In 2008, the newly written Ecuadorian Constitution guaranteed access to healthcare for all citizens. Consequently, a vast amount of resources have been directed toward rebuilding the public healthcare system, which was in shambles due to the effects of neoliberalism. Although national healthcare studies show positive outcomes, community-based research studies from an impoverished rural barrio in southern Ecuador indicate that the public healthcare system has been unable to address a health epidemic. Based on several years of fieldwork, we argue that the failure originates from the continued functioning of the biomedical model of healthcare as the dominant health discourse in Ecuador. The ensuing result has been the construction of health system governed by an "administrative state" that enforces health policies from the top-down and delivers "episodic" emergency-style care. Accordingly, we maintain that the Ministry of Health (MOH) should create a nationwide community-based health promoter program guided by the principles of health promotion.

Environmental education (EE) continues to focus on enhancing people's ecological knowledge to encourage sustainable actions. This deficit approach presumes that once informed about environmental harms, people will work towards sustainable solutions for healthy societies. Yet research overwhelmingly demonstrates that knowledge of environmental problems is insufficient to spur pro-environmental behaviors. Traditional EE, therefore, has largely been unsuccessful at achieving its goals of engendering environmentally friendly practices and institutions. This article investigates the pedagogical efficacy of a participatory action research (PAR) project for enhancing environmental education in college courses. Qualitative evidence indicates that a PAR project incorporated into an Environmental Sociology course helped students understand how their everyday activities (in particular the consumption of bottled water) exacerbate poor human and environmental health, increased their environmental consciousness, and encouraged them to adopt pro-environmental behaviors and promote sustainability initiatives on campus. Based on these outcomes, the author recommends expanding educational policy to include a description of pedagogical methods such as PAR that successfully operationalize the goals of EE. Policy reforms should encourage educators to incorporate participatory, action-oriented learning opportunities that enable students to apply their knowledge to improve real-world environmental problems.