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El artículo examina los efectos que causaron los sismos sobre la salud de la población y sobre la infraestructura de los servicios de salud en México, así como su incidencia sobre el desarrollo de la reforma  planteada para ese sector por la actual administración. Para ello se analizan las características generales de dicha reforma, los obstáculos que enfrentaba y los problemas que surgieron a raíz de los sismos. Se concluye que a pesar de que el sector salud fue el más afectado por la pérdida –sin precedentes en la historia nacional y mundial– de profesionales, instalaciones y equipo, la catástrofe permitió profundizar la reforma del sector y coadyuvar a una mejor distribución de los recursos para la atención médica.Los sismos de septiembre de 1985 tuvieron un gran impacto sobre la estructura de los servicios de salud en México. Más de 10% de las vidas que cobró el desastre se perdieron en los hospitales derruidos,  mientras que en un solo día dejó de existir una cuarta parte del total de la capacidad hospitalaria del sector público en la zona metropolitana. Estos hechos se insertan a su vez en el contexto de una profunda crisis económica, a la cual el sector salud intentaba hacer frente por medio de una reforma estructural sin precedentes. Es pertinente entonces examinar los efectos que han tenido y tendrán los sismos de septiembre sobre el desarrollo de la reforma al sistema de salud en México. Se aborda este problema analizando las características generales de la reforma propuesta a principios del sexenio, los problemas que ya de por sí enfrentaba y los daños que los sismos produjeron en la infraestructura de servicios. Se trata de demostrar que, no obstante la destrucción y el evidente desgaste que representa la reconstrucción, los sismos abrieron nuevas oportunidades para la reforma y literalmente allanaron el camino para su profundización. Se analiza también el grado al que esta coyuntura ha sido favorable para los propósitos del régimen, examinando los obstáculos y problemas que se le presentaron.

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At the threshold of the twenty-first century, the concept of autonomy is a disputed term within academia and among different social sectors globally and regionally. In particular, the meaning of the term 'autonomy' remains elusive and highly contested in the relationships between Indigenous Peoples and Latin American states. The case studies and reflections presented in this special issue provide evidence that the concept of autonomy is not enough to understand the complex relationships between Indigenous Peoples and the kind of state that prevails today in Latin America. Throughout the region, capitalism as a global mode of production continues to expand and dominate, liberal democracy is characterized by limited levels of pluri-cultural participation in state decision-making, and there is widespread corruption and abuse of power among state officials at different levels. Moreover, liberal democracy continues to disregard the pressing socioeconomic needs of the low-income sectors of society, in particular Indigenous Peoples. After reviewing the materials included in the special issue, this introductory essay argues that a theoretical convergence between decolonial and Indigenous studies and scholarship can offer an enhanced perspective for interpreting the meaning of autonomy.

The Nicaraguan autonomous regime has confronted important challenges in the promotion of multi‐ethnic citizenship, as it has been hindered by successive national administrations. This contribution reviews the performance of the autonomous regime by exploring the ongoing contentious reform process of what has become a hybrid model of subnational governance. The argument suggests that the FSLN (Sandinista Front for National Liberation) has continued to press forward its vision of national integration for the Caribbean Coast, and has promoted a political agenda which ultimately aims at subduing autonomy as an avenue for realising the right to self‐determination of Indigenous and Afro‐descendant Peoples.

Autonomy should not be understood as an inherent quality of rural subjects but as fundamentally a political and cultural project. This paper will present an overview of the evolution of the idea, project, and practice of peasant and indigenous autonomy in Latin America from the 1990s to today. It will trace the origins of the process and examine how the different dimensions of the concept of autonomy (economic, political, ideological, and ethnic) came together in the early 1990s to form a coherent although contradictory political project, which attempted to present an alternative to neoliberalism and political paternalism. The paper will assess the extent to which this project addressed the main challenges that the different sectors of the peasantry faced with the neoliberal restructuring of the economy and the deployment of neoliberal multiculturalism in the region. Through the case studies of Brazil, Ecuador, Nicaragua, and Mexico, the paper will argue that the autonomy projects entailed serious contradictions since their inception because by wanting to solve some problems through certain mechanisms, rural

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