User:Katchyaa/sandbox

My PE
I will be working this summer with an organization called GCO which sets up free medical clinics around Wylie, Allen, and Fort Worth TX a few times a month, and orchestrates week long trips to villages in Guatemala, Egypt, and Africa staging free clinics and free construction projects once every three months. Their objectives are to help communities holistically and to start small, therefore they return to the same community within a country every trip and encourage the doctors and laborers from each trip to return to that same village and develop relationships with the communities as they have. Trips are participant and donor funded. My internship will be in Texas and with the indigenous community they've reached out to in La Pila, Guatemala.

PE site
Genocide of indigenous peoples

Kaqchikel people

Guatemala–United States relations

Sector
Access to medicines

Health care quality

Both
Health in Guatemala

Access to medicines
Before March 7th: Before it was updated

Studying access to medicines is relative to my PE experience abroad and in Texas. Healthcare is not only having a doctor around to diagnose you, but also having some kind of means to treatment. In fact, part of Guatemala's own free health care system's problem may be the lack of access to medicine on a country-wide scale.

I don't see any claims explicitly dominating over others, but it is a stub page and therefore there is very little information in general, which leads to some things being highly emphasized over others just by coincidence. For example, almost half of the citations refer to a program in Canada, and 2/7 are from WHO (not in a bad way, just describing their initiative, but the perspective is very heavy for some and not for others).

The links do work! But again, they're mostly Canada and WHO.

There is a list to the Access to Medicine Index, which is great. Maybe some links to different healthcare systems (if the article ends up being divided by country). Maybe a link to the medicine page, some nonprofit pages, or something like that.

The facts are well cited and they're all recent; there just aren't many of them.

There is nothing on the talk page.

This is a mid-level important stub page.

It is part of WikiProject Medicine and WikiProject Pharmacology.

Wikipedia barely discusses this, and there is no dominating voice or opinion.

Post March 7th:

Health in Guatemala
In the section discussing the "Structure and Coverage" of healthcare systems in Guatemala, it divides up the sector well but doesn't compare them much. This is what I'm interested in (why is the public sector failing, and what are all the causes besides "poverty")

Links are good, and there are a lot of them!

Lots on indigenous populations, which is good. The differences between the Ladino and Indigenous experience are also pointed to throughout. However, the section on living conditions doesn't talk about this. ( I happen to know that there are plots of land that are especially secluded, with a mix of indigenous and ladino populations on them, because of a government initiative).

WikiProjects: Guatemala, Health and Fitness, Medicine

C-level article of mid importance and top importance

It was part of a wiki education project at Rice University! It's written like one :)

The history section is about the history of the public healthcare system, which makes sense. However, "Health in Guatemala" could be seen as the history of health even before the government reached out with a public healthcare system. What was healthcare like then? I'm also curious about indigenous healthcare systems.

References to the Armed Conflict are good :) less direct than I'm used to but I suppose that's wikipedia language

The talk page is just peer reviews from the Rice University Class.

Will most likely not do this
Everything looks relevant, but the organization could be better regarding relevance. For example, a section about the first time the bible was translated into the Kaqchikel language is in the same paragraph as the language in general, which implies that the bible is a really important part of their language/culture (a claim for which there is no citation or evidence).

I found a quote: "These early missionaries helped improve the lives of this and countless other tribes..." which is...um...a claim. That is definitely a one sided claim.

Besides this bit about missionaries, the emphasis seems to be more about history than about modern culture and traditions.

There's only one item on the talk page, and it's the correction of a date range that didn't make sense.

This article is part of WikiProject MesoAmerica, Wikiproject Guatemala, Wikiproject Indigeneous Peoples of the Americas, and WikiProject Ethnic groups.

It is a stub article, and mid level importance for a few of the projects (no labeled importance for others).

Access to Medicines

 * Drahos, Peter (2003-02-01). "Access to Medicines". Commonwealth Trade Hot Topics. doi:10.14217/5k3w8fb9ptzv-en. ISSN 2071-9914. 
 * About DoHA (article already talks about)
 * Boslaugh, Sarah E. (2015-11-23). The SAGE Encyclopedia of Pharmacology and Society. SAGE Publications. ISBN 9781506346182.
 * Still need access. Will focus on section about developing countries.
 * Grover, Anand; Citro, Brian; Mankad, Mihir; Lander, Fiona. "Pharmaceutical Companies and Global Lack of Access to Medicines: Strengthening Accountability under the Right to Health". The Journal of Law, Medicine & Ethics. 40 (2): 234–250. doi:10.1111/j.1748-720x.2012.00661.x.
 * Seems to be mostly about HIV (which the article talks about). Maybe skip?
 * Balancing Wealth and Health: The Battle over Intellectual Property and Access to Medicines in Latin America - Oxford Scholarship. doi:10.1093/acprof:oso/9780199676743.001.0001. 
 * More about IP. I think the article already has a lot about IP, will have to read deeper to check for bias.
 * Cartagena, Rosario G.; Attaran, Amir. "A Study of Pharmaceutical Data Exclusivity Laws in Latin America: Is Access to Affordable Medicine Threatened," Health Law Journal vol. 17, no. 1 (2009): p. 269-296.
 * More about IP. I think the article already has a lot about IP, will have to read deeper to check for bias.
 * Chung, Laura (Fall 2010). "Use of Paragraph 6 System for Access to Medicine". North Carolina Journal of International Law & Commercial Regulation. 36: 137–186.
 * Paragraph 6 of TRIPS: Nations without capability to manufacture lots of generic drugs a can import them, and effects on one country who used it.
 * Muzaka, Valbona (Oct 2009). "Developing Countries and the Struggle on the Access to Medicines Front: victories won and lost". Third World Quarterly. 30: 1343–1361.
 * Good about developing countries in general. Maybe I make a new section about developing countries v listing each country out. Or, region of the world? (Latin America, North America, parts of Europe…etc.)
 * Health System Innovations in Central America: World Bank Working Papers. pp. 9–48. doi:10.1596/978-0-8213-6278-5. 
 * Specifically different changes to health systems in Central America, and whether the WB thinks they worked. Didn’t find specificities about medicine through skimming, but I think I can through further reading.
 * Godoy, Angelina Snodgrass (2015-06-01). "Market Myths and Assumptions: Examining the Transnational Politics of Access to Medicines Campaigning in Central America". Studies in Comparative International Development. 50 (2): 187–202. doi:10.1007/s12116-015-9184-4. ISSN 0039-3606.
 * Found a bit about what needs to take place in order for more lax IP to be helpful. Might be a good bias check for the article in its current state.

Health in Guatemala

 * Esquivel, Micaela M.; Chen, Joy C.; Woo, Russell K.; Siegler, Nora; Maldonado-Sifuentes, Francisco A.; Carlos-Ochoa, Jehidy S.; Cardona-Diaz, Andy R.; Uribe-Leitz, Tarsicio; Siegler, Dennis. "Why do patients receive care from a short-term medical mission? Survey study from rural Guatemala". Journal of Surgical Research. 215: 160–166. doi:10.1016/j.jss.2017.03.056.
 * Reasons: reputation and affordability. Could add sections about why each system is preferable over the other (a pro/con table maybe?)
 * Manz, Beatriz; Neier, Aryeh (2004). Paradise in Ashes: A Guatemalan Journey of Courage, Terror, and Hope (1 ed.). University of California Press. doi:10.1525/j.ctt1pprx1. ISBN 9780520240162.
 * Introduction has some stuff about farmworking system that Mayans are often trapped in. Wanted to work into article what it has to say about distance (and forced distance) from major cities/ public hospitals. However, don’t think it’s as relevant now.
 * Gragnolati, Michele; Marini, Alessandra. Health and Poverty in Guatemala. doi:10.1596/1813-9450-2966.
 * Talks about sources of public sector failings. Where to work it into the article…
 * Cerón, Alejandro; Ruano, Ana Lorena; Sánchez, Silvia; Chew, Aiken S.; Díaz, Diego; Hernández, Alison; Flores, Walter (2016-05-13). "Abuse and discrimination towards indigenous people in public health care facilities: experiences from rural Guatemala". International Journal for Equity in Health. 15: 77. doi:10.1186/s12939-016-0367-z. ISSN 1475-9276.
 * Different types of racism experienced in public hospitals. Was thinking of adding Discrimination under “Blocks to access” under Maya Health. Needs another source.
 * Harvey, T. S. (2011-03-01). "Maya Mobile Medicine in Guatemala: The "Other" Public Health". Medical Anthropology Quarterly. 25 (1): 47–69. doi:10.1111/j.1548-1387.2010.01135.x. ISSN 1548-1387.
 * Mobile clinic: other source of healthcare (unmentioned in article). But, only one source.
 * Barrett, Bruce (January 1995). "COMMENTARY: PLANTS, PESTICIDES AND PRODUCTION IN GUATEMALA; NUTRITION, HEALTH AND NONTRADITIONAL AGRICULTURE". Ecology of Food and Nutrition. 33: 293–309.
 * Pesticide poisoning! Needs another source, but will add Pesticide poisoning section.
 * Randolph., Adams, Walter (2007). Health care in Maya Guatemala : confronting medical pluralism in a developing country. Hawkins, John Palmer, 1946-. Norman: University of Oklahoma Press. ISBN 9780806138596. OCLC 85622920.
 * Midwife programs
 * Limited Indigenous Access by distance and cost
 * Pluralism tension
 * Slow bureaucracy
 * 1958-, Kunow, Marianna Appel, (2003). Maya medicine : traditional healing in Yucatan (1st ed ed.). Albuquerque: University of New Mexico Press. ISBN 0826328644. OCLC 657141480.
 * Descriptions of traditional medicine (plant based, how knowledge is passed on)
 * Ketelhöhn, Niels; Arévalo, Rodrigo. "The Guatemalan public hospital system". Journal of Business Research. 69 (9): 3900–3904. doi:10.1016/j.jbusres.2015.11.022.
 * Hoped to get some information about the distance of highlands from public hospitals. Contains mostly charts about where hospitals are located and how many people they help.
 * Greenberg, Linda. "Midwife training programs in highland Guatemala". Social Science & Medicine. 16 (18): 1599–1609. doi:10.1016/0277-9536(82)90290-8.
 * Got as reference from Randolph piece. Midwife programs were problematic.

Summarizing and Sythesizing
Initial Notes: When I've added sentences, I copied the existing paragraph first. You can tell which are mine because they have citations.

The Access to Medicines page was fully updated and fleshed out suddenly on March 7th, which was unexpected, causing me to have to rethink my contribution strategy.

Structure and Coverage

 * 1) I think I might change this header. It includes NGOs which it not always part of the structure of the public healthcare system (so not just the official system structure), but not traditional medicine or the mobile clinic I listed below (so not just methods or sources).

The Peace Accords, which were signed in 1996, called for a change in health provision goals. In 1997, the MOH established a program called the Expansion of Coverage Program (PEC), which worked to improve the availability of health and nutrition services to young children and women in rural areas of Guatemala. As Pena explains, current MOH services do not cover the poor, rural population of Guatemala, making the PEC critical to the rural population. Ever since its creation, the PEC has expanded immensely, now covering about 54% of the health and nutrition needs of rural Guatemalans. The coverage program works with NGOs in the area to promote good health and nutrition to populations who lack sufficient health care. However, important accountability systems regarding transparency and progress were not installed, limiting the program's effectiveness. The services covered by the PEC include care for women and infants, illnesses and emergency care, and environmental care.

There is also an informal sector of healthcare that is often overlooked. Termed the "Maya Mobile Clinic" or the "Other Public Health", traveling salespeople (often men) are a medical resource for Guatemalans living in the highlands. These salespeople offer raw and natural ingredients to mainly indigenous populations and give talks about their health qualities. Maya Mobile Clinics act as a midpoint between the physical distance of the Guatemalan highlands and public clinic locations, and as a midpoint between the cultural gap that separates Maya medicinal norms and values from Guatemala's public health sector's medicinal norms and values.

Pesticide Poisoning (new heading under Conditions)
Due to farming conditions and yield pressures in Guatemala, many agricultural workers are at high risk of pesticide poisoning. People often handle pesticides without protective clothing or gear, soaking it in through their skin and inhaling it into their lungs. A large black market and lack of oversight over legal pesticide use in Guatemala also contributes to its rampant and unsafe use. Pesticide poisoning most likely disproportionately affects indigenous farm workers.

Maya Health
New header (to include existing headers headers):

Medical Pluralism
Note: The alternative medicine page is basically "superstitious people sometimes ignore science and hurt themselves." I feel weird about redirecting there. My definition comes from my citation.

Made a note on the talk page about it, but included it.

Indigenous Guatemalan communities deal with medical pluralism, or the intersection of beliefs and uses regarding traditional and biomedical healthcare. Traditional Maya medical care involves plant medicine and ethnomedical practitioners who learn in one-on-one or self-taught settings. Western medical systems and the Guatemalan public health system have been criticized for not considering ethnomedical practices to be legitimate, and interest among indigenous Guatemalans in taking on ethnomedical apprenticeships has been declining, resulting in tension between practices.

Living Conditions
New paragraph

Government run hospitals are located in the main cities of several provinces. Indigenous peoples' highland locality - often distant from main cities - makes travel to these hospitals expensive, further limiting access. Taking advantage of the importance of midwifery in many indigenous traditional medicinal systems, the Ministry of Public Health decided to better reach indigenous populations through midwife training programs in the 1980s. However, the quality, efficacy, and cultural sensitivity of these programs has been brought into question.

Discrimination
Only once source so far...worth it to keep separate, add to a different one, or keep at all?

Access to Medicines
Blocks to Access : Relabel Hindrances to access(?)

blurb:

Most hindrances to access revolve around market competition and lack of it.

Rename and create some new section headings:
"Current Access" --> "Differences By Geography" and "Differences by Sector"

"Epidemics and access" rather than a bunch of smaller headings mentioning AIDs

Edit "Cost" and "Lack of Generic Brands" sections so they're more separate and concise

Lack of Generic Brands
Many argue that generic brand production in developing countries are essential to bridge the global drug gap. As argued by various sources, the push for more measures such as market and data exclusivity, hinders low-income countries’ ability to to manufacture and produce generic drugs. However, low-income countries often lack the essential infrastructure to allow for generic brand production. In order the use of the medication to be effective, it must be manufactured in optimal laboratory conditions. Developing countries often lack air conditioning, stable electrical power, or refrigerators to store samples and chemicals. Also, quality generic brand production is limited by a government's ability to create effective spaces of market competition and to monitor the quality of generics brands; this ability has been found to be limited in developing countries in Latin America. It also argued that that international aid, state investment, and measures for infection prevention are necessary to allow for generic brand production in low-income countries.

Paragraph 6 System (Under DOHA)
The declaration also allows for countries without manufacturing capabilities to turn to another country for the export of generic brands of patented medicines. This is known as the paragraph 6 system. As of 2010 it had only been called upon once, concerning the import of medicines from Canada to Rwanda, with varying opinions about its results and potential.

Focus on information that can last, or whose updating necessity is obvious.