title: Medical humanitarianism in the United States: alternative healthcare, spirituality and political advocacy in the case of Our Lady Guadalupe Free Clinic.
abstract: Exclusionary practices in dominant market-based systems are recognized as contributing to global health inequities. Undocumented immigrants are particularly vulnerable to unequal access to healthcare. Humanitarian NGOs strive to respond meaningfully to these health inequities among migrants and undocumented immigrants. Few studies describe the work of humanitarian NGOs that advocate for the right to health of undocumented immigrants in high-income countries. This paper discusses immigration, health, and human rights while examining solidarity, spirituality, and advocacy using a U.S.-based example of medical humanitarianism: the 'Our Lady of Guadalupe Free Clinic.' In 2011, the Free Clinic began in the basement of a Catholic parish in Minnesota in response to the lack of access to medical services for undocumented immigrants. Run by a local grassroots organization, it is held every six weeks and offers free primary healthcare to Latino immigrants and the uninsured. In this article, we examine the tricky relationship between humanitarianism and human rights in the U.S. Using ethnography, we draw on participant observation and interviews with 30 clinic volunteers, including health professionals, administrators, language interpreters, and spiritual leaders. The study was conducted September 2012-December 2013 in southern Minnesota. We examine how notions of solidarity, spirituality, and advocacy structure faith-based medical humanitarianism in the U.S. and explore the underlying tensions between the humanitarian mandate, spiritual teachings (social justice, solidarity), and political advocacy. Examining a moment of "crisis" in the Clinic, our study shows that volunteers experience the alliance between spirituality and advocacy with uneasiness. While a spiritual calling may initially motivate volunteers to serve, an embrace of human rights advocacy is important in a sustained effort to provide humanitarian medical care to individuals who fall outside of the political and moral community in the U.S.
authors.affiliation: Department of Anthropology, Faculté d'Anthropologie, de Sociologie et de Science Politique, Université Lumière Lyon 2, Campus Porte des Alpes, Bâtiment K, 5 Av. Pierre Mendès France, 69676 Bron Cedex, France. Electronic address: kristina.tiedje@univ-lyon2.fr.
authors.forename: Kristina
authors.initials: K
authors.lastname: Tiedje
authors.affiliation: Department of Anesthesiology, Mayo Clinic School of Medicine, 200 First St. SW, Rochester, MN 55902, USA. Electronic address: plevak.david@mayo.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Plevak
mesh_terms: D000533:Altruism; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D002410:Catholicism; D054242:Emigrants and Immigrants; D006297:Health Services Accessibility; D006806:Human Rights; D006801:Humans; D008910:Minnesota; D019982:Organizational Case Studies; D009938:Organizations; D010344:Patient Advocacy; D012068:Religion and Medicine; D029181:Spirituality; D014481:United States; D014838:Volunteers / Q000523:psychology
keywords: Faith; Free clinic; Latino immigrants; Medical humanitarianism; Political advocacy; Right to health; Undocumented immigrants; United States