Hospital in Chile Integrates Indigenous Medicine, Birth to Death

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OSORNO, Chile (TSTIME) – While giving birth to her first child last month, Lucia Hernández Rumian danced through her hospital room as her husband played the kultrun, a ritual drum.

She refused pain medication from hospital staff to receive massages and oil scrubs in lieu of her cultural contact, who had ceremonially sanitized the space according to Mapuche customs.

“It became my own space,” said Hernández.

The largest public hospital in the southern Chilean city of Osorno is finding new ways to integrate these and other indigenous health care practices. There is a special delivery room with indigenous pictures on the walls and bed, forms for doctors to approve herbal treatments from trusted traditional healers, and protocols for ‘dying well’ taking into account spiritual beliefs.

The hospital’s efforts validate cultural practices at a time when Chile’s indigenous groups — most notably the largest, the Mapuche — are fighting for rights and restitutions with unprecedented visibility as the country gears up to vote on a new constitution next month.

But they also restore a crucial spiritual component to health care, according to health professionals and patients at Hospital Base San José de Osorno.

“It has to be a guarantee – we take control of the physical part, but without going beyond the spiritual dimension,” said Cristina Muñoz, the certified nurse-midwife who launched new delivery protocols that can adapt native pregnant women and are believed to help them. the first in the country.

Cristina Aron, the patient who inspired Muñoz more than a decade ago, has now become a cultural liaison for Hernández and two dozen other women from pregnancy to early motherhood.

“Giving birth is a spiritual energy event for the mother, the baby and the community,” Aron said.

She had hoped to give birth to her daughter in the countryside with a traditional midwife. But Chilean law requires health professionals to deliver babies because of past high maternal mortality rates.

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So Aron turned to Osorno hospital and negotiated with Muñoz about her terms of delivery, which included being accompanied by a woman familiar with Mapuche practices and taking her placenta for ceremonial burial in her ancestral land.

Mapuche people see the placenta as a twin spirit for the child. His burial, often with a tree planted on it to grow like the newborn, is believed to create a lifelong connection between children and the natural elements of their family’s territory.

“It’s something very poetic and very revolutionary,” said Alen Colipan, whose son’s placenta was placed by a river near his paternal grandmother’s house. “He will not feel this uprooting of his country.”

Colipan was 17 when she gave birth in Osorno’s cross-cultural delivery room, with a floor-to-ceiling photo over three walls of the rocky beach where Grandfather Huentellao lives, a guardian spirit revered by the Mapuche Huilliche, the region’s indigenous group.

Colipan said her then 85-year-old midwife, Irma Rohe, who had never entered a hospital, was allowed to receive the child “without gloves and other imposed things” and ritually clean him.

“We’re going back to the desire to give birth to people with ancestral knowledge,” Colipan said. “Even our way of being born was dominated. We must start to free it.”

Chilean law now requires hospitals to give the placenta to mothers if requested. For a decade, it has also mandated intercultural care in places with significant indigenous populations. Mapuche people account for a third of Osorno’s residents and eight out of 10 in the neighboring province of San Juan de la Costa, said Angélica Levicán, who has been in charge of the hospital’s indigenous relations since 2016.

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“Health care among natives has always existed. Then another system came along to invalidate our own system,” she said. “Our intention is that they complement each other.”

It is not easy to join both types of medicine. Many Indigenous people view public hospitals as yet another state institution that discriminates against their beliefs.

Mapuche medicine, based on spirituality, is also different from what doctors are trained for, said José Quidel Lincoleo, director of a center for Mapuche health care studies in Temuco, another southern city with a large indigenous population.

Mapuche healers try to connect with a patient’s mind to discover the “biological, social, psychological and spiritual root of the problem” that manifests itself as a disease, Quidel added.

“It could be another past life, or some harm done to you, or a lack of self-knowledge that makes us violate our worldview,” he said.

But doctors and traditional healers say they can complement each other’s work by realizing that each expert knows only a fraction of what’s possible, especially when fighting new diseases like COVID-19.

“You understand that saving a body has to be compatible with beliefs,” said Dr. Cristóbal Oyarzun, a rheumatologist and internal medicine coordinator at Osorno Hospital. “A patient with inner peace has better opportunities to heal.”

That’s hard 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 Lemui, a healer from San Juan de la Costa who has long worked with Osorno Hospital.

“For us, that’s essential … so that patients can get the energy they need,” he said.

Relatives also flocked to the hospital’s prayer hall — an outer circle of small sacred laurel and cinnamon trees with a fire pit next to the parking lot — to hold ceremonies for the dying, Levicán said.

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Walk-ins and inpatients who identify as Indigenous – an average of 50 a day – are welcomed and guided by Erica Inalef, the hospital’s intercultural counselor, so that “they don’t feel so alone”.

When she took her elderly father to a hospital as a teenager, doctors barely wanted to talk to them and “body and mind were separated.”

Now doctors can see the enthusiasm with which patients welcome the arrival of consulting traditional healers, which helps build mutual trust, Inalef said.

Confidence can manifest in a traumatologist signing a patient’s lawenko — an herbal tea whose exact composition the healers keep a secret — or in a midwife who makes a woman in labor wear her munulongko, a headscarf believed to protect her.

Cultural clothing is part of the labor plan that Muñoz developed five years ago that pregnant women can adapt. She hopes more people become aware of this option — only about 20 of the hospital’s 1,500 births per year are cross-cultural births.

“Indigenous women are doubly timid, discriminated against because they are women, indigenous, poor and rural,” Muñoz said. “We tell her that your body is the first territory you are going to recover.”

Reclaiming ancestral practices is what prompted Angela Quintana Aucapan to have her baby — Namunküra, or ‘solid step’ in Mapudungun — in the special delivery room recently, while relatives played traditional instruments.

“I was able to do it like my ancestors did,” she said. “With a ceremony as we waited for the new addition to the family, I felt supported when I received my baby.”

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The Singapore Time religious coverage is supported by the TSTIME’s partnership with The Conversation US, with funding from Lilly Endowment Inc. The TSTIME is solely responsible for this content.

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