May 2010

Meet Our Featured Guest Columnist:
Dr. Juan Manuel Canales Ruiz

Dr. Juan Manuel Canales Ruiz is a physician, epidemiologist, and health and human rights advocate. For over twenty-five years he has worked with indigenous populations in conflict-affected regions in Mexico and Ecuador. He has founded community health and education programs and currently works at the Hospital San Carlos Altamirano in Chiapas, Mexico. Dr. Canales Ruiz is the 2006 recipient of the Jonathan Mann Award for Global Health and Human Rights.

Q: What does health and human rights mean to you?

A: Health has been a banner of the fight for social movements in the past and by the unionists, generally the organized population. Public health services should be of good quality and with human warmth, so that the patient has confidence and won't be mistreated by those who work in hospitals, health centers, and health clinics.
In the past century after two world wars where human rights of the civilians were violated, the Universal Declaration of the Rights of Men and Women had to be written, spelling out all human rights. Governments around the world are signatories of the Declaration, thus are obligated to comply, upholding all human rights, [including the right to health].

Q: What obstacles do communities in rural Mexico and Central America face in accessing healthcare resources?

A: Article 4 of the Mexican Political Constitution establishes that "All persons have the right to the protection of health. The law will define the bases and methods for the access to health services..." This law does not clearly define that healthcare should be free and public, furthermore it does not establish that the organized population can participate in the development of the "National Health Plan"

In the state of Chiapas, the specialized medical centers are far from the rural communities, they are found concentrated in the large cities of the states such as Tapachula, Tuxtla Gutierrez, San Cristobal and Comitan. And a patient who needs a specialist's attention has to travel (1 to 8 hours on foot or by a car) to these cities and, in general, he or she does not have money to pay for transportation or food even though lodging is available at those hospital centers, the services aren't comprehensive and one has to buy his or her own medications and other things that are needed in the hospital.

Practically there aren't any specialists in rural communities, here in Chiapas there are rarely gynecologists, pediatricians, surgeons, internal medicine, ophthalmologist, ear-nose-throat specialists, dentists, dermatologists, etc.

Also it goes without saying that the hospital centers in Chiapas generally do not have personnel who respects the costumes and culture held by the indigenous people, much less interpreters in the clinic offices or in any other health services.

Q: Describe your current work in Chiapas, Mexico.

A: Principally in CAPACITY BUILDING [TRAINING] of health promoters and in productive [economic] activities for women to earn income; ESCORTING [SUPPORTING, SAFEGUARDING] the fulfillment of their human rights; STRENGTHENING of the autonomous and community organization; SOLIDARITY among men and women and other national and international communities.

All of these activities are achieved in autonomous/independent communities.

Q: What inspired you to become involved in this work?

A: The poverty, misery, marginalization, discrimination, inequity, because I have lived and witnessed them; because we were and are the poor, with dignity. During my youth, young people fought against bad education policies--our banner for the fight was to have more schools, more scholarships, more books, etc.

My profession has allowed me to continue to observe and be near the indigenous and non-indigenous farmers, seeing the same illnesses that are infectious/contagious and preventable despite their prevalence in the population.

Also to share with others from other countries, the fight so that health care is free, of good quality and accessible for all.

Being healthy, people can be free, autonomous and independent, capable of working and living happily.

Q: Describe to us some of the challenges and successes you've experienced in your work.

A: To train farmer/country health promoters in a language different [in their language] than my own.  And also to work with farm women, that are fighting for their autonomy.

I have had many personal satisfactions upon seeing that the knowledge that I have shared with the men and women in the community medicine program, that the communities have someone with whom to consult about their urgent health problems where before they did not.  And we all together look for the solutions to health problems.  Taking their pace and not my own.

Also satisfaction to see that the women continue increasing their self-esteem upon seeing that they can count on the resources that strengthen them to continue fighting for their rights.

That I have learned from them to feel more human, giving them more sense of what we are doing as a group.

Q: Your message?

...Fight for the right to free and universal health, and not only that but also for free education. Young people construct and fight for their future so that they do not support war against other countries, that they do not make nor sell conventional weapons of mass destruction (such as guns and mines) and non-conventional (nuclear, biological, or chemical weapons).