RESUMEN
Access to antivenoms in cases of snakebite continues to be an important public health issue around the world, especially in rural areas with poorly developed health care systems. This study aims to evaluate therapeutic itineraries and antivenom accessibility following snakebites in the states of Oaxaca and Chiapas in southern Mexico. Employing an intercultural health approach that seeks to understand and bridge allopathic and traditional medical perceptions and practices, we conducted field interviews with 47 snakebite victims, documenting the therapeutic itineraries of 54 separate snakebite incidents that occurred between 1977 and 2023. Most victims used traditional remedies as a first line of treatment, often to withstand the rigors of a long journey to find antivenoms. The main obstacles to antivenom access were distance, poor antivenom availability, and cost. Standard antivenom treatment is highly valued and sought after, even as traditional beliefs and practices persist within a cultural framework known as the "hot-cold" system. The findings are crucial for informing future enhancements to antivenom distribution systems, health education initiatives, and other interventions aimed at mitigating the impact of snakebites in the region.
Asunto(s)
Antivenenos , Accesibilidad a los Servicios de Salud , Mordeduras de Serpientes , Mordeduras de Serpientes/terapia , Mordeduras de Serpientes/tratamiento farmacológico , Mordeduras de Serpientes/epidemiología , Humanos , México/epidemiología , Antivenenos/uso terapéutico , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adolescente , Adulto Joven , AncianoRESUMEN
This article analyzes feelings, experiences, practices, and actions that underlie the meanings attributed to the covid-19 pandemic. Based on a case study located in the province of Tucumán (Argentina), a mixed-methods investigation was developed, interested in capturing life experiences. Discourse analysis show the resignification of life itself, the valorization of close ties, community social capital, the State and politics. From the personal to the political, the interpretive frames people use to signify life experiences during the covid-19 pandemic exhibit differentiated feelings, experiences, practices, and actions.
Este artículo analiza sentimientos, experiencias, prácticas y acciones que subyacen a los significados atribuidos a la pandemia por covid-19. A partir de un estudio de caso situado en la provincia de Tucumán (Argentina), se desarrolló una investigación mixta, interesada en captar experiencias de vida. Los discursos evidencian la resignificación de la propia vida, la valorización de los vínculos, el capital social comunitario, el Estado y la política. Desde lo personal o desde lo político, el marco interpretativo con el que las personas significan las experiencias de vida durante la pandemia por covid-19 configura sentimientos, experiencias, prácticas y acciones diferenciadas.
Asunto(s)
COVID-19 , Pandemias , Humanos , Argentina/epidemiología , Acontecimientos que Cambian la Vida , COVID-19/epidemiología , PolíticaRESUMEN
Resumen Este artículo analiza sentimientos, experiencias, prácticas y acciones que subyacen a los significados atribuidos a la pandemia por covid-19. A partir de un estudio de caso situado en la provincia de Tucumán (Argentina), se desarrolló una investigación mixta, interesada en captar experiencias de vida. Los discursos evidencian la resignificación de la propia vida, la valorización de los vínculos, el capital social comunitario, el Estado y la política. Desde lo personal o desde lo político, el marco interpretativo con el que las personas significan las experiencias de vida durante la pandemia por covid-19 configura sentimientos, experiencias, prácticas y acciones diferenciadas.
Abstract This article analyzes feelings, experiences, practices, and actions that underlie the meanings attributed to the covid-19 pandemic. Based on a case study located in the province of Tucumán (Argentina), a mixed-methods investigation was developed, interested in capturing life experiences. Discourse analysis show the resignification of life itself, the valorization of close ties, community social capital, the State and politics. From the personal to the political, the interpretive frames people use to signify life experiences during the covid-19 pandemic exhibit differentiated feelings, experiences, practices, and actions.
Asunto(s)
Apoyo Social , Pandemias , COVID-19 , Acontecimientos que Cambian la Vida , Argentina , Historia del Siglo XXIRESUMEN
The Covid-19 pandemic has stimulated new appraisals of how social cohesion, including neighborhood-level social capital, fosters resilience in the face of crisis. Several studies suggest better health outcomes in neighborhoods with higher level of social capital, in general and during the pandemic. Building on a growing body of research which suggests that those who live in close-knit neighborhoods have fared better during the pandemic, this article analyzes how social capital influences individual and collective perceptions and attitudes about the experiences of the Covid-19 pandemic in Tucumán, Argentina. To assess this question, we used a mixed-methods approach, combining focus groups, semi-structured interviews, and an online survey (n = 701 respondents) conducted in September 2021. We find widespread experiences of resilience in response to the Covid-19 pandemic, in spite of difficult socioeconomic conditions and perceived poor government performance. Results from logistic regression analysis indicate that perceptions of high neighborhood social capital are associated with more positive outcomes in many dimensions, including personal resilience, ability to cope with uncertainty, perceptions of community solidarity, and reported compliance with public health measures. We further argue that conceptualizations of social cohesion need to be adjusted to local or national-level cultural norms to accurately capture the experience of countries of the Global South.
Asunto(s)
COVID-19 , Capital Social , Argentina/epidemiología , COVID-19/epidemiología , Humanos , Pandemias , Características de la ResidenciaRESUMEN
In the history of Latin American social medicine, numerous works have presented a harmonious link between Rudolf Virchow, Max Westenhöfer, and Salvador Allende, which establishes the origin of ideas of Latin American social medicine in a prestigious European source, represented by Virchow. A key to that story is that Allende was a student of Westenhöfer, a disciple of Virchow who lived in Chile three times (1908-1911, 1929-1932, and 1948-1957). Based on primary sources and contextual data, this article problematizes the relationship between Allende and Westenhöfer, and questions the influence of Virchow in Chilean social medicine.
Asunto(s)
Personajes , Medicina Social/historia , Chile , Historiografía , Historia del Siglo XX , Humanos , Internacionalidad/historiaAsunto(s)
Medicina Social , Equidad en Salud , Política de Salud , América Latina , Historia del Siglo XXRESUMEN
Abstract In the history of Latin American social medicine, numerous works have presented a harmonious link between Rudolf Virchow, Max Westenhöfer, and Salvador Allende, which establishes the origin of ideas of Latin American social medicine in a prestigious European source, represented by Virchow. A key to that story is that Allende was a student of Westenhöfer, a disciple of Virchow who lived in Chile three times (1908-1911, 1929-1932, and 1948-1957). Based on primary sources and contextual data, this article problematizes the relationship between Allende and Westenhöfer, and questions the influence of Virchow in Chilean social medicine.
Resumen En el marco de la historia de la medicina social latinoamericana, numerosos trabajos historiográficos han presentado un vínculo armónico entre Rudolf Virchow, Max Westenhöfer y Salvador Allende, afirmando una procedencia virtuosa de las ideas de la medicina social latinoamericana en una prestigiosa fuente europea, como es la que representa Virchow. Un dato crucial en ese relato es que Allende habría sido estudiante de Westenhöfer; un discípulo de Virchow que vivió en Chile en tres ocasiones (1908-1911, 1929-1932 y 1948-1957). Este trabajo problematiza, usando fuentes primarias y datos de contexto, la relación entre Allende y Westenhöfer, y cuestiona la influencia de Virchow sobre el pensamiento médico-social en Chile.
Asunto(s)
Humanos , Historia del Siglo XX , Medicina Social/historia , Personajes , Chile , Internacionalidad/historia , HistoriografíaRESUMEN
En el marco de la historia de la medicina social latinoamericana, numerosos trabajos historiográficos han presentado un vínculo armónico entre Rudolf Virchow, Max Westenhöfer y Salvador Allende, afirmando una procedencia virtuosa de las ideas de la medicina social latinoamericana en una prestigiosa fuente europea, como es la que representa Virchow. Un dato crucial en ese relato es que Allende habría sido estudiante de Westenhöfer; un discípulo de Virchow que vivió en Chile en tres ocasiones (1908-1911, 1929-1932 y 1948-1957). Este trabajo problematiza, usando fuentes primarias y datos de contexto, la relación entre Allende y Westenhöfer, y cuestiona la influencia de Virchow sobre el pensamiento médico-social en Chile
Asunto(s)
Humanos , Medicina Social/historia , Historia de la Medicina , América Latina , ChileRESUMEN
The mosquito-borne arboviral diseases dengue, chikungunya, and Zika are major public health burdens in Latin America. To analyze the socio-environmental dynamics of these diseases, we apply a political ecology of health and disease framework that is attentive to local etiological frameworks, structural sociopolitical conditions, processes of identity construction, and the contested, politicized nature of public health work. We use multiple qualitative methods to analyze perceptions and interactions with the local environment in relation to mosquito-borne disease across three small communities in Manabí Province, Ecuador. We find that participants' perceptions and practices are complex and multilayered: subjects possess a mixed theory of causation, where these diseases are caused not only by mosquitoes, but also by people's interactions with a changing environment; most environmental management to control vector mosquitoes is carried out informally by women as part of domestic routines; and contrary to public health messaging that stresses the importance of individual agency, participants prefer some of the most invasive techniques for mosquito control (i.e. fumigation with insecticides). However, individual agency in disease control is constrained by poor water infrastructure and lack of public health coordination. Our approach advocates for recognition of local knowledges and sociopolitical constraints in the development of public health messages and interventions.
Asunto(s)
Fiebre Chikungunya , Dengue , Conocimientos, Actitudes y Práctica en Salud , Mosquitos Vectores , Infección por el Virus Zika , Adulto , Anciano , Animales , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/prevención & control , Dengue/epidemiología , Dengue/prevención & control , Ecuador/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Control de Mosquitos , Política , Salud Pública , Adulto Joven , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/prevención & controlRESUMEN
This paper examines the international networks that influenced ideas and policy in social medicine in the 1930s and 1940s in Latin America, focusing on institutional networks organised by the League of Nations Health Organization, the International Labour Organization, and the Pan-American Sanitary Bureau. After examining the architecture of these networks, this paper traces their influence on social and health policy in two policy domains: social security and nutrition. Closer scrutiny of a series of international conferences and local media accounts of them reveals that international networks were not just 'conveyor belts' for policy ideas from the industrialised countries of the US and Europe into Latin America; rather, there was often contentious debate over the relevance and appropriateness of health and social policy models in the Latin American context. Recognition of difference between Latin America and the global economic core regions was a key impetus for seeking 'national solutions to national problems' in countries like Argentina and Chile, even as integration into these networks provided progressive doctors, scientists, and other intellectuals important international support for local political reforms.
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Política de Salud/historia , Cooperación Internacional/historia , Medicina Social/historia , Historia del Siglo XX , Humanos , América LatinaRESUMEN
This paper evaluates the ideological and political origins of a place-based and commercial health promotion effort, the Blue Zones Project (BZP), launched in Iowa in 2011. Through critical discourse analysis, I argue that the BZP does reflect a neoliberalization of public health, but as an "actually existing neoliberalism" it emerges from a specific policy context, including dramatic health sector policy changes due to the national Affordable Care Act, also known as Obamacare; a media discourse of health crisis for an aging Midwestern population; and an effort to refashion Iowa cities as sites of healthy and active living, to retain and attract a creative class of young entrepreneurs. The BZP employs many well-known mechanisms of neoliberal governance: the public-private partnership; competition among communities for "public" funds; promotion of an apolitical discourse on individual responsibility and ownership of health; decentralizing governance to the "community" level; and marketing, branding, and corporate sponsorship of public projects. The BZP exemplifies the process of "neoliberal governmentality," by which individuals learn to govern themselves and their "life projects" in line with a market-based rationality. However, with its emphasis on "nudging" individuals towards healthy behaviors through small changes in the local environment, the BZP reflects the rise of "libertarian paternalism," a variant of neoliberalism, as a dominant ideology underlying contemporary health promotion efforts.
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Política de Salud , Promoción de la Salud/métodos , Política , Salud Pública , Conductas Relacionadas con la Salud , Humanos , IowaRESUMEN
Enemy in the Blood: Malaria, Environment, and Development in Argentina examines the dramatic yet mostly forgotten history of malaria control in northwest Argentina. Carter traces the evolution of malaria science and policy in Argentina from the diseases emergence as a social problem in the 1890s to its effective eradication by 1950. Malaria-control proponents saw the campaign as part of a larger project of constructing a modern identity for Argentina. Insofar as development meant building a more productive, rational, and hygienic society, the perceptions of a culturally backwards and disease-ridden interior prevented Argentina from joining the ranks of modern nations. The path to eradication, however, was not easy due to complicated public health politics, inappropriate application of foreign malaria control strategies, and a habitual misreading of the distinctive ecology of malaria in the northwest, especially the unique characteristics of the local mosquito vector. Homegrown scientific expertise, a populist public health agenda, and an infusion of new technologies eventually brought a rapid end to malarias scourge, if not the cure for regional underdevelopment.Enemy in the Blood sheds light on the often neglected history of northwest Argentinas interior, adds to critical perspectives on the history of development and public health in modern Latin America, and demonstrates the merits of integrative socialenvironmental research. The chapters presents the rationale for malaria control; foreign, national and local influences on malaria control, and the politics and technologies of malaria eradication (AU)
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Malaria/prevención & control , Servicios de Salud , Atención a la SaludRESUMEN
This article explores the politics of malaria eradication in Argentina during the first government of Juan D. Perón. The article developments the theme of historical convergence to understand the rapid mobilization and success of the climatic battle against malaria in Northwest Argentina. The nealy complete eradication of malaria in Argentina resulted from a combination of three factors. First, Carlos Alvarado, the director of Argentina's Malaria Service, had alredy developed a solid but flexible organizational base that allowed a dramatic change in control strategy. Second, an infusion of new technologies, especially DDT but also motor vehicles, was instrumental. Lastly, a radical reorintation of national public health policy in the 1940s, under the direction of Perón and his health minister, Ramón Carrillo, encouraged eradication. These figures embraced and refashioned long-standing organicist ideologies that hitched the strength of the nation-state to the health and vigor of its ordinary citizens. This ideological orientation was reflected in bold, populist political strategies that showcased swift, massive, and expensive public health campaigns, including malaria eradication. In the conclusion, the article explores the ambiguous connections between malaria eradication and an ecological perspective on the disease. [AU]
Asunto(s)
Historia del Siglo XX , Salud Pública/historia , Política de Salud/historia , Malaria/historia , Malaria/prevención & control , Promoción de la Salud/historia , DDT/historia , ArgentinaRESUMEN
This article explores the politics of malaria eradication in Argentina during the first government of Juan D. Perón. The article develops the theme of historical convergence to understand the rapid mobilization and success of the climactic battle against malaria in Northwest Argentina. The nearly complete eradication of malaria in Argentina resulted from a combination of three factors. First, Carlos Alvarado, the director of Argentina's Malaria Service, had already developed a solid but flexible organizational base that allowed a dramatic change in control strategy. Second, an infusion of new technologies, especially DDT but also motor vehicles, was instrumental. Lastly, a radical reorientation of national public health policy in the 1940s, under the direction of Perón and his health minister, Ramón Carrillo, encouraged eradication. These figures embraced and refashioned long-standing organicist ideologies that hitched the strength of the nation-state to the health and vigor of its ordinary citizens. This ideological orientation was reflected in bold, populist political strategies that showcased swift, massive, and expensive public health campaigns, including malaria eradication. In the conclusion, the article explores the ambiguous connections between malaria eradication and an ecological perspective on the disease.