with respect to the majority of the points raised against the intercultural approach up till now that, while traditional healer organizations have almost disappeared and mixed hospitals are underused, it is possible that these interventions have led to learning, and management processes among the traditional healers and population as a whole that at some point may be recuperated by these individuals and groups.
It is not only necessary to demonstrate this, but also admit that several of these processes may have reinforced the exclusion, subordination or hegemony that Indigenous Peoples experience, as we have highlighted in other works 28 Salud Colectiva ; 11 3: The concepts of cosmovision, identity and difference have affected our understanding of intercultural processes, since they drive a search for congruence, coherence and balance that tend to eliminate certain conflicts, ambiguities and contradictions that permeate social groups, including ethnic groups, rather than for information that shows these conflicts exist.
They are concepts that, whether from a reflexive or non-reflexive perspective, encourage an ahistorical perspective of the groups and relationships being studied. It is due to the use of these concepts and certain ways of obtaining information that a large part of the intercultural studies and interventions are biased from the outset. The unilateral search for differences leads us to underline incompatibilities, which is important to be able to understand the difficulties involved in constructing interculturality.
However, this emphasis often leads us to ignore the existence of similarities, which help us to think of the best ways of developing approximation processes. Furthermore, the charismatic relationship is generally associated with male figures in both types of healers.
This hierarchization of healing contrasts with the fact that in both ethnic groups and the rest of Mexican society disease, prevention and healthcare are in the hands of women. That is to say, the control of hierarchical knowledge is exercised by men, while traditional knowledge is a female task.
Melbourne, VictoriaAustralia [email protected] . These comments about the neighboring pueblo of Iztapalapa resonate Historia de iztapalapa yahoo dating. between original residents and others dating from a clear historical period. about la historia de los jodidos: literally, the history of the 'screwed.
Active, [email protected] del Mar, Museo de Historia Natural, Universidad Autónoma de Baja California Sur, *, Active, [email protected] Departamento de Biología, Universidad Autónoma Metropolitana, Iztapalapa State, City, Institution, Number of Specimens, Date Historia de iztapalapa yahoo dating, Notes. México DF México.
[email protected] . However, the medicalisation of traditional healers dates back further than this. . pueblos indígenas de México y Chiapas México: Escuela Nacional de Antropología e Historia/UNACH; México: Universidad Autónoma Metropolitana-Iztapalapa;