avec Alfonsina Faya Robles, Cahiers des Amériques Latines 88-89, 2018, pp.61-78.
Au Mexique et au Brésil, les femmes pauvres sont la cible privilégiée de politiques de santé materno-infantiles. Dans le premier contexte, elles bénéficient d’une aide financière en échange de leur participation à des ateliers de santé et à des visites médicales. Dans le second, elles sont inscrites dans des programmes de santé pendant leur grossesse, accouchement et post-partum. L’analyse croisée des données d’enquêtes menées auprès de femmes de quartiers populaires, de sages-femmes traditionnelles, d’agent.e.s communautaires de santé et de personnel médical met en avant deux processus connexes de régulation des choix reproductifs : la médicalisation de la santé reproductive et la sanitarisation des corps féminins. Nous montrons comment le développement de l’assistance médicale et sanitaire dans ces deux pays, au-delà des changements positifs, soumet les décisions reproductives au contrôle d’agents étatiques de santé, renforçant les mécanismes de régulation et de domination des (corps des) femmes pauvres.
A tool for collaboration between anthropologists and NGOs
Since 1985, the Organization of Indigenous Doctors of Chiapas (OMIECH) has been supporting and promoting the work of traditional midwives in indigenous communities in the Highlands of Chiapas. Collaborating with non-governmental organizations, anthropologists and medical doctors in Chiapas as well as abroad, OMIECH has built an international and intercultural network to raise awareness about the disappearance of traditional midwifery. Since 2010, the Women and Midwives Section of OMIECH has partnered with the French NGO Association Mâ, an organization promoting natural and respected childbirth in France.
I met members of OMIECH in 2013 through the Association Mâ, as I was starting my doctoral studies. We began collaborating as an aspect of my doctoral fieldwork. My research questions stemmed from preliminary fieldwork with OMIECH, and my dissertation, documenting the impact public health policies on indigenous midwives’ work, is informed in part by narratives of midwives who belong to the OMIECH network. As my fieldwork developed, I volunteered for both Mâ and OMIECH, on-site during my fieldwork, and at a distance through communication platforms such as Skype the rest of the time. In this essay, I reflect on our collaboration by presenting my activist researcher position, and the tools we have used to make this collaboration sustainable.
In many ways, activist research is a lesson in humility, as we adapt our methods of research to meet our collaborators’ needs.
“You know, a lot of researchers have come here. We gave them all the information, we talked to them, and then, they never came back,” Micaela Icó Bautista, the coordinator of the Women and Midwives Section of OMIECH told me during the weeks following our first encounter. In addition to never seeing the researchers again, her and her colleagues were upset that they were never acknowledged in the research nor received a copy of any publications about them. The Women and Midwives’ Section shared with me the work of students who interned with them as well as journal and newspaper articles about the organization that they were able to gather over the years. However, according to Micaela and her colleagues, more researchers have come to work with them who never shared their results. In this context, we spent our very first meeting, during which I presented my research interests to OMIECH, discussing common grounds between the organization’s goal and my academic skills.
In many ways, activist research is a lesson in humility, as we adapt our methods of research to meet our collaborators’ needs. As a result of my long-distance collaboration with OMIECH’s Women and Midwives’ Section, I have come in contact with midwives across the globe, and learned to balance between “doing” (being involved in projects) and “writing” (about such projects). In such, my commitment to OMIECH’s political goal taught me to revisit my writing to make it relevant to my partners, as well as writing for advocacy.
Anthropologists working in the field of human rights take on the multiple roles of witnesses, advocates and activists. Ultimately, activist-research relies on the belief that political engagement is in continuity with our anthropological training, what Shannon Speed calls doing “critically engaged activist research” (2006). The activist side of my research also positioned me as an outsider within, providing a vantage point to auto-analyze my own interactions within OMIECH and note the differences in opinion and experience that might arise between my colleagues and myself. Simultaneously approaching OMIECH as a doctoral student and as a member of their French partner organization has placed me in uncomfortable situations at times, but allowed me to fully live participant-observation, and gain the kind of knowledge that allows me to talk about the politics of indigenous organizing “from the gut” (Bernard 2006; 342).
Techniques and Technologies: Making it Work
In total, I completed thirteen months of on-site fieldwork in Chiapas, spread over a period lasting from May 2013 to July 2015. Despite our various geographical locations, OMIECH and I have been able to write projects together, present our work in academic settings such as the 2015 SLACA conference, and organize local events in France and Chiapas.
The use of technology is crucial to conduct this type of ethnography and to collect data without being physically in the field, what I refer to as long-distance ethnography. Maintaining regular contact with OMIECH while in the United States has been essential for my research and even more crucial in developing trust. I conducted long-distance ethnography over a period of four months in 2014 which included the video recording of bi-monthly meetings of the Women and Midwives’ Section, and my response to these recordings through email and/or video messages. In face-to-face participant-observation, the presence of the researcher is slowly erased through a process of habituation and trust building. In a similar way, in long-distance ethnography, the webcam, at first odd, became integrated into the meetings. By the second recorded meeting, I had questions directed towards me/the camera.
The possibilities of activist research are multiplied by the availability of new technologies (videoconferences, file sharing, Internet-based calls). In our case, they have contributed to building a dialogue with such diverse publics as academics, activists, parteras and families in Chiapas, France and the USA. As anthropologists, long-distance ethnography also challenges our research methods, which often limit our “doing” to the field, while the “writing” happens at home. On both OMIECH and my side, technology has contributed to good working relationships between us, allowing both my colleagues to update me with important news from the organization, and me to keep them updated about my dissertation work. Video platforms, instant messaging, and social media all shorten the spatial and mental distance between fieldwork and home. By allowing our research partners to interfere in our daily routine, they create new ethical questions, and make us accountable beyond the occasional phone call. Ethical and methodological questions about long-distance ethnography also make their way in the training of future anthropologists, who, wherever their fieldwork takes them, will rely on their use.
(Published in the Council on Anthropology and ReproductionNewsletter 22(2), 2015)
“Oh, I see, so you want to be a partera (midwife)” is the typical response I hear after explaining the purpose of my visit; that I am doing dissertation research to document how midwives live and work. Although I try to explain my research goal in terms of “helping raise awareness on the difficulties parteras are facing,” I am always met with this same response “so you want to learn how to become a midwife?” And as I have gotten to met parteras and aspiring midwives, I must admit that there is not always a clear difference between what I do and how I act and what they do and how they act: asking questions about pregnancy care, sitting in on prenatal consults, taking notes on almost everything the partera says… There is a thin line between participant-observation and midwives’ apprenticeship model. And indeed, I have been learning a lot about how parteras work and live, but also a hell of a lot about plants given in pregnancy care and massage techniques.
Since October 2014, I have been in San Cristóbal de Las Casas, Chiapas, conducting dissertation fieldwork and volunteering for the Women and Midwives’ Section of the Organization of Indigenous Doctors of Chiapas (OMIECH). As a volunteer, my work consists mainly of two tasks: administrative tasks (aka looking for funding) and logistical support during events and workshops. Since 1985, OMIECH has been strengthening Mayan medical knowledge and organizing health workshops in indigenous Tseltal and Tsotsil communities of Chiapas. Even though I am in Chiapas, some of my notes echo those of Kara E. Miller (Fall 2014 Newsletter). Here too, the parteras – who are referred to as Traditional Birth Attendants in international documents – are frustrated with the lack of possibilities to transfer their skills to the next generation. This is why the Women and Midwives’ section organizes workshops focused on reproductive health, and care during pregnancy, birth, and postpartum. These workshops are open to all members of the community where they take place, and aim to perpetuate botanical and medical knowledge by transmitting it to younger generations.
Picture 1. Tsotsil partera during a community workshop. Photo by author.
The loss of knowledge is accelerated by various factors (young people’s migration, midwifery not an attractive profession economically), one of them being the medicalization of birth. The push to send women to birth in hospitals comes with a deligitimation of indigenous parteras’s knowledge as “not-modern”. Through conditional cash-transfer programs (documented by Vania Smith-Oka in the state of Veracruz), women are pushed to have their prenatal visits and give birth in hospitals. Parteras, on their end, have to attend trainings given by the Health Secretary. These trainings have emerged in the 1980s, and intensified in Chiapas under the pressure of reducing maternal mortality rate to comply with the Millennium Development Goal (Chiapas has one of the highest maternal mortality rates in Mexico). Indigenous traditional midwives either have to follow the trainings or stop practicing. This can have dramatic consequences in places where they are often the only health care provider in their communities.
As I jot down notes during an interview or observation within these different settings, I feel a thrill of delight when their words echo one another. But then I realize this means that these state policies are really achieving great changes for parteras. And like Sisyphus, tirelessly, my colleagues at OMIECH reweave what is being unwoven: traditional medical knowledge, but also, and as important, pride in it and trust within the community.
While “in the field”, my notes are scribbly at times, crystal clear at others, but rarely absent. I try to type them regularly, as a good apprentice-anthropologist, but have stopped feeling guilty when I could not do so. It took me a few months to be able to “let go” and admit there will always be an event I will miss, a trip I cannot make… At my mid-point in the field (already), I have just started to take drawing classes, which helps me expand the range of my notes, when words fail to describe a hand gesture, or when I do not know the terminology for this exact point on the belly that needs to be massaged. These classes have made the familiar look different, and made me look at people in a new way, which in turns adds more depth to my notes.
Life in the field intertwines professional, political and personal spheres. The friendships I have built through this research promise to impact both my career and personal life. As we were searching for plants in the garden of the organization for an upcoming booklet publication, my colleague Micaela corrected me as I got the name of the plant wrong, once again. I could sens, for the first time, an impatient tone in her voice. I pause and I suddenly realized that although I am not studying to become a midwife, every one of the parteras I have met have been a teacher to me, training me a little bit, sharing their story, their tortilla and their endless knowledge. I am looking forward to learning a lot more in the next five months I will be spending with them and I hope my dissertation will bring them knowledge they can use in their struggle.