Rural Belize Research Articles

Identifying Gaps in OT Services in a Developing Country: Healthcare-Clinic Needs-Assessment in Rural Belize

Abstract Date Presented 03/28/20 Limited healthcare in Punta Gorda, Belize, and surrounding villages called for an assessment of needed OT services. Interviews were conducted remotely and with a free healthcare clinic. Four main themes emerged: (1) lack of early intervention, (2) barriers to accessing school for children with developmental disabilities, (3) high caregiver burden, and (4) lack of social-emotional care. Findings support the addition of OT to the available care in rural Belize. Primary Author and Speaker: Kyra Barillier Additional Authors and Speakers: Lisa Jaegers

Creole becoming and the commons: Black freedom in Belize

In rural Belize, Afro-Caribbean people have been generating economies and ecologies that simultaneously articulate with and are other than the global capitalism that initially brought enslaved West Africans and free Northern Europeans to the shores of Central America in the 1700s. What it is to be Belizean Creole initially emerged in the crucible of forest slavery and racial capitalism, but flourished in the generation of reciprocal economies and relational entanglement with the more than human, as blackness associated with freedom in the “bush.” Living in lands that did not interest Belize’s 19th century forestocracy, and that were not desirable for industrial agriculture, rural Creole people created commons for hunting, fishing, and other more than human engagement. The sense of being rural Creole develops from these entanglements and reciprocal relations that assemble with blackness and brownness in ways that are not fully contained within global white supremacist logics. This basis for a rural Creole identity has persisted even as rural Creole people engage today with the global capitalist projects of conservation and tourism, and as they live in transnational diaspora. In these ways, rural Creole people expand human being beyond the over-represented form of Man, as Sylvia Wynter has described the problem of the coloniality of “the human,” into a genre of “human being in common.” This expansion illustrates how commoning creates possibilities for blackness and brownness to thrive.

Natural Language Processing (NLP) in Qualitative Public Health Research: A Proof of Concept Study

Qualitative data-analysis methods provide thick, rich descriptions of subjects’ thoughts, feelings, and lived experiences but may be time-consuming, labor-intensive, or prone to bias. Natural language processing (NLP) is a machine learning technique from computer science that uses algorithms to analyze textual data. NLP allows processing of large amounts of data almost instantaneously. As researchers become conversant with NLP, it is becoming more frequently employed outside of computer science and shows promise as a tool to analyze qualitative data in public health. This is a proof of concept paper to evaluate the potential of NLP to analyze qualitative data. Specifically, we ask if NLP can support conventional qualitative analysis, and if so, what its role is. We compared a qualitative method of open coding with two forms of NLP, Topic Modeling, and Word2Vec to analyze transcripts from interviews conducted in rural Belize querying men about their health needs. All three methods returned a series of terms that captured ideas and concepts in subjects’ responses to interview questions. Open coding returned 5–10 words or short phrases for each question. Topic Modeling returned a series of word-probability pairs that quantified how well a word captured the topic of a response. Word2Vec returned a list of words for each interview question ordered by which words were predicted to best capture the meaning of the passage. For most interview questions, all three methods returned conceptually similar results. NLP may be a useful adjunct to qualitative analysis. NLP may be performed after data have undergone open coding as a check on the accuracy of the codes. Alternatively, researchers can perform NLP prior to open coding and use the results to guide their creation of their codebook.

A mixed-methods needs assessment of adult diabetes mellitus (type II) and hypertension care in Toledo, Belize

BackgroundNon-communicable diseases, including diabetes mellitus and hypertension, continue to disproportionately burden low- and middle-income countries. However, little research has been done to establish current practices and management of chronic disease in these settings. The objective of this study was to examine current clinical management and identify potential gaps in care of patients with diabetes mellitus and hypertension in the district of Toledo, Belize.MethodsThe study used a mixed methodology to assess current practices and identify gaps in diabetes mellitus and hypertension care. One hundred and twenty charts of the general clinic population were reviewed to establish disease epidemiology. One hundred and seventy-eight diabetic and hypertensive charts were reviewed to assess current practices. Twenty providers completed questionnaires regarding diabetes mellitus and hypertension management. Twenty-five individuals with diabetes mellitus and/or hypertension answered a questionnaire and in-depth interview.ResultsThe prevalence of diabetes mellitus and hypertension was 12%. Approximately 51% (n = 43) of patients with hypertension were at blood pressure goal and 26% (n = 21) diabetic patients were at glycemic goal based on current guidelines. Of the patients with uncontrolled diabetes, 49% (n = 29) were on two oral agents and only 10% (n = 6) were on insulin. Providers stated that barriers to appropriate management include concerns prescribing insulin and patient health literacy. Patients demonstrated a general understanding of the concept of chronic illness, however lacked specific knowledge regarding disease processes and self-management strategies.ConclusionsThis study provides an initial overview of diabetes mellitus and hypertension management in a diverse patient population in rural Belize. Results indicate areas for future investigation and possible intervention, including barriers to insulin use and opportunities for lifestyle-specific disease education for patients.

Water Supply and Treatment Design in Rural Belize: A Participatory Approach to Engineering Action Research

As part of a long term engagement in a rural community in western Belize, students responded to community leaders’ requests for an investigation of possible solutions to their water quality and supply problems. A student research team comprised of engineering and college students aimed to employ participatory action research methods to further understand existing challenges and develop a prototype for a water treatment and supply system. After careful analysis of local resources and constraints, the team decided that the most successful solution would combine the use of biofilters to purify the public spring water supply and improved rainwater collection to make use of the extensive storm season. An integrated prototype of these systems was built at the village government school with the purpose of serving as a model for replication in households throughout the village. In a discussion of the team’s methods and reflections, this paper emphasizes the importance of finding a balance between making a design both relevant to the community and technologically successful.

Hillside Health Care Clinic: A Rural Belize International Preceptorship

Christine Legler, PA-C, DHSc Nova Southeastern University Telephone: (503) 531-0534 Email: [email protected]

Differences in Time Use for Mating and Nepotistic Effort as a Function of Male Attractiveness in Rural Belize

This paper explores whether physical attractiveness was a determinant of reproductive strategy in a sample of men living in rural Belize. A theoretical argument is presented to explain why differences in male physical attractiveness should lead to differences in strategy as evidenced by time-use, and why these differences should be especially apparent in nonindustrialized societies. Retrospective data were collected on men’s time use during their last day off from work. The results were that more facially attractive men spent more time in mating effort and less time in nepotistic effort than less facially attractive men. Another component of physical attractiveness, fluctuating asymmetry, was not successful in predicting differences in time use. The results suggest that facially attractive men spend their leisure time seeking sexual access rather than spending it with kin, because their potential fitness returns are higher for this activity, whereas less attractive men receive higher returns to time spent with kin. This could be due directly to fitness returns to nepotism received by less attractive men, or because family involvement displays potential parental investment skills that are attractive to women. This may help build a reputation for reliability; in other words, time spent in nepotistic effort could be an alternative mating tactic that appeals to women’s desire for a responsible paternally investing mate.

Assessment of The Household Food Habits and Dietary Patterns of Rural Belize

OBJECTIVE: Document general demographic data and meal/snack patterns of household members and food preparers; assess dietary variety, dietary quantity, and dietary diversity of food preparers; determine and compare differences in demographic data, dietary scores, and meal/snack patterns among five geographical districts and the six most common ethnicities in rural households. DESIGN: Rural villages and households were randomly selected. Subjects completed in-home interviews conducted by nursing students using a previously developed survey. Demographic data for individual household members and previous 24-hour dietary intake were recorded for each household food preparer. SUBJECTS: Two hundred food preparers and 1219 household members from rural areas in five districts in Belize, Central America. STATISTICAL ANALYSIS: Descriptive statistics; mean differences between groups were assessed by analysis of variance. RESULTS: Dietary variety scores throughout Belize ranged from one to 14 foods, with a mean of 6.57 different foods. Dietary diversity and dietary quantity scores were greatest in the staples and animal food groups. Dietary variety, mean diversity and dietary quantity between districts and ethnicities were not found to differ significantly. Meal/snack patterns chosen most frequently throughout Belize, in each district, and in each ethnicity was three meals per day. APPLICATIONS/CONCLUSIONS: Dietary scores suggest rural Belizeans do not consume a variety of foods and frequently do not select foods from every food group, particularly those items in fruit, vegetable, and fat groups. The study results will be added to the developed database designed to provide information in developing national Food Guidelines.

Fluctuating asymmetry and human male life-history traits in rural Belize.

Fluctuating asymmetry (FA), used as a measure of phenotypic quality, has proven to be a useful predictor of human life-history variation, but nothing is known about its effects in humans living in higher fecundity and mortality conditions, typical before industrialization and the demographic transition. In this research, I analyse data on male life histories for a relatively isolated population in rural Belize. Some of the 56 subjects practise subsistence-level slash-and-burn farming, and others are involved in the cash economy. Fecundity levels are quite high in this population, with men over the age of 40 averaging over eight children. Low FA successfully predicted lower morbidity and more offspring fathered, and was marginally associated with a lower age at first reproduction and more lifetime sex partners. These results indicate that FA may be important in predicting human performance in fecundity and morbidity in predemographic transition conditions.

Initial report of a hepatitis investigation in rural Belize

In spring 1991, Belizian health officials expressed concern about a possible hepatitis outbreak in a banana farming district. A study was designed to identify cases and to address the serological prevalence of hepatitis virus markers. Three populations were studied: (i) persons meeting a clinical case definition for hepatitis; (ii) designated banana workers; and (iii) people in a random sample of households in the community. Information was collected using questionnaires and sera were collected for laboratory testing. This report presents the preliminary results of a study conducted in June 1991. Among people who met the clinical case definition, 24% of 42 tested had immunoglobulin M antibody to hepatitis B virus (HBV) core antigen (anti-HBc IgM). In the worker and household survey populations, 284 and 280 people, respectively, were tested for anti-HBc IgM. In each group, 4% were positive. HBV surface antigen was found in 37% of 43 clinical cases, 18% of workers, and 13% of people in the household survey. Among the 3 study populations, the prevalence of HBV core antibody (anti-HBc) ranged from 73% to 81%. Almost all tested persons had evidence of prior hepatitis A virus infection. Evidence of prior infection with hepatitis viruses A and B was widespread, but an aetiology could not be established for most of the clinical cases. However, the prevalence of hepatitis B markers in this population was very high compared to other reports from the Caribbean.

Citrus and the state: factions and class formation in rural Belize

This article examines local‐level politics and their effect on class formation in two neighboring Belizean villages. Charlestown and More Hope exhibit differing degrees of patronage‐based factionalism, which is related to the state's differential involvement in local politics. This involvement is in turn governed by the perceived political value of individual rural constituencies. The effects of factionalism on class structure in Charlestown—a community heavily contested by the governing party and its rivals—are illustrated in the context of an expanding export‐oriented citrus economy.

Marketing Policy and the Loss of Food Self-Sufficiency in Rural Belize

Past observers attributed Belize's record of national deficits in staple crop production to the country's colonial legacy of suppressed agriculture and underdeveloped infrastructure. Yet following marketing policy revisions in the mid-1970s, Belizean agriculture was able to satisfy the country's requirements for basic staples, suggesting that cultural-historical factors need not preclude food self-sufficiency. Since 1983 food shortfalls and importation have once again developed following the abandonment of earlier incentives for staple production. Marketing policies in agriculture are constrained by patterns of capital accumulation distinctive to peripheral economies as well as Belize's position within the world economy. While the former requires the provision of low-cost food to wage-earning sectors, the latter precludes price incentives for staple crop producers. The effects of these constraints are illustrated with longitudinal data from rural Stann Creek district in southern Belize. Problems in staple...

Belize's REAP programme

What kind of education rural youth in developing countries needs is a question which has been keenly debated. Some argue that rural and urban youth should be exposed to a single system of general education while others advocate an agriculture-oriented education on the grounds that the formal education system has failed to serve t he rural areas adequately (Coombs, I973) and that such an education would help to stem the tide of large-scale migration to urban areas (Balogh, I966). While there have been successful attempts at meeting the educational needs of people from rural backgrounds, for example, the Rural University in Colombia (Barber, r98r) many attempts have failed. This article, however, tells a different tale. Its main concern is with an innovation in the Third World which has achieved a good deal of success: namely, the Rural Education and Agriculture Programme (REAP) in Belize. Its major thrust is a discussion of the main factors that have contributed to this innovation's success. More specifically, this article assesses the extent to which REAP is achieving its objectives of developing positive attitudes towards agriculture and influencing young people to remain in rural Belize and engage in agricultural work. Special emphasis is given to REAP's change process which should prove instructive particularly to educational planners in the developing world since REAP is

Working out or working in: the choice between wage labor and cash cropping in rural Belize

Convinced that economic choices in real life seldom approximate optimality, an increasing number of anthropologists have been studying the cognitive processes of individuals making decisions. This paper discusses and illustrates the advantages of an alternative “statistical behavior” approach to the investigation of economic decision making. Statistical analysis of how men in two Belizean villages allocate their labor‐time between wage labor and cash cropping provides information that cannot be discovered via elicitation of “rules” governing choice. [economics, decision making, Belize]