The Social Medicine Portal

Out in the Rural: A Health Center in Mississippi [with Jack Geiger]

A classic film in community health…

Shot in the fall of 1969 and the winter of 1970, “Out in the Rural: A Health Center in Mississippi” highlights one of the very first Community Health Centers in the United States: the Tufts-Delta Health Center of North Bolivar County, Mississippi. The film captures the broad vision of a community health center involved in far more than traditional medical diagnosis and treatment. For more information on this film, please see an article published in Social Medicine by Dr. Carolyn Chu. This film is posted with the kind permission of Dr. Geiger.

Juan Manuel Canales, Recipient of Jonathan Mann Award

[This was originally posted in July of 2006]

The 2006 Jonathan Mann Award for Health and Human Rights was given to Juan Manuel Canales, a Mexican physician who has worked in the war zones of rural El Salvador and Chiapas, Mexico. This month the Social Medicine Portal highlights the work of this remarkable doctor who has spent over 25 years working alongside Central American and Mexican peasants and indigenous people in their struggle for a better life.

For Juan Manuel, the regular trip to one of the most isolated communities where he works starts before dawn. It begins with a two-hour ride in the foggy darkness. By the time he reaches the place where he has to start walking, the sun has come out and the fog is gone. The mostly uphill walk through pine forest and coffee fields takes another two hours, much of it on narrow footpaths.

Juan Manuel, supported by Doctors for Global Health (DGH), works with indigenous Mayan communities surrounding Altamirano, a rural community in Chiapas, Mexico, many of which are small and geographically isolated. Most of these farmers are supporters of the Zapatista movement, and consider themselves to be “in resistance.” The main component of his work entails training health promoters from these remote indigenous communities and helping them carry out projects in their villages, such as vaccination campaigns, to address the broad health needs of their communities. He also works with volunteer doctors and public health students to introduce them to Liberation Medicine, a model of rights-based, community development work.

Juan Manuel has devoted his life and career to helping oppressed peasant and indigenous communities demand their right to health care by establishing community medicine and public health programs. His understanding of and commitment to human rights and humanitarian law led to his belief that health care is a right, that the Geneva Conventions should protect civilians’ right to medical treatment in the midst armed conflict, and that a rights-based approach is an important tool for indigenous communities to protect themselves.

Championing this cause took no small amount of courage El Salvador in 1980s, where rightwing death squads roamed freely throughout the country and community-based health care was considered a subversive activity. (The support of the US for repression in El Salvador during the war has been well documented by the National Security Archive.)

Juan Manuel lived and worked in areas of heavy conflict, where the population was continually forced to flee bombings and incursions by the Salvadoran army. The violence eventually caught up with him, leaving him with loss of vision in his left eye and an injury to his leg that resulting in a permanent limp. (See photographs of the war in El Salvador taken by renowned war photographer John Hoagland.)

After the El Salvador civil war ended with the 1992 Peace Accords, Juan Manuel stayed in one of the most devastated communities — Santa Marta. He worked closely with the Pan American Health Organization and other groups to aid returning refugees and establish mental health programs for traumatized communities. It was there that he first began to use community radio as a public health tool. He worked extensively with health promoters and midwives to develop simple radio dramas that were humorous, but effective and engaging to teach about human rights and health.

In 1999 Juan Manuel turned his attention to the politically oppressed but fiercely independent populations of indigenous Mayans in Chiapas, Mexico, who are struggling for self-determination and respect for their human rights. (Read some of the history of this struggle, and stay up to date on the latest developments). There Juan Manuel continues to put into practice his belief in the interconnectedness of health and human rights on a daily basis, helping to construct a basic community health system that respects the needs of the indigenous population without imposing the priorities of outside health professionals.

Juan Manuel was honored at the annual Global Health Council awards banquet on June 1, 2006 in Washington, DC. You can read his powerful acceptance speech on the DGH website.

The Jonathan Mann Award was established in 1999 to honor Dr. Jonathan Mann and highlight the vital link between health and human rights. Sponsored by the Association Francois-Xavier Bagnoud, Doctors of the World, John Snow, Inc. and the Global Health Council, the award is bestowed annually to a leading practitioner in health and human rights.

Despite his untimely death in a 1998 plane crash, Jonathan Mann is considered by many to be one of the most important figures in the 20th century fight against global poverty, illness and social injustice. History will especially remember Dr. Mann for bringing to the world’s attention the basic notion that improved health cannot be achieved without basic human rights, and that these rights are meaningless without adequate health. Juan Manuel embodies Dr. Mann’s principles in his daily work. He exhorts us to “invertir en cabeza,” loosely translated, “invest in the mind,” as he trains the future leaders of indigenous communities.

- To read more about Juan Manuel and his work, read the DGH Reporter article “DGH Profile: Juan Manuel Canales”. If you would like to make a donation to help continue to make Juan Manuel’s work possible, you can do so through Doctors for Global Health.