When I started this study abroad program we were told a lot about the concept of intercultural medicine. It seemed to be what everyone we talked to was aspiring to create within the Chilean healthcare system. Now that I have had time to see the problems and goals of an intercultural healthcare system, I am not sure that I agree with the concept. For starters, the majority of people who have spoken to us about trying to create an intercultural system of healthcare are people who do not identify as indigenous and don’t use traditional medicine. On the other hand, those who do practice traditional medicine and often times do identify as part of an indigenous community in Chile have spoken to us mostly about their desire for better communication between Western medicine and traditional healing. In fact, several have even spoken against the current model of intercultural health that the government has tried to implement.
The Chilean government has been trying to promote intercultural health by including traditional medicine within their health centers. While this seems to be a good first step for creating an open dialogue, there are many downsides to this. The first being, that this allows for people to claim that they are intercultural without actually communicating. This was the case in Putre with the Aymaran traditional medics. While the Yatiri and Usuyiri/Qulliri have their own office at the health center in Putre, the doctors don’t refer their patients to them as frequently as their claim of interculturality might suggest. Although, the traditional medics do refer patients with a higher frequency than the biomedical doctors. Obviously, this doesn’t support an environment of equality between the two systems of medicine and it also excludes patients who do not know to actively exercise their right to see traditional doctors.
Another problem with this system is that the current system of interculturality requires both medical practices to be housed within one building. Since the biomedical system is the one defining this type of interculturality, this means that the traditional practices are expected to move within pre-existing biomedical health centers. While for the Aymara people this doesn’t seem to have a significant impact on the effectiveness of the traditional practices, the Mapuche practices are severely impacted in a negative manner. For the Mapuche, the spirituality of the place where the medicinal plants are collected and where the Machi (the Mapuche traditional healers) work are equally, if not more, important than the actual remedies taken. Due to this, many Mapuche people believe that having the Machis practicing within hospitals and health centers decreases the actual healing abilities of the Mapuche practices. Again, this indicates a lack of respect or understanding of the traditional practices.
The Mapuche that we have spoken to throughout the program have told us that for them, a better system of intercultural health would have a system of communication and referral between Machis and health centers, but that each would continue to practice in their own respective places. However, this is only based on several conversations with people who identify as Mapuche. In general, I feel as if I have heard more conversation about the intercultural health system from the Mapuche people than I have from the Aymara.
During our time in Putre, the majority of the conversation about intercultural health came from the biomedical side. This sparked my interest and is currently the basis of my Independent Study Project (ISP). The ISP is a month long research project that is the culmination of our time in Chile. I will be spending the majority of my time in Putre speaking to traditional medics such as Yatiris and Qulliris about their experiences working at the health center there. Additionally, I would like to speak to the people who use the traditional medicine available at the health center and potentially speak to a Yatiri who does not work within the biomedical system. I will also be traveling on rondas (medical rounds in which the professionals of the Putre health center travel to other rural towns in the mountains who do not have their own health centers) to speak to the citizens who use these services. I hope that I will be able to find out more of the Aymara opinion on the current model of intercultural healthcare. Would they too prefer a more multicultural system with better communication and understanding between biomedical systems and traditional practices?
Belen is one of the towns that I will be traveling to during the rondas. It used to be the largest town in the area but has since decreased in population.
