Organizing for an Epidemic: Cholera in Guatemala

After a century of absence, Cholera returned to Latin America in 1991, rapidly spreading to many countries in the sub-continent, including Guatemala National and International health Agencies undertook massive efforts in an attempt to minimize the effects of the disease. New organizations were devised and existing organizations modified to address the epidemic's challenge.

This study explores the organizational dimensions of cholera as a social issue. It asks how people construct cholera as a social order, how they articulate organizations in realizing that order, and what that articulation says about local, national and international contexts.

The research uses data from ethnographic interviews with bureaucrats in International and National Organizations, and with local service providers in Guatemala It contrasts interpretations of cholera across contexts, showing the local nature of understandings of the epidemic. Specifically, agents adjust the meaning of the epidemic to the demands of everyday organizational life, forcing definitions upon each other. In the process, cholera becomes "normalized,'' and powerful agents' definitions prevail.

Unlike this contemporary experience, cholera in the 19th century was catastrophic for Europe and North America. This suggests that the social and institutional context of modernity has developed from an experimental phase to a fully articulated form of life in contemporary society.

The findings show that macro-social referents of individual interactions and micro-social building blocks of large-scale social processes must be brought together to understand a complex phenomenon such as cholera. Further, the forms of contemporary organizational existence are not self-evident, but rather result from active 

efforts by powerful agents exercising their interpretations of reality Finally, the study questions the usefulness of separating the social from the biological, or of treating social categories, such as the health sector, as taken-for granted analytical units, instead of recognizing them as localized social constructs reflecting on the nature of contemporary existence

We must deepen the organizational study of events such as epidemics starting from their local realization, rather than from pre-existing positive theories, in order to identify contextualized theoretical and practical approaches that better serve the needs of actually existing individuals and communities.