Introducción: se analizaron algunas formas de violencia institucional en los servicios públicos de salud en relación con la configuración del espacio, la lógica burocrática y la actuación de los agentes institucionales sobre el comportamiento de los pacientes y acompañantes durante la espera para recibir atención médica. Desarrollo: el estudio se realizó con observación participante y doce entrevistas semiestructuradas y se analizó con tres categorías: la espera, la producción institucional de la sujeción y la alienación del derecho a la salud. Conclusiones: se sostiene que estas formas de violencia institucional son instrumentales en la reproducción de la dominación y la exclusión que se ejercen sobre los usuarios.

Institutional violence and violation of the right to health: Elements to Clara Bellamy rethink the demandability of the right to health in present-day Mexico Palabras clave: derecho a la salud, derechos humanos, violencia institucional, violencia obstétrica, exclusión. SummaryThe objective of the present investigation was to generate evidence on elements that may constitute obstacles in the exercise of the right to health, while documenting violations of said right and characterizing the main forms of institutional violence suffered by users of public health services. The recommendations of the Comisión Nacional de Derechos Humanos (CNDH) (National Human Rights Commission), published in its monthly gazette between 2000 and 2016, were analyzed for cases pertaining to health. A quantitative analysis of simple frequencies and bivariate relationships was carried out and four population profiles were established: pregnant women, non-pregnant women, men and collective cases. Subsequently, a content analysis of the legal narrations for each group was performed and analyzed through four analytical categories: (attention) waiting time, chain of errors, obstetric violence and exclusion. We characterize the patterns present in the violation of the right to health and debate against the arguments that support the notion that most of the errors are mainly due to infrastructure problems. In spite of considering that infrastructure deficiencies effectively influence user attention, a finding of the investigation is that, in a great number of complaint cases presented before the CNDH, infrastructure deficiencies are not the main element, but instead, are superseded by elements related to classism, racism and sexism, perpetrated through practices of discrimination, authoritarianism and social exclusion.

This article discusses how Zapatista women have built themselves as transformative political subjects that disrupt the racist, classist, and patriarchal nation-state. It underscores the importance of reflecting on Zapatista women, on their struggle for particular demands specified in the Revolutionary Women’s Law, especially the collective struggle for obtaining rights such as to land, to participate politically, and to organize themselves in the armed struggle. Instead of entering into debate over whether Zapatista women are feminists or not, this article recognizes how, besides transforming living conditions, the Zapatistas have organized politically and gone from a process of invisibility, silence, and obedience to one of recognition, speech, and command. In this sense, the struggle of Zapatista women is an example of theoretical and practical ruptures within the history of class, gender, and race struggled in Mexico and the world.