Monday, June 20, 2011

INDIGENOUS HEALTH PRACTICES IN EL SALVADOR

Helen E. Dao, MS 

INDIGENOUS HEALTH PRACTICES IN EL SALVADOR 

This article relates to the medicine practices of El Salvador, Central America.  People from El Salvador are divided into two social groups.  The poor and the rich, the gap between both groups is significant. 

About half the population lives below the national poverty line, able to buy food but not clothing and medicine. Over half of these families live in a situation of extreme poverty. Forty-seven percent of the population does not have access to clean water.  The difference between the incomes of the wealthiest and the poorest are extreme and increasing. The poorest 20 percent receive only 2 percent of the national income, whereas the richest 20 percent receive 66 percent. The distinction between the rich and poor is no longer ethnic, as the vast majority of the population is now mestizo, a mixed race (about 97 percent)

PEOPLE
El Salvador's population numbers about 7.2 million. Almost 90% is of mixed Indian and Spanish extraction. About 1% is indigenous; very few Indians have retained their customs and traditions. The country's people are largely Roman Catholic and Protestant. Spanish is the language spoken by virtually all inhabitants. The capital city of San Salvador has about 1.6 million people; an estimated 37.3% of El Salvador's population lives in rural areas.

BRIEF HISTORY
The Pipil Indians, descendants of the Aztecs, and the Pocomames and Lencas were the original inhabitants of El Salvador.

There are few studies that addressed the indigenous health practices and the integration of modern medicine in the Salvadoran health care system but are not comprehensive and do not provide in depth information of traditional healing practices by the indigenous communities.  Because of the violence against the indigenous groups of El Salvador, many tribes felt obligated to assimilate into society and hide their traditional practices and beliefs. 

In 2006, the Center for International Development Conflict Management conducted an assessment for Indigenous people in El Salvador, found that indigenous people begun to hide their traditions and to assimilate into the dominant ladino society as a product of the 1932 massacre “La Matanza” where 35,000 to 50,000 indigenous were killed as the government retaliated again the indigenous for killing 35 ladinos during protest against government policies.  The abandonment of indigenous people tradition and practices accelerated during the 1980-1992 civil war, when death squads killed thousands. Many indigenous people were discouraged from their traditional customs and culture for fear of being associated with targeted grassroots organizations. “ 


The health of indigenous people of El Salvador continues to be tremendously affected not only due to their diet, lack of health care access, and transportation, but also to environmental factors such as industrializations, urbanizations, cultural barriers, etc.  In a join effort to understand and strategize ways to reach out to the indigenous people not only in El Salvador but of the Americas, Pan American Health Organization (PAHO) and World health Organization (WHO), indigenous from Central America Countries representatives, and other organizations agreed to create a framework of health care access for indigenous people through Strategic Framework and Action Plan 1999-2002 of the Health of the Indigenous Peoples Initiative”.  How this indigenous health care system translate to the modern medicine it is important to understand.  Even though indigenous groups have assimilated the mainstream health care system, there still some cultural beliefs and traditions that have survived through out the years.  Not specific details are found in the literature of those traditional practices.  However, one practice that has gone for many generations is that of the curanderos (Healers) for instance, they treat children who in their opinion have the “evil eye” and are treated by hanging the child upside down from his/her feel and slap their soles so the “evil eye” can be spelled.    This is not welcome and/or accepted by medical doctors due to the fatal consequences associated to such practice, brain hemorrhage.

Less and less traditional healing practices are done in public; many indigenous send sick children to the health care worker or a medical doctor to treat more serious conditions.  However, traditions, values, systems of beliefs will always be part of a group and will be passed from generation to generation, perhaps at a lesser level, but will always remain with them.  More research needs to be done about indigenous health practices and how appropriate health care services can reach them.  Some of the indigenous people that have migrated to the United States may seek Western medicine as a last resource due to their cultural beliefs, but also related to health literacy, health insurance, and legal status.


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REFERENCES
1.     Every Culture: Julia Dickenson-Gomez, May 13, 2011. Retrieved June 19, 2011.
2.     Bureau of Western Hemisphere Affairs, March 30, 2011.  Retrieved June 19, 2011 (http://www.state.gov/r/pa/ei/bgn/2033.htm)
3.     PROYECTO PARA EL FORTALECIMIENTO DEL SISTEMA PÚBLICO DE SALUD MARCO DE PLANIFICACION PARA PUEBLOS INDIGENAS (MPPI).  EL SALVADOR, FEBRERO 2011. www-wds.worldbank.org › PublicationsDocuments & Reports , retrieved June 20, 2011.






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