In Chapter 5 we are introduced to Adela, a former midwife turned “home detox” provider. This reminded me of our week 8 reading on the state of midwifery in Mexico. The healthcare inequities plaguing midwifery in rural Mexico are also present in detox care in New Mexico. The first comparison I could make was a loss of trust in institutions. With midwives, the locals were skeptical of people in uniforms likely due to the failure of official healthcare to provide adequate care. In New Mexico, Health Valve burned bridges to the community by closing the local detox clinic for failing to meet internal standards, leaving state health to train the community to be responsible for using Narcan to fight overdoses. There is also a distinct class inequity to treatment, as there were nearby treatment centers that were incredibly expensive, neglecting rural areas and anyone who could not afford treatment.
Returning to Adela, through working as a midwife and experiencing a son becoming addicted to opium and dying, “developed a high tolerance for being in the presence of another body in pain,”(Garcia 194). This, in much the same way as Latin American midwives, tended to come from within communities to provide care when the existing healthcare systems failed to serve them. Is this a good comparison? Could similar techniques be adopted to combat both forms of healthcare inequity?