This his article provides ethnographic evidence about the factors that shape the attitudes of citizens towards the state among communities in the Mexican state of Chiapas. Because we are interested in studying whether political democratization can offer real opportunities for the empowerment of previously oppressed or disadvantaged groups, the communities studied were low income, rural and mostly populated by indigenous groups. Furthermore, these communities are also geographically remote, which means that ensuring good governance and accountability of state officials poses special challenges to regional authorities in these areas. For the same reasons, the population in these communities is especially vulnerable to the impacts of corruption. Specifically, the study focuses on the interactions of community members with health service providers, where corruption can have specially deleterious consequences.