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“Tribe” Of Epidemiologists Are
Focus Of Study In Guatemala
Anthropologist
Finds A Complex Web Of Causes Preventing Epidemiologists From
Achieving Their Dreams
An ethnographic study
of the everyday practice of epidemiology in Guatemala and how it does
or does not contribute to public health has found a complex web of
social and economic factors that help to sustain rather than reduce
existing health inequalities. The author of the paper entitled
“Neocolonial Epidemiology” is Alejandro Ceron, a Guatemalan
physician and a University of Denver anthropologist with masters level
training in epidemiology.
Factors
The multiple
contributing factors operating to hinder epidemiologic practice were
categorized by Ceron as 1) institutional chaos, 2) disciplinary
conformism, 3) global health international relations, and 4) social
relations at national level. Included in these categories were
specific challenges such as insufficient resources, non-compliance
with mandatory disease reporting, failure to publicly report the
results of investigations, and low prioritization of public health.
The paper describes an even longer litany of shortcomings and
limitations, many of them common in developing country contexts, which
have the effect of vitiating the promise inherent in epidemiologic
practice to improve people’s health.
Background
According to Ceron,
“When I graduated from Guatemala’s public university as a physician, I
knew I wanted to become an epidemiologist…I genuinely believed that
epidemiology would give me tools for speaking truth to the powers
responsible for the country’s tremendous social exclusion.” What he
found instead was that epidemiologists were not speaking truth to
power.
In a surprising
evolution to his career, Ceron reports that the more he did
epidemiological work, the less attention he was paying to the social
inequalities that had motivated him in the first place. He states, “I
was living in a paradox: the more I sought the tools for understanding
social inequalities in health, the farther away I was moving from
actually dealing with them.”
Ceron’s study of what
he jokingly calls “the tribe of Guatemalan epidemiologists” was an
attempt to better understand the causes of this paradox. He studied
epidemiologists working at the National Epidemiology Center in
Guatemala.
Ceron’s paper
concludes by describing “Guatemalan neocolonial epidemiology as
undisciplined, intellectually colonized, institutionally weak, norm
obedient, fearful of the powerful, deprecatory of the powerless,
marginal, egocentric, and ineffective.” It does not investigate the
causes of health problems and does not contribute to addressing health
inequalities.
Strengthening
epidemiology would require truly adopting people’s well-being as its
aim and purpose and addressing more of the complex factors which
hinder and frustrate epidemiologists seeking to have meaningful impact
on public health.
To access this paper,
visit:
https://bit.ly/2mwHmEQ ■
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