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Out of sight out of mind: intercultural health technicians in the Peruvian Amazon

Pesantes Villa, Maria Amalia (2014) Out of sight out of mind: intercultural health technicians in the Peruvian Amazon. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

This dissertation assesses the complexity inherent in the use of the concept of interculturalidad to implement projects and policies for indigenous people. The research is based on a case study of a grassroots initiative in intercultural health promoted by AIDESEP, an organization that represents indigenous communities from the Peruvian Amazon. The findings demonstrate the limitations of the strategies of both the indigenous organizations and the state around intercultural health and the creativity that, despite these limitations, a group of indigenous nurse technicians use to provide intercultural health care.
Interculturalidad does not have a single static meaning; rather, its meaning is specific to the context and actor using it. Two different meanings of interculturalidad are discussed in this dissertation, Critical and Functional interculturalidad. Critical interculturalidad is the one usually used by indigenous organizations which aim to effect changes to policy-making processes that have historically marginalized indigenous people and their knowledge. On the other hand, the state’s use of interculturalidad is often limited to a superficial acknowledgement of cultural difference without questioning root causes of discrimination against indigenous people during policy-making. This is known as Functional interculturalidad and, in contrast with Critical interculturalidad, does not aim to make radical changes in indigenous peoples’ social
position. In this dissertation I show that beyond discussions about the meaning of interculturalidad, intercultural policies require flexibility from bureaucratic state structures, and openness for negotiation on behalf of indigenous organizations.
Through the analysis of the approaches used by the Peruvian state and AIDESEP to provide intercultural health in Peru, this research shows that without structural changes in the state’s support and promotion of indigenous medicine, intercultural health will only produce superficial changes. Furthermore, this dissertation shows that without active political support from indigenous organizations, changes in healthcare delivery for indigenous people will remain limited. In the context of health services for indigenous communities in the Peruvian Amazon interculturalidad remains a well-intentioned idea, yet its implementation in health care by indigenous organizations and the state falls short of delivering the transformation it seeks to promote.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Pesantes Villa, Maria Amaliamap128@pitt.eduMAP128
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairSanabria, Harrysanabria@pitt.eduSANABRIA
Committee MemberDeWalt, Kathleenkmdewalt@pitt.eduKMDEWALT
Committee MemberAlter, Josephjsalter@pitt.eduJSALTER
Committee MemberDocumét, Patriciadocumetp@yahoo.com
Date: 29 May 2014
Date Type: Publication
Defense Date: 1 April 2014
Approval Date: 29 May 2014
Submission Date: 3 January 2014
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 288
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Anthropology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Interculturalidad; Intercultural Health; Indigenous People; Amazonia; Health Care; Indigenous Movements in Latin America
Date Deposited: 29 May 2014 23:02
Last Modified: 15 Nov 2016 14:16
URI: http://d-scholarship.pitt.edu/id/eprint/20329

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