Social Medicine / Medicina Social (E-Journal)
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La salud del individuo, de la familia, de la sociedad
Get PDFTwenty-one years ago the Pioneer Health Centre housing the Peckham Experiment, closed. During twelve working years it explored the nature of health and had devised a method for its scientific investigation. Since that time the particular contribution the experiment made to the knowledge of health has not been further developed on.a laboratory scale. But there has been published a statement of the underlying hypothesis which determined the scope of its experimental approach to health.1 This hypothesis opens up a wealth of possibilities for future research and exploration. It is our belief that the times are such that the search for health is a first priority and that it is therefore urgent that this study should be resumed.
The following pages give a very brief description of some features of the original experiment. The field is that of health:- of the individual, of the family, of society.Hace veintiún años cerró el Centro Pionero de Salud que albergó al experimento Peckham. Durante los doce años de su funcionamiento, en él se exploró la naturaleza de la salud y se concibió un método para su investigación científica, desde entonces, la contribución particular que el experimento hizo al conocimiento de la salud no ha sido desarrollada a escala de laboratorio. Sin embargo, se ha publicado una declaración de las hipótesis subyacentes que determinaron el campo de su enfoque experimental de la salud. Estas hipótesis abren una gran cantidad de posibilidades para la investigación y la exploración futuras. Creemos que en estos tiempos la búsqueda de la salud es una prioridad primordial y que, por eso, es urgente que este estudio sea continuado. Las siguientes páginas proporcionan una breve descripción de algunas de las características del experimento original: el campo es el de la salud del individuo, de la familia, de la sociedad
Declaración de Bogotá
Get PDFThe attendees of the XI Latin American Congress of Social Medicine, meeting on the twenty-fifth anniversary of the Association, affirm...Declaración de los asistentes al XI Congreso Latinoamericano de Medicina Social y Salud Colectiva, 14-19 de noviembre, 2009, Bogotá, Colombi
Acta de Ouro Preto. Constitución de la Asociación Latinoamericana de Medicina Social (1984)
Get PDFThose signing below, attendees of the II Latin American Seminar on Social Medicine, have decided to establish the Latin American Association of Social Medicine.Los asistentes al II Seminario Latinoamericano de Medicina Social, acuerdan constituir la Asociación Latinoamericana de Medicina Social, que aquí se publica
Aceleración global y despojo en Ecuador. El retroceso del derecho a la salud en la era neoliberal
Get PDFGuerra y derecho a la salud en Colombia. El caso del Departamento de Nariño
Get PDFThis 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.Se realiza una revisión del cumplimiento del derecho a la salud en Colombia luego de las reforma del sistema de salud en el año 1993, a través de un estudio de caso en el Departamento de Nariño, se muestran los impactos diferenciales que tiene la guerra en la garantía del derecho a la salud de los y las colombianas. Las poblaciones más pobres y vulnerables son afectadas por la guerra y son las que más sienten también vulnerado su derecho a la salud. Los hogares pobres, los grupos étnicos, las minorías sexuales y todas las personas que se encuentran en las zonas de mayor escalada de la guerra son los más vulneradas en sus derechos humanos, incluido el derecho a la salud. Por otra parte, la filosofía y la organización del Sistema de Seguridad Social en Salud han sido funcionales para que los actores armados ilegales, principalmente paramilitares, se apropien y manejen los recursos de la salud y los utilicen para sus propios fines
Crisis económica y salud pública
Get PDFThe current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.La crisis económica global actual, amenaza seriamente la salud de la población. Los desafíos incluyen aumentos en los niveles de desnutrición; de personas sin hogar y en situación de vivienda inadecuada; de desempleo, drogadicción, depresión y otros problemas de salud mental, salud infantil, mortalidad, de violencia y salud ambiental y ocupacional, injusticia social y violación de los derechos humanos, así como una disminución de la disponibilidad, la accesibilidad y la disponibilidad de servicios de salud y odontológicos de calidad. Los profesionales de las salud pueden responder a este panorama promoviendo la vigilancia y la documentación de las necesidades humanas, reevaluando las prioridades de salud pública, educando a la población y a los hacedores de políticas acerca de los problemas de salud profundizados por la crisis económica global, defendiendo políticas y programas adecuados para enfrentar estos problemas y proveyendo directamente programas y servicios necesarios.
Entrevista al Dr. Walter Lear
Get PDFIn this issue of the English version of Social Medicine we are publishing the first of several pamphlets loaned to us by the US Health Activism History Collection. To introduce this collection we travelled to Philadelphia on June 18, 2008 to interview Dr. Walter J. Lear. Dr Lear, born in 1923, is the person responsible for the collection. In a wide-ranging interview in his home Dr. Lear discussed his personal background, the origins and purpose of the collection, the impact of the McCarthy period on the US health left, as well as his vision for the future
Presentación del experimento Peckham
Get PDF“Health is everyone’s birthright; the pity is that so many lose it. In spite of our vast sickness services…the burden of ill-health in the community remains heavy…all this study of disease does not reveal to us the laws of health. It is health itself which must be studied. We must devise laboratories where we can put health, too, under a lens, look at it, discover how it behaves, and find out in what conditions it can grow and spread.”
From Health of The Individual, of the Family, of Society
The Peckham Experiment was one of the 20th century’s most innovative programs in community medicine, influencing the community health movement around the world. It was the brainchild Dr. George Scott Williamson and Dr. Innes H. Pearse, two medically trained biologists who were also a married couple. Both were researchers with experience in the early diagnosis and investigation of disease, and yet they came to the conclusion that studying disease was not the route to attaining or understanding health.El experimento Peckham fue uno de los más innovadores programas de medicina comunitaria del Siglo XX, por lo que influenció al movimiento de salud comunitaria en todo el mundo. Fue creación del Dr. George Scott Williamson y de la Dra. Innes H. Pearse, dos biólogos con formación en medicina, que además estaban casados. Ambos eran investigadores con experiencia en el diagóstico temprano y en la investigación de la enfermedad, pero habían llegado a la conclusión de que el estudio de la enfermedad no era el camino hacia la comprensión o la obtención de la salud. En un mundo centrado en los procesos patológicos y en la cura de la enfermedad, el experimento Peckham y sus fundadores fueron innovadores y valientes de pensamiento
Consecuencias en salud de la desviación de recursos hacia la guerra y su preparación
Get PDFArmed conflict damages health in many ways. These include death and disability directly caused by war, destruction of the societal infrastructure that supports health and safety, forced migration of people both within their own country and as refugees to other countries, promotion of violence as a method to settle conflicts and disputes, and the long-term adverse effects on social relationships.
This special issue of Social Medicine examines the impact of war on human health from a geographically diverse set of countries and from diverse perspectives. Dr. Andrea Angulo Menasse, a researcher from Mexico City’s Autonomous University, documents the very personal story of how the violence of the Spanish Civil War affected one family. In her case study the trauma suffered by Spanish Republicans is traced through three generations and crosses the Atlantic Ocean as the family moves is exiled in Mexico. Dr. Sachin Ghimire from the Centre of Social Medicine and Community Health of the Jawaharlal Nehru University reports on his fieldwork in Rolpa, Nepal, the district from which the Nepal Civil War (also called the People’s War) originated in 1996. Based on 80 interviews, he documents the difficulties faced by health care workers as they negotiated the sometimes deadly task of remaining in communities where control alternated between Nepalese Special Forces and the Maoist rebels. Finally, Colombian researcher, Carlos Iván Pacheco Sánchez, from the University of Rosario in Bogota, brings an epidemiologist’s tools to examine the impact of the ongoing armed conflict in the border Department of Nariño. His discussion is informed by the current debate over health care in Colombia where a recent Constitutional Court decision has found that the current health care system violates the right to health. These three papers amply demonstrate the depth, breadth and relevance of contemporary social medicine.Los conflictos armados dañan la salud de muchos modos, entre éstos están la muerte y la discapacidad causadas directamente por la guerra; la destrucción de la infraestructura social que sostiene a la salud y a la seguridad; la migración forzada de la población, tanto dentro de su propio país como la de refugiados a otros países; la promoción de la violencia como método para resolver conflictos y disputas y los efectos adversos a largo plazo sobre las relaciones sociales
Lo que dice, calla, propone y soslaya el informe de la Comisión sobre los Determinantes Sociales de la Salud. Reflexiones a un año de su publicación
Get PDFThe final report of the WHO Commission on Social Determinants of Health (CSDH), chaired by Dr. Marmot of the United Kingdom, is a remarkable document for what it states, what it silences, what it obscures, what actions it advocates, and what it leaves out. A brief analysis of the Commission´ s statements is presented here. The Report is an important landmark in the history of the social determinants of health and in the trajectory of the WHO, the institution which convened the Commission. For WHO, the report represents an auspicious and welcome change in a regrettable trend; since the 1980’s WHO has abandoned the ideology of its founders, i.e. an interventionist commitment to improve the situation of poor individuals and countries. The early WHO was a strange and contradictory – yet creative – combination of Social and Christian democracies, of Third World activism promoted by countries in the midst of independence or liberation struggles, and of Eastern European Marxism. All of this was perfectly in sync with the role that the United Nations and its agencies played during the Cold War. With the two rival blocks constantly at odds, there existed a fertile middle ground on which initiatives could develop which promoted social justice and which, in turn, provided legitimacy to the rival Cold Warriors who profited from them. After the disappearance of “really existing” Socialism, triumphant Western neoliberalism began harassing any country which attempted progressive social measures, a harassment that sometimes involved the use of force. WHO and its sister agencies of the UN became the new acolytes of neoliberalism triumphant. WHO gave up its leading role in the world’s collective health, and resignedly limited itself to following policies which were designed and implemented by organizations of a neoliberal bent, such as the IMF, the World Bank and the WTO. While the consequences of these policies were not all that clear at the time they were being implemented, their results are clear for all to see: a setback for the concept of health as a social right and a weakening of nation states or communities which prevents them from playing an active role as either service provider or as regulators of the workings of the market. According to neoliberal dogma, the market is the perfect allocator of resources and the ideal arbiter of priorities and policies. Beginning in the unfortunate decade of the 80’s, the market, in both general society and in health, weakened labor, increased unemployment , dismantled universal social coverage, lowered salaries, reduced public health expenditures, privatized services, mandated user fees, and decreased supervision of private health care providers and of the pharmaceutical industry. All these initiatives deteriorated the collective physical health. As to mental health, the replacement of more or less predictable individual lives with the uncertainties and unpredictability of unchecked market forces quite clearly deteriorated it. Unfortunately many of these assaults on mental health will never be well recorded since they are largely unquantifiable.El informe final de la Comisión de Determinantes Sociales de la Salud (CSDH) de la OMS, presidida por el Dr. Marmot del Reino Unido, es un documento notable por lo que afirma, lo que silencia, lo que oscurece, las acciones que propugna y las deja fuera. Se presenta aquí un breve análisis de las declaraciones de la Comisión. El Informe es un hito importante en la historia de los determinantes sociales de la salud y en la trayectoria de la OMS, institución que convocó a la Comisión. Se limitó a seguir políticas diseñadas e implementadas por organizaciones de corte neoliberal, como la FMI, Banco Mundial y OMC. Si bien las consecuencias de estas políticas no estaban tan claras en el momento en que se implementaron, sus resultados son claros para todos: un retroceso para el concepto de salud como un derecho social y un debilitamiento de los estados nacionales o comunidades que les impide implementarlas. desempeñen un papel activo como proveedores de servicios o como reguladores del funcionamiento del mercado