Our Program

Objectives

  • To explore efforts to achieve social and occupational justice in Guatemala, a country with a history of ethnic and class violence
  • To explore the concept of “occupational justice” as an emerging practice area in occupational therapy and applied anthropology, focusing on occupational capacities
  • To examine health disparities in Guatemala through applied medical anthropology theory and human rights discourse
  • To understand the determinants of health and basic epidemiology in developing nations
  • To provide a transdisciplinary fieldwork opportunity to students of occupational therapy, anthropology, and related subjects
  • To promote social justice through partnerships in and around Antigua, Guatemala with NGOs, community groups, health care workers, and other social change agents

Overview

Our program balances academic engagement with critical scholarship on key topics relating to social and occupational justice with applied research and practice and the study of Spanish. 

Students study Spanish one-on-one with individual instructors at their own level and pace for a minimum of 9 hours per week.  In the case of students who are assessed as fluent Spanish speakers, alternate programming in Mayan languages will be made available.  Living in a home stay increases language fluency and understanding of Guatemalan culture.  Both the student home stays and Spanish instruction are organized through our partner Tecun Uman Spanish School (http://www.tecunuman.centramerica.com/main.htm).

Students participate in three weekly seminars on topics that will provide important contextual information and theoretical perspectives through which we can query the current status and potential for advancement of social and occupational justice in Guatemala.  These seminars will include lectures presented by field school faculty, discussion of academic literature, and first-hand engagement with Guatemalan films and case studies.  Students will be asked to read one or more academic articles prior to seminar sessions.  Field school students will also have the opportunity for weekly interactions with Guatemalan scholars and policy advocates through guest speakers, who will be drawn from Guatemalan universities, human rights organizations, and international NGOs and governmental agencies.

Through the Project Groups, students will engage first-hand with research and practice in the promotion of social and occupational justice through working with the field school's partner NGOs and other collaborators.  Each Project Group combines students from both anthropology and occupational therapy backgrounds and will be supervised by field school faculty, providing students the opportunity for individualized mentorship in field methods.  For the 2015 season, the field school will be offering Project Groups in:  NGOs Networks and Perspectives of Child Migration:  Examining Perceptions of Root Causes, Pediatric Practice:  Interrelationships of Play, Nutrition, and Early Child Development, and Sustainable Social Enterprise for Water:  Social Justice, Community Development, and Household Occupations
(see project descriptions below). 

Sample Topics for Lecture & Discussion Seminars

Seminars include lecture and discussion emphasizing our focus on social and occupational justice:

  1. Orientation:  What is Occupational Science and Occupational Therapy? What is Applied Medical Anthropology?
  2. Overview of Guatemalan History and Culture; The Guatemalan Health System
  3. Globalization, Ethnomedical Systems, and Treatment Evaluation
  4. Political Economy of Infectious Disease and Undernutrition
  5. Occupational Capacity and Ethnic Inequality
  6. Development, Gender, and The Politics of Reproduction
  7. Justice and Governance
  8. Health as a Human Right

Typical Weekly Schedule


 

Monday

Tuesday

Wednesday

Thursday

Friday

a.m.

1-hr. Check-in

Lecture/discussion

Group Projects  

Group Projects

Lecture/discussion

Field visits and Group Projects

p.m.

Spanish (3-4 hrs.)

Spanish (3-4 hrs.)

Guest lecture

Spanish (3-4 hrs.)

 

Project Group Descriptions 

NGO Networks and Perspectives on Child Migration:  Examining Perceptions of Root Causes

Faculty:  Ryan Lavalley, MOT, OTR/L; Carolina Axché; Rachel Hall-Clifford, PhD, MPH, MSc

NGO Networks and Child Migration to the United States   

Project Objectives

  •  To explore perspectives of Guatemalans on child migration to the United States and on its root causes 
  • To learn about the responses and actions of Guatemalan non-governmental organizations (NGOs), lawyers and activists, and diverse members of the community in confronting this issue
  • To understand the factors underpinning child migration from Guatemala and the kinds of interventions considered appropriate and feasible among stakeholders using an occupational lens
  • To investigate the role of NGOs in creating improved occupational outcomes for children in Guatemala through  educational, economic, and health-related programs
  • To compare Guatemalan perspectives of child migration to those emerging from international news sources and U.S. policy
  • To position child migration within human rights and social and occupational justice frameworks

 Project Activities

During the summer of 2014, a spike in rates of Central American children migrating unaccompanied to the United States has brought unprecedented levels of attention to this social and political issue.  Governments on both sides of the U.S. border have faced criticism over the opportunities available to children and the response to child migration.  Factors such as family structure, economic security, education, and violence have been cited in the international media as causes for the upsurge in child migration.  Among the issues under fierce debate is the contention that child migrants are legitimate refugees seeking asylum from life-threatening violence and unsustainable living conditions.  This project will focus on how Guatemalans view migration and what they think should be done to address it.

The NGO Networks group will work to explore occupational perspectives on child migration and its causes drawing from among diverse sectors of Guatemalan society.  The project will be developed in collaboration with local NGOs to investigate views of precipitating factors for the migration of Guatemalan children, with particular focus on programming strategies to improve educational and future employment opportunities.  This project builds on previous work conducted by the NAPA-OT Field School on efforts to improve access to and quality of education for very low income families in villages around Antigua.  The NGO Networks group will explore legal and policy approaches to migration used within Guatemala.  By bringing together community, NGO, and legal perspectives, the group will consider human rights and occupational outcomes for Guatemalan migrant children.

Students will receive training to develop and implement semi-structured in-depth interviews with concerned Guatemalans, such as directors and staff members of NGOs, human rights lawyers and activists, and members of  affected communities, in order to understand the issue of child migration  from diverse local and international perspectives. Students will also observe NGO programming designed to address issues of structural violence as causes of child migration, using occupational analyses.  Students will analyze the data arising from Guatemalan viewpoints and critically compare key themes and notions of root causes of migration to narratives appearing in international media outlets. The research findings will be shared with participating NGOs and other stakeholders.

Key competencies gained will include: in-depth knowledge of the roles of NGOs; an introductory understanding of the Guatemalan legal and political system; qualitative research methods, including in-depth interviewing, data coding, and data analysis; occupational analysis; and policy-brief and executive report writing.

NOTE: Students’ willingness to contribute to the report in the 2-4 weeks following the field school end date of June 26 is requested, in order to complete the writing, editing, and/or posting of the report.


Pediatric Practice: The Interrelationships of Play, Nutrition, and Early Child Development

Faculty:  Juliana Gutierrez, MA, OTR/L; Nancie Furgang, MA, OTR/L

Project Goals and Objectives

1. To understand the effects of play within the context of an inpatient infant nutrition unit in Guatemala

  • To identify the therapeutic characteristics and practices of play in relationship to feeding, health, and early childhood development.
  • To recognize the importance of play as part of children’s occupation and its impact on health and development
  • To explore play activities within the context of Guatemala’s culture and within the Hospital Obras Sociales
  • To recognize the importance of play as part of children’s occupation and its impact on health and development
2. To understand the relationship between nutrition and early childhood developmental trajectories and occupational capacity.  
  • To gain insight into issues of nutritional practices, strengths, and deficits as determinants of health and early child development in Guatemala
  • To engage with Guatemalan community members and professionals to extend the student’s understanding of attitudes and practices regarding  feeding, nutrition and developmental milestones 

3. To explore the relationship between occupational capacity and social and occupational justice

Project Activities

Approximately 45% of all children in Guatemala experience chronic undernutrition, which is one of the highest rates in the Western Hemisphere. Undernutrition has a profound impact on early childhood developmental trajectories. Through direct hands-on experience on an in-patient infant nutrition unit, the Pediatric Practice group will focus on the social, political, and economic determinants of child development in Guatemala and the impacts of chronic undernutrition on childhood occupational capacities. The group will specifically consider the clinical outcomes and social implications of local infant and child feeding practices and norms of development, including expectations for play.  

The Pediatric Nutrition group will gain hands-on experience on an infant nutrition unit at Obras Sociales Hermano Pedro, a Catholic charity hospital located in Antigua, Guatemala, serving low-income families throughout the country. The infant nutrition unit is a restricted-entry in-patient medical unit with 25-30 beds, served by a specialized team of nurses, nutritionists, and volunteers. The unit is populated by infants with cleft palate awaiting surgical reconstruction; severely malnourished infants presenting with failure to thrive; and infants and children with neurodevelopmental disabilities requiring special feeding.

Students will be introduced to occupational therapy pediatric practice using developmentally-based and sensory-motor approaches in order to understand the developmental trajectories of children experiencing severe undernutrition.  Observational methods and chart reviews will be used for assessing nutritional and occupational status, and students will experience a variety of feeding techniques and therapeutic approaches based on play and sensory motor intervention strategies. Students will be guided in how to observe and understand the cultural dimensions of early childhood development and explore them in light of the social determinants of health.  The group will develop case study analyses of developmental trajectories of children on the clinical unit, describing in detail the feeding and handling techniques implemented by clinical staff and students.  These techniques will be further analyzed in comparison to the infant feeding and play practices and beliefs found within the local community, which will be elicited through informal engagement with the community and qualitative research methods.


Key competencies
gained will include:  in-depth understanding of the physiological outcomes of infant and child nutrition and impacts on occupation and neurodevelopment; knowledge of feeding and swallowing techniques, sensory-motor and play strategies; ability to use growth parameters/measurements to understand the impact of nutrition on physical development and to compare nutritional status across populations; and qualitative research methods and analysis, including case study methodology.


Sustainable Social Enterprise for Water:  Social Justice, Community Development, and Household Occupations

Faculty:  Rachel Hall-Clifford, PhD, MPH, MSc

Project Objectives

  • To understand the availability of safe water and sanitation in rural Guatemala
  • To understand the interconnections and responsibilities of government, local and international NGOs, and the private sector in the provision of essential services in Guatemala
  • To explore the role of social enterprise in community development
  • To query the concept of sustainability as a development paradigm
  • To develop occupational perspectives and analyses on water procurement at the household level, focusing of women and children, in the context of rural Guatemala
  • To position safe drinking water within human rights and social and occupational justice frameworks

Project Activities

The Sustainable Social Enterprise group will explore Guatemala’s progress on Millennium Development Goal 7, focusing on Target 7C to halve the proportion of the population without sustainable access to safe water and sanitation.  The Guatemalan government remains unable to provide adequate access to safe water for rural populations, leaving them vulnerable to intestinal infections and poor health outcomes.  Transportation of water and its purification typically falls to women or children within Guatemalan households, and distant water sources can pose a significant daily occupational burden.  To address these issues, highly-regarded social enterprise EcoFiltro (http://www.ecofiltro.org/en) provides affordable household water filters through an innovative rural business model in which urban sales offset the cost of filters for rural households.  EcoFiltro requires community adoption of the filter program and implements filter maintenance and hygiene training prior to distributing filters; individual households receive ongoing support and are required to make modest monthly payments for their filters.

The Sustainable Social Enterprise group will partner with EcoFiltro to conduct a program evaluation of rural implementation processes.  Employing qualitative research methods, students will interview EcoFiltro rural field representatives and key staff and conduct interviews and/or focus groups with rural end-users.  Based on this first-hand research, students will highlight trends in community and household adoption of the water filters, with particular attention to community adoption rates and household payment rates.  Research findings will be shared and strategies for program improvement will be developed collaboratively with EcoFiltro.

Key competencies gained will include:  in-depth knowledge of social enterprise as a development strategy; qualitative research techniques, including in-depth interviewing and focus group discussion; basics of public health program evaluation; development of an occupational critique, and executive report writing.

NOTE: Students’ willingness to contribute to the report in the 2-4 weeks following the field school end date of June 26 is requested, in order to complete the writing, editing, and/or posting of the report.