RESUMO
The community-based disaster risk management (CBDRM) framework recognises the crucial role that small- and medium-sized NGOs play during adverse events, particularly in marginalised communities. Despite the global frequency of civil unrest, its effect on NGOs' programmatic, administrative, and operational capabilities is poorly understood. To this end, we completed in-depth semi-structured interviews with eight key informants representing seven health NGOs in Nicaragua several months after widespread and persistent civil unrest erupted in April 2018. Data analysis revealed that all NGOs experienced notable disruptions in community education and health promotion, healthcare provision, fundraising, and strategic planning. Further, NGOs experienced several key challenges in responding to crises, including mobility within and between communities, diminishing financial resources, and safety concerns for staff and volunteers. Several NGOs anticipated long-term adverse impacts. In light of these challenges, we propose that health NGOs create a plan of action to mitigate adverse impacts of civil unrest and promote population health. Specifically, a plan of action should address institutional planning, communication strategies, and partnerships and coalitions. We also propose important ways in which future research could build on this preliminary study.
Assuntos
Distúrbios Civis , Atenção à Saúde , Organizações , Atenção à Saúde/organização & administração , Humanos , NicaráguaRESUMO
The concepts Vivir Bien and Buen Vivir, often translated as 'living well' or 'collective well-being,' are central to contemporary social medicine reforms in Latin America. Owing to increasing social inequalities, notably in the public healthcare sector, Vivir Bien has regional significance as it redefines the neoliberal development goals from economic improvement to so-called post-neoliberal social goals of harmonious co-existence between society and the physical environment. To examine how this abstract concept is conceptualised, is incorporated into, and shapes state-sponsored public health strategies, I analyze the 'Vivir Limpio, Vivir Sano, Vivir Bonito, Vivir Bien !' ('Live Clean, Live Healthy, Live Beautiful, Live Well !') national campaign in Nicaragua that began in 2013. The campaign promotes normative socio-political ideals around environmental health citizenship, including the adoption of indigenous grammars and solidarity. However, analyses of dozens of interviews and 143 household surveys in four historically impoverished, untidy, and unhygienic communities suggest that the campaign's discourses do not resonate with citizens or their socio-economic contexts. In highlighting discrepancies between state-sponsored normative sociopolitical ideals and citizens' lived realities and perspectives, this paper introduces the term 'post-neoliberal citizenship' to reflect contemporary - and changing - conceptualizations of health, wellbeing, and citizenship in post-neoliberal Latin America.
Assuntos
Saúde Ambiental , Reforma dos Serviços de Saúde , Promoção da Saúde/organização & administração , Política , Medicina Social , Objetivos , Humanos , Nicarágua , Avaliação de Programas e Projetos de SaúdeRESUMO
The modernization (i.e. mechanization, formalization, and capital intensification) and enclosure of municipal solid waste management (MSWM) systems threaten waste picker livelihoods. From 2009 to 2013, a major development project, embodying traditional neoliberal policies with inclusive social policies, transformed the Managua, Nicaragua, municipal solid waste site from an open-air dump where as many as 2,000 informal waste pickers toiled to a sanitary landfill. To investigate waste pickers' social and economic condition, including labor characteristics, household income, and poverty incidence, after the project's completion, 146 semi-structured survey questionnaires were administered to four communities adjacent to the landfill and 45 semi-structured interviews were completed with key stakeholders. Findings indicate that hundreds of waste pickers were displaced by the project, employment benefits from the project were unevenly distributed by neighborhood, and informal waste picking endures due to persistent impoverishment, thereby contributing to continued social and economic marginalization and environmental degradation. The findings highlight the limitations of inclusive neoliberal development efforts to transform MSWM in a low-income country.