Academic journal article Journal of Cultural Diversity

Health Beliefs and Practices in Rural El Salvador: An Ethnographic Study

Academic journal article Journal of Cultural Diversity

Health Beliefs and Practices in Rural El Salvador: An Ethnographic Study

Article excerpt

Abstract:

Objective: To investigate the health practices and lifeways of rural villagers in a remote area of El Salvador who had been displaced by the recent civil war. The purpose of the study was to explore their view on health and experiences of loss during the war.

Design: Ethnography (Spradley, 1980, 1999; Agar, 1996)

Method: The participants included any resident of threerural Salvadoran villages who were 18 years of age and over. Participants included nine families, with a total of twelve participants. Data collection included participant observation, audiotaped interviews, demographic information, and field notes. One of the Spanish-speaking key informants acted as the interpreter. The content of all data was analyzed for recurrent themes.

Findings: All nine families were displaced to refugee camps in Honduras during the civil war. Two cultural themes that emerged from the data were: 1) War: "We lost everything; we had to leave running," and 2) Health: "It's in God's hands."

Conclusions: It is a challenge to encourage culture-specific care that acknowledges Salvadoran herbal remedies, strength of spirit, and a belief that a Supreme Being controls their lives. The health practices of the participants were shaped by their experiences of suffering from loss of family members during the war, displacement from theirhomes, and lack of potable warter and environmental sanitation.

Implications: To make a positive impact and effect change on health services in these rural areas, efforts should be directed toward democratic and community-based social and economic development within the context of the cultural system. Recent earthquakes (2001) have intensified the need for improvement in environmental factors including potable water.

Keywords: El Salvador, Health Beliefs and Practices, Ethnographic Study

El Salvador is the smallest, most densely populated country in the Americas. It compares in size to the state of Massachusetts and has a population of nearly six million people. Currently, the country struggles with the sociopolitical issues of a new republic and the challenge to deliver health care to the economically disadvantaged people in both rural and urban areas.

The Pan American Health Organization (PAHO) reported that of the people in the country who report some type of illness, only 12% seek medical care. Most illness is untreated or treated with folkways within the family. Of those who seek care, 12% receive it from the Salvadoran Social Security Institute which provides health benefits to insured workers, 42% from the Ministry of Health (MOH) and Social Welfare, and the remaining 46% from private services, one-fifth of which correspond to nongovernmental organizations. Health care services are heavily concentrated in urban areas and are not readily available to Salvadorans living in rural areas. Sixty percent of all physicians, nurses, and dentists are concentrated in the capital, San Salvador, and 70% of all specialized physicians are working in establishments such as hospitals and health centers in the public system. In estimated 2000 census data, there were 26.5 physicians per 10,000 population and 5.2 hospital beds per 1000 population (PAHO,2000). Diseases of the circulatory system are the leading cause of death, representing 33% of the total mortality rate. These were followed by external causes, 19% (83% of them in males, with accidents and homicides heading the list); neoplasms, 14.2%; communicable diseases, 10% (with intestinal infectious diseases predominating); and conditions originating in the perinatal period, 4.3%. Demographic statistics reveal the seriousness of health crises that follow natural disasters such as the destruction caused by Hurricane Mitch and earthquakes in 2001 (Table 1). Health indicators in maternal-child and women's health are especially alarming, with an infant mortality rate of 40 per 1000 live births (Table 2). …

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