“The Maned wolf (Chrysocyon brachyurus) is a canid from the regions of grassland of Chaco in Argentina and Paraguay, in the Llanos de Moxos region in Bolivia, the Pampas del Heath sanctuary in Perú, and the rivers’ basin Paraguay and Paraná, in South America. It is corpulent in comparison to other wild canids, an impression reinforced by the density of its coat and the distinguishable fur around its neck. It can reach 74 lb. The body structure resembles that of a fox, although the long legs give the animal a very peculiar clumsy look.”
The Maned wolf
This zoological description of the Maned wolf is far from the magical perception the population of the Bolivian Amazon has of the animal. Its bones, together with tobacco leaves and Chaco tortoise are used to smoke the children when they suffer “malviento”(evil), a sickness caused by “looking at a horrible thing” and whose symptoms are crying, seizures and lack of appetite. “There are traditional diseases that can only be cured with traditional medicine” tells me Ms. Flabia Mercia in the Nazaret Healthcenter, located in the middle of the jungle, more than 55 miles away from the nearest urban center, Riberalta.
Ms Flabia and her grandson Angelo – Nazaret Heathcenter
Ms. Flabia comes with a child in her arms, her 4-month-old grandson called Angelo, and listening the naive questions that I ask the nurses, she (from her people and culture perspective) explains to me the various sicknesses with patience and with a smile.
“The shock -she says-goes beyond, he wants to steal the souls of children. It usually appears after a fall that must be correctly identified“. The child can not sleep, he gets pale, cries,…these symptoms indicate clearly that “Ayayu” is going away, their soul is fading. The naturist or healer of the community bathes them in urine and basil, smokes them and puts their clothes outside down (outside seams). “If it is a scare -tells me Fabia-the symptoms disappear almost immediately“.
At a time when child malnutrition is “fashionable” in the health aid agenda, in the Amazonia, they have a particular remedy. The “mocheo” causes the child to sweat, to lose weight, to debilitate his skin, and to lose strength. It is caused by some evil trees, the spirit of a deceased or to bump into a snake. “We have to slaughter (quarter) a cow -explains Ms Flabia- we have to slit it open and the child is introduced inside for 5 minutes. Later, we have to dry and cover the child. The next day, we wash and bathe the infant with warm water“.
Although some of these diseases of the inhabitants of the jungle were known, the truth is that biomedical medicine, as a rule, always ignored them, creating an often insurmountable barrier between the population and the health system. But, in the last decade, it seems that these health models (western and traditional) that could appear antagonistic, have reached a truce after decades of combat. Nowadays, it is sought that in each health centre there is a traditional healer or doctor (it must be accredited) to work hand in hand with the ministry’s health personnel. “What I can not cure, you can, and what you can not, I can” explains Carlos Vargas, a nurse that is responsible for the Nazareth Center, expressing aloud the common motto repeated as mantra both Western medicine technicians and wise shamans in traditional medicine. Building a balance between different medicines is no longer a chimaera in Bolivia.
Dalsy and Carlos – Nazaret Health Center
But this symbiosis does not always work. There are indigenous communities, like the “Esse ejjas” or “Chamas” that do not trust in the western healthcare system. They turn their back on it, and they do not believe in its virtues. Others, not so remote, first turn to traditional medicine and, only if this does not work, go to the health unit. They are often ‘late’ in order to save lives, especially those of malnourished children.
With almost 98.6 degrees and all the humidity concentrated in that little waiting room, in Nazaret, I felt that deep emotion that emanates from us, those who believe that being healthy is the main motor of our lives. The deep emotion of the commitment of health workers that, once again, in extreme conditions, ready for whatever. The deep emotion that emerges when you see political commitment (despite all the nuances we can find) of a country that, for the first time in all its history, recognizes the right and the beliefs of all the nationalities that inhabit its land. How many lives will have been saved only with this recognition? How many people will have approached the door of a hospital now that they are no longer second-class citizens? We are facing leaders who for the first time resemble their people, policies and strategies that embrace the multiculturalism that defines this country invented by the colony and its heirs.
“Mapaje”‘s root, Bolivian Amazon
And perhaps deeper, I felt the excitement that generates going against the flow and winning. María Angélica, who has been leading our actions here for more than five years, explains how they have managed to get to know in detail from each health centre the characteristics of each family, the number of pregnant women, how they collect their garbage, how it is their home, what academic training they have, what water system, how many traditional doctors there are, etc … Nazareth health workers have turned the waiting room into the control room of the Enterprise itself; maps, sketches, projections, population pyramids line the walls of this small health oasis. The door has been opened wide to the community, to their beliefs and perceptions. We are facing the power of foamy and polystyrene, pins, silicone, and Scotch.
There are no databases, algorithms, private insurance companies interested in buying patient data.
Here there are no tablets, no smartphones, perhaps because the Evo government expelled the cooperation of the US and its large NGOs accusing them of intrusion, and Bill Gates does not find an ally in the government of Bolivia to sell his gadgets. There are no databases, algorithms, private insurance companies interested in buying patient data. Motivation is learned from the beginning. People that have the desire to give health to those who cannot afford it, respecting what they believe and with an investment that the state can assume.
Poster made with foamy – Health centre of October 12
With these data, they anticipate the problems, ensure that all women pass pre-natal controls, diabetics take their medication, rubbish is managed properly, they coordinate with healers, there is access to water, etc … In the last two years, for example, diarrhoeal diseases and respiratory diseases have been reduced by more than 10% and almost 100% of women give birth in health units.
It is nothing new that grows in the most fertile soil on the planet, but unfortunately, it is something forgotten. It already worked in hundreds of countries, but this way of giving health is not equivalent to business. The insane advance of technology as an end and not as a means has banished this way of doing public health, so close, so ours, so effective and efficient.
medicusmundi‘s team in Riberalta
Seneide, who lives just 10 meters from the health centre, prepared us a coffee and Creole bread. She saved my life: the miles, change of altitude and temperature were leaving my body was exhausted and my mind was becoming useless. She tells me that she is married to“El Malario”, the person in charge of carrying out the malaria tests to the entire community of influence of the health centre. She travels more than 18 miles (ca. 29 km) by motorcycle to reach all the population. She was trained for 18 months, there are people that are trained for a year, “it depends of the intelligence of each person” – tells me Seneide, that she herself years ago was also “La Malaria” in another community. Where do you get the desire to go to the deepest point of the jungle? What pushes them to get up and get on the bike with a bunch of covers and slides for the test?
Seneide – Community of Nazaret
We return to Riberalta at approximately two o’clock, under the sun and a lot of humidity. The jungle produces a hypnotic state similar to the one you embrace when you look for minutes at the sea, the horizon, the snowy plains or the desert dunes. You feel that you have always belonged to this immensity of life, green, vegetation and infinite rivers. Maybe is something that we carry inside, even before our DNA, something that makes us return to the time when we did not even exist, but life did. There is no fear nor rejection, on the contrary, you feel like you are in an eternal embrace, a dream that you never want to wake up from.
In that altered state, I thought of my people, in the desire to see this vast and powerful extension of life. I thought of all those who have not been lucky enough to see this lung and imagined how to face it, they would gradually transform, forgetting the urgent, the ephemeral, and merging with this harmony.
I thought that those who cut down, burn or exploit this paradise, perhaps suffered from “scare” and they left the “Ajayu” to never return and now, they want to condemn us all to a future in which, perhaps our children, do not know what it means to breathe oxygen, do not understand that everything is about one health, what surrounds us, what we are, what we believe, what we love.
Iván Zahínos Ruiz
International Relations Coordinator
*Translated from Spanish to English by Susanna Pujol Clivillé