Más allá del diagnóstico médico: Explorar la diabetes en Samaipata
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Rev. aportes de la comunicación
Abstract
Esta investigación examina cómo las personas que viven con diabetes en Samaipata, Bolivia, afrontan su enfermedad dentro de un sistema de salud pluralista, con la coexistencia y uso simultáneo de diversas prácticas médicas, biomédicas y tradicionales. Se analizan las narrativas de pacientes y profesionales de la salud, así como experiencias de estigma, redes de apoyo y preferencias de tratamiento. Se adoptó un enfoque de métodos mixtos que incluyó entrevistas con pacientes y personal sanitario, además de un experimento de asignación de recursos. Los resultados evidencian que ambas partes sostienen narrativas de la enfermedad que coexisten en estructuras dominantes y subordinadas, aunque presentan discrepancias. La perspectiva predominante del personal de salud tiende a desestimar las limitaciones en el acceso a la atención y transfiere la responsabilidad del manejo de la enfermedad a los pacientes. Esto promueve la interiorización de narrativas médicas, refuerza el estigma y debilita las redes de apoyo social, con diferencias según el género. El experimento de asignación reveló que la población prioriza el gasto en frutas y verduras (34,1%), seguido de medicina alternativa (27,2%) y medicina convencional (16,3%), sin que ningún participante dependa exclusivamente de esta última. Estos hallazgos podrían atribuirse a la percepción de ineficacia de la medicina convencional, sus limitaciones de accesibilidad y el arraigo cultural de la medicina alternativa en la comunidad.
This study examines how people living with diabetes in Samaipata, Bolivia, cope with their condition within a pluralistic health system, which is understood as the coexistence and simultaneous use of diverse medical practices, including both biomedical and traditional approaches. It explores the narratives of patients and health professionals, as well as experiences of stigma, social support, and treatment preferences. A mixed-methods approach was employed, combining interviews with patients and health personnel with a resource allocation experiment. The findings show that both groups sustain illness narratives that coexist within dominant and subordinate structures, though with discrepancies. The predominant perspective of health professionals often overlooks limitations in access to care and shifts the responsibility for disease management to patients. This promotes the internalization of medical narratives, reinforces stigma, and weakens social support networks, with gender-based differences. The allocation experiment revealed that participants prioritized spending on fruits and vegetables (34.1%), followed by alternative medicine (27.2%) and conventional medicine (16.3%), with no participant relying exclusively on the latter. These results may be explained by perceptions of the ineffectiveness of conventional medicine, its limited accessibility, and the cultural rootedness of alternative medicine in the community.
This study examines how people living with diabetes in Samaipata, Bolivia, cope with their condition within a pluralistic health system, which is understood as the coexistence and simultaneous use of diverse medical practices, including both biomedical and traditional approaches. It explores the narratives of patients and health professionals, as well as experiences of stigma, social support, and treatment preferences. A mixed-methods approach was employed, combining interviews with patients and health personnel with a resource allocation experiment. The findings show that both groups sustain illness narratives that coexist within dominant and subordinate structures, though with discrepancies. The predominant perspective of health professionals often overlooks limitations in access to care and shifts the responsibility for disease management to patients. This promotes the internalization of medical narratives, reinforces stigma, and weakens social support networks, with gender-based differences. The allocation experiment revealed that participants prioritized spending on fruits and vegetables (34.1%), followed by alternative medicine (27.2%) and conventional medicine (16.3%), with no participant relying exclusively on the latter. These results may be explained by perceptions of the ineffectiveness of conventional medicine, its limited accessibility, and the cultural rootedness of alternative medicine in the community.
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No. 39