OSORNO, Chile (AP) 鈥� In labor with her first child last month, Lucia Hern谩ndez Rumian danced around her hospital room while her husband played the kultrun, a ritual drum.
She turned down pain medication from the hospital鈥檚 staff to get massages and oil rubdowns instead from her cultural liaison, who had ceremonially purified the space according to Mapuche customs.
鈥淚t became my own space,鈥� Hern谩ndez said.
The largest public hospital in the southern Chilean city of Osorno is finding new ways to incorporate these and other Indigenous health care practices. There's a special delivery room with Native images on the walls and bed, forms for doctors to approve herbal treatments from trusted traditional healers, and protocols for 鈥済ood dying鈥� mindful of spiritual beliefs.
The hospital鈥檚 efforts validate cultural practices at a time when Chile鈥檚 Indigenous groups 鈥� particularly its largest, the Mapuche 鈥� are fighting for rights and restitutions with unprecedented visibility .
But they also restore a crucial spiritual component to health care, according to health professionals and patients at Hospital Base San Jos茅 de Osorno.
鈥淚t must be a guarantee 鈥� we take charge of the physical part, but without transgressing on the spiritual dimension,鈥� said Cristina Mu帽oz, the certified nurse-midwife who launched new delivery protocols that Indigenous pregnant women can customize and are believed to be the first in the country.
Cristina Aron, the patient who first inspired Mu帽oz more than a decade ago, has now become a cultural liaison to Hern谩ndez and two dozen other women from pregnancy into early motherhood.
鈥淐hildbirth is a spiritual energy event for the mother, the baby and the community,鈥� Aron said.
She had hoped to deliver her daughter in the countryside with a traditional midwife. But Chilean law requires professional health workers to deliver babies because of past high maternal mortality.
So Aron turned to Osorno鈥檚 hospital and negotiated her delivery conditions with Mu帽oz, including being accompanied by a woman conversant in Mapuche practices and taking her placenta to bury ceremonially in her ancestral lands.
Mapuche people see the placenta as holding a twin spirit to the child鈥檚. Its burial, often with a tree planted on top to grow as the newborn does, is believed to create a lifelong connection between children and the natural elements of their family鈥檚 territory.
鈥淚t鈥檚 something very poetic and very revolutionary,鈥� said Alen Colipan, whose son鈥檚 placenta was placed by a river near his paternal grandmother鈥檚 house. 鈥淗e will not feel this uprooting from his land.鈥�
Colipan was 17 when she gave birth in Osorno鈥檚 intercultural delivery room, with a floor-to-ceiling photo across three walls of the rocky beach that is home to grandfather Huentellao, a protector spirit revered by the Mapuche Huilliche, the region鈥檚 Indigenous group.
Colipan said her then-85-year-old midwife, Irma Rohe, who had never entered a hospital, was allowed to receive the infant 鈥渨ithout gloves and other imposed things鈥� and ritually clean him.
鈥淲e鈥檙e going back to wanting to give birth with people with ancestral knowledge,鈥� Colipan said. 鈥淓ven our way of being born was dominated. We have to begin to liberate it.鈥�
Chilean law now requires hospitals to give the placenta to mothers if requested. . Mapuche people account for one-third of Osorno鈥檚 inhabitants and eight of 10 in the adjacent province of San Juan de la Costa, said Ang茅lica Levic谩n, who has been in charge of Indigenous relations for the hospital since 2016.
鈥淗ealth care among Indigenous people always existed. Then came another system to invalidate our own system,鈥� she said. 鈥淥ur intention is that they complement each other.鈥�
To join both kinds of medicine is not easy. Many Indigenous people perceive public hospitals as yet another state institution that discriminates against their beliefs.
Mapuche medicine, based on spirituality, is also different from what doctors are trained for, said Jos茅 Quidel Lincoleo, director of a center for Mapuche health care studies in Temuco, another southern city with a large Indigenous population.
to discover the 鈥渂iological, social, psychological and spiritual root of the problem鈥� that is manifesting as a disease, Quidel added.
鈥淚t could be another previous life, or some harm done to you, or a lack of self-knowledge that makes us transgress on our worldview,鈥� he said.
But doctors and traditional healers say they can complement one another鈥檚 work by realizing that every expert only knows a fraction of what鈥檚 possible, especially when battling new diseases like COVID-19.
鈥淥ne understands that saving a body needs to be compatible with beliefs,鈥� said Dr. Crist贸bal Oyarzun, a rheumatologist and coordinator of internal medicine at Osorno鈥檚 hospital. 鈥淎 patient with inner peace has better opportunities to heal.鈥�
That鈥檚 hard to achieve in the aseptic, isolated environment of a hospital, especially during the pandemic. Mapuche healers continued to pray and 鈥渟piritually accompany鈥� patients from afar, said Crist贸bal Tremigual Lemui, a healer from San Juan de la Costa who has long collaborated with Osorno鈥檚 hospital.
鈥淔or us that is essential 鈥� so patients can receive the energy they need,鈥� he said.
Family members also flocked to the hospital鈥檚 prayer space 鈥� an outdoor circle of small sacred laurel and cinnamon trees with a firepit next to the parking lot 鈥� to hold ceremonies for the dying, Levic谩n said.
Walk-ins and admitted patients who identify as Indigenous 鈥� an average of 50 a day 鈥� are welcomed and accompanied by Erica Inalef, the hospital鈥檚 intercultural facilitator, so that 鈥渢hey don鈥檛 feel so very alone.鈥�
When, as a teen, she took her elderly father to a hospital, doctors would barely talk to them, and 鈥渂ody and spirit were separated.鈥�
Now, doctors can see the enthusiasm with which patients welcome the arrival of consulting traditional healers, and that helps build mutual trust, Inalef said.
Trust can manifest in a traumatologist signing off on a patient鈥檚 lawenko 鈥� an herbal tea whose exact composition the healers hold secret 鈥� or in an obstetrician allowing a woman in labor to wear her munulongko, a headscarf believed to protect her.
Cultural clothing is one section in the labor plan Mu帽oz developed five years ago, which pregnant women can customize. She hopes more will become aware of this option 鈥� only about 20 of the hospital鈥檚 1,500 births each year are intercultural deliveries.
鈥淚ndigenous women are doubly timid, discriminated against for being women, Indigenous, poor and rural,鈥� Mu帽oz said. 鈥淲e tell her, your body is the first territory you鈥檙e going to recover.鈥�
Reclaiming ancestral practices is what drew Angela Quintana Aucapan to have her baby 鈥� Namunk眉ra, or 鈥渇irm step鈥� in Mapudungun 鈥� in the special delivery room recently, while relatives played traditional instruments.
鈥淚 was able to do it as my ancestors did,鈥� she said. 鈥淲ith a ceremony while we waited for the new addition to the family, I felt supported as I received my baby.鈥�
___
Associated Press religion coverage receives support through the AP鈥檚 collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.
Giovanna Dell'orto, The Associated Press
