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Complex Illnesses and Complementary Cures

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Abstract

This chapter explores diagnostic procedures and their attendant social processes, followed by an analysis of how diagnosis and treatment relate to the olvidos of Chile. It is argued that the categories of disease in biomedical/psychiatric practice and in shamanistic healing practice lead to fundamentally different notions of the patient’s body, which have different implications for the patient’s relationship with his or her social world. The practice of the biomedical doctor is based on defined, established disease categories, while the patient’s subjective experience and the experience of his or her social relations are mostly only relevant in order to identify signs and symptoms that correspond with the categories. In shamanistic practice the use of a disease category focuses on causality rather than a set of symptoms. It is argued that this calls for much broader intersubjective involvement.

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Notes

  1. 1.

    Interview with Juan Ñanculef, see Latcham (1924: 435).

  2. 2.

    An example of this is the practice of the so-called nguillatún-misa, a combination of a Christian mass and the Mapuche ritual of fertility, nguillatun, where a sheep was sacrificed as the “symbol of God” while a bishop (in this case, Monseñor Guido de Ramberg) blessed the food and drink (described in Forster and Montecino 1996: 63).

  3. 3.

    Law Decree no. 725, published 31 January 1968.

  4. 4.

    ISAPRES are “private entities that offer a series of medical insurance and workman’s compensation packages in return for a basic 7% payroll contribution plus an additional premium of 2–3% depending on the size of the package” (Borzutsky 2006: 150).

  5. 5.

    There is tendency for women to have less access to the private health system, as only 13.8% of the insured are women (Borzutsky 2006: 152).

  6. 6.

    According to my own survey, 32% of the respondents claimed to have suffered from depression, 30% from anxiety and 46% from nerves (or sistema nerviosa).

  7. 7.

    “El estado reconoce el derecho de los indígenas a mantener y desarollar sus propias manifestationes culturales, en todo lo que no se oponga a la moral, las buenas costumbres y el orden público” (Articulo 7, Ley Indigena 19.253). (The State recognizes indigenous rights to maintain and develop their own cultural manifestation, in ways which do not offend public morals, common customs and the public order. [Indigenous Law 19.253, Articulo 7].)

  8. 8.

    An example of a lawsuit is given by the Chilean anthropologist Ana Mariella Bacigalupo, who, in the article “The Mapuche Man Who Became a Woman Shaman”, describes the case of a machi who was accused of homicide by poisoning of one of her patients, a 17-year-old boy (Bacigalupo 2004).

  9. 9.

    These are the most common illnesses which I encountered during my fieldwork. For a more comprehensive list, see Citarella et al. (1995) and Bacigalupo (2007).

  10. 10.

    A medical certificate is an official document that is issued by clinicians and required in order for students and workers to be excused from school or work responsibilities and to lay claim to such things as disability payments.

  11. 11.

    Interview with Dr Eduardo Paez.

  12. 12.

    In 1929 the construction of the Hospital Regional Temuco commenced; it was completed in 1933. In 1976 it was remodelled to its current design and in 2004 was renamed the Hospital Regional Hernán Henriquez Aravena. Today the hospital also functions as a university hospital and forms part of the Faculdad de Medicina de la Universidad de la Frontera as an institution for higher education.

  13. 13.

    When I later run into her on the street, she explains to me that she needed the medical certificate for a grant application for her daughter’s university studies.

  14. 14.

    The two most important questions for diagnosing depression according to CIE 10 are listed as “¿Se ha sentido triste o deprimida la mayor parte del tiempo, o casi todos los días?” and “¿Ha estado desinteresada (o) o incapaz de disfrutar la vida la mayor parte del tiempo, casi todos los diás?” (Ministerio de Salud 1998).

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  1. University of Southern Denmark, Odense M, Denmark

    Dorthe Brogård Kristensen

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Kristensen, D.B. (2019). Complex Illnesses and Complementary Cures. In: Patients, Doctors and Healers. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-97031-8_3

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  • DOI: https://doi.org/10.1007/978-3-319-97031-8_3

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