“The recognition of ancestral medicine is an act of resistance.” This is postulated by the doctor, midwife and current health coordinator of the Peoples of Bolivia, Vivian Camacho, when she tells why she undertook, more than 15 years ago, a journey whose focus is on unlearning what she learned during her conventional medicine studies in order to turn towards the knowledge of their ancestors. It is an act of resistance, as he deepens, because it implies questioning and overthrowing monoculturality in health, the one that determines that it be thought of and imposed universally by white and privileged men – those who were able to access the first universities without restriction – and to people just like them. That notion that, even being obsolete, continues to be taught in the classroom.
That is what he refers to when he talks regarding the importance of decolonizing health. Because basically, as he explains, we have been plagued by structural racism and machismo since colonial times. “All spaces are invaded by mercantile and patriarchal logic; one of those is certainly health. For this reason, we cannot speak of a feminist struggle without speaking of an anti-capitalist struggle”, he posits. “When we talk regarding health we need to refer to the care and protection of life in all its expressions and forms, including biodiversity and cultures. An extractivist model that does not care regarding this is not consistent with having decent health for all. We must not see it in a technocratic way that divides and sections, and for that we must identify from where we position ourselves and how we think regarding our identities and territories”.
And it is that Bolivia, as Camacho says, is a land of people who heal. “We are Quechua and here our way of conceiving life is directly related to how we coexist with our environment, plants, water sources, seeds and food. Therefore, the invitation is to rethink what civilizational paradigm we are often blindly replicating; a western macroculture has imposed itself on us with massacre, genocide and looting and has taught us to lower our heads with clubs, ”he explains. “But we are being able to identify those countries of the global north that believe themselves to be ‘first world’ and call us underdeveloped or third world –also saying that it is our fault that we are, because we are ‘poor people who don’t know work and develop’ –, they might only be deployed because they fed on the pain and looting of the global south”.
Camacho was 25 when he decided to leave the institution, following having studied in Belgium and having worked in a community school in São Paulo. In Belgium he had been part of the liver transplant unit of a hospital, and he had seen his colleagues get on a helicopter the day before the interventions, pick up a heart and a liver, and return to do the transplant . Realities, as she recalls, unimaginable for the southern hemisphere. “It was beautiful to see that level of medical and technological advances, but I wondered when that possibility would come to my country, where people die from diarrhea and cough. Then in Sao Paulo I saw how the rich came and went in stable conditions, but when someone from the favela came, they had no way of sustaining post-surgery care because they did not have things as basic as food. For whom I had studied, I began to question. And who did he want to work for?
Did that push you to return to your community?
That crisis was what led me to leave the institution and get closer to what is ours, to ancestral knowledge and to be a midwife and companion of women from our territories. Life was helping me to unlearn and de-medicalize the learned process of childbirth care in order to retake the wisdom of the grandmothers; care for the space in which childbirth takes place and that women feel loved and protected.
I also had to learn how hormones intervene at the time of childbirth and opt for humane and respectful care. That has been my journey in recent years and I have traveled back to Europe to be able to work and speak regarding obstetric violence. And it is that ancestral medicine is the commitment we have with our people, it is not a medicine that is made because they are going to pay us. It has to do with a world view, with reciprocity, mutual support and collaboration, but not only human, but also with plants and territories. My dad always told me that it was the previous generation that lent us life, so that we might pass it on to the next. That’s why she had to be taken care of; because the next deserve to be born with clean water, clean air and with access to certain basic rights.
Medicine and science defined a universal being; white, without disabilities and with rather Europeanized attributes. All the investigations were developed taking that being as a reference, leaving out the rest of the population. How does that affect those who are not considered?
Most medical and scientific disciplines developed at a time in history when universities were for rich men. Therefore, the medicine was and continues to be taken by them; to this day they are the minds of men thinking for different bodies. And that happens in all the universities of the world.
I studied in San Simón in Cochabamba and then in Belgium, and in both places the same paradigm prevails; there is a standardization of knowledge and learning and they have been training us without greater political-social criteria. We doctors are taught to repair the human machine, but a machine totally detached from the identity, political, social and historical context. And that affects the parameters even, because everything is designed for big men of a certain structure. For example, the characteristics of the global south are not considered, much less of a woman.
Why say that we women serve commercialized medicine as long as we continue to be the largest market? We are the cannon fodder and that is why each of our biological processes is taken over by the pharmacy; Each of our hormonal transformation processes is pathologized, be it menarche, pregnancy, childbirth, menstruation or menopause. And to that is added that an extremely castrating and violent aesthetic governs. In several hospitals they do a cesarean section and liposuction at the same time. They do aesthetic surgical procedures along with the medical procedure because we will never be beautiful enough for a market that feeds on our insecurity.
Our reactions are also pathologized. When we are angry, when we are tired, we are called hysterical or neurotic.
Of course, the anger belongs to the man, but we are crazy or hysterical for having an outburst or for verbalizing that we are tired. They tell us that we are in our day, but the truth is that we are upset because they treat us badly or despise us or insult us or harass us on a daily basis. That is what they do not want us to make visible. It’s easier to blame ourselves for being so emotional. And, in turn, emotionality has been cut and left aside, putting reason above everything else. But our emotions are regenerative and we draw strength from our tears.
In the indigenous worldview, tenderness is emphasized.
When we review historically, although the patriarchy has crossed all territories and cultures since colonial times, we can see that prior to that there were powerful ladies, warriors who led armies to liberate their peoples. This serves to remind us that women, in our ancestral towns, have always been part of the power structure and that is what we have to claim now. Because we need each other. But for that we have to first deal with our own inconsistencies or embedded machismo, including women, and point to the community and mutual support. Monoculture, as well as monoculture, make life die. That is why we must respect diversity and strengthen dialogue.
You talk regarding the importance of nutrition, but it is unlikely that a Western doctor would say the same. How do we move towards preventive medicine?
Mercantile medicine is made to produce and reproduce consumers and focuses on diseases and not on the integrality of life. To speak of preventive medicine, we must speak of the defense of the land, of cultural identities, and recognize once more the wise midwives, healers, and farmers who were historically persecuted. Because the way we are, the big industries poison our water, take over the territories, wage war because it’s a big business, and force us to consume their products. And when we get sick, we have to take their medicine to heal us from their poisons. It is worth asking, then, whose rights are we defending?
Being thoughtful but above all being tender at this time is part of the resistance that seeks to preserve humanity, so as not to become mechanical and mechanized automatons, indifferent to life, either because it has hurt us too much and we don’t want to feel or because we really we do not care. The moment we keep crying, we keep feeling. And that mobilizes us and encourages us to organize ourselves.
