Newsletter from the Sierra Madre #74

September, 2014

Struggle for Health and Rights in South America's Southern Cone

Health professionals who side with the disadvantaged


Introduction

In April of 2014, I, David Werner, was asked to visit Chile and Argentina, the two countries that flank the imposing Cordillera de los Andes in South America’s southern cone. The corresponding groups that invited me – of occupational therapists and of community doctors –represent the more radical, social-change-seeking arm of their respective professions, much in the way that the “Theology of Liberation” is the socially progressive arm of the Catholic Church. In sum, within their professions they are the mavericks who stand up for the rights of marginalized people.

View of Temuco in southern Chile, as seen from a mountain park at the edge of the city, where the natural forest has been preserved.

View of Temuco in southern Chile, as seen from a mountain park at the edge of the city, where the natural forest has been preserved.

In Chile, I was invited by the School of Occupational Therapy at the “Universidad Mayor” in the southern city of Temuco. The staff of the School believes that occupational therapists should function as “agents of social change.” In addition to helping persons in situations of disability cope with the sometimes brutal realities of the existing social order, with its inequalities and barriers to inclusion, they strive to make society more egalitarian, compassionate, and welcoming of diversity. This focus on human rights and social justice as the overarching goal of OT has been emerging and expanding worldwide, though in some countries more than others.

In South Africa, a radical OT named Frank Kronenberg, in 2001, edited a groundbreaking book titled “Occupational Therapy without Borders” (to which I wrote the preface). I was pleased to learn that the school of OT in the Universidad Mayor uses this book, along with my handbooks, “Disabled Village Children” and “Nothing About Us Without Us,” as basic texts. ** Staff and students there welcomed me as an old friend, and as an ally in the effort to build a healthier more inclusive society.

My invitation to Temuco was spearheaded by Eduardo Herrera Osorio, co-director of the School of Occupational Therapy at 'Universidad Mayor.' Here, on one of our field trips to visit Community Based Rehabilitation activities among the Mapuche tribal people, a traditional thatched hut, or ruca.

My invitation to Temuco was spearheaded by Eduardo Herrera Osorio, co-director of the School of Occupational Therapy at 'Universidad Mayor.' Here, on one of our field trips to visit Community Based Rehabilitation activities among the Mapuche tribal people, a traditional thatched hut, or ruca.

In Argentina, I was invited to the “3rd Congress of the Federation of General Medicine,” held the big tourist city of Mar de Plata, 400 km south of Buenos Aires. ** In Argentina medicina general is a specialty that corresponds in some ways to “family practice” in the US. However the médicos generalistas within the Federation of General Medicine have a strong, action-oriented commitment to human rights and holistic development, with a focus on the underlying social and environmental determinants of health. They are strong advocates of the far-reaching structural changes needed to build a community where people live in harmony with one another and with the natural ecology. They aspire to Health for All through comprehensive Primary Health Care as advocated in the Declaration of Alma Ata. The médicos generalistas espouse the frontline role of local promotores de salud (community health workers), and to this end they make good use of my books “Where There Is No Doctor” and “Helping Health Workers Learn.” At the Congress both the generalistas and promotores welcomed me as old friend and comrade in the struggle for a healthier, more humane social order. As with the OTs in Chile, I felt very much at home.

At the 3rd Provincial Congress of General Medicine the three guest speakers were David Werner (left), Maria Zuniga (2nd from left), and Julio Monsalvo, who were given homage as pioneers in Primary Health Care, in Mexico, Central America, and Argentina, respectively. The moderator of this final session of the Congress was Carmen Baez, an international health editor whom I first met in Mozambique 20 years ago.

At the 3rd Provincial Congress of General Medicine the three guest speakers were David Werner (left), Maria Zuniga (2nd from left), and Julio Monsalvo, who were given homage as pioneers in Primary Health Care, in Mexico, Central America, and Argentina, respectively. The moderator of this final session of the Congress was Carmen Baez, an international health editor whom I first met in Mozambique 20 years ago.

Mar de Plata, where the Congress was held -- a huge beachside city, with over 800 hotels -- is devoted almost exclusively to tourism. Thank heavens that we were there in the off-season!

Mar de Plata, where the Congress was held -- a huge beachside city, with over 800 hotels -- is devoted almost exclusively to tourism. Thank heavens that we were there in the off-season!

Challenges to Health in the Southern Cone

Access to Services

On the positive side, both Chile and Argentina are currently at a level of economic prosperity that makes it feasible to provide access to general education and basic medical care to virtually everyone. Public hospitals and clinics provide care to the indigent that is essentially free of cost. In Argentina, free public health services are made available even to visiting foreigners, and reportedly there is a constant flow of sick people from poorer countries north of the border into Argentina for medical attention. (The countries in southern South America have an alliance similar to the European Union, which allows unobstructed travel from one country to the other.) While this increased level of access to services is commendable, serious problems associated with inequality, poverty, poor diet and ecological degradation remain.

Inequality as a product of free market “development”

Chile and Argentina are often lauded as success stories of free market policies. National health levels in these countries are much higher than in most Latin American and Caribbean countries. And, with the notable exception of Cuba, the levels of education and health tend to be higher. The free-market economic system of both countries is largely modeled after the United States—complete with its ever-expanding corporatocracy. Likewise, wealth and power are increasingly stratified. The rich get richer and the poor get poorer. Also, as in the US, the broad middle class is becoming more compromised as excessive personal debt becomes a lifelong trap, and the purchasing power of wages shrinks to the extent that in the average household, both husband and wife have to work to make ends meet. The growing polarization of wealth and opportunity in turn deepens social unrest and dysfunction.

Argentina, like Chile is a land with huge economic disparity

Argentina, like Chile is a land with huge economic disparity

Poverty

Argentina has a disturbingly high rate of unemployment and underemployment. According to Bloomberg, unemployment fell from 17.8% to 15.6% in May of this year! For the estimated 40 percent in the informal economy, wages are too low and uncertain to cover basic necessities. Of those living in absolute poverty, children help support their families by begging, stealing, picking through garbage, or peddling drugs.

According to independent studies around 30% of the people in Argentina live in poverty, and 9% in extreme poverty. The figures provided by the government are considerably lower, to support its claims at reducing poverty – claims that some economists and sociologists say are false. Yet rather than trying to eliminate poverty—which would require more equal redistribution of wealth and power—the government tries to mollify the worst effects.

Children begging

Children begging

Child labor

Child labor

Street children

Street children

In Argentina’s stratified society: Supermarkets for the haves, garbage pails for the have-nots

In Argentina’s stratified society: Supermarkets for the haves, garbage pails for the have-nots

Diseases of a consumer society

Hungry children at government sponsored food kitchen

Hungry children at government sponsored food kitchen

The pattern of health in Chile and Argentina now more closely resemble that of the “overdeveloped” countries. Ill health and death from the infectious “diseases of poverty” have largely been replaced by “diseases of a consumer society” (which doesn’t necessarily mean the “diseases of affluence”). Even in the sprawling slums of Buenos Aires and Rosario, the numbers of severely undernourished children, while substantial, are fewer than might be expected given the multitudes living in poverty (estimated at 30% of the population).

Today in both Argentina and Chile, one finds extensive, though inadequate, programs that provide food supplements and support services. Nevertheless, many of the biggest health problems—for both children and adults—are associated with poor diet, often coupled with obesity. A growing pandemic of diabetes, heart disease, stroke, and cancer have become the region’s major killers.

Paradoxically, at least in the metropolitan areas (Argentina is now 82% urban!), obesity is distressingly widespread among the poor. Low income families customarily consume a lot of high-sugar, high-fat junk foods because they are cheaper, faster, and more aggressively advertised. Coca-Cola, McDonalds, KFC, and other corporate junk food outlets are everywhere.

Huge slums like this one comprise the “septic fringe” of Buenos Aires, Rosales, and other major cities in Argentina

Huge slums like this one comprise the “septic fringe” of Buenos Aires, Rosales, and other major cities in Argentina

The wealth of the few rests upon the poverty of the many.  Being poor is not a crime

The wealth of the few rests upon the poverty of the many. Being poor is not a crime

The growing groundswell of unrest resulting from the great divide between rich and poor is widely expressed in graffiti

The growing groundswell of unrest resulting from the great divide between rich and poor is widely expressed in graffiti

If there is no bread for the poor, there is no peace for the rich

If there is no bread for the poor, there is no peace for the rich

Ecological demise in the southern cone

In lockstep with the growth-at-all-costs development paradigm of Milton Friedman and the “Chicago Boys,” both Chile (from the days of Pinochet) and Argentina have sacrificed long-term environmental sustainability for short-term mega-profits of the ruling class. To this end, not only have health and wealth become drastically stratified, but the natural balance of whole ecosystems has been ravaged by giant extractive industries—many of them foreign owned. Excessive mining, deforestation, and giant agribusiness not only are causing environmental havoc at a local level, but contribute irresponsibly to global warming. The gigantic glaciers of the Andes—which supply much of the water for the coastal lowlands—are shrinking at an alarming rate. In Chile, to provide pulp for its burgeoning paper industry (paper is a major export), the vast natural forests have largely been replaced by huge monoculture plantations of eucalyptus and pine. These boundless commercial plantations, owned by a handful of wealthy plutocrats, acidify the soil, deplete the ground cover, and cause rapid runoff that produces excessive flooding followed by droughts. Yet Big Agro and Big Timber have such powerful political lobbies that, instead of being regulated, are heavily subsidized by government. The result is vast, short-term prosperity for the ruling class and long-term devastation for the disempowered majority. Chile’s elite have learned well from the North American model.

A monoculture eucalyptus plantation. Millions of acres of native forest in Chile have been replaced by eucalyptus and pine plantations, which contribute to environmental demise and water shortage

A monoculture eucalyptus plantation. Millions of acres of native forest in Chile have been replaced by eucalyptus and pine plantations, which contribute to environmental demise and water shortage

And so has Argentina. To all appearances, the country has prospered mightily from its aggressively extractive market economy. As in Chile, much of Argentina’s prosperity and growth has come from giant agribusiness, where cattle and soybeans play a very prominent role as primary exports. Soy beans, to which nutritionists and agronomists used to sing high praises, when produced on a massive scale are found to have a darker, even perilous side. The huge amount of energy consumed in the cattle industry, with its vast emission of greenhouse gasses, is a significant contributor to global warming, and its stockyards add to pollution. The mega-production of soybeans, which supply everything from stock feed to bio-fuel on the global market leaves a pernicious ecological footprint. In the vast areas where this mono-crop is planted, the integrity of the soil is fast losing ground. Because planting soybeans does not require significant plowing, but simply the opening of a small cleft to drop in the seed, the soil where the crop is grown is becoming very hard and compacted. It no longer serves as a sponge for rainwater. Instead, the surface water runs off, which causes flooding and fails to replenish the underground water table. Combined with the high use of fossil fuels, this major mechanized production is contributing to ecological demise, global warming, and pending water shortage. But in keeping with the global economy, the bottom line is short-term economic growth for those who already have far more than their share.

Narcotics use and trade

This boy injects _cocodrilo_ known as “the drug of the poor.” A byproduct from the production of heroine, it is much cheaper but more dangerous to health -- and extremely addictive

This boy injects _cocodrilo_ known as “the drug of the poor.” A byproduct from the production of heroine, it is much cheaper but more dangerous to health -- and extremely addictive

In Argentina, as in a number of Central and South American countries, the implementation of Free Trade Agreements (such a NAFTA in Mexico) have made it difficult for small farmers to compete with the price of subsidized US corn (maize) and other agricultural produce. This led to a massive exodus from the countryside to the cities, where a great many urban young people are unable to find employment. And for those who find jobs, basic wages are hard to survive on. With little hope for a better future, many despair and turn to drug use or trafficking, or both. As in the United States, most of the drugs used locally are imported: primarily cocaine from Columbia.

Today one of the main hotspots for drug use and trafficking, with all the associated problems of crime and corruption, is the city of Rosario, 400 km north-west of Buenos Aires. Rival drug gangs compete with each other, often with the complicity of the local authorities and police. Adolescent boys, called soldaditos (little soldiers), are recruited as vendors.

*Soldaditos* (juvenile drug vendors) outside a *bunker* in Rosario.

*Soldaditos* (juvenile drug vendors) outside a *bunker* in Rosario.

In the slums and alleyways throughout the marginal barrios, one finds tiny brick huts, called bunkers, that serve as miniature “drug stores.” A soldadito – to peddle the drugs without being robbed – crawls into the bunker through a tiny door, which is then locked on the outside with several padlocks. The only air in the tiny brick cubicle comes in through a single hole the size of one brick, through which money and drugs are exchanged.

The hole in the brick wall of a *bunker,* through which a *soldadito* sell drugs

The hole in the brick wall of a *bunker,* through which a *soldadito* sell drugs

Police make periodic arrest of the *soldaditos*

Police make periodic arrest of the *soldaditos*

At the end of 8 or 10 hours, the dealer unlocks the door and the boy turns over the money he has collected and the remaining drugs. Then he is replaced by another soldadito.

There are said to be thousands of these bunkers in Rosario. Typically, the authorities make little effort to close them down, but do make periodic raids. One of the incentives for the juvenile soldaditos is that they are allowed (by the mafia) to carry a gun.

Sex change, HIV, and “elephantiasis”

In Argentina, in spite of having a largely Catholic population, at least nominally, the culture seems to be relatively open in terms of sexual diversity. Marriage of gay couples has recently been legalized, and same-sex couples were awarded the same rights as male-female couples. There is also a strong popular movement in terms of women’s reproductive rights, including the choice of abortion.

Argentina prides itself in its health plan covers a wide range of personal needs and makes condoms, as well as treatment for AIDS, universally available. I was told that in the country currently over 3000 transgendered people have undergone sex change. Argentina is unique in that surgery for sex change is freely available for those who want it. A careful psychological evaluation is required prior to surgery.

As with many of the young people who turn to taking and selling drugs, for the cross-gender population, the lack of economic opportunity has led to problems. A significant percentage of those who have undergone sex change end up as sex workers. I was told by a couple of médicos generalistas who took part in the Congress in Mar de Plata, and who work with people who are HIV positive, that in Argentina approximately 35% of sex workers are HIV positive.

Another problem that various male-to-female sex-changed individuals are experiencing derives from their efforts to change their body shape. In hopes of appearing more feminine, they inject aviation oil their breast area and hips—as a low-cost alternative to silicone implants and cosmetic surgery. Apparently, licensed doctors are not involved in this procedure. The cross-gendered individuals often do it to each other.

The downside of this invasive procedure is that, with time, the aviation oil tends to seep downward and slowly accumulate in the lower legs and ankles, which can become so swollen that they have the appearance of elephantiasis. For this condition, virtually no treatment exists.

Community Based Rehabilitation (CBR) in Chile

Overview

I met with mothers at the *Centro Comunitario de Rehabilitación* in Saavedra, which they had started with the help of the OT school in Temuco.

I met with mothers at the *Centro Comunitario de Rehabilitación* in Saavedra, which they had started with the help of the OT school in Temuco.

While in the south of Chile I had a chance, through the faculty of Occupational Therapy at Temuco Universidad Mayor, to visit a number of initiatives that address disabled peoples’ needs in the surrounding rural area, including some of the Mapuche families and collectives.

Chile is one of the few countries in Latin America where the central government has launched a national program of Community Based Rehabilitation (CBR). In implementing the CBR model, it has largely followed the guidelines of the WHO/ILO, which in practice tends to be incorrigibly hierarchical in its administration procedures, despite its rhetoric regarding the need for strong participation and leadership at the community and family levels.

One of the coordinators of the national program is Eladio Recabarren, a former student of mine at the University of Boston’s School of International Public Health. Eladio used to be a leader of EPES (Educación Popular en Salud) in Santiago. He has a strong commitment to the empowerment of the underdog, and has been trying to place the national program more in the hands of the people, especially disabled persons themselves. However, Eladio is engaged in an uphill battle. Working toward similar participatory goals, the Occupational Therapy Department at the Universidad Mayor in Temuco has been forging new ground in terms of promoting a more bottom-up, participatory approach, especially in more isolated and rural communities. It was with this objective of more empowering, participatory approach to Community Based Rehabilitation, especially among the indigenous population in the rural area, that the OT Department had invited me to Temuco.

Examples of CBR activities among the Mapuche

In rural areas there tends to be very little by way of rehabilitation services for disabled people. In some cases, with the assistance of OT staff and students from the Universidad Mayor, groups of mothers of disabled children have mobilized the creation of small centers to provide the needed services. An example is a group of mothers in the town of Saavedra, who organized to launch their own modest Centro Comunitario de Rehabilitación, and pressured the regional office of the Servicio Nacional de Discapacidad to help build and support it. This cooperative family-run program is led by Norma, a poor single mother of three disabled children, each with a different type of disability. Norma’s energy and dedication are contagious. She has motivated the group to courageously promote the acceptance and inclusion of their disabled children in the community and in local schools. They have also organized a variety of fundraising activities.

On a field trip to Araucario Norte, we visited the Union of Children and Parents for Normal Integration, run collectively by local health workers, community organizers, disabled persons, and parents of disabled children. Next to a playground outside their small community center, on a stucco wall, they had created a colorful mural portraying disabled and non-disabled children playing together. At the Union I was welcomed with open arms. Everyone was familiar with my book, Disabled Village Children. I was delighted to see they had copied drawings from it to share information about disability.

The inspiration behind the *Centro* came from a woman named Norma, who had 3 disabled children

The inspiration behind the *Centro* came from a woman named Norma, who had 3 disabled children

One of Norma’s children, Macarena (on the left) was born deaf and with physical deformities. Doctors said she would never walk or speak. But now the girl does both, and attends a normal school. She and her mother came to the seminar on Community Based Rehabilitation in Temuco, at which I was a keynote speaker.

One of Norma’s children, Macarena (on the left) was born deaf and with physical deformities. Doctors said she would never walk or speak. But now the girl does both, and attends a normal school. She and her mother came to the seminar on Community Based Rehabilitation in Temuco, at which I was a keynote speaker.

Banner for the *Unión de Niños y Padres para la Integración Normal*

Banner for the *Unión de Niños y Padres para la Integración Normal*

At their meetings families used and discussed pictures from *Disabled Village Children.*

At their meetings families used and discussed pictures from *Disabled Village Children.*

Eliana Mellado and Eduardo Herrera, director and co-directors of the School of Occupational Therapy, pose with me in front of the mural painted by members of the Union of Children and Parents for Normal Integration.

Eliana Mellado and Eduardo Herrera, director and co-directors of the School of Occupational Therapy, pose with me in front of the mural painted by members of the Union of Children and Parents for Normal Integration.

On my visits to different community-based projects, I kept coming across cases where illustrations or information from my books were used by families to meet their children’s needs. For example, one family we visited lived in a house on a steep hill 50 feet below the traveled road. Two sisters who lived there had ataxic cerebral palsy. The family, with the help of OT students, had built a long series of rustic parallel bars, made from the trunks of young trees. These bars permitted the girls to climb up to the road independently. With pride, they demonstrated how they could do so. (As it turned out, the bars were a big help to me as well.) Another set of bars led from the back of the house to the latrine.

Two girls with ataxic cerebral palsy use rustic parallel bars to climb the steep slope to climb from their home to the road. The father found the idea in *Disabled Village Children.*

Two girls with ataxic cerebral palsy use rustic parallel bars to climb the steep slope to climb from their home to the road. The father found the idea in *Disabled Village Children.*

Another single bar lets the girls reach the outhouse

Another single bar lets the girls reach the outhouse

On our forays to the countryside surrounding Temuco, in an area called Nuevo Imperial, we had the opportunity to visit the Boreo Filulawén Centro de Salud Intercultural. This remarkable Intercultural Health Center—run by a local Committee of Mapuche community leaders and shamans from the local community—aspires to combine traditional medicine with Western medicine. Reflecting this goal, the center juxtaposes traditional buildings with modern ones. The community meeting hall, where people gather to discuss health-related problems, is in essence an oversized, traditional, oval, thatched-roofed ruka. (See picture below.) The traditional healing hut is oval like a ruka, but made with modern materials and painted bright blue. It is staffed by a machi (traditional Mapuche healer/shaman). The allopathic medical clinic, next to the traditional healing hut, is square, architecturally more Western, and is staffed by a licensed doctor and nurse.

The *Boreo Filulawén Centro de Salud Intercultural,* (Intercultural Health Center) serves a mixed ethnic community

The *Boreo Filulawén Centro de Salud Intercultural,* (Intercultural Health Center) serves a mixed ethnic community

The Intercultural Health Center combines traditional and modern, both in its building-style and in its health care

The Intercultural Health Center combines traditional and modern, both in its building-style and in its health care

Student occupational therapist pose with the chief shaman (white pants) in front to the *ruca,* (traditional Mapuche house), which at the *Centro* is used as a meeting hall and classroom

Student occupational therapist pose with the chief shaman (white pants) in front to the *ruca,* (traditional Mapuche house), which at the *Centro* is used as a meeting hall and classroom

But for all the proximity and good will, when it comes to healing, to all appearances the two treatment centers – traditional and modern – remain leagues apart. People can choose which kind of medicine they want. But there seems to be little communication between the two breeds of practitioners. Likewise few guidelines exist to help people decide when a traditional or Western medical treatment might be more appropriate.

While Intercultural Health Center recognizes and provides both systems of healing, functional integration has not yet been fully realized. This integrative challenge is discussed, and some guidelines for choosing between modern and traditional treatment depending on the ailment, are provided in my book Aprendiendo a Promover la Salud (Helping Health Workers Learn). At the Center we had probing discussions about such concerns with the machi (traditional healer) and other Mapuche staff, but the licensed doctor was unavailable during our visit.

Mapuches in Chile Stand Up for Their Rights

First impressions

In recent years the Mapuches have been rediscovering their traditions and reasserting their rights

In recent years the Mapuches have been rediscovering their traditions and reasserting their rights

Since the beginning of colonialism, indigenous peoples the world over have been exploited and denigrated, if not exterminated, by colonizers who took possession of their lands. This is true for native peoples throughout the Americas. In the southern cone of South America, one of the largest tribes of “original people” is the Mapuche, who still subsist in substantial numbers in the southern part of Chile and Argentina.

Like indigenous peoples in many parts of the world in recent years, at least some of the surviving Mapuches in southern Chile are reaffirming their traditional values and standing up for their rights, that is, the rights of Pachamama (Mother Nature).

In Chile, laws have been passed to return some of the most sacred tribal lands to the Mapuches. However, wealthy wigka (non-indigenous) landlords and corrupt officials have largely blocked effective land redistribution. In response, groups of Mapuches are demanding the return of their traditional lands. In a number of towns and villages near Temuco, protests, road blocks, and confrontations with the police and landlords have taken place. Some Mapuche activists have been arrested, and several killed. But they have succeeded in regaining some of their tribal lands.

Mapuche children at an assembly concerning indigenous rights

Mapuche children at an assembly concerning indigenous rights

Mapuches are now demanding their original land rights

Mapuches are now demanding their original land rights

I was told by the occupational therapists who invited me to Chile that groups of Mapuches that they work with have been using my books, both on Primary Health Care and Community Based Rehabilitation, as a part of their effort to gain greater control over the determinants of their health. For this reason, community health activists and collectives of families with disabled children were eager to have me visit, to exchange ideas and experiences. In turn, I accepted this invitation as an opportunity to meet with and learn from these tribal people about their initiatives to improve the situation of disabled and vulnerable people, and to stand up both for their own rights and the rights of the Earth (which they consider deeply interconnected). This opportunity to visit tribal villages and learn from the Mapuche about their struggle for health and rehabilitation convinced me to travel to Temuco.

My visit to southern Chile was indeed fascinating, and it was a great pleasure. I was warmly welcomed by everyone, on all sides of the ethnic landscape. We had a wealth of illuminating exchanges.

But the reality of the “tribal villages” I’d hoped to visit was quite different from what I had imagined. The vast majority of Mapuches no longer live in ethnically cohesive villages. Some are in isolated farmsteads, often as peasant laborers. But most are in typical Chilean villages and towns, mixed largely into the general population. In rural areas some older women still wear traditional dress, and there are elders who still speak in their native language. But most of the younger generation converse in Spanish and wear Western clothing. On Mapuche farms one still sees an occasional ruca, or traditional oval thatched hut. But rucas are now used primarily for storage or as quaint little restaurants or craft stores for tourists. Most of the original people now live in mud brick or cement block houses like other low-income families.

The impact of “development” on the environment and life of the Mapuche

Conguillio National Park, near Temuco, lies in the middle of the ancestral territory claimed by the Mapuche. The Llaima Volcano, periodically still active is regarded as sacred

Conguillio National Park, near Temuco, lies in the middle of the ancestral territory claimed by the Mapuche. The Llaima Volcano, periodically still active is regarded as sacred

The Mapuches remain the largest tribal population in southern Chile and Argentina. While in southern Chile, I had a chance to visit the ancestral heartland of the Mapuche, now conserved in the Conguillio National Park. This is certainly one of the most beautiful mountainous wilderness areas in the Americas.

It’s easy to understand why the Mapuche considered this region holy. Crowning the majestic range of mountains is the towering Llaima Volcano, its twin-cratered peak flanked with slowly flowing glaciers and perennial snow, which melts only when the volcano erupts, as it still does every decade or so. And with each eruption the imposing landscape changes. When rivers of lava pour down in serpentine paths, new lakes and lagoons are formed, often leaving the skeletal tips of giant trees protruding from their surface.

Conguillio National Park is one of the few areas in Chile where the natural environment has been preserved. Most of the ancient vast forest have been timbered and replaced by commercial eucalyptus and pine plantations

Conguillio National Park is one of the few areas in Chile where the natural environment has been preserved. Most of the ancient vast forest have been timbered and replaced by commercial eucalyptus and pine plantations

Adding to the mystic aura, the ridges and slopes of the mountains are festooned with lush native forest, dominated by giant Araucaria, or monkey-puzzle trees, which resemble pines and approach the size of the California redwood or Sequoia, with trunks up to 8 feet or more in diameter. These towering trees, far more primitive than pines and related conifers, are known to be up to 3000 years old. They grow very slowly, only 10 cm. per year, yet the biggest ones are up to 300 feet tall! They were already huge when Christ was born, and even more enormous when the Europeans first colonized the south end of the Americas and began to cut them down.

The *araucaria* – the national tree of Chile – is a sacred tree to the Mapuches, as well as a traditional source of food and medicine. It used to dominate the ancient forests of the Andes, and still does in a few protected areas that remain

The *araucaria* – the national tree of Chile – is a sacred tree to the Mapuches, as well as a traditional source of food and medicine. It used to dominate the ancient forests of the Andes, and still does in a few protected areas that remain

The *araucarias* grow at only 10 cm. per year, and the biggest ones are over 3000 years old

The *araucarias* grow at only 10 cm. per year, and the biggest ones are over 3000 years old

Now these sacred trees, found only in a few areas where native forests remain, are strongly protected. But the old forests, which once covered the southern half of Chile, have now been almost completely timbered, and replaced by commercial eucalypt and pine plantations which are economically lucrative for the present, but ecologically disastrous in the long run.

The Mapuches know this and weep. They weep for the ravaged environment with which they lived in balance for thousands of years. Their roots are interwoven with the oldest of the Araucarias. As their habitat is being destroyed, so is their culture and sustainable way of life. But the Mapuche people, along with indigenous peoples in many parts of the world, are taking a stand for their rights, for the rights of nature, and ultimately for the rights of all life on this endangered planet.

Visit to a Mapuche farmstead

One Sunday during my stay in Temuco I had the chance to visit the farm of a Mapuche family, about 40 km east of the city. One of the OT staff at the University was of mixed ethnicity, and his aging Mapuche grandparents are farmers. When we arrived at their farmstead they welcomed us politely. Wary of strangers, at first they were somewhat reserved. However, as we began to discuss questions of social justice and human rights, and as I described some of the campesinos’ struggles for their land rights in Mexico, they warmed up. In time, the elderly grandfather, who is now overweight and diabetic, became quite lively, and told us the history of his family and his people. He explained how, in his youth, his entire village had been forced off the communal land where they had lived for generations. He told how the militia arrived, arresting him and other young men on trumped up charges, and had tortured them (essentially, water-boarded them), trying to make them incriminate others. His family sold their belongings to pay lawyers’ fees, trying to win their constitutional land rights. But their efforts yielded little. In the end, his family was allotted a barren plot of land that was small, inferior, and distant from their familiar villages and ancestral land. Slowly and at great sacrifice they developed the land and managed to eke out a living.

Mapuche Uprising to Defend their Ancestral Lands

Background

Mobilization of Mapuches over their land rights – and the rights of the land

Mobilization of Mapuches over their land rights – and the rights of the land

For many years the Mapuches were thus exploited, humiliated, and dispersed. Their children were required to go to school where they were taught in Spanish. They learned social studies from the colonial perspective. Every attempt was made to strip them of their culture and to assimilate them into the Euro-American lifestyle. But for all these attempts to eradicate their indigenous roots, a significant portion of the Mapuche held stubbornly to their sense of solidarity.

In recent years, scattered and displaced as they are, Mapuches have begun to organize, to reassert their traditional values. This included their age-old beliefs in the sacredness of the land. And they are demanding their ancestral rights. From their native perspective, they consider that the destruction of the environment and the extraction of its resources is a form of genocide that will bring hunger and thirst and death, first to those who are poorest and most vulnerable, and ultimately to all.

Map of the original Mapuche Nation, including areas of both Chile and Argentina, to which the native people hope to reclaim sovereignty

Map of the original Mapuche Nation, including areas of both Chile and Argentina, to which the native people hope to reclaim sovereignty

As a result, a groundswell of organized action among the Mapuche is now underway. The more radical movement is demanding that the heartland of the Mapuche become an autonomous Mapuche Nation, or Meli Wixan Mapu. Geographically this would extend in a broad band through south-central Chile across the Andes and well into Argentina.

Massive mobilization

The most recent action, taken on April 26, 2014, was a “massive mobilization” by the ancestral Mapuche communities situated in the Comuna de Cura Cautin, which is the territory of the precordillera (foothills of the Andes) that includes the Conguillio National Park and the Llaina Volcano. The mobilization, in the form of an autoconvocatorio (self-organized popular assembly) was led by the territorial “werken,” (spiritual-political leaders). The importance of the event was stated by the werken Alberto Curamil, as follows:

”… throughout the Mapu territory our people denounce the processes of invasion that we live with daily. Yet we have not heard any announcement or measure of concrete action by our government to reign in or deflect the disaster being unleashed by the timber industries, the commercial fisheries, the massive hydroelectric projects, the salmon farms, the transgenic crops and the pesticides that continue to poison us. We are gathered to assert our demand, not for discourse but for concrete action, with measures that guarantee things will change.”

… en todo el Wallmapu y en cada zona nuestra gente denuncia y comunica los procesos de invasión que se viven a diario, no hemos escuchado el anuncio de una sola herramienta o medida concreta de parte del nuevo gobierno para frenar o siquiera torcer el desastre al que nos están arrastrando las empresas forestales, las pisciculturas, centrales hidroeléctricas, salmoneras, los transgénicos y plaguicidas que nos siguen envenenando. Nosotros nos reuniremos para exigir y para movilizarnos, no vamos por discurso sino hechos concretos, herramientas que garanticen que las cosas cambiarán”.

An activist leader, or *werken,* speaks to an assembly about the rights of both the people and the land

An activist leader, or *werken,* speaks to an assembly about the rights of both the people and the land

Mobilization of Mapuches in a town near Temuco

Mobilization of Mapuches in a town near Temuco

The activists, or werken, behind this most recent mobilization made clear that the Fvtal Mapu Xawvn (Territorial Mapuche Alliance) consists of, and is led by, members of the Mapuche Nation:

“As such, this IS NOT A CHILEAN ORGANIZATION with functional jurisdiction in the interest of the State of Chile. Rather it is a reunion of the kind in which our forbearers gathered to converse and make decisions, where every Mapuche always had and has a space.

We persist with our claims as a Nation on our ancestral Mapu territories.

With this social protest we advance our proposals in accordance with current reality and the situation of domination in which we find ourselves, where the recuperation of our territory and its ecological preservation is our central struggle.

Our struggle is real and not virtual. But we understand the necessity to communicate: to denounce to the whole world the ethnocide and genocide wrought by the Chilean state. And at the same time we value the solidarity and appreciation for our cause, which is similar to the cause of other peoples and social actors who struggle for their liberty.”

*The full statement of the April 26 Mapuche mobilization from which the above is extracted can be accessed, in Spanish, at: http://radio.uchile.cl/ or http://alianzaterritorialmapuche.blogspot.mx/

Urban mobilization and organized protest

Urban mobilization and organized protest

This mobilization was held precisely in the middle of a location where the giant corporation Agricola Rio Blanco is counting on the appropriation by the Chilean government of a vast sector of land in order to construct the proposed “Hydroelectric Center de Paso Alto Cautín.” The giant dam to be built there would flood out thousands of acres of sacred Mapuche ancestral land, and in the process bring about drastic ecological degradation.

According to the organizers of the protest:

“The collective motivation for this encounter comes from the need to let the world know the devastating blows the Chilean/Western model of development is committing against life (the land and ecosystems), in the ancestral and actual territories of the Mapuche people, in stark contradiction to international standards, both in regard to environment and to universal human rights.”

La motivación colectiva por reencontrarse tiene que ver con la necesidad de dar a conocer al mundo los atropellos que el modelo de desarrollo chileno-occidental comete contra la vida (la tierra y sus ecosistemas), en los espacios ancestrales y actuales del pueblo mapuche, en abierta contradicción con los estándares internacionales en materias medioambientales y de los derechos de los pueblos universalmente reconocidos.”

For the defense of the Mapuche Territory and for Natural Environment

For the defense of the Mapuche Territory and for Natural Environment

This banner demands the freeing of Mapuche political prisoners – but also the closure of the big hydroelectric project in Mapuche claimed territory.

This banner demands the freeing of Mapuche political prisoners – but also the closure of the big hydroelectric project in Mapuche claimed territory.

Suppression of the Mapuche uprising

During the dictatorship of Pinochet, the Mapuches, together with other disadvantaged groups, were further marginalized and exploited. But with the ousting of Pinochet and the entry of a somewhat more humane and people-centered government, they hoped to gain a greater voice with regard to their land and their rights. To a limited extent this was the case. A number of laws were passed in their favor. But the new government was still too immersed in the global economy, and primed by the powerful corporate lobby. So despite the talk of reform, exploitation of the people and the environment has largely continued. So the Mapuche have taken a stand.

Their protests and demands for their ancestral land rights and preservation of the environment has been, of course, a serious threat to the powerful commercial and corporate interests in the country and beyond. Most threatened are the fossil fuel multinationals, the mining industry, and the timber barons, all that have been plundering the environment in their ruthless, single-minded pursuit of profit. It is no surprise, therefore, that the military and police have been sent in repeatedly to enforce “law and order.” This has resulted in heated confrontations, including arrests and violations of human rights. At times people have been attacked while peacefully working in their fields. Participants in demonstrations have been forcefully restrained and arrested.

Argentine military opens fire on Mapuche farmers

Argentine military opens fire on Mapuche farmers

Chilean *carbineros* (rifle-bearing police) try to intimidate a Mapuche settlement

Chilean *carbineros* (rifle-bearing police) try to intimidate a Mapuche settlement

But the Mapuches have stood their ground. Even the children take pride in their culture, and stand up for their peoples’ rights and land.

This child proudly joins a protest to defend the rights of nature

This child proudly joins a protest to defend the rights of nature

This old man bravely defends the rights of children

This old man bravely defends the rights of children

It is an encouraging sign that a growing number of the huinca (non-Mapuche) citizens are recognizing and demanding the Mapuches’ right to defend their nation against the ecologically disastrous exploits of corporate interest. A broad, progressive inter-ethnic movement is growing, which looks to the long-term common good of both nature and humanity. It recognizes that we all have much to learn from the indigenous people who for millennia have lived with respect for and in intimate balance with the natural world.

Many progressive groups in Chile oppose state terrorism against the Mapuches and support them in their demands for preservation of the natural environment

Many progressive groups in Chile oppose state terrorism against the Mapuches and support them in their demands for preservation of the natural environment

Rethinking Development, and Rediscovering Our Traditional Harmony with Nature

The Mapuches traditionally felt that they belonged to the land rather than it to them. They revered the primeval forest and glacier-covered volcanos as sacred sources of life

The Mapuches traditionally felt that they belonged to the land rather than it to them. They revered the primeval forest and glacier-covered volcanos as sacred sources of life

It is interesting, in the course of events, the way things seem to go full circle. There was a time when human beings were more attuned to the rhythms of the sun and the seasons. To a large extent homo sapiens relationship with the natural environment was symbiotic, or mutually beneficial. But as the human species mastered a greater range of technical skills, its dominant members began to exploit the natural world, as well as society’s vulnerable and or less aggressive members.

Eventually the most assertive decision-makers of society began to define success in terms of power and possession, rather than in terms of harmony and collective action for the common good. In time this acquisitive, extractive, winner-takes-all approach to life became increasingly celebrated and globalized. This paradigm of domination and exploitation is now embodied in the “free market system” – free meaning free to exploit both people and the environment, while disregarding and externalizing the human and ecological costs. The mansions, private airplanes and yachts of the wealthy elite are essentially paid for by the suffering of marginalized people. And the damage to the ecosphere is so great that the future of life on the planet is now at risk.

Mahatma Gandhi, when someone asked him what he thought of civilization, said, “I think it would be a good idea.” And surely, the path that the so-called civilized world has taken in recent years has, in many ways, become increasingly cruel, self-centered, and unsustainable.

As “Western Civilization” conquered the world and colonized its “underdeveloped” lands and peoples, those on top of the pecking order began to subjugate the “natives,” whom they regarded as subhuman. After, slaughtering, enslaving, and decimating millions, they tried to strip the remainder of their traditional customs and values, and indoctrinate them with the beliefs and values of the “civilized” invaders.

Eventually, the “natives” were recognized as human beings, and awarded some basic rights, including the right to vote. But full equality and equal opportunity still remain a distant hope for many of the world’s ethnic minorities. Overall, the indigenous peoples of many lands have remained underprivileged and marginalized. They have been browbeaten into accepting their low social status, into feeling ashamed of their traditional clothing and customs, and into embracing the values, worldview, and lifestyle of the dominating culture.

Having internalized the oppressors’ distain for their traditional way of life the surviving indigenous peoples have suffered a pervasive loss of self-esteem as well as social cohesion. The resulting hopelessness and existential despair has characteristically led, in turn, to high rates of alcoholism, drug use, unhealthy food habits (junk food), obesity, hypertension, diabetes, and other consequences of psychosocial dysfunction.

The predominating aim of the ruling colonizers, whether armed with bibles or muskets, was “to keep the natives in their place,” principally as servants, common laborers, farm-hands, and the like. Brainwashed as they were, the indigenous population frequently submitted to the subservient role assigned to them. However, some indigenous peoples courageously managed, under the surface, to preserve at least part of their ancient beliefs and philosophies of life. Above all they retained their communal values and their reverence for the natural world. This cultural resilience was more in evidence where such peoples were able to sustain the integrity of their villages, even when relegated to “reservations” or “tribal lands.”

In the latter part of the 20th century, and even more so now in the new millennium, a groundswell of reawakening has been emerging among the original peoples in many parts of earth. This reawakening may be due in part to the fact that the dominant development model of “Western Civilization” is beginning to self-destruct. The fault lines are obvious to anyone who dares to look critically at the interrelated mega-crises of today’s ailing world.

What is more, the driving force of the dominant development model—based on exploitive extraction for private ownership rather than shared productivity for the common good—is in blatant contrast to the ancient praxis of indigenous cultures. As their remaining spiritual healers and seers watch with alarm the escalating crises of today’s unbalanced world, they are rediscovering that many of their age-old customs may in fact be a wiser, more sustainable path to for human development than the dog-eat-dog, free-market paradigm of today.

This re-affirmation of the traditional values of indigenous peoples has become an increasingly important element in the growing movement for radical systemic change. A growing coalition among forward-thinking people in all corners of the Earth is striving to replace the moribund free-market economic paradigm with a more cooperative, more democratic approach to production and needs-meeting.

The fact is that the free-market system, in which wealth and power tend to concentrate into the few hands of a ruling elite, at the expense of the many, is anything but democratic. Increasingly, the CEOs and board members of corporations—a tiny minority—rule the workforce, and ultimately the world. It is a system that not only concentrates wealth, but controls the institutions of learning and the mass media to the point that the public is so misinformed that meaningful democratic elections and decision making are dangerously impaired.

Fortunately, as wealth continues to concentrate in fewer hands, as the basic needs of more people remain unmet, as ecological systems continue to deteriorate, and global warming approaches the tipping point of no return, increasing numbers of people are beginning to wake up—and to say, “¡Ya basta!” – Enough is enough.

Indigenous peoples in many parts of the world are taking a stand and making demands to defend the “Rights of Nature.” As they organize and raise their voices, in some countries they have played a key role in replacing governments that primarily represent big business with ones that come closer to representing the needs of common people and of the environment. It is no accident that the two Latin American governments that are more representative of the common people and their needs are those of Bolivia and Ecuador. Both these countries have large, historically marginalized, indigenous populations that have found a voice and stood up for their own rights and the rights of the natural world. And these two countries, with a new popular voice from below, have built a declaration of those rights into their new constitutions.

And the original peoples of Bolivia and Ecuador are not unique in declaring the rights of nature and humans against the exploits of transnational corporations. Throughout much of Latin America tribal peoples are doing battle with the giant mining and oil companies. Likewise, in the US and Canada, Native Americans are challenging the powerful corporations that are pursuing the ecologically perilous Keystone Tar-Sands Pipelines. The “Idle No More” indigenous movement based in Canada has rallied such a strong grassroots resistance to the pipeline that the governments of both Canada and the United States are now more reticent to back it.

At the same time, unusual alliances of former enemies are emerging, as both “cowboys,” and “Indians” join forces to oppose the ominous pipelines. And those concerned about local contamination and dangers to wildlife are aligning with the climate scientists and macro-environmentalists who see the pending tsunami of global warming.

These new coalitions of forward-looking people—across racial, national, and historical divides—provide a ray of hope that we humans may finally come to our senses and take the radical steps needed to prevent our species and millions of others from joining the ranks of the dodo and the dinosaur. But the systemic changes needed are profound. We the people—individually and collectively—must learn to live in harmony with one another and with the environment. We must learn to leave a much smaller ecological footprint, and to develop life styles that facilitate not only our own health, but the health of future generations and of the earth itself.

Throughout the Americas and beyond, indigenous peoples have traditionally held this all-embracing vision. For example, through the ancient “Great Law of Peace,” the Haudenosaunee (Iroquois) tribe of North America embraced the Seventh Generation Principle, whereby all people’s actions and decisions should be guided by how they may affect the lives and well-being of their descendants seven generations into future. By the same token, other tribes—the Lakota, the Algonquin, the Cherokee—all celebrate the principle that, “We are all related to and respect everything in life.”

This same concept is espoused by original people of Central and South America. The tribes in jungles of Ecuador uphold the guiding principle called Sumak Kawsay or Buen Vivir (Living Well), which similarly implies a deep sense of kinship with their human and non-human neighbors. At the First Regional Assembly of the People’s Health Movement—Latin America, which took place in Cuenca, Ecuador in October 2014, the concept of Sumak Kawsay was the overarching theme of the Assembly. Fittingly, many of the participants in the Assembly were indigenous health workers and activists from several Latin American countries. It was very encouraging to hear them speak to the need to implement in practical ways the vision of Sumak Kawsay and the Seventh Generation Principle. The affirmation of these ancient values offers a realistic basis for the hope that a worthwhile future might still be possible for the only planet we have.

My exchange with representatives of the Mapuche Nation in Chile, reinforced the realization that we have much to learn from indigenous and other extramural groups about ways of living which are more inclusive, respectful, and sustainable than the dead-end development paradigm that dominates today.

Conclusion

Overall I greatly enjoyed my visits to Chile and Argentina – and I learned a lot. Above all, I realized more deeply that Western Civilization by no means has all the answers, and that that the model of socioeconomic development it has imposed worldwide, is in the long run, a one-way road to disaster. Every system, traditional and modern, has its strengths and its weaknesses. Such ancient concepts of the human spirit such as Seventh Generation and Sumak Kawsay—if we can open our minds and hearts to them—can help us up the steep path of transformation we must climb if we are to allow life to continue on this beautiful but ailing Planet.

Postscript by Julio Monsalvo

Julio Monsalvo at the 3rd *Congress of General Medicine* in Mar de Plata

Julio Monsalvo at the 3rd *Congress of General Medicine* in Mar de Plata

Julio Monsalvo, an aging Argentine pediatrician, social activist, and coordinator of the Argentine branch of the People’s Health Movement, played an important role both in the First Assembly of the People’s Health Movement in Cuenca, Ecuador in October, 2013 (see our Newsletter 72 – click here), and in the Congress of General Medicine in Mar de Plata, Argentina in April, 2014. Here are Julio’s comments on the need for radical systemic transformation, if we are to have a sustainable future:

CARE FOR THE FUTURE GENERATIONS

In previous Letters [in Julio’s blog Esperanzas y Alegremia] we spoke of the Care of our Future Generations. We declared our hope that, within the maelstrom of the paraphernalia of neo-liberalism with its laws of the market and its consumerist morality, the voices of Ancient Knowledge will oblige us to consider the seventh future generation as we make decisions that affect us today.

Coincidental with this Knowledge, we share the simple and overwhelming academic concept of sustainability given us by the well-known and respected Lester Brown.

Present day society is indeed sustainable when it satisfies its own needs without denying the needs and perspectives of the future generations.

The Constitution of the Nation of Argentina also addresses the question of the care of the future generations.

The first paragraph of Article 41 of the Constitution adopted in 1994 clearly states that today’s productive activities shall not compromise the needs of future generations:

All citizens have the right to a healthy and balanced environment, fit for human development, one in which today’s productive activities satisfy present needs without compromising those of the future generations; today’s generation has the obligation to preserve the environment.

Notwithstanding its critical importance, a constitutional article has no value whatever if all people that live in this land, wherever they are, and whatever activities they engage in, do not incorporate the spirit of that article into themselves.

This article of the Constitution forces us to ask, what indeed are today’s needs, and how shall we move forward so that the activities that satisfy today’s needs do not compromise those of the future generations.

To the Victory of Life!!

CUIDAR LAS GENERACIONES FUTURAS

Venimos conversando en Cartas anteriores acerca del Cuidado de las Generaciones Futuras.

Decíamos de la esperanza que nos da, en medio de la parafernalia neoliberal con sus leyes del mercado y su moral consumista, que lleguen las voces de las Sabidurías Ancestrales que nos indican pensar en la séptima generación futura antes de tomar decisiones que puedan afectar el entorno.

Coincidente con esas Sabidurías, compartíamos el sencillo y contundente concepto académico de sustentabilidad que nos trae el afamado y respetado Lester Brown.

Es sustentable una sociedad cuando satisface sus necesidades sin afectar las perspectivas de las generaciones futuras.

La Constitución de la Nación Argentina también nos habla del cuidado de las generaciones futuras.

El primer párrafo del artículo 41º de la Constitución sancionada en 1994, expresa con claridad que las actividades productivas no deben comprometer las generaciones futuras:

Todos los habitantes gozan del derecho a un ambiente sano, equilibrado, apto para el desarrollo humano y para que las actividades productivas satisfagan las necesidades presentes sin comprometer las de las generaciones futuras y tienen el deber de preservarlo.

Con toda la importancia que tiene lo sancionado en la Constitución, de nada vale si no se internaliza en cada persona que habita este suelo, donde quiera que esté y cualquiera que sea su actividad.

Este artículo de la Constitución induce a preguntarnos cuáles son realmente las necesidades presentes y cómo proceder para que las acciones que realicemos para satisfacerlas no afecten las generaciones por venir.

Hasta la Victoria de la Vida Siempre!!

Julio Monsalvo