Naomi Klein in Cochabamba!

A few weeks ago, the journalist Naomi Klein (of The Nation) came to Cochabamba to talk about the Spanish version of her book, The Shock Doctrine: The Rise of Disaster Capitalism. It was so incredible to hear her talk, especially in the city that first showed that a popular uprising can indeed triumph over an irresonsible transnational corporation, driving Bechtel out of Cochabamba after they privatized the public water utility and hiked prices 300 percent in 2000.

Klein´s book documents the history of the idea first espoused by Milton Friedman that "only a crisis, actual or perceived, produces real change" when it comes to economic policy. She details examples of how the IMF and their elite allies in governments around the world have used the state of shock after natural and man-made disasters to implement unpopular economic austerity measures and privatizations when people are least likely to resist them. From the 1973 coup of Allende in Chile, to Russia in 1993, China in 1989, the Falklands War that gave Margaret Thatcher the popularity to make serious changes in Great Britain, to the ugly aftermath of Hurricane Katrina, to the most privatized war in history in Iraq, this pattern repeats itself.

Klein gave a disturbing description of the way companies took advantage of the aftermath of Hurricaine Katrina to benefit themselves. Blackwater provided policing, other companies found a market in building shelters or selling water. And the reconstruction process has totally changed the face of much of New Orleans, replacing public housing with condos and casinos. Five thousand black families had lived in housing projects on some of the most valuable land in the city before the hurricaine. Klein quoted a New Orleans politician as saying "We couldn't clean out the housing projects, but God did."

Her argument really confronts the assumption that neoliberal economic policy goes hand in hand with democracy. Bolivia was a turning point for this ideology in 1985 because it was the first time that a democratically elected government implemented the neoliberal program. Before it had only worked in dictatorships like Pinochet´s, a marketing problem for Milton Friedman and his "Capitalism and Freedom" thesis.

In Bolivia the "shock" was the terrible inflation crisis caused by the collapse of tin prices and an inept leftist government in the early 1980's. But what get´s left out of the official history is that Bolivian President Victor Paz Estenssoro never mentioned his neoliberal plans to reorganize the economy during his election campaign and designed the whole policy in secret with an emergency economic team. They showed their new policy to the IMF even before his own cabinet or the Bolivian congress had seen it. Apparently the IMF official told them the package was everything they could ever dream of, but that if it didn´t work, he had diplomatic immunity and could hop a plane to Miami.

After the policy was implemented and thousands of miners lost their jobs, Bolivians held huge strikes and protests. The government declared a state of seige and arrested 1,500 protesters and kidnapped 200 of the top labor leaders to the Bolivian jungle. It was hardly a democratic process.

Klein´s message is that being aware of this pattern can help us confront it, instead of deferring to strong leaders in the aftermath of a crisis we can organize, the way that workers did in Argentina after the 2001 economic crisis, when they took over their shuttered factories and started cooperatives to continue producing without the management.

I think we have a lot to learn in the U.S. from a country like Bolivia. As Klein put it, the societies with the most powerful historical memory have stronger resistance to neoliberalism. We´ve become so comfortably indifferent in the U.S. that there´s little protest when public housing's mowed over or private companies win outrageous contracts to repair the destruction we´ve caused in Iraq. But after 500 years of resistance to colonialism, Bolivians are no longer willing to sit quietly in the face of such exploitation.

Here are a few market scenes from my second visit to Potosí, I love the markets here!

These are special honey covered pastries for Corpus Cristi.

Why would you ever go inside to buy anything? :)
Cool mural in Potosí "For brotherhood between the peoples of Latin America."

A few more thoughts about my time in Torotoro

I feel like I got to experience Andean culture a little more deeply there; it's so incredibly different from ours. Something I really like, and am trying to understand better is the concept of Ayni, or reciprocity. People give to eachother so generously even when they have very little because there´s an understanding that someday in the future, be it tomorrow or in 20 years, that person will give back to you in some way. I said something to Don Luciano, the traditional healer who helped me translate interviews in the rural village of Tambo K'asa, about how I felt bad I hadn´t brought something to give to the people I was interviewing, like a mandarine orange or a bag of coca. He said to me,"That´s okay, there's always next time," with full knowledge that it could be years before I ever came back to Tambo K'asa. But time is a different concept here.

The cool thing about Ayni is how it binds a community together. When someone gives you something without pay, you stay connected to them because you have to return the favor someday. In contrast, when we pay someone for a service or good they give to us, the social interaction ends right there, it´s paid and done with. Torotoro is a very poor place economically, but even though they don't have money, hardly anyone goes hungry because the community shares and trades with eachother. Sometimes a guy would show up at our house with a huge bag of potatoes and I would think, how did we pay for that? But it turned out we'd given them corn a few weeks ago. It's this continuous web of reciprocity that connects people in deeper ways.

I thought a lot about how individualistic we learn to be in the U.S. and how I find it hard at times to even make myself share my food with a stranger on the bus. But it's just what you do here, you never eat in front of someone without offering them some. I really believe that humans aren´t innately selfish or individualistic, it´s just that we´ve become socialized that way in the Western world.

So in case you´re interested, here is the abstract for my project in Torotoro. It sounds better in the original Spanish, though, I suck at translating:

Intercultural Public Health in Torotoro, Potosí

In much of rural Bolivia, the population has difficulty accessing the public health system. Physical, economic, and cultural barriers all prevent the indigenous quechua population from using the public health services available to them. The Evo Morales administration has proposed a new public health model called “Salud Familiar Comunitaria Intercultural” (SFCI) that attempts to remedy these cultural barriers, such as language, beliefs, customs, traditions, and the preference for traditional medicine. But it still hasn´t been defined what the model SFCI will look like once implemented. Torotoro, in the far north of the department of Potosí, is a municipality that has begun to adapt their services to the local culture and integrate tradicional medicine into the public system. Torotoro is one example of how certain aspects of SFCI might be implemented.

In hopes of better understanding this new model, the cultural barriers for the indigenous quechua population´s usage of the public health system were investigated in Torotoro. The central questions of the investigation were, “Do cultural barriers prevent the population from using the services available to them?” and “Does the population access the services more, now that they´ve been made more culturally appropriate?” Using interviews with health center personnel, traditional healers, and residents of the municipality, three aspects of culturally appropriate health services were studied: intercultural attention of the birthing process, intercultural practices of the health center personnel, and the satisfaction with and use of traditional medicine.

It was documented that the implementation of intercultural attention of the birthing process has resulted in increases in the percentage of births that are attended in the health center. The personnel have good knowledge of the quechua language and the beliefs and traditions of the population and respect the knowledge and skills of the traditional healers. The majority of the population interviewed have positive feelings towards the health center and support the idea of having traditional medicine also available there. Furthermore, the traditional healers in the municipality are very organized and commited to their project, although they lack somewhat the resources to provide the best attention possible. Cultural barriers to the usage of the center still do exist, but the progress that has been witnessed in Torotoro suggest that the model SFCI will indeed be able to increase access to the public system in other areas as well.

Interculturalidad y Accesibilidad: Un Nuevo Modelo de Salud Pública en Torotoro, Potosí

En mucha de la zona rural de Bolivia, se ha visto una falta de acceso de la población a los servicios de salud. Las la geografía prohibitiva, la falta de recursos, y las barreras culturales como el idioma, las creencias, costumbres, tradiciones, y la práctica de la medicina tradicional por la población impiden el uso de los servicios por la población originaria campesina. El gobierno de Evo Morales ha planteado un nuevo modelo que se llama Salud Familiar Comunitaria Intercultural (SFCI) que enfrenta estas barreras culturales. Pero todavía no se ha definido específicamente como va a funcionar. El municipio de Torotoro en el extremo norte de Potosí ha empezado un proceso de adecuación con interculturalidad y la integración de la medicina tradicional y es un ejemplo de como se podría implementar estos aspectos del modelo SFCI.

Con el fin de entender mejor este nuevo modelo, se investigó el problema de la vivencia cultural como un factor para el acceso a los servicios de salud de las poblaciones originarios quechuas. Las preguntas centrales eran ¿Son las barreras culturales un factor para que la población no acuda al servicio de salud? y ¿La población acude más y tiene más satisfacción con los servicios de salud ahora que hay adecuación intercultural? A través de entrevistas con el personal de salud, los médicos tradicionales, y la población de Torotoro, se estudió tres aspectos de la adecuación: la utilización del parto intercultural, las prácticas que realizan el personal de salud sobre la adecuación intercultural, y la satisfacción y el acceso a la atención de la medicina tradicional.

Se ha visto que la implementación del parto intercultural va aumentando cada año el porcentaje de partos atendidos en el Centro y que el personal de salud maneja muy bien el idioma quechua, conoce muchas creencias y tradiciones de la población, y respeta los conocimientos de los Médicos Tradicionales. También, la mayoría de la gente que entrevisté se siente bien con la atención del centro y apoya la atención de la medicina tradicional en el Centro. Además, los Médicos Tradicionales son muy organizados y comprometidos a su proyecto, aunque faltan materiales y ambientes para brindar la mejor atención a sus pacientes. Todavía existen barreras culturales al acceso al Centro pero a pesar de eso, el progreso que se ha visto en Torotoro sugiere que el modelo SFCI podrá mejorar el acceso al sistema público en otros lugares también.


Some pictures from Cochabamba:

A walk in Parque Nacional Tunari, 2 blocks from where I live in Cochabamba.



The Cochabamba Valley at sunset from Parque Tunari.


So this I just thought was a funny picture; what the call a "euro-casa" with a painting of Che. Lots of Bolivians go to Spain to make money and then come back to Bolivia to construct huge, grandiose, and in my opinion ugly houses in the style they have in Europe. A lot of times they´re half finished becuase the person has returned to Spain to make the rest of the money to finish it. They always stick out strangely in comparison with the normal houses around them, and seem like a gaudy expression economic inequality. Thus plastering Che´s face across the side of a euro casa seemed to me an ironic mixture of symbols.

Torotoro, Potosí

¿Imaynaya kashanki?
That means "how´s it going?" in quechua! In reply you´d say ¨Walejya" if you´re doing well!
I returned to Cochabamba a week and a half ago and finally finished my project report and presented to my professors this past friday. It was an amazing process, but man am I glad to be done!
My time in Torotoro was absolutely incredible. I interviewed about 60 doctors, nurses, traditional healers, and members of the population and lived with an amazing family that I fell in love with! I have so much to tell y´all about it, but not enough time right now to do it justice. I wanted to get these pictures up though, so enjoy, and I will elaborate more very soon (since I have much more free time now that classes are over!)
Chau!
Kirsten
The Centro de Salud Torotoro and the one ambulance in the county.

The intercultural birth room in the Centro; women can give birth kneeling or crouching or sitting on the mattress while holding on to the bar. They only have to use the gynecological position if there´s a complication and the doctor has to intervene.

The Asociación de Médicos Tradicionales los Amautas that attend patients in the Centro on Sundays and walk up to 12 hours each way to meet together once a month to discuss ways to improve their practices and elaborate better medicines. It was so inspirational to work with them!Feliza, a naturalist and my host mom and good friend, in front of the Médicos Tradicionales' consulting room in the Centro de Salud.Don Victoriano, President of the Asociación, in the consulting room in the Centro.Don Luciano, Médico Tradicional, on the 4 hour walk to his community of Tambo K'asa, which I visited for a few days.
Feliza and I in front of her house where patients come to consult her for naturalistic healing. The dinosaur on the sign is because Torotoro is famous for the dinosaur tracks they found there.
Sonia, Olga, Lydia, and Santos, four of the seven kids I lived with in the main room of their house.
Vilma, the oldest daughter with a beautiful aguayo (cloth for carrying everything from babies to potatoes to coca to clothing, Andean backpack you might say) that her mom Feliza wove (more incredible aguayos in the background, all woven by Feliza).
Feliza and Olga laughing about something, as they were most of the time!

Parade that began the Congress of Sindicatos Campesinos from all over the North of Potosí that was happening the first day I arrived in Torotoro- notice the Wiphala, or multicolored flag of indigenous unity that you see everywhere in Bolivia.