Society for Medical Anthropology
Eileen Anderson-Fye (Case Western Reserve U)

I was flooded with memories last January as I stepped into the rural high school on Ambergris Caye, Belize. Nearly two decades earlier, I had begun dissertation research here regarding the health and well-being of the first mass high school-educated cohort of young women in the tourism-centric region. On my first day of fieldwork, the principal announced that I hoped to speak to interested students during their study halls. As soon as the next bell rang, a line of young women formed, all eager to share their stories with an insider-outsider—someone deemed trustworthy and also not fully embedded in the history and lineage of the community. Now I had returned, this time to learn more about how those young women’s adolescent experiences had influenced their own development as adults—and also driven changes in their community.

My initial work (1996-2001) had taught me that these young women were not blank slates upon which global narratives were written. Rather, they brought their own ways of seeing the world to bear upon transnational media, images, messages, people, and opportunities. More, their life stage as teenagers—attuned carefully to new technologies and media—mattered enormously in how they marshaled community changes to further their educations and improve their well-being.

I came back this year with the support of the National Science Foundation’s cultural anthropology program (BCS-1261814). Since graduation, these young women had transitioned from the courageous, sometimes harrowing choices made to secure improved futures to experiencing them. They had jobs, children, and challenges that continued from adolescence—along with new concerns and opportunities. They had seen remarkable success in educational achievement, scored well on global mental health indicators, and dramatically reshaped gendered power dynamics within their families and the community itself. Largely driven by concerns toward enhancing their well-being and reducing actual or potential gender-based violence, they had made the most of the process and products of their education.

This cohort of young women was the first to receive school-based computer training on the Internet. They became savvy in learning how to seek information that addressed their daily concerns. Their increasingly diverse classrooms also afforded a new type of peer-based social networking. The concurrent extraordinary growth of the tourism sector helped assure them that pursuit of a high school diploma—a requirement for “good” service sector jobs—would bring a tangible reward. In the past, women only were eligible for jobs (like hotel maid) where wages were below subsistence level. With a diploma, they could secure the “good” jobs (eg, hotel receptionist) paid enough for a woman to achieve financial independence.

My return this winter involved two goals: first, to understand more about the role secondary education plays in the young women’s ongoing subjective and objective health outcomes in a context of continuing rapid development and globalization; and second, to explore further the concept of adolescent well-being in hopes of enriching knowledge that can improve experiences and results for this realm of growing global concern.

The earlier work had contributed to policy and practice further strengthening girls’ education. Yet the young people of 2015 also faced new, often pernicious influences—for example, the ubiquity of social media and its attendant hypersexualization in some content. During the first three months of this year, meanwhile, the community witnessed significant increases in incidents of murder and rape over the previous year.

These developments carry meaning both for current adolescents and those who were part of the original study cohort. Cohort members who are now adults have used their much-strengthened economic position (relative to their own mothers) to escape gender-based maltreatment within their homes (and, in some cases, to rescue their mothers from such circumstances as well). But they now encounter an environment where, in addition to many positive changes, technology allows exploitive messages and dangers to proliferate, and increasing lethal violence poses unimaginable risks. Health care remains well behind even the barest standards of higher income nations, in both quality and access. Several women in the original cohort shared heart-wrenching stories of losing or nearly losing a child because of inadequate medical care. At the same time, today’s youth find themselves navigating new paths to adulthood—ones that simultaneously offer greater economic promise and additional threats to their emotional and physical well-being.

The interior of the high school looks much as it did in 1996, albeit with a few more classrooms. Outside, however, a tall stone wall encircles once-open areas facing the sand and surf. The barrier stands as both reassurance of safety in an ever-more dangerous time, as well as a painful reminder of the presence of forces once unthinkable in a community that began as a small fishing village. How do we begin to understand the impact of these changes on a cohort of young women whose extraordinary resilience allowed them to seize emerging opportunities of globalization? More, how do we define and understand adolescent well-being in a climate of constant, sometimes utterly unexpected, sociocultural change?

The complexity of these questions cannot be overstated. Even beginning to answer them demands rigorous, person-centered, longitudinal ethnography employing both qualitative and quantitative methods. This approach requires intensive engagement, but it is the only one that can yield the type of fine-grained insights about individual and community experiences and attitudes that can inform theory, practice and policy in ways that carry meaningful benefit for today’s youth, and those who follow them—both in this community and in others around the world.


The author in a classroom at her field site in Belize. Photo courtesy Alexis Guerrero

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