Value of communication, value of language: Nahuatl speakers and public health services in Sierra Norte de Puebla

Abstract

Abstract This paper is based on the data collected during fieldwork in the northern part of Mexico’s state of Puebla in 2018–2019. During that period, there was a need to gather information that would serve as a starting point for the participatory-action research project in San Miguel Tenango, a village where the majority of people speak Nahuatl as their mother tongue. In contrast, the employees of the health center located in the village have been exclusively Spanish-speaking doctors and nurses assigned there by the state department of health. The paper analyzes problems of communication between the medical staff and Indigenous patients, many of whom are not proficient in Spanish. It presents two different perspectives on communication in local health care settings, the one of medics and the other of patients. On comparing between them, we can recognize that the existing strategy of overcoming language barriers in Tenango, based mainly on family interpreters, has certain shortcomings, unnoticeable for the staff of the health center. The communication problems are discussed in the context of changing language attitudes among Nahuatl speakers. In addition, the paper includes a critical overview of recent initiatives to promote the use of Nahuatl in health services in the state of Puebla.