Congenital Syphilis Prevention in Colombia: Multiple Ontologies, Silences, Absences and Collateral Realites
Estrada Jaramillo, AL; Estrada Jaramillo, AL
Date: 22 July 2024
Thesis or dissertation
Publisher
University of Exeter
Degree Title
PhD in Anthropology
Abstract
Why is that a preventable disease is not being prevented, or at least, not being prevented as expected? That is the case for Congenital Syphilis (CS), the transmission of Syphilis from mother-to-child in Colombia. Despite several efforts made by public health authorities through the implementation of Clinical Practice Guidelines (CPG) ...
Why is that a preventable disease is not being prevented, or at least, not being prevented as expected? That is the case for Congenital Syphilis (CS), the transmission of Syphilis from mother-to-child in Colombia. Despite several efforts made by public health authorities through the implementation of Clinical Practice Guidelines (CPG) in 2014, there has not been a significant reduction in the incidence of CS in Colombia, which has become more acute during the COVID-19 pandemic.
In this study, I argue that not acknowledging other ontologies (realities) besides those from science and “experts” is one of the main problems for CS prevention. In Quibdó, Manizales and Riosucio (Colombia), where this study is conducted, several ontologies are enacted in a bundle of practices that not only clash, contradict and cooperate, but also make CS appear and disappear at certain moments, places, and for some people.
To address these issues, data was collected using online methods such as document analysis, interviews, Online Asynchronous Focus Groups (OAFG) and diaries with mobile phones or WhatsApp (January – August 2021) with healthcare workers and administrators, traditional midwives, pregnant women or recent mothers and their partners (Indigenous, Afrodescendants, migrants, Internal Displaced people).
Through the multimodal and apparently fragmented-discontinuous data, I uncovered silence, absence and discontinuity practices related to diverse care assemblages, stigmas and taboos. Those practices challenge the assumption that more knowledge and awareness regarding the CPG, and individual and behavioural measures, would be effective for CS prevention.
It is argued that CS prevention as a matter of care requires the integration of diverse caring assemblages (that incorporate biomedicine, traditional medicine, midwives, religion, curanderismo and online resources) in order to address taboos and stigmas, as well as silence and absence practices. This suggests the need for the local, regional, national and international coordination of practices in order to stop configuring the neglect of CS.
Doctoral Theses
Doctoral College
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