Neo-Colonial Epidemiology: Public health practice and the right to health in Guatemala

Abstract

This is a study of the everyday practice of epidemiology in Guatemala and how it shapes and is shaped by the notion of the right to health. Much of the research on the relationship between public health and human rights adopts either a critical position towards public health as a potential human rights violator, or an uncritical assumption that what is good for public health is good for human rights, without an examination of how that relationship happens. With my research I show that the human rights impact of epidemiological practice is not unidirectional, and that it is influenced by the concrete configuration of transnational and local forces (political, economic, ideological, bureaucratic, scientific and symbolic) mediated by social relations in which the epidemiologist plays a key moderating role. I introduce the notion of "Neo-Colonial Epidemiology" to synthesize the ways in which these forces take shape in the Guatemalan context, where institutional chaos, disciplinary conformism, international health relations, and national social relations play key roles. To complete this research I spent a total of eighteen months doing fieldwork in Guatemala, over a period of three years.