Citizen participation overplanned: The case of a health project in the Guatemalan community of San Pedro La Laguna

Paul, Benjamin D.; Demarest, William J.

doi:10.1016/0277-9536(84)90209-0

Cited by 23 publications

(8 citation statements)

References 3 publications

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“…San Pedro was selected for this pilot project to evaluate function, efficacy, and practicality of locally available filters based on (1) perceived willing citizenry; (2) an active youth leadership group; (3) town-elected representatives interested in facilitating project; (4) previous evidence of source lake water contamination; (5) reported elevated levels of gastrointestinal illness, particularly among children less than 5 years old (source: Guatemalan Ministerio de Salud Pública y Asistencia Social, Sanemiento Ambiental); and (6) previous evidence of non-compliance of potable water systems with government mandated chlorination (source: Guatemalan Ministerio de Salud Pública y Asistencia Social, Sanemiento Ambiental). In addition, San Pedro has had a documented history of failed interventions that have suggested that a traditional top down approach will not work (Paul and Demarest 1984) (personal communication with town leaders); indeed, some of the most effective organization and change for Guatemala indigenous citizens has come about by decentralization and greater responsibility at the municipal level, enabling them to address issues related to quality of land and water health through their own modes of organization (Rasch 2012).…”

Section: San Pedro De La Lagunamentioning

confidence: 99%

Employing CBPR to investigate function, utility, and longevity of household filters to improve potable water quality for indigenous peoples at Lake Atitlán, Guatemala: a pilot study with San Pedro de La Laguna

Roegner

Ochaeta

Bocel

et al. 2016

Energ. Ecol. Environ.

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Cyanobacterial blooms at Lake Atitlán in Guatemala threaten and compromise the livelihood and health of local residents. Indigenous Tz'utujil, Kaqchikel, and K'iche' rely directly on lake water for drinking, bathing, cleaning, cooking, and fishing. Nonpoint source runoff and untreated wastewater pumped directly into the lake contribute to high fecal pathogen loads into source waters. Concurrent nutrient loading results in cyanobacterial blooms further compromising water quality. A lakeside municipality facing high rates of childhood gastrointestinal illness volunteered to engage in community-based participatory research (CBPR) to evaluate efficacy, utility, and longevity of filters in households. The filters consistently reduced the risk of coliforms and E. coli in household water drawn from the lake based on World Health Organization guidelines. Household surveys were simultaneously administered through a student leadership group regarding water usage, water quality, and community health. Filters demonstrated ability to reduce high loads of fecal indicators from source waters and ability to remove a cyanobacterial toxin (microcystin) at 10 lg/L in deionized water. Further studies are imperative to determine longevity of use in households and CBPR provides a powerful avenue to test efficacy of a possible intervention while engaging stakeholders and empowering community members with sustainable solutions.

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Section: San Pedro De La Lagunamentioning

confidence: 99%

Employing CBPR to investigate function, utility, and longevity of household filters to improve potable water quality for indigenous peoples at Lake Atitlán, Guatemala: a pilot study with San Pedro de La Laguna

Roegner

Ochaeta

Bocel

et al. 2016

Energ. Ecol. Environ.

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“…In addition to the military and guerrillas, promoters were subject to accusations deriving from personal and communal jealousies. In the highly polarized political context of the violence, accusations against promoters became a method through which personal grievances and aspirations for personal gain could be exacted through violence justified by the State (Davis ; Paul and Demarest ). The economic success of promoters as well as connection to external development programs often incited jealousies both within and between communities, which fueled some accusations of promoters supporting the guerrillas (Cabrera ).…”

Section: The Behrhorst Health Promotermentioning

confidence: 99%

Shifting identities:

Maupin

2015

Annals of Anthropol Pract

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Guatemala is one of the first countries in the Americas to establish community health worker (CHW) programs, and CHWs have served a central role in both large‐scale national programs and small‐scale nongovernmental organization (NGO) projects. The role of CHWs, including their training, responsibilities, and idealized identities, has never been uniform, and has fluctuated over time in response to changing international health paradigms, national socioeconomic and political processes, and local‐level power structures and expectations of the position. In this paper, I examine the changing nature of CHWs in the Central Highlands of Guatemala by focusing on the case of the Behrhorst Clinic in Chimaltenango, Guatemala. The Behrhorst Clinic was one of the first to implement a CHW program in Guatemala, and is one of the few NGOs in the region to operate continuously since the 1960s, providing a unique case study to examine the history and transformation of CHWs in three distinct sociopolitical periods: the Primary Health Care era (1960s–1970s); the sociopolitical violence (1970s–1980s); and the aftermath of the violence (1980s–2000s). This longitudinal analysis of the Behrhorst health promoter program highlights central, ongoing issues facing CHW programs in Guatemala and beyond including: the political susceptibility of community participation and empowerment programs; community participation and representation; and the long‐term and intergenerational impact of CHW positions that function as a mechanism for socioeconomic advancement through the provision of curative services.

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“…These unintended consequences are especially striking when the emphasis on grassroots participation in PHC projects runs up against the deep factionalism in particular communities. For example, Paul and Demarest (1984) describe how political and religious divisions frustrated plans to form a "representative committee" to oversee the PHC clinic in a Guatemalan village. Because the project promised valuable resources, long-standing factions competed for its control and undercut each other's efforts.…”

Section: (A Similar Move Is Made By Maclean and Bannerman 1982)mentioning

confidence: 99%

“…and agency have been used in this literature. The survey offers a reorientation for future work, based on the suggestions of Paul and Demarest (1984), Stone (1989), and others, which is then applied to the RHDS project in Jeanty. 2…”

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confidence: 99%

Politics, Practical Logic, and Primary Health Care in Rural Haiti

Brodwin

1997

Med Anthropol Q

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During the 1980s, an ambitious project for health development restructured medical services throughout rural Haiti. The "Rural Health Delivery System" (RHDS) pursued several goals of primary health care, including dispensary-based maternal and child health services and the provision of low-cost drugs. Based on fieldwork in a single village, this article examines how local residents pushed the project in unpredictable and ironic directions. People did not regard dispensary services-which were planned and financed by international health agencies-as essentially foreign elements in the local health-care system. They rather engaged with the dispensary according to long-standing local strategies for prestige and economic advance. Despite the dramatically new shape of biomedicine introduced by the RHDS, the dispensary remained for most people a recognizable arena to gain access to state resources or to contest state control over their lives. The "success" of clinic services, and the "failure" of the project to distribute essential drugs arose more from people's practical routes to symbolic and material power than from the formal plans of health planners or state bureaucrats. This practice-based analysis provides another dimension to both the liberal and neo-Marxist critiques of international health development.

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Citizen participation overplanned: The case of a health project in the Guatemalan community of San Pedro La Laguna

Cited by 23 publications

References 3 publications

Employing CBPR to investigate function, utility, and longevity of household filters to improve potable water quality for indigenous peoples at Lake Atitlán, Guatemala: a pilot study with San Pedro de La Laguna

Employing CBPR to investigate function, utility, and longevity of household filters to improve potable water quality for indigenous peoples at Lake Atitlán, Guatemala: a pilot study with San Pedro de La Laguna

Shifting identities:

Politics, Practical Logic, and Primary Health Care in Rural Haiti

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