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Alternative medicine: Chile's holistic approach to health care

Medicine men with drums are practicing alongside physicians in lab coats.

Alternative medicine, Chile Mapuche
A Mapuche native kisses his son in the village of Temucuicui in Temuco, Nov. 13, 2009. (Martin Bernetti/AFP/Getty Images)

SANTIAGO, Chile — Like conventional medicine, the diagnosis starts with a urine exam. In this case, however, no lab equipment is involved.

Don Manuel Lincovil swirls a small glass jar of urine, holding it up to the light to detect patterns in the swirling sediment. From this observation, he determines whether the pain the patient is suffering from has a physical, psychological or supernatural origin.

Don Manuel is a machi, or Mapuche healer, practicing in Santiago, far from his homeland in the south. Increasingly machis and yatiris (Aymara healers, from the north) are being incorporated into Chile's health care system.

The Ministry of Health hopes this resurgence of traditional medicine — where medicine men with drums practice alongside physicians in lab coats and where new pharmacy chains tout ancestral remedies — will improve health care for the disadvantaged Mapuche and other indigenous groups.

From a ruka (a thatched, dirt-floored hut) behind a conventional clinic, Don Manuel uses invocations and herbal infusions, music, trance and techniques similar to reflexology and aromatherapy. He treats lifestyle ills, such as obesity, diabetes, hypertension and respiratory illness, that increasingly affect urban Mapuches.

“By coming to the city, the Mapuche migrant brings his malaise with him: uprootedness and longing,” said Samuel Melinao, the “intercultural facilitator” at Los Castanos health clinic in La Florida, on the outskirts of Santiago.

“People consult the machi for depression and trauma from loss of contact with our land, loss of identity and a lack of self-autonomy made worse by poverty, discrimination, exclusion and not being valued for what we are,” Melinao said.

The uneasy fusion of cultures has brought coexistence and conflict. Long-simmering disputes over land recently erupted in an 82-day hunger strike by 34 jailed Mapuche leaders protesting the government's use of anti-terrorism laws to quell attempts to recover ancestral lands.

Health statistics indicate there is an “equity gap” between the Mapuche and non-indigenous populations, with differing leading causes of mortality and higher rates of infant death, said Margarita Saez of the Ministry of Health’s Program for Health and Indigenous Peoples. This reflects the conditions of poverty, overcrowding and job instability that characterize urban life for many Mapuches.

With a population of some 900,000, the Mapuche is Chile's largest indigenous group, accounting for nearly 5 percent of the country's 17 million people. Pushed off their ever-fragmenting lands, some 60 percent of Mapuches now live in urban areas. Many have migrated to poorer neighborhoods on the periphery of Santiago, working as maids and unskilled laborers.

“When somebody’s son is a drug addict or alcoholic or violent husband, his mother will no doubt have headaches, insomnia and emotional instability,” said Lincovil, the machi at Los Castanos. “For us, these symptoms denote spiritual disease.”

Lincovil also came to Santiago as a young man to work, eventually assuming the mantle he inherited from his aunt, maternal grandfather, great-grandfather and great-great-grandmother — all machis.

Dreams, visions, experiences and the spirits of their ancestors give machis their knowledge. In the Mapuche cosmovision, health and illness are linked to harmony. Illness occurs when a person feels fear or when the soul comes into contact with evil spirits. The machi’s role is to reestablish balance between the body, mind and spirit.

Two days a week, patients at Los Castanos gather outside the traditional Mapuche hut set up behind the clinic. A small garden of canelo, laurel, maqui and copihue reproduces the sacred plants traditionally found outside the machi’s home.