TACOMA, Washington — Panama is located on the isthmus connecting North and South America, with the Panama Canal serving as a primary source of economic prosperity. In recent years, the nation has experienced an average annual GDP growth of 4.6%, and a decline in the national poverty rate of 1.6%. Healthcare access, however, is a principal issue among inhabitants, particularly among rural and Indigenous communities. The nonprofit organization Global Brigades is working to address this issue by tackling health and economic inequalities. In an interview with The Borgen Project, participant Daphne Binto of Boston College’s Global Brigades in Panama explained the dire circumstances of healthcare access in the indigenous village of Ipeti Guna. Lack of infrastructure, medical resources and wellness knowledge lead to high percentages of preventable illnesses among these communities in particular. Global Brigades in Panama partners with 108 communities and 86,000 individuals in order to employ comprehensive, community-focused strategies that provide essential medical and economic services.
Healthcare in Panama
Throughout the nation, disparities between rural and urban healthcare pose a threat to citizens’ well-being. In rural regions, often occupied by Indigenous populations or individuals of African descent, government medical services operate on a more limited scale than urban regions with fewer facilities and services available. As of 2015, there were only 1.3 hospital beds per 1,000 people in rural regions, while urban populations possessed 2.9 hospital beds per 1,000 people. These discrepancies are partially caused by the unequal distribution of GDP growth, as well as a public policy focus that has traditionally centered around economic, rather than social issues.
Hardships for Indigenous Populations
Panama comprises various provinces and districts, with Indigenous populations residing in autonomous regions and villages. Social security services and health care insurance are available for citizens residing within the Panamanian government’s jurisdiction. However, Binto stated that certain Indigenous communities, such as Ipeti Guna, are not accounted for in this scheme.
Historically, Indigenous populations have struggled to acquire rights and partake in political conversations. Though the nation has welcomed the United Nations’ Declaration on the Rights of Indigenous Peoples, its integration into public policies has lacked efficacy. Of the five Indigenous regions, known as “comarcas,” only three are granted the ability to enact policies of their own accord. While the government recognizes the existence of the comarcas, in 2016, it became apparent that Indigenous territories would not be included in official governmental conversations and decisions. Traditionally, it has also been difficult for Indigenous populations to participate in the legislative process, which has resulted in cases of eviction and religious site destruction.
These political realities have acute medical consequences. Among the Indigenous population, the maternal mortality rate is four times greater than that of the remaining population, and life expectancy is shorter by 11 years.
Additionally, 81% of the Indigenous population lives in extreme poverty, and the daily average wage in comarcas is meager, further complicating healthcare affordability.
An Overview of Global Brigades
Global Brigades is committed to addressing these economic and health inequalities. The organization operates in six countries around the world and strives to provide health and economic services to strengthen communities.
A defining characteristic of this organization is its commitment to a “holistic approach” that enacts programs that are both sustainable and scalable. This strategy prioritizes primary health care, dental care, banks owned by the community, clean water access, sanitation systems in homes and economic development. Some specific examples include health education initiatives, professional healthcare, financial literacy services and the implementation of water pipes and eco-friendly stoves.
Global Brigades in Panama
In an interview with The Borgen Project, participant Daphne Binto of Boston College’s Global Brigades in Panama explained healthcare issues that plague the indigenous village of Ipeti Guna. Since the village is not formally recognized by the Panamanian government, residents did not have access to institutional healthcare. Poverty was prevalent among the population as individuals struggled to acquire sufficient food and potable water, and these nutritional deficiencies further jeopardized the community’s health.
Binto also stated that the community lacked a health clinic or hospital, so the Brigade serviced medical exams, health check-ups and educational programs from “pop-up” clinics in a local school. The primary mode of transportation for community members was walking, so in emergency situations, individuals were not able to receive proper medical care because of their inability to travel to a medical facility.
Binto also noted sanitation concerns that resulted in diarrheal disease, as individuals utilized the same water source for bathing, drinking and defecating. Incomplete knowledge of medical histories posed further problems for patient referral and proper treatment, and the group worked to architect an effective medical record database. Specifically focused on dental and reproductive health, the group also provided resources and training sessions to increase community-awareness of commonly-treated illnesses. According to Binto, “the biggest things were essentially just getting people the medication they need because a lot of the illnesses that we saw were easily preventable.” Sessions taught on toothbrushing, self-administered breast exams and water purification were given in order to tackle these prevalent issues. The group also administered over-the-counter medicine (a rarity in the village) and provided extra supplies that were stored for future use.
As Global Brigades continues into its 17th year of operation, it is working to ensure that economic and health inequalities are rectified among impoverished regions in Panama. Within the Panamanian government, steps have been taken to address concerns with the appointment of Indigenous persons to administrative positions concerned with Indigenous affairs. Additionally, the World Bank has provided $80 million to support the Panamanian Indigenous Peoples’ Development Plan, which seeks to increase the availability and quality of education, clean water and sanitation sources, health services and infrastructure. Along with the efforts of Global Brigades in Panama, these actions will not only improve healthcare access but the well-being of communities as a whole.
– Suzi Quigg