Chapter 5 addresses the problems Triqui people face when interacting with healthcare professionals in Mexico and the US. San Miguel has only one clinic, a government-run facility alternately staffed by a resident or nurse, neither of whom works in the town longer than a year. The resident and nurse during Holmes’s fieldwork were from Oaxaca City and didn’t speak the Triqui languages. Holmes asked a government official for permission to observe and learn from the clinic staff. The official responded, “‘That doctor doesn’t know anything’” (112). This response—a common refrain that Holmes heard in many contexts—prompted him to investigate the problematic relationship between clinicians and Triqui patients. This chapter revisits the cases of Abelino, Crescencio, and Bernardo, focusing on the healthcare professionals with whom they interacted in Washington State, California, and Oaxaca. Their experiences serve as a point of departure for a broader discussion of the structural factors impacting migrant and Indigenous health care.

The Clinical Gaze

Holmes approaches migrant health from the perspective of providers to understand how they perceive and respond to Triqui patients—and to assess the care they offer. He draws on the work of Michel Foucault, who described a paradigm shift in the field of medicine between the 18th and 19th centuries.