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_______________________________________________________401 Review A NEW DAWN IN GUATEMALA: TOWARD A WORLDWIDE HEALTH VISION Edited by Richard Luecke. 264 pp. Prospect Heights, IL: Waverly Press, 1993. $11.95 (paper). IN 1977, the World Health Assembly (WHA)—the governing body of the World Health Organization (WHO)—passed resolution WHA 30.43, which called on governments participating in WHO to set a primary goal of attaining of a level of health which will permit citizens of the world to lead socially and economically productive lives by the year 2000. The WHA subsequently adopted resolution WHA 32.20, which urged the WHO member states to define and implement national, regional, and global strategies for attaining "health for all by the year 2000." Some strategies predating this noble goal (for example, China's "barefoot doctors") and subsequent efforts (such as Cuba's Family Doctor Program), have made remarkable progress toward this end. Few, if any, however, have done so with such universal sensitivity and applicability to underserved or nonindustrialized communities as that offered by the life and story of Dr. Carroll Behrhorst. A New Dawn in Guatemala is a tribute to his passionate commitment and dedication by way of essays about this remarkable man's vision. Carroll Behrhorst, M.D., was a family physician by training who lectured and taught from nearly 30 years of personal experiences in Guatemala with primary health care. The essays in this collection are taken from Behrhorst's own writings and from spokespersons among the Mayan Kaqchikel Indians; noted anthropologists; physicians and teachers of physicians; agriculturists; primary care exponents; and community developers from various parts of the world. The writers point to the importance of integrating the physical, psychological , social, and spiritual understandings of health and disease. The Kaqchikel authors in the introductory essays write of the respect, compassion, and cultural sensitivity that underlie such understandings. The other essays look toward creative combinations of medicine and public health, and toward cooperative ways by which professional and technical workers can join people in their current struggles with health problems. Dr. Behrhorsf s writings span 28 years. Essays from his earliest works speak of the critical first steps of learning from the people of the community about Journal of Health Care for the Poor and Underserved · Vol. 4, No. 4 · 1993 402__________________________________________________________ problems and priorities that need to be addressed. As the founder and coordinator of the Chimaltenango Development Program in Guatemala, he guided the transition of an initial futile effort to cure the sick into a general community program geared to activities that the residents wanted and needed and that resulted in self-empowerment and improved community health. He restates the importance of this point in a 1990 piece when he writes that "development" is about the indigenous people working on their own terms, learning from their own failure and building on what they themselves have done. This theme of listening to the community's perceived needs and joining that community in its efforts to effectively address what it defines as its own problems runs throughout this collection of essays. Behrhorst underpins his thoughts on primary health care with statements from the WHO and the Declaration of Alma Alta. He writes about a strategy to achieve a community process directed toward problem-solving. This process includes the community identifying problems, planning their own approaches to solutions, implementing the actions, and carrying out evaluations of their efforts. The concluding set of essays give witness to the universal applicability of what Behrhorst passed on from his experiences in Guatemala. "Despite important differences in culture, language, and race," writes Behrhorst, "the rural poor of all continents share a commonality forged of poverty, exploitation, disease, malnutrition, and hunger" (p. 56). Essays cite successes derived from Behrhorsf s influence on other continents. Essays about urban translations of learnings from Chimaltenango as applied to the South Bronx in New York and to the south side of Chicago appear just before the conclusion of the book. A New Daiun in Guatemala brings to the fore important lessons from a corner of the world which has long been displaced from the center of public attention. The most valuable contribution of these essays is their timely refocusing on successful community-centered...


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