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Comparative Studies of Health Systems and Medical Care
From the Fat of Our Souls: Social Change, Political Process, and Medical Pluralism in Bolivia (Comparative Studies of Health Systems and Medical Care)
From the Fat of Our Souls offers a revealing new perspective on medicine, and the reasons for choosing or combining indigenous and cosmopolitan medical systems, in the Andean highlands. Closely observing the dialogue that surrounds medicine and medical care among Indians and Mestizos, Catholics and Protestants, peasants and professionals in the rural town of Kachitu, Libbet Crandon-Malamud finds that medical choice is based not on medical efficacy but on political concerns. Through the primary resource of medicine, people have access to secondary resources, the principal one being social mobility. This investigation of medical pluralism is also a history of class formation and the fluidity of both medical theory and social identity in highland Bolivia, and it is told through the often heartrending, often hilarious stories of the people who live there.
- GenresAnthropology
288 pages, Paperback
First published March 10, 1991
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February 4, 2020
Tail wags dog……….but so what?
Three kinds of people could be found in Kachitu, the pseudonym for a small town on the altiplano of Bolivia, near Lake Titicaca, at the altitude of 13,000 feet, back in the 1970s. There were Aymara Indians, who had lived in the area for millennia. They had become Catholics centuries ago, but still adhered to a lot of their folk beliefs, especially when it came to medicine. There were Aymara Methodists who had been converted to this Protestant denomination only in the 20th century. They used home remedies, but their thoughts about sickness and healing tended to be more cosmo-politan, less Aymara. The Methodists had come to dominate business and any modern sector activities in town. These two groups spoke Spanish, if at all, as a second language. And third, there were Spanish-speaking mestizos, people whose families at some time in the past had mixed with whites or had at least totally abandoned Aymara culture. The mestizos had dominated the town and the outlying haciendas up to 1952. They enjoyed a higher standard of living than the others thanks to their ownership of land, power connections to the white elite living in La Paz, the big city, and to the web of godfathers and godchildren which worked always in their favor. After the revolution of 1952, when elite power was overthrown and when the mestizos lost most of their land in the land reform, which favored the indigenous population, many mestizos left for La Paz while the others suffered a decline in wealth, power, and prestige. So, there were big differences in religion, status, and wealth in Kachitu, along with beliefs in different kinds of medicine and medicinal practice. The ethnic groups tended to turn into a different system of social class.
FROM THE FAT OF OUR SOULS is a wonderful anthropological study written by a scholar who would have contributed much more to the field if she hadn’t died in her early 40s back in 1995. It must be considered one of the pioneering or “classic” studies of medical anthropology, a book which cannot be avoided if you are interested in the area. The author is concerned with medical pluralism which means that in the same place there are varying ideas about what causes illness or disease and equally varied ideas about how to deal with them. These ideas are connected to ethnicity, cultural identity, or social class. She gives well-written, even entertaining examples from the Bolivian society she lived in for two years. You may say that her concerns are 1) the cultural construction of illness and 2) the flexibility of ethnic/class identity as seen in the different approaches to medicine by the three groups in Kachitu . Medicine connects to social mobility and class formation. If you wanted to change your status in society, you had to change your medical behavior and beliefs as well. But some people still adhered to beliefs that belonged to lower or higher groups. So, people made different decisions at different times according to the socio-cultural statements they wanted to make to others.
But I was bewildered to find that Crandon-Malamud argued in such a way that I felt the tail was wagging the dog. She said (p.138) “As new identities are negotiated and forged, social life in town is transformed. Within medical pluralism, medical dialogue, and resources are a means to create social change.” After reading her excellent study and wrestling with her argument, I feel that no, it’s the other way around. The political, social, economic, cultural, and legal changes in Bolivia from 1952 to 1980 altered society in the town which led to wide variances in medical practice. These variances are CAUSED by the changes, they did not PRODUCE the changes! Anyway, I can still say “So what?” It’s a brilliant piece of work which clearly depicts and analyzes a society that contains medical pluralism. Her examples are really convincing. It’s only her conclusion that puzzled me.
Three kinds of people could be found in Kachitu, the pseudonym for a small town on the altiplano of Bolivia, near Lake Titicaca, at the altitude of 13,000 feet, back in the 1970s. There were Aymara Indians, who had lived in the area for millennia. They had become Catholics centuries ago, but still adhered to a lot of their folk beliefs, especially when it came to medicine. There were Aymara Methodists who had been converted to this Protestant denomination only in the 20th century. They used home remedies, but their thoughts about sickness and healing tended to be more cosmo-politan, less Aymara. The Methodists had come to dominate business and any modern sector activities in town. These two groups spoke Spanish, if at all, as a second language. And third, there were Spanish-speaking mestizos, people whose families at some time in the past had mixed with whites or had at least totally abandoned Aymara culture. The mestizos had dominated the town and the outlying haciendas up to 1952. They enjoyed a higher standard of living than the others thanks to their ownership of land, power connections to the white elite living in La Paz, the big city, and to the web of godfathers and godchildren which worked always in their favor. After the revolution of 1952, when elite power was overthrown and when the mestizos lost most of their land in the land reform, which favored the indigenous population, many mestizos left for La Paz while the others suffered a decline in wealth, power, and prestige. So, there were big differences in religion, status, and wealth in Kachitu, along with beliefs in different kinds of medicine and medicinal practice. The ethnic groups tended to turn into a different system of social class.
FROM THE FAT OF OUR SOULS is a wonderful anthropological study written by a scholar who would have contributed much more to the field if she hadn’t died in her early 40s back in 1995. It must be considered one of the pioneering or “classic” studies of medical anthropology, a book which cannot be avoided if you are interested in the area. The author is concerned with medical pluralism which means that in the same place there are varying ideas about what causes illness or disease and equally varied ideas about how to deal with them. These ideas are connected to ethnicity, cultural identity, or social class. She gives well-written, even entertaining examples from the Bolivian society she lived in for two years. You may say that her concerns are 1) the cultural construction of illness and 2) the flexibility of ethnic/class identity as seen in the different approaches to medicine by the three groups in Kachitu . Medicine connects to social mobility and class formation. If you wanted to change your status in society, you had to change your medical behavior and beliefs as well. But some people still adhered to beliefs that belonged to lower or higher groups. So, people made different decisions at different times according to the socio-cultural statements they wanted to make to others.
But I was bewildered to find that Crandon-Malamud argued in such a way that I felt the tail was wagging the dog. She said (p.138) “As new identities are negotiated and forged, social life in town is transformed. Within medical pluralism, medical dialogue, and resources are a means to create social change.” After reading her excellent study and wrestling with her argument, I feel that no, it’s the other way around. The political, social, economic, cultural, and legal changes in Bolivia from 1952 to 1980 altered society in the town which led to wide variances in medical practice. These variances are CAUSED by the changes, they did not PRODUCE the changes! Anyway, I can still say “So what?” It’s a brilliant piece of work which clearly depicts and analyzes a society that contains medical pluralism. Her examples are really convincing. It’s only her conclusion that puzzled me.
Displaying 1 of 1 review