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Medicine men with drums are practicing alongside physicians in lab coats.
Carolina Vidal rests from her twice-weekly walk to the ruka to pick up two liters of the brown infusion she drinks three times a day. After losing an eye to facial paralysis, traditional doctors in the clinic next door referred her to the machi.
Victoria Valdes sought relief from depression when three different kinds of pills taken simultaneously "didn't do anything for me anymore." She credits the machi with putting her life back on track.
Neither Vidal nor Valdes identify themselves as Mapuche, although, like most Chileans, they embrace their mestizo heritage. In the La Florida ruka, the mix is mix is 50/50 between Mapuches and "winkas" (the Mapudungun word for Chilean/foreigner, literally “thief, usurper”).
“We aren’t here to cater exclusively to the Mapuche community,” Melinao said. “Our mission is to bring our tradition of healing to anyone who seeks it.”
One-third of greater Santiago’s 37 districts host intercultural health centers with a machi in attendance. The program began in 1996 to meet the needs of the Mapuche, who make up 85 percent of Chile’s indigenous population. In 2006, the country’s first Mapuche hospital opened its doors in Nueva Imperial, a small town in the heart of the Araucania region, some 700 kilometers south of the capital.
The program also incorporates a handful of healers from among the eight other recognized indigenous groups, including an Aymara medicine man in a clinic in the center of Santiago. Some clinics are run by the government; others by NGOs and Mapuche organizations.
Program success is measured not by conventional indicators of patients cured, but by satisfaction with the service. The La Florida ruka, which attends 260 patients a year, is booked to capacity. Treatments last from three months to several years.
The system is not without critics. Some disparage the trend as neo-shamanism. They point to the explosion of new Mapuche-inspired remedies and drugstores. At Farmacia Makelawen, with branches in several major Chilean cities, a top-selling item is palwen, the Mapuche Viagra.
But Ana Maria Oyarce, an anthropologist working with the United Nations Latin American and Caribbean Demographic Center, describes the intercultural health program as an “ethical imperative to provide care to vulnerable groups.”
“The motive is not simply to improve the health of indigenous people but to respect their rights,” she said. Intercultural health “is not a benefit, but a collective right — the right to be visible as a people.”
Provision of traditional medicine must not supplant the possibility of opting for more conventional alternatives. “What’s the right prescription?” she asked. “Anywhere from machi to scanner.”