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Zugl.: Mainz, Univ., Diss., 2007

The goal of this thesis is to explore the recent changes in the social landscape of a Wapishana village, due to long-term separation from kin. I consider the impact of a recent educational shift from small scale community based education to regional boarding schools on family life and community structure amongst Amerindian people in the hinterland of Region 9, Guyana. Furthermore, the project analyzes an emergent form of spirit possession that affects almost exclusively young women who live in the dormitories, locally referred to as the sickness. Using the sickness as an analytical lens, the thesis examines the ways in which young Amerindian women navigate a shift in expectations from their parents and communities as well as how they experience this rapid social change and transformation. Various vantage points employed in the analysis of the sickness help to illustrate the complexities of the current lived reality of Amerindian life. By exploring the experience of kinship and community in the Wapishana village of Sand Creek, it is possible to demonstrate how these relationships are produced and reproduced in everyday life through the sharing of space and substance. Furthermore, it is necessary to consider different aspects of the Creole and Amerindian notions of the spiritual world and their intervowenness in Wapishana lives, drawing out human and non-human agency and how they effect change in the world. Additionally, drawing on the anthropology of education, the thesis identifies the influence the state has on people's lives through institutionalized education, and locates this process within the wider context of historical indigenous residential schools. The ethnographic data on the experience of the sickness is put in dialogue and contrasted with other conceptions of spiritual vulnerability in Amerindian communities, examples of ‘mass hysteria' in schools or other institutional settings in other parts of the world, and the Afro-Caribbean experience of spirit possession. Finally, through an analysis of the etiology of the sickness, the final chapter draws on Amazonian literature to examine the embodiment of gender and the local gendered history of knowledge production in the area. The sickness is a phenomenon that permeates life in Southern Guyana for Amerindian youth, their families, and their communities. Undoubtedly, these various themes found in Wapishana young women's lives influence one another, irrespective of an ultimate manifestation of spirit possession. In the concluding section I show how these themes can be placed in the wider Amazonian framework of alterity and ‘Other-becoming', illustrating how this phenomenon provides a productive tool for the analysis of the experience of rapid social change among Amerindian youth and the impact of these transformations throughout the region.

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In regions of the world that experience a deficit of surgical care, educational initiatives can foster the development of a skilled surgical workforce. Implicit in training these health workers is the mandate to retain them in the country in order build capacity. Eyal’s framework presents ways in which locally relevant training can improve retention and outlines the ethical and pragmatic concerns of such initiatives. In 2006, Guyana established it’s first surgical training program, an example of locally relevant training. The University of Guyana Diploma of Surgery (UGDS) program was selected for this case study research. Consistent data collection, supported by a systemic procedure to analyze that data, is paramount to increase the effectiveness of the UGDS program. The purposes of this dissertation research were two-fold. Firstly, it sought to understand how the UGDS program influences retention and the ways in which the UGDS members contribute to capacity building and the program’s sustainability. Secondly, this program evaluation provides a useful context to inform Eyal’s framework. 8 graduates, 2 trainees, 4 faculty members and 2 persons identified as policy makers were interviewed. Interviews were conducted face to face, and then transcribed. Surveys were administered to graduates and trainees and reflective journals were coded and analyzed. Overall, the data mapped fairly well onto Eyal’s framework. The results of the study suggest that the benefits and concerns Eyal outlines would be better represented along a continuum rather than being classified as either advantageous or disadvantageous with respect to retention. While Eyal’s claims generalize across settings, he should acknowledge this limitation and consider the important role that context plays. Overall, the results suggest that the UGDS program has positively influenced retention and capacity building. Key recommendations were made to the UGDS program that aim to improve retention and capacity building. As regions continue to face challenges associated with providing adequate surgical care, fostering retention and capacity building is recommended so that a sustainable surgical workforce can meet surgical needs. / Thesis / Master of Health Sciences (MSc)

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A take-home milk supplementation programme consisting of 2 kg dry powdered milk offered monthly for 12 months to children 6--24 months of age in participating primary health care clinics was evaluated by assessing weight changes in supplemented and control children. Growth charts of supplemented (n = 362) and control (n = 410) children were summarized by the intercept and slope from the regression of individual weight measurements on age. The 2 groups were stratified by gender, ethnicity (Indo-Guyanese and Afro-Guyanese), and age intervals 0--6, 6--24, and 24--30 months which corresponded to pre, during, and post supplementation periods, respectively. Supplemented Indo-Guyanese girls gained significantly (p < 0.001) more weight than their controls: the difference being approximately 40 grams per month. No other differences were observed in the other gender/ethnic groups. Contextual information collected in a sub-sample of 60 mothers/caregivers of beneficiaries revealed that the supplement was mainly consumed with porridge, and tended to be shared more in the Afro-Guyanese than in Indo-Guyanese households. Over 90% of the beneficiaries were satisfied with the programme and wanted it to continue while 74% stated that it was of financial benefit. For future programmes, the use of locally produced infant cereal was recommended.

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