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.

In most places on the African continent, multiple health care options exist and patients draw on a therapeutic continuum that ranges from traditional medicine and religious healing to the latest in biomedical technology. The ethnographically based essays in this volume highlight African ways of perceiving sickness, making sense of and treating suffering, and thinking about health care to reveal the range and practice of everyday medicine in Africa through historical, political, and economic contexts.

An unsettling exploration of the hidden power dynamics of global health, seen through the lens of childhood diarrhea and its treatment within the Guatemalan context. Deaths from childhood diarrhea seem preposterous in high-income countries. Yet, for children under five years old in the rest of the world, diarrhea is the third highest cause of mortality. Despite a glut of prevention and treatment programming spanning more than forty years, this least glamorous of global health ills remains a critical problem. In Underbelly, Rachel Hall-Clifford takes a hard look at the pathways of global health funding and development policies and the outcomes they deliver for recipient individuals and communities. Drawing on fifteen years of ethnographic research in highland Guatemala, Hall-Clifford focuses on the provision of primary health care services as a critical exemplar of how global health and development programs fall short. Guatemala has a fragmented health system, the author explains, that guarantees health as a human right but also suffers from systemic racism, inadequate health services and access to those services, community distrust from a legacy of harm and violence, and a demeaning paternalism. Bringing together the discourses of global health and medical anthropology, Underbelly explores the ways in which global health—its actors, structures, and systems—perpetuates the challenges it purports to fix: this is the underbelly. Hall-Clifford argues that global health programs, conceived in offices distant from the places in which they are delivered, often have unintended consequences and contribute to pluralistic and exclusionary health systems that mirror neoliberal economies. She argues that if we are to fix this entrenched crisis of health inequity, we must use the immense resources of global health to center local communities as drivers of change. With a foreword written by Waleska López Canu, an Indigenous Maya medical director, and an afterword by Arthur Kleinman, renowned expert in global health, this book underscores the importance of looking deeper into what seems on its surface incontrovertibly “good” to understand the more complex realities on the ground and in people’s lives.

This contributed volume explores flexible, adaptable, and sustainable solutions to the shockingly high costs of birth across the globe. It presents innovative and collaborative maternity care practices and policies that are intersectional, human rights-based, transdisciplinary, science-driven, and community-based. Each chapter describes participatory and midwifery-oriented care that helps improve maternal and newborn outcomes within minoritized populations. The featured case studies respond to resource constraints and inequities of access by transforming relations between providers and families or by creating more egalitarian relations among diverse providers such as midwives, obstetricians, and nurses that minimize inefficient hierarchies within maternity care. The authors build on a growing awareness that quality and respectful midwifery care has lower costs and improved outcomes for child bearers, newborns, and providers. Topics include: Sustainable collaborations including transfers of care among midwives and obstetricians in India, The Netherlands, Germany, United Kingdom, and Denmark Midwifery-oriented, femifocal, indigenous, and inclusive models of care that counter obstetric violence and gender stereotypes in Mexico, Chile, Guatemala, Argentina, and India Doula care and midwifery care for women of color, previously incarcerated women, indigenous women, and other minoritized groups in the global north and south Practices and metrics for improving quality of newborn and maternal care as well as maternal and newborn outcomes in disruptive times and disaster settings Sustainable Birth in Disruptive Times is an essential and timely resource for providers, policy makers, students, and activists with interests in maternity care, midwifery, medical anthropology, maternal health, newborn health, obstetrics, childbirth, medicine, and global health in disruptive times.

The concept of “Waithood” was developed by political scientist Diane Singerman to describe the expanding period of time between adolescence and full adulthood as young people wait to secure steady employment and marry. The contributors to this volume employ the waithood concept as a frame for richly detailed ethnographic studies of “youth in waiting” from a variety of world areas, including the Middle East Africa, Asia, Europe, Latin America and the U.S, revealing that whether voluntary or involuntary, the phenomenon of youth waithood necessitates a recognition of new gender and family roles.

A free ebook version of this title is available through Luminos, University of California Press’s Open Access publishing program. Visit www.luminosoa.org to learn more. Mal-Nutrition documents how maternal health interventions in Guatemala are complicit in reproducing poverty. Policy makers speak about how a critical window of biological growth around the time of pregnancy—called the "first 1,000 days of life"—determines health and wealth across the life course. They argue that fetal development is the key to global development. In this thought-provoking and timely book, Emily Yates-Doerr shows that the control of mothering is a paradigmatic technique of American violence that serves to control the reproduction of privilege and power. She illustrates the efforts of Guatemalan scientists, midwives, and mothers to counter the harms of such mal-nutrition. Their powerful stories offer a window into a form of nutrition science and policy that encourages collective nourishment and fosters reproductive cycles in which women, children, and their entire communities can flourish.

"In the early to mid-twentieth century, the governments of Ecuador and Guatemala sought to expand Western medicine within their countries, with the goals of addressing endemic diseases and improving infant and maternal health. These efforts often clashed with indigenous medical practices, particularly in the rural highlands. Drawing on extensive, original archival research, historian David Carey Jr. shows that indigenous populations embraced a syncretic approach to health, combining traditional and new practices. At times, the governments of both nations encouraged--or at least allowed--such a synthesis, yet they also attacked indigenous lifeways, going so far as to criminalize native medical practitioners and to conduct medical experiments on indigenous people without consent. Health in the Highlands traces the experiences of curanderos, midwives, bonesetters, witches, doctors, and nurses--and the indigenous people they served. Carey interrogates the relationship between 'progressive' public health policy and indigenous well-being, offering lessons from the past that remain relevant in the present. Our best way forward, this history suggests, may be a compassionate syncretism that joins indigenous approaches to healing with science and a pursuit of environmental and social justice"--