The Wenner-Gren Blog

Madimenos schedules a family health day with one Shuar family in a remote village in southeastern Ecuador.

Felicia Madimenos is Assistant Professor of Anthropology at Queens College, City University of New York. In 2009, while a doctoral candidate at the University of Oregon, she received a Dissertation Fieldwork Grant to aid research on ‘Lifestyle and Reproductive Effects on Bone Mineral Density in an Ecuadorian Forager-Horticulturalist Population,’ supervised by Dr. James Snodgrass. This year, she was awarded the Engaged Anthropology Grant to follow up her work with Shuar communities and conduct a series of workshops, presentations and family days to disseminate information regarding health issues in the community. 

In a remote rural Shuar village located along Rio Morona, an elderly Shuar man, sits in a wheelchair as his wife pushes him along the rocky, unpaved road. As he makes his way closer to the now-defunct clinic space, my colleagues and I can see that his right leg is missing just below the hip. Along with his wife, he is accompanied by his eldest daughter, son-in-law and grandchildren. Because of a community-wide meeting we held days earlier, the family was aware that Shuar nurses, accompanied by American anthropologists, were staying in the village and were providing information about basic health issues.

Clearly, there was nothing any of us could do for his leg although initially, he refrained from mentioning his leg at all; he merely wanted information about his general health and well-being. He explained that two years earlier he was diagnosed with diabetes by a doctor from a clinic located three-hours up the road, and the doctor stated that they needed to amputate his leg due to his condition. While plausible, something seemed amiss with the story. As we continued to talk, his son-in-law, feeling increasingly comfortable to talk openly, narrated in detail the events leading to the amputation of his father-in law’s leg. In short, his father in-law had stepped on a rusty nail while working in his garden and it became seriously infected, which eventually resulted in a trip to the doctor. “Can stepping on a nail give you diabetes?,” the son-in-law asked. “No,” we responded firmly, although we wondered whether diabetes exacerbated the infection, or whether there was miscommunication of some kind. As it turned out, the man’s fasting glucose levels were optimal, and based on data we had for him from years earlier, there was no indication that insulin-resistance was ever an issue. Further, the man claimed to have never taken medication for diabetes but accepted the fact that his leg was removed because of it. This type of miscommunication, that stepping on a nail could cause diabetes which warranted an amputation, while one of the more extreme examples, reflects a common theme in my line of research.

A Shuar colleague and local health care provider assisted by community members presents on health and family planning in a rural Shuar community.

This interaction highlighted the critical importance of providing both contextual information and clarifying misinformation about the causes and prevention of illness and disease, and stressed the need to bridge communication barriers. Explanations by medical doctors who diagnose/treat disease and anthropologists who study health are simply not enough because this information gets filtered, forgotten, and lost after people leave the clinic to continue on with their daily lives. Health interviews with Shuar reveal that most people are unclear about what information is relevant to a given condition, and so when given a chance they may often provide an overwhelming amount of information about multiple conditions they have experienced at different times, on the reasonable assumption that it is all pertinent. However, health care workers are busy, and discussions with Shuar reveal that most think many clinicians do not listen to them, making them more inclined to present their most immediate symptoms with no additional information. It goes without saying that for our participants to retain a sense of agency in matters regarding their own health, and for health information to be useful and remain effective over the long-term, this knowledge must be individualized and translated into a tangible, transparent, and accessible form, with ample time for active ongoing individual dialog between participant and information provider.

The funds provided by the Engaged Anthropology Grant allowed me to reconsider how my colleagues and I conduct health research in a non-clinical, non-Western setting and reinforced the importance of the process of disseminating health information. Within the first few days of arriving in this remote village where we had worked during an earlier field season, we organized a community-wide meeting where we re-introduced ourselves and our research. This opportunity provided an ideal platform to field questions and address community concerns and, moreover, it stressed the need for a more personalized interaction with community members. In order to maximize our engagement with participants both old and new, we scheduled family health days where entire families would meet with the team of nurses and anthropologists to ask health-related questions, receive follow-up assessments and updated individualized information on health and prevention. When necessary, we would provide first aid or pass information to local health care providers for diagnosis and/or to dispense necessary medicines.

Shuar male peruses health pamphlets during the health and family planning presentation in a rural Shuar village.

Prior to our arrival, I designed educational packets, adapting content from public health resources, and synthesized and condensed health information. Whenever possible, I emphasized images rather than written text. Each packet addressed health issues that we commonly encountered in past research and that Shuar participants most frequently report experiencing including anemia, dehydration, urinary tract infections, gastrointestinal issues, and chronic health problems that are increasing in prevalence (e.g., diabetes, cardiovascular disease, hypertension). Family health days provided an opportunity to personalize explanations regarding health issues and allowed us to distribute these materials to Shuar participants and discuss them individually and extensively. Some families hovered over the educational materials while children giggled at the images, and others asked for additional copies to bring to extended family and friends. Many were visibly excited to take a tangible reminder of this meeting home. “This is good,” says Carlos, a middle-aged Shuar man who came with his wife and eight children. “After you leave, we have this to remind us of the things you told us.” In addition to educational materials, based on consultation with community leaders, a Ministry of Health nurse, and local health promoter, our team donated basic over-the-counter medicines readily available in any Ecuadorian pharmacy, including antibiotics and parasite treatment kits, to be distributed as necessary after we departed.

Over the next few weeks, we participated in a community-wide workshop on family planning, initiated by the area’s Ministry of Health and led by our colleague, a local Shuar community health promoter and nurse. It is not uncommon for Shuar families, particularly in the more remote regions, to have upwards of 10-11 children. In a region where new government education centralization plans will position the nearest primary school two-hours away, where children need money for travel and school supplies, and where a childhood visit to the doctor requires a six-hour walk or two-hour canoe trip, information on family planning is increasingly of critical importance. However, it remains a very sensitive subject. Many participants in the past have shared with us the tribulations of having such large families and while the Ecuadorian government provides gratis family planning services, few Shuar, especially in these remote regions, have immediate and regular access to, or even information on contraception. This educational workshop was essential to establish a comfortable discourse on family planning and to discuss what options are available to Shuar in order to be active agents in matters concerning their own health and bodies. The presentation evoked the notion that larger, overarching factors trickle down and interact to shape individual health and well-being. Feeling like one has control over his/her surroundings, whether by being armed with knowledge that one has choices regarding the size of the family unit, or recognizing that modifiable aspects of lifestyle can shape how one feels from day to day are significant, and often overlooked forces that intimately influence personal health. Whether Shuar who attended this workshop felt this information was useful or not is unclear but we did not observe evidence of tension; participants seemed to be engaged in the discussion, and generally had a positive response. As health researchers, we knew that many participants had privately requested information on birth control, but this meeting appeared to go far towards normalizing an open discussion of these delicate issues and in creating awareness that people’s own health and bodies are in their command.

Madimenos discusses health measures with a Shuar father and his child

Lack of information, misinformation, and miscommunication regarding the causes, treatments, and preventative strategies for common and increasingly prevalent health issues warrants action on the part of the health researcher to stave off potential graver health problems in the future. For example, in another community closer to town where we presented health information with a local nurse, it was commonly believed that there was medication that could “cure” diabetes, despite the fact that three elderly people in the town had diabetes and were taking medication to control it. In discussing diet and prevention, it became apparent that one young woman was very knowledgeable about these issues, and yet it was only in the context of this presentation that this came to light, and we could reinforce to others that she was an excellent available resource for information on the topic.  In short then, one remedy is for researchers to develop opportunities that empower communities by making accessible the knowledge and information necessary for community members to participate in, and affect informed decisions about their health, but moreover to approach this within the context of resources reasonably available to the participants. It is clear from my experience that for this approach to be successful, collaborations with local colleagues are essential, and individual as well as community-level dialogue is integral.

Gaby Vallejo, the Bolivian author who wrote "Tomasa Quispe en los ojos de Felipe", and Dr. Scarborough.

Isabel Scarborough is Assistant Professor of Anthropology at Parkland College and Research Affiliate at the Anthropology Department of the University of Illinois at Urbana-Champaign. In 2007, while a doctoral candidate at the University of Illinois, she received a Dissertation Fieldwork Grant from the Wenner-Gren Foundation to aid research on ‘Market Women Mothers and Daughters: Politics and Mobility in the New Bolivia,’ supervised by Dr. Andrew Orta. In 2012, she received the Engaged Anthropology Grant to return to her fieldsite in Cochabamba, Bolivia to conduct a three-day workshop and produce a children’s book based on her research on the country’s informal markets. 

This summer I traveled to my fieldsite in Cochabamba, Bolivia, where I had studied how indigenous informal market women in this city incorporate themselves into the global market. In my research, I was particularly interested in the contrast between the older generation of merchants who were barely literate and still marked their indigeneity through their dress and language, and their daughters who—now in their late twenties—had acquired a college degree before returning to informal vending. Why were these young women willing to go back to informal vending when they now had the credentials to get jobs in formal businesses? Many fellow anthropologists have discovered in the course of their ethnographic work in Africa, Asia, and Latin America that the informal market is turning into the largest form of employment in the developing world. Cochabamba is no exception to this trend and, indeed, shows the informal market taking over regional and international trade in addition to moving the economy of this city of over 700,000 people. The young market women of my study chose to continue working in their mother’s trade, despite their education, precisely because of this growth and the economic benefits brought by this line of work. However, notwithstanding these financial incentives, informal market women also perceived a continued marginalization of their actions given their historically-subordinate identities as both female and indigenous. Over eighteen months of fieldwork I held many conversations with market women of both generations who keenly felt that Bolivians misunderstood how their trading activities contributed to the region’s economy. Because of this, I wanted to raise awareness in Cochabamba on the significance of the informal market; the purpose of my Engaged Anthropology Grant.

My approach to this project targeted two distinct populations; the local academic and professional community that studies the informal market in Cochabamba, and the urban lower and working classes of which the market women are a part.  I worked with colleagues at the graduate school of the local state university, CESU – Universidad Mayor de San Simón, to put together a workshop for the first group. The Wenner-Gren Foundation sponsored a two-day seminar in which participants who included undergraduates and professionals—some of whose families worked in the informal sector—read and discussed ethnographic work on the informal market and the importance of market women. These readings included my own published work on the Cochabamba market, which I translated into Spanish for the workshop participants. A copy of this translated article that is based on one my dissertation chapters will be published in the next issue of the social sciences academic journal of this university, Decursos. In addition, some of the participants in the workshop and I will collaborate on two future articles for this journal that will combine our data on the informal market in this city. This continued exchange of ideas and information contributes to the second aim of this workshop which was to strengthen the links between US and Bolivian academia.

A second activity in my efforts to raise awareness on the work of informal market vendors involved the design, writing, and publishing of a children’s storybook. This idea was inspired by my conversations with the market women who show unstinting dedication to their children’s education, many of whom I often observed supervising their little one’s as they did homework among their mother’s market stalls, or working longer hours in order to send their sons and daughters to private schools at great sacrifice. The market women had often pointed out the dearth of good reading materials for their children, and mused on how few if any of the storybooks they saw had any stories about families in trade. Teaming up with renowned Bolivian author Gaby Vallejo, we put together a book that tells the story of a young boy, son of a market woman, and his perceptions of his mother on the day on which he will leave her to immigrate to Spain where his father and other family members work and reside. The book, titled, Tomasa Quispe en los ojos de Felipe, (“Tomasa Quispe through the eyes of Felipe”) shows Felipe’s journey through the marketplace where he notes many of the commercial activities that take place, the hard work of the women at the vending stalls, the family life in the passageways between stalls, and his sorrow and that of his mother at their imminent separation.

The book’s edition, financed by Wenner-Gren, was published in Cochabamba and is illustrated with pictures from the marketplace juxtaposed with drawings of Felipe and his mother, Tomasa. After its distribution in the markets, the publication was presented to the non-profit children’s library Thuruchapitas for its dissemination and distribution. The book will be donated to public schools in Cochabamba and given out as prizes at reading contests and workshops throughout the city. During my stay in Cochabamba, I also organized a reading of the text with school children, many of whose mothers were market vendors, with some of Thuruchapitas’ volunteer teachers.  The children who attended the reading all received a copy of the storybook, as will any other children who participate in the library’s weekly readings over the next few months.

I hope that, in some small way, these two activities meant to raise awareness of the importance of the informal market return the generosity of the market women who made me welcome and collaborated on my doctoral dissertation work. I am excited to return to my fieldsite in future and continue engaging with these women whose experiences have much to teach us about Bolivia’s changing socioeconomic structures.

March in Valle de Sibundoy, Putumayo on August 30, 2013 in support of the National Agrarian and Popular Strike.

The Wenner-Gren Foundation awards the Engaged Anthropology Grant to former grantees in order to allow them to return to the field and share their work with the community that hosted them. In keeping with the grant’s purpose of breaking contemporary anthropological research outside of the confines of one’s home institution and the English-speaking academy at large, we require those awarded to write a guest blog post describing their experience, as an accessible way to learn about the ways anthropologists and the Wenner-Gren Foundation are supporting engaged, equitable scholarship. In today’s entry, we welcome Kristina Lyons, UC President’s Postdoctoral Fellow at the University of California-Santa Cruz in Anthropology and the Center for Science & Justice, who originally received a Dissertation Fieldwork Grant in 2007 while a doctoral candidate at the University of California-Davis to aid research on ‘Science, Storytelling, and the Politics of Collaboration: Advocacy against Aerial Fumigation in Colombia,’ supervised by Dr. Marisol de la Cadena. 

“Make sure the right anthem is going to sound off,” jokes Profe Miguel, provoking a loud round of laughter among us. “Not the national anthem, but el himno del pueblo [the anthem of the people]!”

The crackle of the loudspeakers brings three thousand small farmers to their feet. Some lightly tap the beat, others mouth the lyrics meditating behind closed eyes or sing aloud in low voices. The commission of government representatives attending the meeting this morning also stands tall. I search their eyes wondering what kinds of emotions are veiled behind a row of stoic faces.

“And now the pueblo that rises up in the struggle

with the voice of a giant shouting: forward, forward!

The pueblo united will never be defeated…”

Protestors camped at a strike concentration point in Villagarzón, Putumayo. September 2013.

Originally composed and taken up as the international anthem of the Chilean resistance movement after the September 11, 1973 military coup, this song can be heard celebrating the spirit of hope, unity and struggle in mass rallies, marches and demonstrations around the world. Today, on the 17^th day of the National Agrarian and Popular Strike in Colombia, we are at the negotiation table between regional small farming leaders and state officials in Villagarzón, Putumayo. The national government has arrived to request that protestors unblock Putumayo’s highways in exchange for the negotiation of regional-level reforms to agrarian policy, infrastructure and social investment. Small farming leaders, however, argue that they will only lift the strike if and when President Santos recognizes and agrees to negotiate with the National Working Group of Dialogue and Accord (MIA) that gathers together the demands of all the sectors participating in the strike: the country small and medium farmers, small miners, and health and transportation sectors. The MIA is calling for the suspension of the free trade agreement with the United States in order to address crisis in the nation’s agricultural sectors; the participation of small miners in mining policy and an end to a national development model fueled by extractive industry; the recognition of the political and territorial rights of rural communities; alternative legislation to combat the increasing privatization of health and education; and a reduction in the exuberant cost of transportation and fuel.  An evident tension exists between the State’s desire to contain the strike by promising regional-level reforms, and the MIA’s intention to achieve deep structural transformations in the nation’s political and economic model. No agreement can be reached this morning. The strike continues compañeros.

Conversing about a dissertation chapter with small farming families while preparing sirindango leaves in Mocoa, Putumayo. August 2013.

Agricultural practices in southwestern Colombia have been a site of contention since the 1980s when illicit coca production soared and provoked military-led state and foreign policy responses (i.e. the U.S.-Colombia “War on Narcoterror”) aimed at its eradication. My dissertation fieldwork between 2005-2011 was set in a region where the “securitization of development” not only attempts to eradicate illicit crops, but to discipline the productive capacities and contested governance of tropical forest ecologies in ways that forcibly equip them to become “modern” and “moral” landscapes of licit capitalist worlds. Though USAID export-oriented strategies to substitute coca prove attractive to many rural families, my research explored the way a growing network of farmers and soil scientists have begun to counter these official “solutions”, arguing they foment extractive practices that subordinate Amazonian ecologies to profits; exacerbate the scarcity of local food and markets; and ultimately, fail to eradicate coca and its deriving violence. Thus, my dissertation fieldwork not only followed the material practices of farmers and scientists, but also tracked how in both their projects, albeit differentially, rather than an entity from which production can be extracted, soils take on new meanings and capacities as what I conceptualize as “partners in/for life”. This provision leads to struggles between farmers, technocrats, politicians, aid workers and scientists over the meaning of “peace”, “productivity”, “rural development”, “sustainability”, and what constitutes a “good and healthy life”.

Participating in a community radio program with Jorge and Edgar socializing locally produced Amazonian-based life projects and alternative agricultural philosophies. Mocoa, Putumayo. August 2013.

Upon returning to Bogotá and Putumayo with the support of the Wenner-Gren Engaged Anthropology grant between June and September 2013, I was able to contribute to national and regional debates about local alternatives to “illicit” coca cultivation, the historical social abandonment of rural frontier zones, and resistance to ago-industrial development during a time when “agrarian issues” have emerged at the core of the national peace process between the Colombian State and FARC guerrillas to end the country’s fifty-year armed conflict.  While in Bogotá, I circulated my dissertation among soil scientists with whom I conducted fieldwork, and forged new collaborative initiatives with other academics working in the Amazon, as well as contributing to a research project at the Center for Historical Memory that was established through the Law of Victims and Land Restitution. In Putumayo, due to the particular conjuncture of the national strike, my dissertation was able to contribute to community training workshops on the Plan for Integral Amazonian Development proposed by and for small farmers in the region, as well as joining the technical team accompanying strike leaders in their negotiations with state officials. I returned dissertation materials to the farming families that are the protagonists of my research, and received their feedback and selection of photographs, stories and designs to be included in a future book manuscript.   Furthermore, the socialization of my dissertation material this summer served to propose and fund a documentary film project that will transmit Amazonian-based farmer-to-farmer agricultural knowledge and practices among an extensive network of small-farming associations in the department of Putumayo. This continued engagement project will draw out the potential collaborations that can emerge between two kinds of local knowledge – science and non-science – in order to highlight the cultural stakes of the rural life-worlds struggling to emerge in a geopolitically contentious agricultural frontier.