Conceptions of tuberculosis and therapeutic choices in Highland Chiapas, Mexico

Tuberculosis continues to be a serious disease among the poor, indigenous population of Highland Chiapas, southern Mexico. Ethnographic fieldwork among Tzeltal Indians has focused on how cultural perceptions of illness and curing influence the Indians' utilization of health care services for tuberculosis diagnosis and treatment. This article presents the views on tuberculosis and health-seeking activities of several patients in the Tzeltal hamlet of Yochib (municipality of Oxchuc). In this community, religious change (Protestantism) and the presence of a health clinic promoted biological interpretations of illness and acceptance of Western medical treatments. While patients in Yochib do not understand tuberculosis in biomedical terms, they nonetheless utilize Western services (both local and urban) to obtain treatment. Because of the long duration of tuberculosis therapy, however, these patients manifest contrasting attitudes. The article focuses on the cultural factors that influence patients' medical choices, curing strategies, and their decisions to adhere to long-term treatment regimens.