Health and Nutrition in Amazonian Ecuador
Language of Instruction: English
Contact Hours: 45 hours, 3 cr
Program Pitt in Ecuador
About the Course
The course is designed for premed majors, anthropology majors interested in health, and others planning careers in health-related fields. It uses readings, lectures, field trips and research with Kichwa people to explore major issues in global health as applied to the context of Ecuador and the Amazonian region. These include the negotiation between biomedical assessment of health risks and solutions on the one hand and those of the indigenous medicine practiced by a majority of the population on the other. By focusing on the concrete case of the Amazon the course prepares students to understand the increasingly global context of contemporary healthcare practice. The course builds skills and experience that will be useful in working in cross-cultural medicine anywhere.
Learn to understand health care policy comparatively.
Learn how to listen to patients whose understanding of illness is culturally different.
Learn how chronic diseases and health problems sometimes result from development itself.
Understand the challenges of providing quality health care in low-resource environments
Understand how changing diet is affecting indigenous populations.
Understand how key health risks such as STD, diabetes, suicide, alcoholism, or domestic violence are shaped culturally.
Practice research skills in the assessment of health behavior.
Class Participation. Students are expected to come to class prepared and ready to participate in class discussion. Note that completing readings and participating in class discussion will also improve grades for the other assignments (10% of grade)
Fieldnotes. Students should record fieldnotes for all visits and fieldtrips. However, you will need to submit 6 sets of fieldnotes over the month in which the course takes place. Fieldnotes are detailed summaries of what you observed and heard. They also include descriptions of the events, venues, and unstructured interviews/conversations, in which you have participated. You should have a set of fieldnotes for at least 4 of the 6 fieldtrips on which we will go, and up to two sets of fieldnotes on your observations while participating in related activities as part of the other course you are taking, and in community activities:
The fieldtrips, as of right now are:
Tena market and pharmacy;
Chonta Punta Health Post;
Amopakin Traditional Midwife Center;
Making Chicha and Natural Medicine;
Presentation by the Shaman.
Fieldnotes are due 2 days after the event/fieldtrip. They are usually 3—5 pages (700 – 1200 words) in length (some will be longer and more detailed than others), and should include a brief set of analytic conclusions regarding the event/fieldtrip. Fieldnotes will be shared among the students so that they can be used to write the mini-ethnography. (5 pts/each =30 pts total).
Interviews. In groups of 3-4, students will conduct 2 interviews with local Kichwa residents. Students are responsible for developing interview guides, conducting interviews, taking notes/recording responses, and writing a summary of responses as a group. (20% of grade)
Mini-ethnographies. Each student will submit a final report in the form of a mini-ethnography.
MNI-ETHNOGRAPHIES ARE DUE ON OR BEFORE August 5, 2018
You will have access to the materials collected by you colleagues. You will choose a topic/theme that interests you and review all the materials that you have studied and that you and your colleagues have collected (readings, lectures, your own participant observation, fieldnotes, interview summaries).
You can incorporate your individual observations/conversations while in Ecuador: e.g. what you see on trips to Tena and other places, what people in the community say, what you observe playing soccer, walking in the reserve, etc.
Examples of topics are, but are definitively NOT limited to: Kichwa thinking about the body and how it effects Kichwa use of health resources; Kichwa food ways and health; medical pluralism in the Upper Napo; success or limitations of the Ecuadorian health care system to meet the need of Napo Kichwa; comparisons between biomedical and traditional birth, OR childcare, OR chronic illness; the impact of the epidemiological/nutritional/demographic transitions on Kichwa lives.
You will use data collected by you and your colleagues to address your question. Your analysis should draw on concepts and data from materials in readings and lectures.
Mini-ethnographies will be 6-8 doubled spaced pages (1500 - 2000 words). They will include an introduction that addresses why the particular question or topic you have chosen to address is interesting to you and significant in a broader sense; the body of the report will present and summarize data from your observations and interviews and those of your colleagues; Drawing on what you have learned from readings, lectures, and class discussions, the report will conclude with a discussion of the meaning and importance of the data and any conclusions you can draw from the data. (40 pts.)
Tentative Course Schedule
Week 1: Introduction to Health in Amazon and the Ecuadorian Healthcare System
Arrive in Quito
Travel to Iyarina
Introduction to the course
Key concepts in understanding the health of indigenous peoples: local biologies, structural violence, health disparities, medical pluralism.
READ TELL ME WHY MY CHILDREN DIED.
Observation and taking fieldnotes; recording what you see and hear; approaches to analysis.
Visit to Amopakin – all day
Week 2: Observing the Ecuadorian Health Care System
The ontology of health and health care, health/communication, biomediatization.
What is the nature of narrative? How are narratives produced?
What is the purpose of narrative?
What is the power of narrative? Of stereotyping narrative?
How can narrative be part of “care”? (What is “care”?)
Dr. Will Waters:
The Ecuadorian Healthcare System: The challenge of providing comprehensive care in a developing economy.
Dr. Wilma Freire:
Nutrition in Ecuador: Regional and local issues; the nutrition of indigenous peoples; the nutrition transition in Ecuador.
Aging in Indigenous communities.
Drs. Freire and Waters:
Policy options: Impact of government assistance to mothers with dependent children on the health of indigenous families.
Week 3: Intercultural health
Visit to Chonta Punta Health Care Center -- all day
Visit to the Tena hospital
Interviewing techniques and developing an interview guide
Food systems of the Amazon, hunting, etc.
Visit to the Friday market and interview with a pharmacist.
Week 4: Community Perspectives of Health; Food and nutrition in the Amazon
Debriefing on first set of interviews; approaches to analysis; the mini-ethnography
How do Kichwa people experience the health care system? Interviews with Kichwa people (Sindy, Atahualpa).
Work on summaries of interviews in groups
Meeting in groups, sharing fieldnotes and interview summaries.
Catch-up. Discuss the mini-ethnographies
Wrap Up. Travel to airport.
Mingas and Conviviality