The Association of Communitarian Health Services (ASECSA) and the Role of Religion and Health in Central America
The Association of Communitarian Health Services (ASECSA) is a transnational, religiously influenced health program in Central America created during the Cold War. ASECSA was founded in 1978 by a small group of international health professionals with ties to programs started by Catholic and Protestant clergy and laity in Guatemala’s western highlands in the 1960s. It introduced a model of healthcare in which Maya health promoters and midwives became partners in healing rather than objects to be cured. Support for the health programs and ASECSA came from secular and religious international agencies, including the United States Agency for International Development (USAID), German Misereor, Catholic Relief Services, and the World Council of Churches. ASECSA was founded to disseminate knowledge of popular health education strategies used by health promoters and midwives to provide preventive and curative medical services to their communities. The education methods grew from Paulo Freire’s Pedagogy of the Oppressed and its use by religious agents influenced by liberation theology. Although it was founded in Guatemala, ASECSA’s publications and meetings attracted participation by health professionals and paraprofessionals from Mexico, Central America, and even the Caribbean. Ecumenical religious centers affiliated with liberation theology in the 1960s and 1970s facilitated the development of popular health programs that played a defining role in the region.
The role of religion shifted dramatically in Central American politics during the 20th century, as the Catholic Church moved from a position as conservator of the status quo to a powerful force for reform and human rights. The century also witnessed the rise, then the “boom,” of Protestant—specifically Pentecostal—religion. By the century’s end, Central America had become among the most Protestant regions of Latin America, with every country except Costa Rica and Belize measuring a large and rising evangélico minority. These changes unfolded alongside, and deeply affected, one of the most traumatic and violent periods in the region’s history, the so-called Central American crisis of the late 1970s and 1980s, when Nicaragua, El Salvador, and Guatemala became the battlegrounds for one of the last large proxy wars of the larger Cold War, between Marxist insurgencies and authoritarian governments.