Globalization and vulnerable populations in times of a pandemic: a Mayan perspective
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COMMENTARY
Open Access
Globalization and vulnerable populations in times of a pandemic: a Mayan perspective Claudia Sotomayor1* and Alejandra Barrero-Castillero2,3 Globalization has a double face that brings to the table free flow of trade, investments, and profits across nations with the hope of improving global integration that eventually will produce the best economic, social, and political outcomes for humanity. From a public health perspective, globalization has improved health and life expectancy in many populations, but unfortunately, it has endangered many others due to the erosion of the environment, the global division of labor, the exacerbation of the rich-poor gap between and within countries, and the accelerating spread of consumerism [1]. As a result, global health conditions are marked by inequities due mostly to poverty and lack of access to healthcare services. In a Pandemic setting, these disparities are exacerbated. Experience from the influenza pandemic in 2009, show that there are several causes for such event [2, 3]. First, low-income and minority workers may have difficulty in adhering to directives to stay home from work because of the nature of their jobs as part of the essential workforce and the necessity to work [4]. Further, their living conditions may be marked by overcrowding and sometimes lack of basic sanitation as well as psychosocial stressors and conditions that may increase the risk and susceptibility to develop or worsen underlying medical conditions [5, 6]. Indigenous populations around the world face even more dramatic challenges, experiencing a higher degree of socio-economic disadvantage, marginalization, poor access to health care and essential services, and lack of access to effective monitoring and early-warning systems. Even in the instances where health care services can be reached, indigenous communities frequently face discrimination, disproportionally increasing the risk and * Correspondence: [email protected] 1 Pellegrino Center for Clinical Bioethics, Georgetown University, Washington DC, USA Full list of author information is available at the end of the article
vulnerability in public health emergencies like during this global unprecedented pandemic [2].
The Mayan experience A good example of how globalization affects indigenous and vulnerable populations is the Mayan Communities in the Yucatan Peninsula. In our early years of practicing physicians, we volunteered at a non-profit organization that provided community health care to Mayan Communities in the State of Quintana Roo, Mexico. The experience not only shaped our future career choices, but taught us the complexity that entails providing adequate healthcare to marginalized and vulnerable populations. We witnessed a rooted distrust of the healthcare system, the corruption of the government, a high degree of socio-economic marginalization, and many underlying host factors and medical conditions that increase the risk of diseases and complications, many of which we were unable to subside. These remote
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