OSORNO, Chile (AP) — During her first birth, Lucía Hernández Rumián danced in her hospital room while her husband played the Kultrún, a drum used in their culture’s ritual ceremonies.
She refused to take painkillers and instead received massages and scrubs applied by an “intercultural attendant” who had cleaned the space according to Mapuche traditions.
“I’ve appropriated my space,” Hernandez said.
The main high-complexity public hospital in Osorno, a city in southern Chile, is finding new ways to integrate these and other indigenous medical practices. It features a special delivery room with pictures of the original peoples on the walls and bed, and forms for doctors to approve herbal treatments performed by trusted traditional healers (machis). It also has protocols for a “good death” that respect the spiritual beliefs of the indigenous people.
The hospital is working to validate these indigenous practices at a time when the indigenous peoples of Chile – and in particular the most numerous, the Mapuches – are waging an intense campaign to assert their rights and seek restitution ahead of a vote on a new constitution to promote. planned for the month of September.
According to health professionals and patients at Hospital Base San José de Osorno, they are also trying to restore a crucial spiritual component in medical care.
“It has to be a guarantee. We take care of the physical part without overstepping the spiritual part,” explained Cristina Muñoz, the midwife who promoted the new protocols for births in indigenous women, believed to be the first to be implanted in the country.
Cristina Aron, the patient who first inspired Muñoz more than a decade ago, is now the “intercultural companion” of Hernández and the two dozen women she treats from pregnancy to postpartum.
“Birth is an energetic spiritual event for the mother, the baby and the community,” Aron said.
She hoped to give birth to her daughter in the countryside with a traditional midwife. However, due to high maternal mortality rates in the past, Chilean law requires births to be attended by professionals.
Therefore, Aron went to the Osorno Hospital and negotiated with Muñoz the terms of the confinement, including the presence of an attendant immersed in Mapuche practices. Later, the placenta was taken to plant in ancestral lands.
The Mapuche believe that the placenta preserves a twin spirit of the baby. That their funeral—usually accompanied by a tree planted in the same spot to grow with them—creates a lifelong connection between the little ones and the natural elements of the family territory.
“It’s something very poetic and very revolutionary,” said Alen Colipán, mother of a child whose placenta was planted next to a river near her paternal grandmother’s home. “He will not feel the uprooting of his country.”
Colipan was 17 years old when she gave birth in the Osorno intercultural delivery room. Three walls are covered with a photo of this rocky beach, home to Taito Huentellao, a guardian spirit worshiped by the region’s Huilliche Mapuches.
He said his midwife, Irma Rohe, is 85 and has never been hospitalized, but that she received the little boy “without gloves or other things imposed” and was allowed to cleanse him according to indigenous rituals.
“We want to give birth again to people with ancestral knowledge,” said Colipan. “Even our way of being born was dominated. We have to start breaking free.”
Chilean law now requires hospitals to deliver the placenta to the mother if she so chooses. For a decade it has enabled intercultural care in places with a significant indigenous population. According to Angélica Levican, who has been in charge of the hospital’s relations with the indigenous people since 2016, the Mapuche make up a third of the inhabitants of Osorno and 80% in the neighboring province of San Juan de la Costa.
“The health of the original people was always there. Then another system came along to invalidate ours,” Levican said. “Our intention is that they complement each other.”
The coexistence of both drugs is not easy. Many tribal peoples believe that public hospitals are another state institution that discriminates against them because of their beliefs.
Mapuche medicine is based on spirituality and is very different from what doctors are taught, said José Quindel Lincoleo, director of a study center for Mapuche medical care (Ta Iñ Xemotuam Center for Health Studies) in Temuco, another city to the south a large indigenous population.
Mapuche healers seek to connect with patients’ minds to learn “the origin of the biological, social, psychological and spiritual problem” that manifests as an illness, Quidel said.
“It could be from a past life or damage they did to you. Or a self-doubt that makes us transcend our worldview,” he added.
Traditional doctors and healers say they can complement each other, admitting each expert only knows part of what’s possible, especially when treating emerging diseases like COVID-19.
“It is understood that salvation of the body must be consistent with beliefs,” said Dr. Cristóbal Oyarzún, Rheumatologist and Head of the Medical Responsibility Center at Osorno Hospital. “The patient with inner peace has a better chance of recovery.”
That’s difficult to achieve in the aseptic, isolated environment of a hospital, especially during the pandemic. Mapuche healers continued to pray and “spiritually accompany” patients from afar,” said Cristóbal Tremigual Lemuy, a machi (healer) from San Juan de la Costa who has long worked with Osorno Hospital.
“For us, this is essential…to get the energy a patient needs,” the healer said.
Family members have access to a circular outdoor area surrounded by laurel and cinnamon trees where they can pray and perform ceremonies for the dying, Levicán said.
The hospital accepts walk-in patients who identify as Indigenous – about 50 a day – who are greeted and escorted by Erica Inalef, an intercultural liaison at the hospital, “so they don’t feel so lonely,” he said.
When he was a teenager, when he took his elderly father to a hospital, the doctors hardly spoke to him and “body and mind became separated,” he said.
Doctors now see patients’ enthusiasm when traditional healers come, and that helps build trust, Inalef said.
This trust may prompt an orthopedic surgeon to recommend a lawenko—an herbal water whose exact composition healers don’t reveal—or an obstetrician to allow a woman about to give birth to wear a munulongko, a headscarf adopted will that it protects that.
The “clothing of culture” is one of the aspects of the birth plan that Muñoz prepared five years ago. Muñoz hopes patients will be better informed about this option. Only about twenty of the 1,500 births the hospital attends each year are intercultural.
“Indigenous women are twice as shy, discriminated against because they are women, indigenous, poor and rural,” Muñoz said. “We tell them: Your body is the first territory to be reclaimed.”
The revival of ancestral traditions prompted Ángela Quitana Aucapan to give birth to her baby in a special hospital room while her relatives played traditional instruments.
“I could do it like my ancestors did,” he said. “Waiting for the new family member with a ceremony and feeling accompanied to conceive my baby.”
Associated Press religious coverage is supported by The Conversation US and funded by the Lilly Endowment Inc. AP is solely responsible for the content.