Doctoral Dissertation Research: Negotiating Care in Intercultural Integrative Medicine

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Providing culturally appropriate care for diverse populations has become a significant challenge for health care systems. There is significant debate among healthcare professionals about appropriate methods of practice in intercultural integrative settings. Common approaches have included training traditional birth attendants and incorporating ethnomedical practices within biomedical facilities. But significant questions remain about the how intercultural communication and healthcare delivery are transformed through these interventions. This project, which trains a graduate student in how to conduct rigorous, empirically-grounded scientific fieldwork, examines how biomedical practitioners negotiate medical authority and social inequalities within intercultural healthcare settings. The results of this research will be shared with healthcare professionals, and among anthropologists and other social scientists interested in studies of biomedicine and healthcare inequalities. Findings from this study will be presented to the participating clinic, and disseminated through academic and non-academic publications, presentations, and reports in English and Spanish with the aim of developing care outcomes and strategies for improving intercultural health care.Trisha Netsch Lopez, under the supervision of Dr. Kathleen DeWalt, will explore how conflicts over the delivery of healthcare in intercultural contexts are reflected, reproduced, or contradicted implicitly within everyday interactions between healthcare providers. The study will take place at an intercultural health clinic in Ecuador, a setting internationally recognized by biomedical health professionals for its inclusion of intercultural healthcare in delivery methods. This research examines the most intrinsic challenges to culturally appropriate health programs: who has the authority to define the role of culture, the limits of participation, and the direct and indirect beneficiaries of such programs. It will also make important contributions to medical and linguistic anthropology by combining linguistic and ethnographic methods to explore the intersection of political discourses of health and everyday care encounters. The study will combine quantitative and qualitative linguistic analyses of maternal health appointments with policy document analysis and interviews with health care providers, health officials, indigenous activists, and community members. This combination of methods allow for a multi-level analysis to understand how the act of intercultural communication shapes/is shaped by political discourses of culturally appropriate health care and indigenous rights, as well as the needs and viewpoints of patients, providers, and the surrounding community.