bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding Mapuche-Williche Conceptions of Diabetes Mellitus and Arterial Hypertension from the Perspective of Intercultural Health
Authors: Bermedo Muñoz Sergio Hernán
Published: January 2025

Background: In order to create a culturally relevant health model, we examined how users from the Mapuche-Williche community, Chile's largest indigenous population, understood the causes of Diabetes Mellitus and Hypertension.

Objective: To describe both popular conceptions and traditional therapeutic practices used by Mapuche-Williche patients with Diabetes and Hypertension.

Setting: Health clinics located in the Cacicado de Riachuelo Jurisdiction of Rio Negro.

Materials and Methods: This is an exploratory/descriptive study using the techniques of Social Anthropology to incorporate elements of indigenous health concepts into the positivist logic of biomedicine. Recruitment was non-random. We employed both case studies and in-depth interviews. Interviews were analyzed by constructing categories which described the meanings and significance that the interviewees themselves saw in their understandings and practice.

Results: As explained by our patients, the Mapuche-Williche cultural system involves a therapeutic process during which traditional Mapuche-Williche medicine may complement, alternate with, or substitute for traditional Allopathic Medicine.

Conclusions: Diabetes Mellitus and Hypertension are not recognized illnesses within traditional Mapuche-Williche medicine. This creates difficulties in terms of adherence to biomedical treatment. Patients substitute traditional healing for biomedicine. These considerations suggest the need to develop an intercultural health model within the commune of Rio Negro.
From social determinants to social interdependency: Theory, reflection, and engagement
Authors: Ventres William , Dharamsi Shafik , Ferrer Robert
Published: January 2025

Introduction
Scholars and practitioners in medicine and public health have devoted significant time and effort to defining the social determinants of health and identifying resulting inequities in health outcomes. By focusing predominately on social determinants as referent sources of morbidity and mortality, however, health care professionals can be led to believe that the origins of poor health-related outcomes are disconnected from the ways in which social, economic, political, and environmental factors are established and maintained.

Discussion
We introduce the concept of social interdependency in health ¬and illness as a way to (1) reinforce the need to consider the root causes of social determinants, and (2) accepting communal and personal responsibility for acting to ameliorate their effects. Developing a sound understanding of social interdependency in clinical practice, public health research, and health care advocacy involves an iterative process of observation, reflection, and action. Effecting positive change within these disciplines is a shared obligation. We present a case study that demonstrates these principles of social interdependency.

Conclusion
Developing and applying a social interdependency in health and illness means moving from imposition to inclusivity, from investigation to involvement, and from investment in medicine and public health as a product to one of process. This process—the movement from social determinants toward social interdependency—showcases how we live in a world where none of us is so separate from another that we cannot benefit by envisioning and desiring for others what we might desire for ourselves.
Pragmatic barriers for delay in access to HCV testing services: Perspective of People With Injecting Drugs and living with HIV
Authors: Madge Varada Jayant , Sogarwal Ruchi , Mehra Sunil
Published: January 2025

Background: Hepatitis C (HCV) is emerging as a major public health problem and its co-infection with HIV is on the rise especially in People With Injecting Drugs (PWID). Barriers for delay in accessing services for HCV care may lead to disease progression and impact the society in the form of loss of productive workforce. Aim: This qualitative research was undertaken to explore the barriers for delay in testing for HCV amongst PWIDs. Methods and Material: The study was conducted in two districts of India i.e. Imphal (Manipur state) and Amritsar (Punjab state). A total of 32 PWIDs participated through In-Depth Interviews (IDI) and Focus Group Discussions (FGD). Results: Mostly, the barriers reported for delay in HCV testing were related to socio economic context in which the PWIDs live; inhibitions to get tested due to fear of a positive result, unavailability of HCV services particularly in rural and remote areas, financial costs and long waiting period. Drug use amongst females influenced care seeking behavior. Conclusion: PWIDs face significant health risks of HCV. The socio economic and health systems related barriers create gap for continuum of care for PWIDs. Supportive role of the health care providers, awareness on viral hepatitis, care and support from family is thus fundamental to PWIDs living a healthy life. Key words: Barriers, Hepatitis C Virus, PWID, Health Systems and continuum of care.
Risk of Viral Hepatitis B and C Among Young Adolescents Who Inject Drugs: A Future Public Health Challenge
Authors: Madge Varada Jayant , Vinayakan E. K. , Garg Rishi , Mehra Sunil
Published: January 2025

Background: Adolescents are vulnerable populations and due to lack of health information on injecting drugs and viral hepatitis, it is likely that they could engage into unsafe injection and sexual practices that could be risky for their health. Aim: The present paper is an attempt to explore the risky patterns that make adolescents vulnerable to Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). The adolescents were part of the intervention, “Prevention and Early Management of Hepatitis B and C among high risk group in Amritsar and Imphal, India”, that was conducted from October 2014 till January 2018 Material and methods: In this intervention, 29 [out of 1700 People Who Inject Drugs (PWID] were adolescents. Risk assessment tool was used to monitor their health condition and adherence to harm reduction practices. Since the number was small, simple frequency distribution (number and per cent) was used to analyse the data and numbers are used to elucidate the overall results. Results: Overall the findings showed that out of 29 adolescents, 25 of them were actively engaged in sexual practices and most of them did not use protective mechanisms like condoms. Seven were injecting more than 30 shots per day and eight adolescents mentioned that they shared needles. Three adolescents in this intervention, were diagnosed with HCV positive and were linked to treatment during the project period. Four adolescents showed symptoms of STI and were treated for the same in the past one year. Conclusion: The findings suggests targeting the young population for intervention by providing continuous education sessions on harm reduction practices and follow up to reduce the risk of transmission of HBV and HCV.
Decarcerating America : Once Again
Authors: Drucker Ernest
Published: January 2025

The original meaning of Decarceration first hit me in 1964, when I was a clinical psychology intern in Brooklyn, at the Maimonides Hospital Department of Psychiatry where I first saw youthful drug users as patients, and ( more often ) in the streets of the community. This was before the “war on drugs” was declared by Pres. Nixon in a press conference on June 17, 1971, at which time President Nixon declared drug abuse "public enemy number one." But at this point in history even socially oriented institutions like Maimonides had little clinical experience with drug users - and the American criminal justice system had yet to discover and imprison them.
Chuukese community experiences of racial discrimination and other barriers to healthcare: Perspectives from community members and providers
Authors: Inada Megan Kiyomi , Braun Kathryn , Cassel Kevin , Yamada Seiji , Comptom Randy , Mwarike Parkey , Sentell Tetine Lynn
Published: January 2025

Racial discrimination is a critical barrier to quality healthcare for many ethnic/racial groups in the United States (US). Chuukese are a rapidly growing, yet understudied, Pacific Islander group in the US. Research suggests that Pacific Islanders in the US have a high burden of chronic and infectious diseases, but underutilize preventive health services. The purpose of this study was to explore the Chuukese community’s experiences with healthcare, particularly reports of racial discrimination. In-depth interviews were conducted with nine Chuukese community participants and eight healthcare providers serving this community in Hawai‘i. Purposive and referral sampling were used to identify participants. Data were analyzed using framework analysis. Barriers to healthcare utilization included inadequate healthcare coverage and lack of trust between providers and patients due to differences in language and culture. All participants shared examples of racial discrimination experienced by Chuukese individuals both in and out of the healthcare system. Many participants revealed that racial discrimination was often difficult to discuss openly, and that it negatively impacted their health by increasing stress and mistrust and decreasing access to needed services. Participants recommended concrete actions to broach conversations regarding racial discrimination, including creating a neutral agency to address complaints and asking about patients' family and community experience with discrimination. Providers shared how they modified their care to better serve Chuukese patients by recognizing and building on community assets, such as strong religious and family connections. These findings are relevant to providers working to address racial discrimination and improving healthcare for underrepresented immigrant ethnic groups.
Becoming a victim, from pain to empowerment‬
Authors: Artaza Varela Camilo Eugenio
Published: January 2025

The following work is the result of an experience held in the city of Barquisimeto Lara state during 2016, which I define as an encounter with the dignity of family members victims of police abuse, who in the midst of the pain have undertaken a fight for justice , building together and together spaces of protest and mobilization for activation and training in human rights. The testimonies contained in this article were made through in-depth interviews and exploratory conversations with five members of the Argimiro Gabaldón front, within the framework of the training of popular therapists to care for victims of police abuse and violation of rights with the Organization No Government "Support Network for Justice and Peace".
Disability and gender inequality, the disadvantage for women
Authors: Karam Calderón Miguel Ángel , Castillo Sánchez Yazmín , Moreno Pérez Pablo
Published: January 2025

In the field of health, it is considered that the gender perspective should start from the recognition of the deep inequalities of health based on gender. Gender, as a social construction, is a very important factor, which increases biological vulnerability and accompanies biology in determining health inequalities. Being a man or a woman favors health differences and these are significant within any socioeconomic group, and especially when it comes to women with disabilities.

There is little literature in Latin America and particularly in our country about the inequality status of women with disabilities, however, the data obtained makes clear reference to the fact that women with disabilities occupy a lower status in our society, finding themselves in a situation of enormous social, economic, educational and professional disadvantage.

Therefore, in this work it is intended, through the review based on secondary sources, to carry out an analysis that allows the integration of the gender perspective with the social conception of disability, for the understanding of inequality in our societies and the elaboration of strategies to redefine social relations in fairer and more equitable terms and a notion of citizenship that includes everyone, transcending from the hegemonic reductionist vision of medicine to a broader and more inclusive vision.
Contribution of guarding to quality of life among chilean people living with HIV
Authors: Araya Alejandra Ximena , Iriarte Evelyn
Published: January 2025

Background: Guarding is a self-care process that individuals use to manage chronic illness; it refers to the process of maintaining vigilance over a person’s self and network. This study evaluates the relationship between quality of life and guarding among people living with Human immunodeficiency virus/Acquired immunodeficiency syndrome (PLHA). Method: A cross-sectional study of 209 people living with Human immunodeficiency virus/Acquired immunodeficiency syndrome was conducted in Santiago, Chile. PLHA completed a questionnaire about characteristics of quality of life, human immunodeficiency virus symptoms status, social network, demographics, and guarding. Illness characteristics were obtained from medical records. Results: Hierarchical multiple regression revealed that having more close friends/relatives, fewer Human immunodeficiency virus symptom status, and less guarding behavior was significantly related to a higher quality of life. No relationship was found between quality of life and demographic and illness characteristics. Conclusion: Together, study variables explained 58.8% of the variation in the quality of life.
Doctors Gone Bad: Physicians, Dictatorships, and Warrior Cultures
Authors: Donohoe Martin
Published: January 2025

During World War 2, the guiding Hegelian philosophy of Nazi Medicine was one of rational utility, meaning “what is useful is right.” Nazi Medicine was essentially an arm of state policy, with a focus on racial purity, beginning with the sterilization of 370,000 “misfits and undesirables”; followed by the involuntary euthanasia of 70,000 elderly, chronically-ill, and mentally-disabled persons; and culminating in the large-scale genocide of over 6 million Jews, Catholics, gypsies, and others. The Final Solution was based on Social Darwinism, a movement with disturbing parallels in the American and British eugenics movements. Individual worth was conceived of in economic terms. Propaganda focused on obligations to the state. Doctoring the nation became more important than doctoring individuals. There was a significant focus on preventive medicine and public health, including anti-tobacco and anti-alcohol campaigns, reductions in environmental toxins, and organic farming, all designed to improve the Aryan stock. Medical journals were relatively silent about ongoing abuses. Movies and textbooks reinforced Nazi ideology.
Civil Society Report to the Commission on Social Determinants of Health
Authors: Civil Society Representatives of
Published: January 2025

A hundred and fifty years after his death we continue to be reminded of Virchow’s comment: “Do we not always find the diseases of the populace traceable to defects in society”? We continue to seek “defects in society” that need to be remedied if health is to be given its rightful place. Today, more so than ever before, we are reminded that, ultimately, politics played out at the global scale, determines whether people live or die. Civil Society welcomes the opportunity provided by the Commission on Social Determinants of Health (CSDH) to explore these issues in detail. Civil Society has been consistent in arguing for an approach to health that echoes Virchow’s famous words.
Declaración pública de la Asociación Latinoamericana de Medicina Sosical, ALAMES-Uruguay
Authors: Borgia Fernando
Published: January 2025

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Reproductive Behavior of Immigrant Latin American Women in Spain
Authors: Acevedo Cantero Paula
Published: January 2025

The present study analyzes fertility patterns among a group of Latin-American female immigrants examining the impact of decade of birth, educational level, and migration on reproductive behavior. The study group was composed of 138 Latin-American women, aged 18 to 59 years, and residing in Spain. Menarche occurred at a mean age of 13.6 years old (sd 1.8) and the social initiation of fertility, as determined by age of first cohabitation, occurred at a mean age of 21.4 years (sd 0.4). Neither of these variables was affected by decade of birth. However, there were significant educational influences on age at first cohabitation. Women with a higher educational level showed delayed cohabitation and decreased fertility rates. On the other hand, there was in increase in the number of induced abortions after immigration to Spain seen among the youngest women. In conclusion, age at first cohabitation is an important indicator for the analysis of community demographic dynamics, although this age is conditioned by educational level. Likewise, adaptation to new social structures and situations is associated with changes in reproductive behaviors and may lead to practices among women that put their health at risk.
Caring for Active Duty Military Personnel in the Civilian Sector
Authors: Waitzkin Howard , Noble Marylou
Published: January 2025

Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessments, clinical interventions in acute situations, and documentation that assists GIs in obtaining reassignment or discharge. Most clients who use Network services come from low-income backgrounds and manifest psychological rather than physical disorders. Qualitative themes in professional-client encounters have focused on ethical conflicts, the impact of violence without meaning (especially violence against civilians), and perceived problems in military health and mental health policies. Unmet needs of active duty military personnel deserve more concerted attention from medical professionals and policy makers.
¡Salud! Southwest Tour
Authors: Souers Joanna Mae
Published: January 2025

During this summer of 2009, 12 American medical students from the Escuela Latinoamericana de Medicina (ELAM – Latin American School of Medicine) in Havana, Cuba will board a Recreational Vehicle (RV) to travel across the Southwest region of the United States visiting a number of tribal settlements of American Indian Nations, community colleges and universities. While at the various sites the students will share their personal experiences of what it’s like to study at ELAM while promoting the availability of full scholarships for students, volunteer their services while learning about some of the more significant health concerns affecting American Indian populations and to build personal and professional relationships with health care practitioners and members of Native American communities.
Making it Politic(al): closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health
Authors: Birn Anne-Emanuelle
Published: January 2025

The anniversary of the publication of Closing the Gap in a Generation (CGG) offers a moment to reflect on the report’s contributions and shortcomings, as well as to consider the political waters ahead. The issuance of CGG was not the first time the World Health Organization (WHO) raised the problem of global inequalities in health. Numerous analysts and advocates have compared CGG to the 1978 Declaration of Alma-Ata. Some see CGG as a continuation of Alma-Ata; others malign it for paying insufficient attention to the principles, background documents, and lines of action proposed in the Alma-Ata declaration.

We might understand the two reports as bookends to 30 years of brutal global capitalism, punctuated by the “lost decade” of the 1980s, the end of the Cold War, and, more recently, the implosion of global finance. This period saw the publication of two seminal neoliberal health manifestos –the World Bank’s 1993 World Development Report and the WHO’s 2002 Commission on Macroeconomics and Health report. Both feature the term “investing in health” in their title, conveying “a double meaning—investing [through “cost-effective,” narrow, technical interventions] to improve health, economic productivity, and poverty; and investing capital, especially private capital, as a route to private profit in the health sector.”
A Reminder and a Memorial [Book Review]
Authors: Franklin Alfred White
Published: January 2025

Originally published in the British Medical Journal on March 22, 1980, Volume 280, pages 851-855.

The Quality of Life: the Peckham Approach to Human Ethology. Innes H Pearse. (Pp 194; £6 50.) Scottish Academic Press.1979.

The biologist studies man as a physical organism existing in a space-time world of measurable dimensions. This organism has the ability to adapt to changes in its environment; to the processes ofgrowth, development and aging; and to disease. The main objectives of medicine have been to help both adaptation and defence. Prevention through hygiene and immunisation, drugs, surgical removals, and replacements-all these make their contributions, which have increased in complexity and expense, disappointing Beveridge's hope in 1949 that a National Health Service plus rehabilitation (then a novelty) would so improve health that the Service would wither away.
To avoid and prevent ill health are worthy aims; to promote health is also worthy, but something different. It was to study healthy living that Dr Scott Williamson, Dr Innes Pearse, and their colleagues devised the Peckham experiment, of which this book is at once a reminder and a memorial. They wanted to study Homo sapiens in his natural habitat and they began their exploration as biologists. In an initial family club of 150 families they noted that disorders, however skilfully treated, recurred in the environment out of which the disorder had arisen. So, in 1935, they designed a laboratory in which human beings could be observed growing up and creating new families. The centre, purpose-built, combined maximum visibility throughout, flexibility, and free access to all members. By the outbreak of war 800-900 families had grown their own lively social life. Many of the original families rejoined when the centre reopened after the war. It finally closed in 1951. Meanwhile, the observers had invented a new role.
War and the Right to Health in Colombia: A Case Study of the Department of Nariño
Authors: Pacheco Sánchez Carlos Iván
Published: January 2025

This paper reviews compliance with the right to health in Colombia following the reform of the Colombian health system in 1993. A case study in the department of Nariño shows the differential effects of war on the guarantee of the right to health of Colombians. The poorest, most vulnerable populations are affected by war and suffer the greatest violation of their right to health. Violations of human rights, including the right to health, are greatest among poor homes, ethnic groups, sexual minorities and all those living in areas where war is at its most intense. Moreover, the social security health care system’s philosophy and organization have enabled illegal armed agents, mainly the paramilitary, to appropriate and manage health resources and use them for their own ends.
On the 25th Anniversary of ALAMES
Authors: Franco Agudelo Saul
Published: January 2025

Twenty five years ago, in a peaceful rural corner of Ouro Preto, Brazil, twenty people decided to establish the Latin American Association of Social Medicine (ALAMES). We were searching for new theoretical horizons and better health conditions for the people of our region. Twenty of us signed the declaration, but there were hundreds at the Ouro Preto meeting and thousands more who were committed to and interested in the new organization. We were cognizant of what had preceded this event. We knew that 140 years before us a group of German revolutionaries had undertaken a radical reform of thinking and practice in health services and education. Their ideas had not disappeared; they remained alive in several countries and were embodied in the work of thinkers like Giovanni Berlinguer. We knew that in our continent, recently hit by the systemic crisis of capitalism in the 1970’s and burdened by a massive external debt, the countries of the southern cone were struggling to emerge from dark and bloody military dictatorships. Revolutionary winds were sweeping across Central America and the Caribbean. We were also conscious that a social science component – intentionally functional and instrumental in character – had recently been introduced into the curriculum for training health care professionals. Nonetheless the training and practice of health care professionals remained dominated by a disease-centered theoretical perspective and a bio-centric logic. Teaching was more concerned with the interests of the established powers than those of the impoverished majorities.
Von bösen Schulden und globaler Verantwortung. Das Beispiel Haiti zeigt, wie das System der Auslandsschulden die Menschen schutzlos einer Katastrophe ausliefert
Authors: Gebauer Thomas
Published: January 2025

Von bösen Schulden und globaler Verantwortung. Das Beispiel Haiti zeigt, wie das System der Auslandsschulden die Menschen schutzlos einer Katastrophe ausliefert

This commentary was originally published in the Medico Rundschreiben January 2010 and is reprinted here in the original German with the kind permission of the author.
Harm Reduction Unit of the City of Santo André, São Paulo State, Brazil: An Evaluation
Authors: Moreira da Silva Silvia , Baldini Soares Cássia , Ezequiel Santos Vilmar
Published: January 2025

The Harm Reduction Unit (HRU) in Santo André (São Paulo State) was created to improve the health of people who either live or work on the streets: drug users, commercial sex workers (male and female), men who have sex with men, sexually exploited adolescents, transsexuals, transvestites, lesbians, and women working in brothels. This project was undertaken to evaluate the HRU from the perspective of its users. A semi-structured interview was administered to nineteen users from different segments of the populations served by the unit. The major weaknesses of the HRU were felt to be its inconsistent presence in some areas and the absence of psychologists to provide follow-up care. The unit was seen as promoting better health, increased use of condoms, reduction in drug usage, increased access and use of health care services, and less sharing of equipment used in drug consumption. Users see the HRU as a sympathetic presence whose ongoing work provides them with a sense of security and protection. The impact of the HRU went beyond harm reduction; users reported transformative changes such as increased awareness of their social rights and knowledge about how those rights can be demanded. Users

had been given new tools to face their problems and seek access to education, work, and housing.

Key words: harm reduction, illegal drugs, health service evaluation, social problems
Social Medicine in Timor Leste
Authors: Anderson Tim
Published: January 2025

‘“Social medicine”, a  concept notably developed in Latin America by Salvador Allende in the 1930s, links up a broader model and ethos of public health with processes of social transformation. In recent years that influence has spread to Timor Leste, through a very large Cuban health cooperation and training program. This paper considers to what extent an endogenous “social medicine” might be developing in Timor Leste. Such a development would require transition away from the existing model based on small, private clinics.

The paper accepts Guzmán’s observation that Latin American social medicine is a wider, more dynamic and participatory model than that presented from European epidemiology – the ‘social determinants’ approach – but asserts that there are different forms of social medicine, conditioned by distinct histories and cultures. If earlier Chilean social medicine was a key element of that country’s radical social democracy, and Cuban social medicine expressed revolutionary solidarity and internationalism, what might be the character of an East Timorese social medicine?

This paper traces the idea of ‘social medicine’ from Chile, through Cuban solidarity aid, to the synthesis emerging in Timor Leste. This is an interpretive history, making use of past analyses, contemporary information on the Cuba-Timor Leste health program and the East Timorese responses. It includes a number of interviews and direct observations of pedagogy and practice. It concludes that a transition to social medicine in Timor Leste has some advantages: the large scale of the new training program; a sympathetic culture; and potential leadership. Less certain is the exact form of East Timorese social medicine. However the ideas seem set to be absorbed into a domestic culture of community solidarity, inclusive Christianity, and an independent spirit.
Nursing Shortage in India with special reference to International Migration of Nurses
Authors: Gill Reema
Published: January 2025

In any health system, the health worker determines the nature and quality of services provided. Data demonstrate that most health systems across the globe face nursing shortages, varying across regions and rural-urban distribution. Although nursing services are an integral part of both preventive and curative aspects of India's health system, the nursing estimates of the country shows that India has been facing shortage of nurses since independence. Studies show that professional, social and economic reasons are considered to be behind the nursing shortage in India. Similar reasons induce Indian nurses to look for migration opportunities in other countries. The high income countries have discovered India as a new source of well trained, English-speaking nurses to overcome their nursing shortages. This has resulted in mass migration of nurses from India which in turn may lead to non-availability of standard quality health services especially to the poor section of the population in the country. Strong political commitment is required for improving the nursing situation in India.
Risk Behaviors among Undocumented Immigrants in Northern Mexico: 2006-2007
Authors: Agudelo Botero Marcela , Jaramillo Cardona Martha Cecilia
Published: January 2025

Introduction: The purpose of this study was to analyze some major aspects of health of the undocumented migrant population at the northern Mexican border (Tijuana and Mexicali) between 2006 and 2007.

Methods: We used a database of 1,535 interviews with undocumented migrants conducted by Doctors of the World. This sample is not random, and therefore not necessarily representative of all migrants in circumstances similar to those of the individuals covered in this study.

Results: Among the migrants, alcohol consumption had diminished during their travels, while smoking and drug-taking increased. Migrants also frequently engaged in unprotected sex and exchanged sex for other privileges. We found that a significant proportion of the migrants suffered physical and psychological violence perpetrated mainly by police authorities.

Conclusions: The issues faced by migrants should be included in political and academic agendas in order to better understand the challenges faced by this population and to provide insight into their true situation, with a view to proposing targeted public policies.
The Invisible Plagues: A Conceptual Model of the Neglect of Neglected Tropical Diseases
Authors: Mantilla Bryanna
Published: January 2025

Neglected tropical diseases (NTDs) affect at least 1 billion people worldwide and are estimated to threaten millions more. NTDs are widespread, primarily affect socially marginalized and vulnerable populations, and contribute to and reinforce global poverty. Although NTDs have significant medical, social, economic and political implications, they receive low priority in global health policies. Moreover, the existing literature has not yet examined the inherently social linkages of NTDs to global inequality, power and “development.” This article takes a critical sociological approach in order to construct a conceptual model to explain NTDs’ “neglect.” Distal level factors in the model include: global inequality and non-modifiable biological aspects (geographic isolation, chronic and disfiguring disease outcomes and concurrent infections). Intermediate level factors include: poverty and neoliberal health policy. Proximal level factors include: lack of research and development; lack of funding for interventions; the dominance of disease-specific interventions; lack of infrastructure and medical services; social isolation; epidemiological methods that underestimate NTDs’ disease burden; and social stigma. Further refinement of such a model may enable global health advocates to create more effective and comprehensive strategies to end not only the “neglect” of NTDs but the social contexts that have created this “neglect.”
What Happens to Whistleblowers, and Why
Authors: Lennane Jean
Published: January 2025

Whistleblowers — people who speak out in the public interest — are valuable to society, often being instrumental in opposing corruption and dangers to the public. Whistleblowers are often subject to reprisals that can have serious health, financial, career and relationship consequences. Powerful organisations have a predictable set of responses to whistleblowers, sending a message to other employees that dissent is unwelcome and avoiding dealing with the problems identified by the whistleblowers. Laws and agencies set up to protect whistleblowers are often flawed or corrupted. At a psychological level, responses to whistleblowers involve obedience to authority, groupthink and other processes. Whistleblowers need to be prepared for reprisals by collecting lots of information, not relying on official procedures and being prepared for a lengthy struggle. More education, research and action are needed to oppose corruption and support whistleblowers.

Key words: whistleblowers; corruption; psychology; health
The Social Context of Workplace Bullying and Its Link to the Health of Workers in Brazil
Authors: Barreto Margarida
Published: January 2025

This essay deals with a frequently discussed theme: the organization of work and the health of people who work, revealing that as ways to organize work have been modified in today’s workplace, work has intensified and the forms of exploitation of the working class have multiplied. Various studies in this field allow us to understand the conditions of work and organizational density, including work itself and the use of time by the capitalist establishment as well as emergent risks that workers are exposed to in their daily work lives and the demands that they are subjected to during their exhaustive work days.

KEY WORDS organization of work, workplace bullying, flexibilization of labor
Drinking seawater: Users’ perspectives in La Ceja, Colombia
Authors: Arias  Valencia María Mercedes , Soler Terranova Wilmer , Arango Tamayo Gustavo
Published: January 2025

Objective: describe the phenomenon of the usage of sea water in the municipality of La Ceja, Colombia. Methodology: Field work with ethnographic tools were applied for the analysis; 30 sea water dispensaries were visited and 76 interviews were conducted. The participants were from both sexes, all ages, diverse marital status and occupations. Results: The attributed effects go from ailments healing, doubtful or no efficacy, up to negative effects. Users attribute benefits in illnesses such as chronic gastrointestinal and respiratory problems, migraine, skin problems and varicose ulcers. There were representations of sea water like panacea and miracle; the sea is related to the origin of life and the salt is related to healing. Conclusions: Users employ it as health complement and as alternative to western medicine. Need as an incentive and also faith emerge with the logic of the phenomenon of drinking sea water. We call the attention of health institutions to have this and other phenomena in mind as well as their health implications. Key words: collective health, Sea water, Qualitative research.
Subjectively-Assigned versus self-reported race and ethnicity in US healthcare
Authors: Witzig Richard S. , Dery MarkAlain
Published: January 2025

Documenting patient “race” descriptors in clinical medicine, epidemiology, and public health data and analysis has been routine in the US. However, patient race has historically been and is still most often subjectively-assigned rather than self-identified. Even when self-identification is allowed, persons must often self-deny parts of their ancestry by adhering to restrictive race categories. In contrast, most other countries ignore so-called race and may use other ancestral background information including family and geographical histories, language(s) and/or ethnic group(s) membership.

We performed two studies involving 160 patients to investigate subjectively-assigned versus self-reported race using a verbal questionnaire in a New Orleans medical clinic. Results revealed that the subjectively-assigned race recorded by the hospital administration/physician was incomplete and therefore inaccurate.

Clinicians and researchers must make more accurate and respectful ancestral inquiries in order to derive useful information about individual and population health risks and disease conditions, while also being mindful of potentially erroneous race data previously gathered and conclusions inferred in healthcare literature.
The right to identity: Implications of using subjectively-assigned race in US healthcare
Authors: Witzig Richard S.
Published: January 2025

In the US, so-called race descriptors have historically been used to ensure control over enslaved and immigrant groups and classes. This paper examines historical, clinical, statistical, and human rights implications for subjectively-assigned race in US healthcare.

When compared to other patient descriptors such as age and sex, race is far inferior in terms of method of acquisition, accuracy, precision, and clinical importance. Examination of current US government documents soliciting race reveals categories inconsistent with existing federal guidelines, thereby confounding data at the origin of collection. Subjective and inaccurate labeling can endanger patients who are subjected to race-based disease diagnoses and/or treatments when a more complete ancestry is not elucidated.

As an aggregated collection of ethnic groups, racial categories are intrinsically open to statistical confusion, and complete ancestral data should be collected for analysis. The inaccuracies inherent in racial categories can result in study design bias, decreased data quality, and possible corrupted conclusions.

The subjective assigning of a person’s race – “race-labeling” or “medical race-profiling” – is properly a human rights issue, as the right to accurately define one’s individual or group ancestral heritage is a fundamental right supported by the United Nations Universal Declaration of Human Rights.
Profit, not health, driving Europe's Syria agenda
Authors: Botenga Marc Johan
Published: January 2025

The Syrian conflict has cost over 130,000 lives, and forced over 7 million people, nearly a third of the total population, to flee their homes. Through arms deliveries, unbalanced diplomatic efforts, and unwavering support for Qatari and Saudi-Arabian interventions in the conflict, both the US and Europe have contributed in no small part to the escalation of the conflict. Far less known is how the European Union’s pre-conflict health advocacy in Syria likely facilitated the current radicalization by widening the gap between the people and a state basing much of its legitimacy on the provision of social services.
Working in solidarity: The student Anti-Dengue Campaign of 2012
Authors: Souers Joanna Mae , Brown Ketia L. , Flores Laravic T. , Koch Kari L. , Rodriguez Maiti C.
Published: January 2025

The student Anti-Dengue Campaign (Dengue Pesquizaje) of 2012 in Havana, Cuba took place over a 10-week period when classes at the Latin American School of Medicine were suspended starting in January. Students were assigned to designated areas of Havana and oriented to go door-to-door, educating Cubans on the signs and symptoms of dengue and measures of preventing disease transmission. Dengue is a serious illness that can manifest with classic symptoms such as fever, headache, rash, retro-orbital pain, myalgias, and arthralgias or it can lead to hemorrhagic dengue and shock. Incidence over the years has increased due to the introduction of new serotypes, mobility, urbanization and population growth. The Anti-Dengue Campaign encouraged students to work in solidarity with the community and practice the basic principles of primary care, providing them with a special skill set to understanding disease control and epidemiology.
Unraveling the “Cuban miracle”: A conversation with Dr. Enrique Beldarrain Chaple
Authors: Chaufan Claudia
Published: January 2025

An interview with a Cuban physician and professor of Epidemiology and Anthropology at the Medical University of Havana, Cuba, unravels so-called Cuban miracle, by laying out the history and foundations of a health system built on the principles of health equity and justice. The interview traces the beginning of the system to the Cuban revolution, briefly providing the social and public health background to this revolution, elaborates on the training of medical personnel and on the Cuban state policy of medical internationalism, and underscores that achieving a modicum of health justice in Cuba’s neighboring country will require freeing US health care from the chains of a profit driven system.
Shaking Off Our Lassitude: Creating a Global Health Service-Learning Program Founded in Social Medicine
Authors: Coughlin Francis Xavier
Published: January 2025

This paper describes the creation and implementation of a global health service-learning elective. The elective was supported by Brown University and Rhode Island Hospital. It was designed for fourth year medical students and internal medicine residents during the winter of 2012, based in Santiago, Dominican Republic. The aim of the course was to create a structured global health elective with principles based in social medicine and social justice. Following a service-learning paradigm, one half of the course was a clinical experience, based in a large, urban teaching hospital, a primary care clinic, and a rural health promotion program. The other half of the course was a structured compilation of assigned readings, lectures, films, field visits, and reflection sessions that placed the clinical experiences into a national and international context. The course analyzed systemic causes of poverty as well as the role of structural violence in creating poor health. Finally, using Rudolf Virchow’s call for physicians to be the “natural attorneys of the poor” as a foundation, we explored the role of the physician-advocate in terms of social justice and solidarity with the poor.
Revisiting Bandoeng
Authors: Litsios Socrates
Published: January 2025

Despite the fact that the Bandoeng Conference on Rural Hygiene, organized by the League of Nations Health Organization (LNHO) in 1937, has been called a “milestone in health and development”, surprisingly little has been written about it. This neglect is seen by Iris Borowy, author of a history of the LNHO, to be consistent with how “the social medicine program in international health policies in the 1930s … has been forgotten by today’s heirs.”

In her authoritative book on the LNHO, Borowy describes in some detail how this Conference came about, what factors determined its agenda and some of the tensions present due to the “profound ambiguity that existed on the questions of colonialism, of the role of Western medicine in Asia and, by extension, on the West as a model for the entire non-Western world.” More recently, Annick Guénel has added to our understanding of some of these tensions by examining more closely several of the country reports prepared in advance for the Conference.

Bandoeng has been used by several authors to contrast the past with the present. Dr Halfdan Mahler, Director General of World Health Organization (WHO) (1973-1988), for example, noted the parallels between the outcomes of the Bandoeng Conference and WHO’s Primary Health Care (PHC) approach. Similarly, Socrates Litsios has used the malaria-related outcome of Bandoeng to draw attention to how it resembled the ‘new’ WHO malaria control strategy developed in the 1990s. Sunil Amrith, on the other hand, has teased out how Bandoeng’s outcomes helped shape India’s notions concerning public health during its late Colonial and Post-Colonial period.
Las raíces políticas de la lucha por la justicia en salud en América Latina
Authors: Virn Anne-Emanuelle , Nervi Laura
Published: January 2025

En 1952 Chile aprobó una de las leyes más integrales del mundo relativas a la atención de la salud, comparable en alcance, unificación y nombre a la del Servicio Nacional de Salud (NHS, por sus siglas en inglés) lanzado cuatro años antes en el Reino Unido. Sin embargo, tan sólo 21 años después, este histórico hito fue abruptamente liquidado. ¿Cómo se explica este cambio? Los desarrollos de las políticas de salud en América Latina –en sus variedades más y menos equitativas- a menudo son retratadas como si siguieran una marcha por etapas en dirección al universalismo, haciendo resonar la refutada teoría de W.W. Rostow sobre las etapas del desarrollo económico. Pero una lectura contextualizada de las vicisitudes de las luchas por la justicia en salud en una variedad de países de América Latina sugiere una imagen contrastante. Momentos de ganancias, salpicados por períodos de represión y estancamiento, revelan una mucho más compleja historia de la lucha de clases por parte de los trabajadores agrarios e industriales, pueblos indígenas, mujeres militantes y otros movimientos sociales –aliados con los correspondientes partidos políticos- contra poderosas elites políticas y económicas.
Health for all: Implementing the Right to Health in the Post-2015 Agenda. Perspectives from the Global South
Authors: Meisterhans Nadja
Published: January 2025

In September 2015 UN-member states agreed on a new framework to replace the Millennium Devel-opment Goals (MDGs). The new framework will guide global health politics, an area which is increasingly important on global agendas, and affect the lives of billions of people. One major question arising in the recent debates on the Post-2015 process is the extent to which the new process will be able to oblige states, international organizations, and private health actors to establish and contribute to health systems that are equally accessible to all. This study re-examines the Post-2015 debate utilizing the critical perspectives offered by social movement networks, and it uses these perspectives to examine the concept of global governance and more specifically global governance for health.

This study will employ the critical perspectives emerging from the Global South that posit that global governance for health improves the situation for the structurally marginalized only when it is part of a general transformation of the existing world order. Global governance in general needs to be reframed using a bottom-up and human rights based approach that empowers those who are affected by political decisions made at the national and global level