Artesanía, Inequality, and Health

After a long bus ride back into Cusco, we were given the afternoon to explore some of the city.  Dr. Garcia accompanied three other students and myself to a museum of Pre-Columbian art.  The artifacts were stunning, but the descriptions of each item were nearly as interesting.  The captions continually referenced the “modernity” of the Chimu  culture, even the “vanguard” Mochica who were “Picassoesque.”  Dr. Garcia observed that these cultures and their artwork only seem to possess value when they resemble our contemporary reality.  They are without worth in their own right and are legitimated only by associatation with modern, occidental standards.

Ironically, the very descendants of the Pre-Columbian Picassos are some of the most denigrated members of Peruvian society.  Even though they continue the artistic traditions of their forbears, their work is more often referred to as "artesanía"--something akin to "arts and crafts."  Through the promotion of their culture in the face of continued inequality, it seems as though they are being treated as the unfortunate relics of a bygone era.  This inequality is alive and well in healthcare, as we learned during a lecture later that evening.  

In the Cusco department there are less than 10 doctors per 10,000 residents, though the distribution of these doctors is largely confined to the city.  Most physicians do not speak Quechua and thus lack the ability to connect with many of their patients.  However, positive movements seem to be afoot.  Birthing centers are being built as a concession to traditional obstetrics, all the while keeping women closer to medical facilities in the case of emergencies.  We have spoken with many who are very concerned with promoting human dignity through a greater respect for language and culture.  And yet, as I sit as judge of the Peruvian system, I am reminded of the shortcomings of our own structures.  In what ways has western medicine clashed with communities in the United States?  How does this effect the efficacy of care?  

Having worked in public health in the U.S., I know that we too must grow in our understanding of the diverse populations that are treated by American providers.  Recognizing the problem is, in itself, a challenge; but it is made easier by having stepped outside of our context to observe the ways in which Peruvians are seeking to address their standards of care.