Privatization and the New Medical Pluralism

Shifting Healthcare Landscapes in Maya Guatemala

Edited by Anita Chary and Peter Rohloff - Contributions by Peter Benson; Anita Chary; Alejandra Colom; Shom N. Dasgupta-Tsikinas; David Flood; Rachel Hall-Clifford; Nora King; Jonathan Maupin; Carla Pezzia; Peter Rohloff and Paul Wise

Privatization and the New Medical Pluralism is the first collection of its kind to explore the contemporary terrain of healthcare in Guatemala through reflective ethnography. This volume offers a nuanced portrait of the effects of healthcare privatization for indigenous Maya people, who have historically endured numerous disparities in health and healthcare access. The collection provides an updated understanding of medical pluralism, which concerns not only the tensions and exchanges between ethnomedicine and biomedicine that have historically shaped Maya people’s experiences of health, but also the multiple competing biomedical institutions that have emerged in a highly privatized, market-driven environment of care. The contributors examine the macro-structural and micro-level implications of the proliferation of non-governmental organizations, private fee-for-service clinics, and new pharmaceuticals against the backdrop of a deteriorating public health system. In this environment, health seekers encounter new challenges and opportunities, relationships between the public, private, and civil sectors transform, and new forms of inequality in access to healthcare abound. This volume connects these themes to critical studies of global and public health, exposing the strictures and apertures of healthcare privatization for marginalized populations in Guatemala.

Lexington Books

Pages: 226 • Trim: 6¼ x 9¼

978-1-4985-0537-6 • Hardback • September 2015 • $121.00 • (£93.00)

978-1-4985-0538-3 • eBook • September 2015 • $115.00 • (£88.00)

Subjects: Health & Fitness / Health Care Issues, Social Science / Anthropology / Cultural, Political Science / Public Policy / Social Services & Welfare

Privatization and the New Medical Pluralism

Shifting Healthcare Landscapes in Maya Guatemala

Hardback

eBook

Summary

Privatization and the New Medical Pluralism is the first collection of its kind to explore the contemporary terrain of healthcare in Guatemala through reflective ethnography. This volume offers a nuanced portrait of the effects of healthcare privatization for indigenous Maya people, who have historically endured numerous disparities in health and healthcare access. The collection provides an updated understanding of medical pluralism, which concerns not only the tensions and exchanges between ethnomedicine and biomedicine that have historically shaped Maya people’s experiences of health, but also the multiple competing biomedical institutions that have emerged in a highly privatized, market-driven environment of care. The contributors examine the macro-structural and micro-level implications of the proliferation of non-governmental organizations, private fee-for-service clinics, and new pharmaceuticals against the backdrop of a deteriorating public health system. In this environment, health seekers encounter new challenges and opportunities, relationships between the public, private, and civil sectors transform, and new forms of inequality in access to healthcare abound. This volume connects these themes to critical studies of global and public health, exposing the strictures and apertures of healthcare privatization for marginalized populations in Guatemala.

Details

Lexington Books

Pages: 226 • Trim: 6¼ x 9¼

978-1-4985-0537-6 • Hardback • September 2015 • $121.00 • (£93.00)

978-1-4985-0538-3 • eBook • September 2015 • $115.00 • (£88.00)

Subjects: Health & Fitness / Health Care Issues, Social Science / Anthropology / Cultural, Political Science / Public Policy / Social Services & Welfare

Author

Anita Chary is an MD/PhD candidate in anthropology at Washington University in St. Louis.

Peter Rohloff is an instructor in medicine at Harvard University, an internist at Brigham and Women’s Hospital, and a pediatrician at Children’s Hospital Boston.

Table of Contents

Preface
Acknowledgements
IntroductionPeter Rohloff & Anita Chary
Part One: The Public-Private Interface
Chapter 1Strategic Alliances: The Shifting Motivations for NGO Collaboration with Government Programs
Jonathan Maupin
Chapter 2“Mi Familia Pobreza”: Conditional Cash Transfers and Maternal-Child Health in Rural Guatemala
Shom Dasgupta-Tsinikas and Paul Wise
Chapter 3Forced Motherhood in Guatemala: An Analysis of the Thousand Days Initiative
Alejandra Colom
Part Two: Commoditizing Care
Chapter 4“This Disease Is for Those Who Can Afford It”: Diabetes in Indigenous Maya Communities
David Flood and Peter Rohloff
Chapter 5Capitalizing on Care: Marketplace Quasi-pharmaceuticals in the Guatemalan Health-seeking Landscape
Rachel Hall-Clifford
Part Three: Navigating Novel Resources
Chapter 6Engaging Mental Healthcare in a Disengaged System
Carla Pezzia
Chapter 7Hysterectomies and Healer Shopping: Cervical Cancer and Therapeutic Anarchy in Guatemala
Anita Chary
Chapter 8Leveraging Resources in Contemporary Maya Midwifery
Nora King, Anita Chary, and Peter Rohloff
Chapter 9Conclusion: A Bad Conscience of Justice!
Peter Benson
References
Contributors
Index

Reviews

The long-term effects of neoliberal agendas to privatize global health are still being revealed, particularly in developing countries still recovering from devastating policies of structural adjustment. This collection offers stunning and often harrowing ethnographic details about these effects in Guatemala. Without romanticizing the nation's past or glossing over its persistent national challenges, the authors here reveal how the blending of public, private, humanitarian and for-profit medical resources today far too often fails patients, marginalizes indigenous healers, and secures profits for the wrong reasons. This should be a model for studies of medical pluralism for the 21st Century
— Vincanne Adams, University of California, San Francisco

This volume offers a nuanced, yet amazingly lucid and hard-hitting critique of the NGOization of health care, even in contexts like Guatemala where the postcolonial state offered little before implantation of neoliberal policies. This “Republic of NGOs” offers a pluralism that nonetheless displaces traditional, indigenous health systems. A must read for scholars and students of medical anthropology, NGOs, and contemporary Central America.
— Mark Schuller, Northern Illinois University