After I read the part of this study in our textbook for the course, I looked up the actual study online, Cultural Adaptation of Birthing Services in Rural Ayacucho, Peru. In rural communities such as Ayacucho in the Andes of Peru, indigenous people are wary of the modern medicine that is starting to gain a foothold in the region. The traditions of these people have diminished as time progresses due to increasing globalization and the political conflict that ravaged the country for approximately two decades causes a deep-rooted sense of distrust in anything the government has to offer. Even their religion has come to be dominated by the Catholicism imposed on the region when the Spaniards arrived. Therefore, it is not surprising that medical practices among the indigenous population are also at odds with the ideals of modern medicine.
In the study, a program is implemented to decrease the mortality rate among the indigenous community in Ayacucho, Peru. Rather than instruct mothers on different birthing practices, physicians opted to combine traditional practices with modern medicine in the hopes that women would feel more comfortable, and ultimately lead to more successful births. Modifications to birthing procedures were implemented to accommodate for indigenous traditions: allowing the husband or a traditional birth attendant to be present during the birth, training health professionals to speak Quechua (three-fourths of the population in the region is Quechua-speaking), using some traditional herbs and medicine during the procedure, and returning the placenta to the parents for proper burial. The program increased the number of women who turned to official town clinics to receive care, rather than solely rely on traditional practices.
I traveled to Ayacucho, Peru in the summer of 2011 as part of BU’s abroad program and I volunteered at the Centro de Salud San Juan Bautista, known locally as a “posta.” At the clinic, I observed primarily in the OBGYN department. There was a mix of backgrounds, although the majority of women that received care were of indigenous origins. Besides some colloquial phrases and words, none of the health workers knew how to speak fluent Quechua and many of the patients would come accompanied by their husbands or a relative who could translate for them. During the visits, I observed that the obstetricians would scold the indigenous women for missing their monthly appointments to check-up on their pregnancies or for not taking their vitamins. This would always make me uncomfortable given that there was a severe language barrier, not to mention that these women would already wait for hours to be seen. I conducted surveys to gage the opinions on the care from the patients themselves; for many, the lack of resources left bad impressions on the quality of service being received. Others would tell me that doctors were still not able to cure “mal de ojo” or the “evil eye”, one disease out of a list usually rattled off. During class one day, an anthropologist who studies this break between indigenous traditions and modern medicine spoke to us about the developing care in the region. Besides doctors not being able to care for a number of diseases particular to these indigenous communities, birthing practices and care for newborns also differed greatly. A baby born in some communities is swaddled very tightly, practically bound, with special fabric until a certain age, thumb-sucking is prohibited, and newborns are given special treatment based on their gender. While I was quick to dismiss some of these practices as “ignorant” and even unsafe in some cases, the reasoning behind these practices is ultimately just different. Indigenous communities are not ignorant but rather their perceptions of life and nature are entirely different. Some traditions for the sake of honor and family are respected, while in our culture those rituals are seen as backward. By listening to this speaker and watching the treatment of some patients at the posta, I realized that there was not one way to practice medicine. Like anything else in the world, people simply have different notions when it comes to living.
Although the number of indigenous mothers who go to a local clinic is increasing, there is still a wide disconnect between the two traditions. Indigenous populations have a history of being society’s most marginalized sector. In Peru especially, the indigenous community has suffered a great deal from the racism that invaded the country since its founding. The armed conflict between the Marxist guerrilla movement and the Peruvian government resulted in 70,000 deaths, of which 75% were Quechua-speaking victims. Much work is still yet to be done for these people, especially in terms of development. I find it crucial that the few clinics that are available provide a care that caters to both the patient and health standards. While in the past this region may have experienced the need to accept one or the other, health is an area in which there is not a single answer. We have still much to learn from each other.
This is one awesome article post.Thanks Again. Really Great.