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Intercultural Health Practices: Towards an Equal Recognition Between Indigenous Medicine and Biomedicine? A Case Study from Chile

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Abstract

Over the past few years, intercultural health has become an emerging issue in health policy. Intercultural health is an approach in health that aims at reducing the gap between indigenous and western health systems, on the basis of mutual respect and equal recognition of these knowledge systems. This article questions the applicability of such a concept in the context of Chile. Here, conflicting interests between the Mapuche and the Chilean state are related to aspects of economic development, modernity processes, integration, intercultural relations, and indigenous rights and are deeply reflected also in projects for an intercultural health system. By analysing the experience of the intercultural practice of Makewe Hospital, this article argues that effective and equitable intercultural health practices will not take place unless there will be an integral valorisation of the Mapuche culture from a broader perspective.

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Notes

  1. Even though community participation in local health systems became more popular with neoliberalism, its history started with the Declaration of Alma-Ata of 1978, which was an attempt to develop an action strategy for the development of a comprehensive system of primary health care in all countries, with priority given to the most needy population groups. This was formulated by leading world health organizations such as Pan American Health Organization (PAHO) and World Health Organization (WHO). In fact, the Alma Ata declaration was a result of the realization that the main problem of health in recent decades was not a general supply of health care but its unequal distribution and the exclusion of the poor, especially in poor countries. Therefore, the Alma Ata declaration’s central organizing principle was a low-cost strategy utilizing paraprofessional health workers to administer preventive and simple curative measures in the countryside. With this approach, leading health organizations throughout the world have sought to extend inexpensive health coverage to rural areas, to promote community participation in health, and to achieve no less ambitious a goal than “health for all by the year 2000” [37].

  2. The promotion of intercultural health aimed to be achieved through technical assistance, ad hoc training activities, meetings and seminars. The main objectives of the Integral Development Program for Indigenous Communities involved (1) designing reference models for intercultural health care, based on experience with existing intercultural health activities in Chile; (2) improving the quality, sensitivity and cultural relevance of health services, through awareness, information and training activities of the 10 health services; (3) strengthening indigenous medicine, as part of a model intercultural health care, with funding for meetings among indigenous medicine practitioners, and support for formulating proposals; and (4) improving access to intercultural health services, with financing for projects originating in indigenous communities.

  3. The ngillatun is a prayer ceremony which is held at harvest time and is led by a machi.

  4. The rewe (or rehue) is a tree trunk set in the ground and surrounded by canes of colihue located in row and adorned with white, blue or yellow flags and branches of trees. At its summit it has a representation of a human face with seven steps rising up from the earth to this summit. It symbolizes the connection with the cosmos. This rehue is a symbol of great importance that is used in important celebrations like the Machitun, Guillatun, We Tripantu (Mapuche New Year) and others.

References

  1. Angell, A., Lowden, P., & Thorp, R. (2001). Decentralizing development: The political economy of institutional change in Colombia and Chile. Oxford: Oxford University Press.

    Google Scholar 

  2. Barrett, D. B., Kurian, G., & Johnson, T. M. (2001). World Christian encyclopedia: A comparative survey of churches and religion in the modern world. New York; Oxford: Oxford University Press.

    Google Scholar 

  3. Bengoa, J. (2000). Historia del pueblo Mapuche (Siglo XIX y XX). Santiago de Chile: LOM ediciónes.

    Google Scholar 

  4. Berg Kroll, W. (2001). Saludo Direccion del Servicio de Salud Araucanía Sur. In Tercer Encuentro Nacional Salud y Pueblos Indígenas: Sistematización de Experiencias de Trabajo Intercultural en Salud (p. 18). Servicio de Salud Araucanía Sur. Temuco, Chile.

  5. Birn, A., Zimmerman, S., & Garfield, R. (2000). To decentralize or not to decentralize, is that the question? Nicaraguan health policy under structural adjustment in the 1990 s. International Journal of Health Services, 30(1), 111–128.

    Article  PubMed  CAS  Google Scholar 

  6. Bossert, T., Larranaga, O., & Ruiz Meir, F. (2000). Decentralization of health systems in Latin America. Pan American Journal of Public Health, 8(1–2), 84–92.

    Article  PubMed  CAS  Google Scholar 

  7. Bourdieu, P. (1971). Genèse et structure du champ religieux. Revue Francaise de Sociologie, 1(2):295–334.

    Google Scholar 

  8. Chureo Zuñiga, F. (2001). Modelo de Salud Intercultural del Hospital Makewe. In Tercer Encuentro Nacional Salud y Pueblos Indígenas: Sistematización de Experiencias de Trabajo Intercultural en Salud (pp. 40–42). Temuco, Chile: Servicio de Salud Araucanía Sur.

  9. Citarella, L. (2000). Medicinas y culturas en la Araucania. Editorial Sudamericana. Chile: Santiago.

    Google Scholar 

  10. Conrad, P. (2007). The medicalization of society: On the transformation of human conditions into treatable disorders. Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  11. Cuadra, S. (1994). Social Movement and strategies in third world development, research report no. 33, December 1994. Lund: Department of Sociology.

    Google Scholar 

  12. Eriksen, T. H. (1993). Ethnicity and nationalism: Anthropological perspectives. Chicago: Pluto Press.

    Google Scholar 

  13. Fassin, D. (2000). Les Enjeux Politiques de la Santé. Paris: Editions Khartala.

    Google Scholar 

  14. Green, S. (1989). Consensus and Coercion: Primary health care and the Guatemalan state. Medical Anthropology Quarterly, 3(3), 246–257.

    Article  Google Scholar 

  15. Gustafson, B. (2002). Paradoxes of Liberal Indigenism: Indigenous movements, state processes, and intercultural reform in Bolivia. In D. Maybury-Lewis (Ed.), The politics of ethnicity: Indigenous peoples in Latin Americas States. Cambridge, Mass: Harvard University David Rockefeller Center for Latin American Studies (Distributed by Harvard University Press)

  16. Habermas, J. (1994). Struggles for recognition in the democratic constitutional state. In A. Gutmann (Ed.), Multiculturalism and “The politics of recognition” Charles Taylor (et al.). Princeton, NJ: Princeton University Press.

  17. Hall, G., & Patrinos, H. A. (2005). Indigenous peoples, poverty, and human development in Latin America. London: Palgrave Macmillan.

    Book  Google Scholar 

  18. Ibacache Burgos, J. (2001). Modelo de Salud Intercultural del Hospital Makewe. In Tercer Encuentro Nacional Salud y Pueblos Indígenas: Sistematización de Experiencias de Trabajo Intercultural en Salud (pp. 42–44). Servicio de Salud Araucanía Sur, Temuco, Chile.

  19. Johnson, R. L., Roter, D., Powe, N. R., Cooper, L. A. (2004). Patient race/ethnicity and quality of patient-physician communication during medical visits. American Journal of Public Health, 9(4):2084–2090.

    Google Scholar 

  20. Kymlicka, W. (1995). Multicultural citizenship: A liberal theory of minority right. Oxford: Clarendon Press.

    Google Scholar 

  21. Ladio, A. H., & Lozada, M. (2004). Patterns of use and knowledge of wild edible plants in distinct ecological environments: A case study of a Mapuche community from Nothwestern Patagonia. Biodiversity and Conservation, 13(4), 1153–1173.

    Article  Google Scholar 

  22. Laveist, T. A., & Nuru-Jeter, A. (2002). Is doctor–patient race concordance associated with greater satisfaction with care? Journal of Health and Social Behaviour, 4(2), 296–306.

    Article  Google Scholar 

  23. Levy, J. A., & Pescosolido, B. A. (2002). Social networks and health. The Netherlands: Amsterdam. Boston, MA: JAI.

    Google Scholar 

  24. Montenegro, R. A., & Stephens, C. (2006). Indigenous health in Latin America and the Caribbean. The Lancet, 367, 1859–1869.

    Article  Google Scholar 

  25. Morgan, L. (2001). Community participation in health: Perpetual allure, persistent challenge. Health Policy and Planning, 16(3), 221–230.

    Article  PubMed  CAS  Google Scholar 

  26. O’Neil, J., Bartlett, J., & Mignone, J. (2006). Best practices in intercultural health. Washington, DC: Inter-American Development Bank.

    Google Scholar 

  27. Paley, J. (2001). Marketing democracy: Power and social movements in post-dictatorship Chile. Berkeley: University of California Press.

  28. Pan-American Health Organization, PAHO. (2001). Makewe-Pelale: Un Estudio de caso en la complementriedad en Salud. Washington, DC: PAHO.

    Google Scholar 

  29. Parse, R. R. (2003). Human becoming community change concepts. In R. R. Parse (Ed.), Community: A human becoming perspective (pp. 23–47). Sudbury, MA: Jones & Bartlett.

    Google Scholar 

  30. Patterson, E. (2004). Different religions, different politics? Religion and political attitudes in Argentina and Chile. Journal for the Scientific Study of Religion, 43(3), 345–362.

    Article  Google Scholar 

  31. Postero, N. (2004). Articulations and fragmentations: indigenous politics in Bolivia. In N. G. Postero & L. Zamosc (Eds.), The struggle for indigenous rights in Latin America (pp. 189–216). Susses Academic Press.

  32. Ray, L. (2007). Language of the land: the Mapuche in Argentina and Chile, IWGIA.

  33. Schouten, B. C., & Meeuwesen, L. (2006). Culture and medical communication: A review of the literature. Patient Education and Counselling, 6(4), 21–34.

    Article  Google Scholar 

  34. Summerfield, D. (2002). Effects of war: Moral knowledge, revenge, reconciliation, and medicalised concepts of “recovery”. British Medical Journal, 3(5), 1105–1107.

    Article  Google Scholar 

  35. Taylor, C. (1994). The politics of recognition. In A. Gutmann (Ed.), Multiculturalism and “The politics of recognition” Charles Taylor (et al.). Princeton, NJ: Princeton University Press.

  36. Torry, B. (2005). Transcultural competence in health care practice: The development of shared resources for practitioners. Practice, 1(7), 257–266.

    Article  Google Scholar 

  37. Triandis, H. C., & Trafimow, D. (2001). Culture and its implications for intergroup behavior. In R. Brown & S. L. Gaertner (Eds.), Blackwell handbook of social psychology: Intergroup processes. Oxford: Blackwell.

    Google Scholar 

  38. Turner, B. M. (2004). The new medical sociology: Social forms of health and illness. New York, NY: W.W. Norton.

    Google Scholar 

  39. van Wieringen, J. C., Harmsen, J., & Bruijnzeels, M. (2002). Intercultural communication in general practice. European Journal of Public Health, 1(2), 63–68.

    Article  Google Scholar 

  40. Weinstein, M. (1997). Participación social en salud. Santiago, Chile: Acciones en curso. FLACSO.

    Google Scholar 

  41. Wiley, A. S. (2008). Medical anthropology: A biocultural approach. University of Southern California.

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  1. Department of Social Sciences, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada

    Maria Costanza Torri

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Torri, M.C. Intercultural Health Practices: Towards an Equal Recognition Between Indigenous Medicine and Biomedicine? A Case Study from Chile. Health Care Anal 20, 31–49 (2012). https://doi.org/10.1007/s10728-011-0170-3

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