Excerpt: Territories in Resistance: A Cartography of Latin American Social Movements
Territories in Resistance: A Cartography of Latin American Social Movements
By Raul Zibechi, Translated by Ramor Ryan
Chapter 3
A community has an emancipatory approach to health care when it recovers its own healing powers, which have been ex- propriated by the medical industry and the state, and liberates itself from the control that capital exercises over health care through multinational pharmaceuticals. Zapatista health care practices, as well as those of many indigenous peoples and piqueteros groups, share many commonalities despite their enormous cultural differences.
Indigenous peoples often recover their ancestral knowledge, which goes hand-in-hand with recognizing the wisdom of traditional health practitioners while not discarding modern medicine. In fact, they attempt to combine the two. Much like when communities decide to construct a school, so too the first step in community health care is constructing a lo- cal dispensary capable of dealing with those emergencies that cause the highest mortality rates.
But Indian peoples have their own long tradition of healthcare.
In the traditional indigenous cosmovision, there is no separation between health and lifestyle or, that is, the community. Therefore, “the health of individuals as physical bodies, depends, at root, on the health of the community” (Maldonado 2003). The concept of healing in indigenous medicine is identical to the concept of healing in that society and it is based on a dense network of reciprocal social relations: minga (community work), community assemblies, and collective fiestas. These are spaces for “harmoniously liberating the subconscious, both of the individual and the collective” (Ramon 1993, 329).
In indigenous societies, the capacity to heal emerges from self-generated structures, unlike Western society, which has medical bodies that are separate from society as a whole and that control and monitor health care. Indigenous health practitioners have organized in various regions to recover and enhance indigenous medical knowledge. (Acero and Dalle Rive 1998; Freyermuth 1993). This is part of the emancipatory process of the indigenous peoples of our continent and part of the lengthy process of constituting these peoples as political subjects. In some cases, indigenous organizations (such as CONAIE in Ecuador and the Regional Indigenous Coun- cil of Cauca in Colombia, among others) have created their own health programs, with the support of doctors and nurses trained in Western medicine, and with some support from the state (CRIC 1988).
The Zapatistas have set up a system of health care in the five Caracoles that cover all rebel communities. Some eight hundred of casas de salud [community health centers] are operating, served by a similar number of health promoters, alongside a dozen municipal clinics and two hospitals that perform surgery (Muñoz 2004). The San Jose hospital near La Realidad was built in three years by thousands of indigenous locals working in shifts. There is also a training school for health promoters there, as well as dental care facilities, an herbalist center, and a clinical laboratory. Several volunteers hailing from the communities work full-time in the hospital; they do not receive a salary but are supported by the Good Government Council, which “provides them with food, travel expenses, footware, and clothes”(Muñoz 2004). The Zapatistas have set up an herbal laboratory there as well:
This dream started when we realized that the knowledge of our elders and our elderly was being lost. They know how to cure bones and sprains, they know how to use herbs, they know how to oversee the delivery process for pregnant women, but all of that tradition was being lost with the use of medicines purchased in the pharmacy. So we came to an agreement among the people and brought together all the men and women that know about traditional healing. It was not easy to bring everyone together. Many compañeros [comrades] did not want to share their knowledge, saying that it was a gift that cannot be transferred because it is something they carried within them. But then a sense of awareness and understanding grew among the people, the heath authorities held discussions, and they convinced many to change their way of thinking and to participate in the courses. They were some twenty men and women, older people coming from the communities, who acted as teachers of traditional health and about three-hundred-fifty students signed up, most of them Zapatista compañeros. Now they have increased the amount of midwives, bonesetters, and herbalists in our communities. (Muñoz 2004, 319)
In the autonomous regions, there is a functioning network of community health centers and clinics, dental consultants, clinical analysis and herbal laboratories, where eye and gynecolological services are available, and pharmacies. Consultations cost a nominal fee for the Zapatista base and are often given free of charge. Anybody in the communities, Zapatista or not, can avail themselves of the medical services; the medicines are dispensed without cost if they have been donated and sold at cost if they were purchased; traditional medicines are free. In some Caracoles, infusions and oin ments are made from local medicinal plants. All this has been accomplished through the work of indigenous communities as well as through national and international solidarity efforts. Significantly, the Mexican state has not been involved at all.
Autonomous piqueteros groups organize health care around the same principles, despite the differences between Mayan cultures and popular sectors in a huge city like Buenos Aires, birthplace of the Latin American labor movement and a showplace of global consumerism. During the health workshop held at the Autonomous January gathering in 2003, groups concluded was that “the cure is within the movement itself.” The MTD has organized preventative health clinics in many of the neighborhoods where they have a presence, staffed by professionals working in solidarity. This is true of other piquetero groups as well. The MTD Solano in Buenos Aires and MTD Allén in Neuquén supply their members with free medicines and eyeglasses. This illustrates what can be acomplished beyond the market: Thanks to a sympathetic optician, discarded or out-of-style frames are paired with lenses bought at cost and now all the movement’s members in need have affordable glasses.
The MTD also mixes, packages, and distributes medicinal herbs purchased directly from local producers. Now the movement is proposing to take it a step further by developing homeopathic tinctures from plants cultivated in small community plots. The result is that piquetero families are discovering the advantages of alternative medicine and using conventional medicine less frequently, or doing so only in emergencies. In some neighborhoods people have begun working with Chinese therapies such as acupuncture and have organized workshops dealing with native herbs in order to broaden the use of alternative cures (Salud Rebelde 2004).
The movement has also set up “reflection groups” in every neighborhood “to deal with personal problems, relation- ships, feelings, and collective growth.” In these groups, ac- cording to one participant, “one learns to lose fear; that fear is a sickness.”
Indeed, with respect to dependency on doctors and specialists, these groups believe that “verticality induces sickness” and that “wellness is finding ourselves” (Enero Autonomo 2003). The story of one of these groups’ meetings, as told by a social psychologist who participates in the movement and who coordinated their first meeting (which was held in a very poor neighborhood under MTD Solano influence), speaks for itself:
After the presentations, we began the meeting with an open question: Does anybody want to say anything? It was like turning on a tap. Almost immediately an anguished woman began telling us that she had been sexually abused as a girl by her father. Between sobs, she told a story of overcrowding, promiscuity, males and females sleeping in the same room, and the subsequent violations as part of family life, a situation all too common for poor households in the townships spread through the peripheries of big cities.
When she had finished her painful story, the silence in the room was powerful, a silence made from seventy-odd, quietened people, the silence of not knowing how to react together when so much deep pain was exploding forth in the room, seeking a response forty or fifty years after the event, a resonance, or some kind of understanding or forgiveness or just simply to be heard. Those assembled seemed uncertain how to express the compassion they felt toward the companera. In the end, the group focused on the most basic fact: that the companera had shared her pain with them and now they must begin to consider what can be done about it. Really it was just a simple notion, but one that opened the way for the participation of other voices. Words of comfort flowed out, understanding, hugs, gestures of solidarity, in many instances from others who recognize in themselves a similar kind of suffering. (Ferrara 2004)
Certainly, as indicated by the indigenous and piqueteros, it is the movement and community itself that has the power to heal. But the paths were different for each.
Indigenous peoples are recovering their traditional medicinal practices, which had been suppressed by the conquerors; the ex-workers and unemployed, molded by the culture of consumption, have had to de-institutionalize work, space, time, and politics to reinvent their lives. In summary, this has included:
• self-managed productive projects, or production “for itself.”
• opening up spaces in the “galpones”6 and in move- ment territories in order to have permanent and free meeting places in which new relations are practiced.
• “the integration of the various temporal spheres of everyday life and respect for time itself,” meaning an attempt to reunite time fragmented and parceled up by the system.
• and practices of horizontality, autonomy, collective participation, dignity, cooperation-based solidarity, and direct democracy as opposed to representation, hierarchy, and the instrumentalization of the tradi- tional political practices (Sopransi and Veloso 2004).