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Poznań, Poland - Morasko Kampus, room: 3.44
Complicating the imagined ethnic borders in rural reproductive health care: Experiences from the Peruvian Andes
Peru has been described as ‘fractured society’ (Cabrera,2017); and nowhere has this been more obvious than within state-health care. The poor, indigenous-Quechua in the rural-highlands receive free-of-charge, but sub-par, family-planning and reproductive care that has historically shown a biopolitical agenda with the forced sterilisations of this population. Main reasons given for discriminatory care is the profile of the health-workers; white, coastal, urban, and university-educated, they have been said to look down upon their illiterate, rural, indigenous patients and express prejudice behaviours (Ewig,2010) leading to reproductive-governance (Morgan,2012). The border disjunctions here are not international, or even necessarily regional, but ideological and imagined. This paper aims to complicate the persistent narrative. Based on a year of ethnographic fieldwork in the Southern-Andes, the research suggests that in certain contexts, the workers are themselves indigenous, rural Quechua-speakers. The fact that unequal reproductive health care continues therefore invites new questions of imaginary borders; not one of lineal racism as hitherto implied, but a narrative of intra-community discrimination; a Peruvian phenomenon called ‘choleando’ (Bruce,2009). It will be argued that this is encouraged through discourses of ‘aspirational whiteness’ and ‘modernity’ (Guerra-Reyes,2013) that touch all members of indigenous-communities. Furthermore, the precarity within which rural health-workers operate exacerbates the problem; obstetricians who are largely female suffer gendered discrimination at work; individualised blame for the past sterilisations, and isolation from families whilst at their rural workplace. The paper concludes that to address these imagined borders in care between communities, we must also attend to the (often-overlooked) experiences of rural-indigenous health-workers.