“No hay drama”: Precarity, Neglect, Mental Health, and HIV-AIDS among Women in Chile

Paula Saravia (PI)

 

During the last decade, there has been an increase in the diagnosis of mental health illnesses and HIV-Aids in the rural, semi-rural and underserved communities of the Northern metropolitan area of Santiago, Chile. In 2016 the local mental health care center in Lampa and the National Network of Original Peoples (RENPO) reported to the Ministry of Health their concerns about the staggering mental health and HIV/Aids diagnoses impacting Mapuche peoples and Haitian migrants. However, the government has not yet responded to said concerns. What are these alarming statistics and the government silence about this problem showing about the experience to live and be ill in rural and semi-rural Santiago? What are the meanings behind the narratives of precarization, alcoholism, and neglect expressed by mental health and HIV-Aids patients in Lampa?

This research proposes a discussion on both the epidemiological information available and the lack of detailed statistics conveying the magnitude of HIV-Aids and mental health illnesses among indigenous peoples and migrants. This work aims to show the lived experience of precarity and illness and the socio-symbolic structures that give meaning to diagnoses and treatment in Lampa vis-vis state neglect.
Ethnographic work was conducted in Lampa during August and September of 2016 with the Chile Global Health Field School and included 25 in-depth interviews, participant observation, and 140 surveys focused on illness experience, subjective well-being, and community engagement.
 
We analyze what produces the blurry frontiers between medical categories and diagnoses about illnesses of the “body” and “mind." In Lampa, cultural epidemiology of depression refers to an embodied experience of the life of the “poor,” linking this experience to precarity and everyday forms of structural violence, including state neglect. Hence, cultural categories such as “drama” and “stress” become relevant for keeping pain, suffering, fear, and anguish in the shadows. These socio-symbolic structures, which give meaning to illness and healing, are also oriented towards ways of being in the world that neglect the reality of the “imaginary” suffering and focus instead on “natural” bodily suffering, one that is socially accepted and that allows for hope and potential healing. Finally, in this study, I argue that the ways in which diagnosed patients face their illness are linked to broader sociopolitical processes, such as struggles for ethnic historical claims (reinvidicación) and indigenous political participation - promoted by the state in the form of intercultural health programs - and to social conflicts that emerge from accelerated international migration - indigenous and non-indigenous - in Northern Santiago.

Research poster presented at the UC San Diego public health research day.