By Amaya Alvarez
The Zapatista struggle has improved the health of indigenous people in Chiapas. Clearly defining health care as a basic human right, the Zapatista health care system also occasionally extends their services to other humans in need, independent of whether or not they live in Zapatista territory.
In the midst of the Intergaláctico- a gathering of people all over the world, organized by the Zapatistas to inspire discussion about alternatives to the dominant neo-liberal model- two men at the Zapatista Clínica la Guadalupana receive a puking tourist.
The men inquire about symptoms and take my temperature and blood pressure. For 24 hours I sleep in one of the hospital bed. Every few hours, including in the middle of the night, I wake up to the questions of sympathetic caretakers. "Do you still have diarrhea? Can you describe to us what it looks like?"
The hospital is beautiful but very modest. Every time I need to use the toilet, a friend has to fill a bucket with water to flush the toilet.
I am a patient in the Zapatista caracol Oventic in Chiapas. The one hour journey from San Cristobal de las Casas to Oventic is a journey from fancy cafés filled with western tourists to little comedoras where indigenous people in ski-masks sell tamales, boiled corn and atole. It is a journey from smooth paved streets to incredible quantities of black mud. Despite my best attempts to stay well and participate fully in the Intergaláctico, I find myself doubled over with the illness caused by the amoebas and parasites that plague the bellies of the people of the region who continue to lack access to potable water. However, there is a lot to be learned from the toilet of a Zapatista hospital, and I have the chance to ask a lot of questions about the way the Zapatista health system works.
In Oventic, indigenous people who belong to the EZLN, the Zapatista National Liberation Army, govern autonomously. In practice, this means that the Zapatistas have created systems of health care and education independent of the state of Mexico. The promoters of health and education are people who teach children and care for the sick without pay. The funding that is available for such projects comes from civil society all over the world who stand in solidarity with the Zapatistas, and never from the government, which, for hundreds of years, has neglected its responsibility to provide these basic services in indigenous communities in Chiapas.
Thanks to the combination of medicine, food and oral re-hydration salts that they give me at the clinic, I'm feeling much better the next day. I sit down with three health promoters to discuss the Zapatista health care. Anastasio coordinates the work at the Clínica la Guadalupana, Celia and Guadalupe specialize in gynecology. They speak Tsotzil as their mother tongue, and answer my questions in Spanish at a calm pace, every now and then double-checking the meanings of certain words. Though the open window we hear the romantic Banda-music that a band dressed in ski-masks plays further down the hill.
The decision of Zapatistas to create an autonomous health care system was driven by profound necessity. "There are a lot of curable illnesses. But in the villages there is no one to cure them, and people have no money to pay for the journey to the doctor. So we, as health promoters, provide services here in villages," Anastasio comments proudly.
The indigenous poor are excluded from the government health care services. "Mestizos, who have money, get treated fast. Moreover, hospitals are nice and clean, and when a poor farmer arrives in dirty shoes, doctors don't even let him enter," Anastasio maintains.
In Zapatista village clinics, houses of health care and "mini-clínicas" receive patients free of cost. At least as important as treatment is the prevention of disease. The health promoters train people in isolated villages about the importance of the use of latrines, boiling water and keeping the yard clean. Children are also vaccinated in the village.
"Here we can treat for example parasites and diarrhea, pneumonia and skin infections. Only when we cannot cure something, we transport the patient to a government hospital," explains Celia.
The attempt of the Zapatistas to improve local conditions had already started before the 1994 uprising. Clínica la Guadalupana began its work in 1992. During these years it has developed significantly. Now the clinic has general reception, dental care, gynecological care, eye exams, an optician, and a maternity ward as well as a laboratory, pharmacy and a special laboratory for medicinal plants.
Clínica la Guadalupana was started by eight health promoters; currently there are 40. In the Oventic area, which is one of the five administrative areas of the Zapatistas, there are 300 health promoters.
The clinic, which is largely dependent on foreign support, is lacking medicines and materials. One way to cut down dependency on money has been to turn towards the village elderly to learn about medicinal plants. "Approximately 40 percent of the medicine we use comes from plants," Anastasio tells us.
There is also a room for surgery in the clinic, but surgery is beyond the skills of the health promoters. "Here there is no permanent doctor, but an Italian doctor compañero has been coming to support us every now and then for several years."
New health promoters are constantly trained in the villages. The promoters are trained by French doctors of the Médicos del Mundo project together with more experienced health promoters. "The course starts with preventative medicine. Then we learn about different parts of the body and what happens when some intestine gets sick. The training has three levels and every level lasts from eight months to a year," says Guadalupe.
When my belly starts to return to normal and I have finished probing most of my curiosities about the logic and practice of Zapatista health care, most of the revolutionary tourists who have participated in the Intergaláctico are returning to picturesque San Cristóbal de las Casas.
I leave the muddy paths and misty hills of Oventic contemplating both the urgent need for comprehensive, free health care services and my own privilege- knowing how many people are excluded absolutely from the most basic health services, and that I, with my European travel insurance card, can visit any hospital I wish and pay for whatever treatment is prescribed if I should have another case of diarrhea.
