Agustín Sangines García

Ashoka Fellow
Fellow Since 1989
Centro Rural Integrador de Salud y Educación (CRISE)


This profile was prepared when Agustín Sangines García was elected to the Ashoka Fellowship in 1989.
The New Idea
Drawing on many years of experience working in rural and Indian regions of Mexico, Agustin has set up a regional health system which involves practical, action oriented training together with an innovative system for classifying diseases.
Agustin maintains that rather than creating new externally inspired organizations dealing with preventative medicine, existing grass roots organizations should be integrated into the network.  From these organizations health promoters are recruited and trained sometimes in their own communities and sometimes in neighboring villages.  He draws heavily upon traditional organizational structure both in terms of local groups he involves with regard to the customs of the region.  Training sessions follow the tradition of fiestas and communal hospitality with different villages playing host to health promoters during weekend courses and these courses being open to whole host community not just the promoters from the next village.
Agustin maintains that it is impossible to separate health from social justice and sickness from injustice.  They are interrelated in a cycle of poverty and disease, misery and sickness. Any approach to medicine must therefore consider the wider social context and not just the isolated individual and his or her particular illness.  To this end, Agustin has devised a series of epidemiological sheets which register an individual's sickness and its apparent and essential causes.
As well as reducing child mortality and creating greater awareness of the needs for hygiene, safe and sanitary living conditions and better nutrition Agustin is setting up local dispensaries staffed by volunteers which will offer cheap, often herbal, remedies for common ailments.  Agustin also expects to reduce risks involved in pregnancy and childbirth and the number of hospitalizations.
He is at present working in 17 zones in the region of the Isthmus of Tehuantepec with 50 health groups well established and another 50 in formation.  Within a few years Agustin will start work on a national training program.  He is convinced that his approach of "the medicine of liberation" is the only appropriate one for countries such as Mexico which still suffer centuries of oppression and social injustice particularly in the more remote rural areas.
The Problem
The Strategy
The Person

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