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 2013 season, the field school will be offering Project Groups in: 
NGOs and the Educational Transition, NGO Networks and Surgical Referrals, and Pediatric Nutrition (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 for Health:  Primary Care Delivery

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

Project Objectives

  • To understand the role of non-governmental organizations (NGOs) in the provision of essential health services in Guatemala
  • To investigate the interactions of local and international NGOs and government agencies in Guatemala in order to understand the impacts of international aid paradigms and policies
  • To elucidate the process that patients must navigate in order to receive health care in Guatemala
  • To conduct NGO program evaluations concerning primary care and to provide feedback on programming, redundancies, and gaps in service coverage to participating organizations
  • To develop occupational perspectives and analyses on NGO activities by and with staff and the communities or populations served

Project Activities

The NGO Networks for Health group will investigate the interactions of a health-focused NGO program and government health agencies in the Antigua area, particularly focusing on primary care delivery.  While the Guatemalan government health system provides largely adequate coverage for emergency and tertiary care surgical needs, effective, appropriate, and accessible preventive and primary care services are often lacking.  This gap in service provision is in part filled by NGOs, both Guatemalan and international, who employ varying strategies for reaching and serving patients.

Employing qualitative research methods, students will interview NGO service coordinators, seek the input of recipients of NGO primary care services, and conduct observations of NGO programming.  Based on this first-hand research, students will highlight specific issues within the primary care delivery of an NGO program and pinpoint areas for strategic improvement in the delivery of services.  Both the research findings and suggestions for improving primary care delivery will be shared with participating NGOs and other stakeholders. 

Key competencies gained will include:  in-depth knowledge of the international NGO structure; qualitative research techniques; basics of public health intervention mapping and evaluation; development of an occupational critique, 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 27 is requested, in order to complete the writing, editing, and/or posting of the report.


Pediatric Practice: A Sensory Integration Approach to Nutrition, Feeding and Pediatric Development

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

Project Objectives

  • To understand and utilize the theory and practice of sensory integration as it relates to feeding and early childhood development within the context of an inpatient infant nutrition unit in Guatemala
  • To understand and appreciate the sensory components  of feeding, handling and early childhood development
  • To understand the relationship between nutrition and early childhood developmental trajectories and occupational capacity
  • To gain an introduction to feeding and sensory integration techniques used to facilitate early child development
  • To recognize the impact of physiological, environmental, and contextual conditions that impact the child’s ability to self-regulate and participate in feeding and other developmental occupations.
  • To gain insight into issues of nutritional deficits as determinants of health and early child development in Guatemala
  • To engage with Guatemalan members of the student’s  field school community to further extend the student’s understanding of attitudes and practices regarding  feeding, nutrition and development 
  • 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 and malnutrition are recognized as significant factors that impact and typically undermine 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.  

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 a developmentally-based and sensory integration 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 sensory integration based 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 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 poor infant and child nutrition and impacts on occupation and neurodevelopment; knowledge of feeding and swallowing techniques and sensory integration 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 Technologies for Community Development

Faculty:  Gari D. Clifford, DPhil, MSc, MA

Project Objectives

  • To understand the role of low-cost devices and sustainable technologies in the delivery of health and development programs
  • To investigate the potential use of a mobile phone-based system for communication and monitoring local community development workers for a Guatemalan NGO
  • To innovate on the use of technologies and implementation strategies that would be most useful for our NGO partner
  • To consider the impacts of international aid paradigms and policies on development programming and implementation in the Guatemalan context
  • To explore and articulate the ways in which use of low-cost technologies can empower communities through improved participation and power over provision of public services
  • To develop occupational perspectives and analyses on the use of sustainable technologies for community development with NGO staff and the communities or populations served

Project Activities

Low-cost technologies, particularly technologies based on mobile phones, have been established as an essential emerging avenue for the provision of health care and the deployment of community development initiatives in resource-constrained environments.

Working in partnership with a local NGO, students will solicit the input of NGO service coordinators and community participants in order to understand the need for mobile phone-based communication using SMS-text messaging within community projects.  Based on this first-hand research, students will create an implementation plan for an existing SMS-text messaging system, highlighting the scale of need, level of readiness of participant communities and stakeholders, and potential barriers to successful implementation.  The implementation plan will be shared with our partner NGO.  No technical skills are required to participate in this group; students will focus on implementation strategies and potential outcomes of sustainable technologies rather than technology development.   

Key competencies gained will include:  knowledge of sustainable technology currently used in health and development projects globally; basics of the design of SMS-text messaging systems for development projects; knowledge of the international development structures; qualitative research techniques; development of an occupational critique, and project implementation plan 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 27 is requested, in order to complete the writing, editing, and/or posting of the report.