The Apparent Contradiction Between Women’s Vulnerability and Agency as Demonstrated in their Healthcare Seeking Behaviors in the Sierra Madre Region’s Community of Honduras

Ishani Premaratne, Harvard College ‘15


The role of the market is inseparable from the political and biomedical forces at play within healthcare today. During the present “moment” in global health, there is increasing attention being paid to the role of the patient in determining his or her healthcare experience. Notably, research has shown that active patient participation in health care—referred to as “patient co-production”—is associated with improved clinical outcomes. However, this is not to say that the sea of diverging treatments and pharmaceuticals that the patient must navigate is one unhampered by unexpected and unforeseen obstacles. If we were to extend the metaphor even further, we might say that these patients, too, are often maneuvering without a compass—or at least not one that the traditional biomedical establishment would have them use. Thus, the evolving role and behavior of the patient in seeking and receiving healthcare—and the thought processes fueling these—is a fascinating subject of study for the medical anthropologist who seeks to understand how this reciprocal exchange has changed the overall function of the modern healthcare system. In the long run, this information might be leveraged to improve its function. Biehl and Petryna provide a useful explanatory model with regard to the patient’s role in When People Come First: Critical studies in Global Health:

“While the culture of biomedicine is undeniably powerful, it is also speculative and improvised, and patients do not simply become the diagnostic categories and treatments that are applied to them. People may inhabit them to greater or lesser degrees, but they are also able to refuse them, or to redefine and deploy them to unanticipated ends. Understanding today’s capacious pharmaceuticalization of health care requires analytical tools and methods that can account for the entanglement of multiple social forces and markets in defining the politics of health, the unregulated circulation of pharmaceuticals and their chemical effects, and the role of patients in creating demand.” 

This paper provides a critical exploration of the particular role of women as patients and the main stewards of healthcare in their families in the rural community of Honduras in the Sierra Madre region of Chiapas, Mexico. The author spent 3.5 months living and working within this community in order to conduct ethnographic fieldwork and study the interactions between patients and their healthcare system while it changed before their eyes.

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