Racism against Totonaco women in Veracruz: Intercultural competences for health professionals are necessary

Abstract

Racism is a neglected but relevant cause of health disparities within multi-ethnic societies. Different types of racism and other expressions of discrimination must be recognized, critically analyzed, and actively reverted. This paper is based on anthropological fieldwork conducted in three medical facilities in the indigenous region Sierra de Totonacapan in the highlands of Veracruz in Mexico and analyzes maternal health and identifies levels of racism as perceived by female indigenous patients. Applying a theoretical framework that defines racism at three levels, namely, institutionalized, personally mediated, and internalized racism. We empirically distinguish and acknowledge human rights omissions and violations and then analyze the sources of racism in close relation to an intersectional view on gender-, class-, and race-based forms of discrimination. Finally, in addition to investment in health goods and skilled birth attendants, we propose an intercultural competence approach to manage racism, among other ideologies. This approach targets health professionals as conscious, reflexive, and transformative actors of intercultural interactions with culturally diverse patients. OPEN ACCESSCitation: Dörr NM, Dietz G (2020) Racism against Totonaco women in Veracruz: Intercultural competences for health professionals are necessary. PLoS ONE 15(1): e0227149. https://doi.

Perspective Chapter: Cultivating Environments of Belonging in Psychiatry, Clinical Psychology and the Allied Mental Health Fields

“…For example, in mental health counselling, it is not about who has more or less racism in their lived experiences, but rather how racism is experienced qualitatively due to the junction of other ascribed social identities and the differential allocation of/access to resources that may make racism easier to handle [21]. In recent years, the usefulness of intercultural competency in overcoming racism in patient-professional communication and treatment provision has received some attention in the transcultural mental health discourse [22]. The phrase 'intercultural competency' is sometimes used interchangeably in the literature with terms like 'multicultural competency' , 'cross-cultural competency' and 'transcultural competency' .…”

“…With the current emphasis on the value of lived experience expertise and the potential for including it throughout the research process, it should be clear that therapists who are racialised as Black and Of Colour are, to some extent, lived experience experts when it comes to the topic of racism. Many mental health professionals are positioning Black Lives Matter as a framework for supporting Black and Brown patients by focusing on reversing the impact of traumatic historical and current racism on mental health [22,46,47]. However, often this position is met with benevolent racism [48].…”

Discriminação racial e saúde: ações dos profissionais de saúde na assistência à mulher em processo de abortamento provocado

“…Estas últimas são desqualificadas 24,29 , sendo atribuído um estado de anormalidade psíquica ao praticarem um aborto. Os resultados expressam indícios de que as instituições de saúde e os profissionais desses hospitais abarcam em suas práticas a violência institucional 38,40,41,43,49,53 , sobretudo com práticas desumanizantes de atenção 51,52 e violência simbólica 52 . Ademais, a não priorização do atendimento às mulheres com abortamento é evidente na pouca atenção dada a estas usuárias, e a existência de discriminação racial.…”

“…Ademais, a não priorização do atendimento às mulheres com abortamento é evidente na pouca atenção dada a estas usuárias, e a existência de discriminação racial. São identificados nos artigos as precárias condições das unidades de saúde, deficiências da infraestrutura dos serviços, com superlotação das maternidades 44,47,[51][52][53][54] .…”

“…Na análise dos serviços obstétricos foi possível perceber duas áreas nas quais a literatura associa a presença e reprodução da violência institucional: de um lado os conceitos e valores dos próprios cuidadores frente ao aborto 43,53 e ao cuidado prestado nas maternidades 49,51 e, do outro, as normas institucionais e o processo de trabalho 37,39,42 . Combinados, estes fatores evidenciam atitudes e práticas que remetem à violência institucional.…”