Cosmologies in the Clinic: Tradition, Recuperation, and Medical Practice in Bolivia

• In Event: Healthcare and the Paradoxes of Participation

Abstract

Cultural competency has become an important requirement for medical doctors in numerous countries. As scholars have argued, this training often simplifies “culture” and assumes that it lies with the patient rather than the practitioner. Expanding on this nascent literature, this paper examines how cultural competency training in Bolivia operates as a tool of political change, in the context of state-led efforts to recuperate indigenous knowledges. Since the election of President Evo Morales in 2005, the state has embraced an ideological project of “decolonization” that proposes to reinstate indigenous cosmologies as viable alternatives to Western institutions. In keeping with this logic of recuperation, healthcare reforms now require state-employed, medical doctors and students to conduct research on “traditions and beliefs” in the rural communities where they work. According to Bolivian Ministry of Health officials, these efforts do more than raise awareness; they are a key means of reversing the exclusions of the healthcare system. As they argue, Bolivia’s majority indigenous population is often subject to racist treatment and unable to access adequate healthcare services. This paper examines how medical doctors and students rework state recuperation efforts in their clinical practices. It considers how shifting concepts of “the indigenous” map onto their interactions with patients, their approach to the body, and their understandings of biological and cultural difference.

Author

• Gabriela Elisa Morales, Yale University