Challenges of improving health in the Autonomous Zapatista communities in Chiapas, Mexico

Chiapas, the southern-most state in Mexico, remains a region plagued by poverty and political turmoil. It is the poorest state in Mexico. Centuries of poverty and social injustice resulted in an armed uprising in Chiapas in 1994, with a call for greater independence and human rights for the indigenous people. A state of “low intensity warfare” between the Mexican government and indigenous people persists. Fundamental economic disparities and social injustices continue.

In 1999, Doctors for Global Health accepted an invitation to promote health and human rights in group of indigenous communities. In partnership with local leaders, we have developed an integrated community-based primary health care program. The project provides training to health promoters in more than 20 communities on topics including basic first aid, treatment and prevention of common health problems, communication and teaching strategies, and community organization.

The mission of DGH is to promote health, education, social justice and human rights; to work with partner organizations to bear witness for human rights; to educate and inspire others; to sponsor projects which emphasize community-oriented primary care.

Challenges to improving health in these communities include the continuing atmosphere of threat and intimidation due to the presence of the Mexican Army as well as various paramilitary groups. There are also language and cultural barriers that increase the difficulty of teaching and implementing changes.

Improving health status in the indigenous communities requires a long-term commitment and the ability to gain the trust of people who have experienced centuries of poverty and injustice.