From policy to practice: Insights on intercultural health in SACA

Our partners in South and Central America joined our latest webinar to share their expertise and reflections on integrating traditional knowledge into health systems to ensure equity and improve the health of Indigenous Peoples.

26 September 2023 Andreea Enea

The latest P2P webinar invited speakers from the Pan American Health Organisation, the Fund for the Development of Indigenous Peoples of Latin America and the Caribbean, and Hospitalito Atitlán.

On August 31, WDF hosted the fourth webinar facilitated by our Partner2Partner Academy (P2P) – an open space for learning, innovation, and knowledge-sharing with and between our partners in the areas of diabetes prevention, care and advocacy.

The session, called ‘Intercultural Health and NCDs: Global Perspectives and Experiences of Indigenous Peoples in Latin America’, included key speakers from the Pan American Health Organisation (PAHO/WHO), the Fund for the Development of Indigenous Peoples of Latin America and the Caribbean (FILAC), and Hospitalito Atitlán in Guatemala.

From interculturality in diabetes management and ways of harnessing and rescuing the knowledge and practices of traditional medicine, the participants had the exciting chance to hear directly from Indigenous peoples about their lived experiences.

‘Indigenous peoples face many barriers to healthcare and are disproportionately impacted by diabetes and other NCDs’, explains Line Bechmann, Programme Manager at WDF and moderator of the webinar. ‘So it is crucial to pay more attention to intercultural health and how to integrate conventional medicine with traditional practices’. 

There are over 476 million Indigenous peoples living in 90 countries – 6.2 per cent of the global population, according to the United Nations. Compared to non-Indigenous populations, they are three times more likely to be living in extreme poverty. In such circumstances, traditional medicine has been a fundamental resource for centuries and continues to be a mainstay for those facing health disparities.

Therefore, increased attention to Indigenous communities and non-communicable diseases (NCDs) is well-founded – and leading organisations are taking action.

Locals in Guatemala celebrate the healing power of medicinal plants - part of the heritage and ways of life of the Indigenous People.

The World Health Organisation launched the Global Centre for Traditional Medicine (GCTM) in India to optimize the contribution of traditional medicine to global health and held the first Traditional Medicine Global Summit this August – the same month the International Diabetes Federation (IDF)  presented the first-ever report on Diabetes among Indigenous Peoples.

The latest P2P Academy webinar follows suit and reflects the WDF’s increased commitment to supporting the Indigenous peoples and the efforts of many partners sharing the same cause.

Making space for intercultural health dialogues

To shed light on the topic, two PAHO representatives – Carmen Antini Irribarra, Diabetes Prevention and Control Advisor, and Sandra del Pino, Regional Advisor on Cultural Diversity – were invited to share about the global approaches to an area that is highly relevant to a region that is multiethnic and multicultural – one that requires practical solutions and the leadership of governments.

As the two speakers explained, people with diabetes should have access to equitable and affordable health care and treatment. To meet this need, PAHO supports cost-effective programmes that reduce risk factors, strengthen primary healthcare, and provide timely diagnosis and quality treatment for all those affected’.

Nonetheless, a mindful approach to ethnicity and health is paramount. To catalyse that, their work revolves around five strategic areas at a policy level – data collection, promotion of intercultural health policies, social participation and strategic alliances, recognition of ancestral knowledge and complementary traditional medicine, and capacity development.

Sandra del Pino remarked that more inclusivity is needed, for ‘the richness that Indigenous peoples bring to us with their knowledge and the ways we can integrate their worldviews of health and illness in the interventions’. This requires a horizontal exchange of knowledge. ‘There is no hierarchy, and it is precisely this way that we can create intercultural health dialogues – a space where diverse cultures can reach agreements to improve health outcomes for people facing greater vulnerability and to promote cultural differences as enriching.

PAHO and FILAC are currently in dialogue regarding regional initiatives to enhance social participation and strategic alliances by involving Indigenous peoples and local experts in interculturality to adopt differentiated approaches when working with health issues.

The latest WDF-funded project led by FILAC empowers Indigenous communities to promote and protect their health according to their culture – here, locals enjoy a Healthy Eating Fair in Bolivia.

The local health system – traditional system synergy

A regional experience was shared by Ernesto (Tito) Marconi, Coordinator of the Indigenous Cooperation Initiative, and Evelin Rosso, responsible for the diabetes prevention project in Bolivia, both representing FILAC – WDF partner and leading Indigenous organisation in South and Central America with significant experience in programmes for and with Indigenous peoples.

The data spoke for itself, as they presented FILAC’s research findings on the impact of type 2 diabetes on Indigenous peoples in Bolivia, Guatemala and Nicaragua. The study is part of the regional project Prevention and Control of Diabetes in the Indigenous Populations in Bolivia, Guatemala and Nicaragua (WDF19-1730).

‘It is important to strengthen the local health systems in our countries that serve remote rural municipalities where the conditions of care have not been adequate’, explained Ernesto Marconi, ‘but at the same time, we need to articulate existing mechanisms of traditional medicine – including midwives and doctors – according to each cultural context’.

This synergistic approach already shows positive signs.

‘We believe the actions carried out in our areas of intervention are effectively contributing to our purpose – not only strengthening health systems but traditional systems as well, engaging in local dialogue to work with a disease as important as diabetes’, he added. ‘For that, we hope to continue to work with WDF, to whom we are deeply grateful for the support’.

Community screening and awareness activities in Nicaragua, part of the regional project WDF19-1730.

Embracing cultural differences and breaking the stigma

Josue Israel Lacán, who works as an ambulance driver for Hospitalito Atitlán in Guatemala (long-term partner of WDF ) was invited to share his first-hand experience working in the Indigenous communities and living with type 2 diabetes.

The speaker took the participants through the various challenges that locals are facing. On one hand, healthcare workers are reluctant to recommend traditional medicine for diseases such as diabetes because of a lack of scientific knowledge, and on the other hand, people receiving a diagnosis are discriminated against because of a lack of understanding of the disease.

‘We realise the controversy in terms of medical advice and understanding of plants’, Josue Israel Lacán explained, emphasizing the need for more dialogue and culturally appropriate solutions. ‘The medicine is very scarce in some areas or expensive for a population that ‘lives day to day and has no alternative access to medicines’.

In South and Central America, the number of people with diabetes is estimated to increase by 48% to 49 million by 2045, while the prevalence is estimated to grow by 25%, reaching 11.9% in 2045, according to the IDF’s Diabetes Atlas. To prevent this, culturally sensitive and holistic policies and programmes are paramount, and WDF has supported such community-based initiatives on the ground to improve access to diabetes prevention and care, accommodating the Indigenous peoples’ concepts of health and empowering them to take ownership and lead the way.

Indigenous people as empowered stakeholders in a previous diabetes prevention and management programme in Bolivia.

A forum that catalyses partnerships – and local knowledge

The P2P webinar, this time held in Spanish, engaged everyone in an exciting – and even longer than expected – dialogue.

One participant, Hernán García, Deputy Director of Traditional Medicine and Intercultural Development for the Mexican Ministry of Health, shared that they completely agreed with the approach taken in the project involving Guatemala, Bolivia and Nicaragua, and were more than happy to share their own research done in Mexico in the past 20 years.

‘Wonderful to see the potential of the P2P Academy unfold another important niche of work with our community of stakeholders in South and Central America, who took us from policy to practice in just 90 minutes’, remarked Yildiz Arslan, Programme Manager for WDF’s P2P Academy.

Indeed, the session generated new ideas. But it ended with a very clear call to action: more dialogue. ‘It is important to have more spaces like this’, added Ernesto Marconi, ‘and relevant dynamics in which we can learn first-hand about different experiences and frameworks that will surely contribute to the fight against diabetes’.

The P2P webinars provide a forum for interesting knowledge-sharing about solutions to the issues WDF partners share. Finally, Line Bechmann reassured the participants, ‘we are proud to see such a positive engagement at a regional level and we’ll continue to provide this space – this is truly valuable learning’.

P2P Academy is a platform that supports capacity building of our WDF partner institutions in the areas of diabetes prevention, care and advocacy through training, networking, research and innovation. P2P Academy is also a tool for WDF to address unmet or unforeseen needs arising along the way to ensure the best possible impact of a project.

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