Raza

While others have written about “race” and racialized biology,^13,14,15,16 my work is about the construction of social identities that allow for the gendered manipulation of “race.” What is being racialized is not just the biological body or the national body, but also the moral body. Thus, I turn to the work of Marisol de la Cadena and Elizabeth Roberts to argue that raza in Latin America is a complex social category that extends beyond “race” to include class, education, and “culture.” My argument is not about deciding whether “race” is essentially biological or primarily a social construct - rather, I am concerned with how a history of colonialism in Mexico has opened a space for racialization processes which lead to the production of differential (“race”-infused) identities.

While I resist reducing race to a matter of biology, biological race is used to define the right and wrong types of reproduction, which in turn shapes policy and practice both nationally and transnationally.¹⁷ While medical anthropologists have extensively studied these effects in the realms of international population policy and migration,^18,19,20,21 and have analyzed how nineteenth and twentieth-century battles about slavery, miscegenation, immigration, population control, and eugenics resulted in the categorization of people into fit and unfit reproducers,^22,23,24,25 my work addresses Brubaker and Dillaway’s call to:

…conduct comparative research on the subjective experiences of pregnant and birthing women at multiple social locations and multiple contexts, as well the experience and perspectives of midwives and medical providers in order to provide a more critical and meaningful analysis of the complicated intersections of ideology, politics, practice and bodily experience.²⁶

I employ Robert’s notion of raza [race] and provide ethnographic examples of how “reproductive governance” is applied to the supposedly hyper-fertile indigenous women. In doing so, my work is informed by a binational discourse critiquing public health systems in Latin America.^{4,27,28,29,30,31,32,33,34,35,36} By including medical care as another means to mark and transform race, Roberts³⁷ is calling attention to the malleability of material reality, and thus critiques tendencies to mark a divide between nature and culture, and assumptions about the universality and fixity of biological processes.^38,39,40,41 She explains that in the Andean context, public health services were developed to intervene upon poor and indigenous populations, and especially hyper-fertile indigenous women.^42,43 Thus, while raza is pliant, plastic, and cultivatable in the Andes, it is still used to justify inequality.

Similarly, De la Cadena points to how raza is shaped by employment, locale, dress, class, levels of “decencia” [decency] and sexual conduct.⁴⁴ De la Cadena explains how pervasive racism in Peru is erased, using a rhetoric of cultural difference:

These exculpations of racism are embedded in a definition of race rhetorically silenced by the historical subordination of phenotype to culture as a marker of difference. In other words, Peruvians think their discriminatory practices are not racist because they do not connote innate biological differences, but cultural ones.⁴⁴

For De la Cadena, cultures are vessels of immanent inequalities, leading to the mystification of racial discrimination and “racism without race.” Culture is achievable, and categories such as Indians and mestizos emerge from interactions and not from evolution. One’s phenotype can be subordinated to one’s intelligence and morality if these have been corrected by “education.” Thus, a brown-skinned individual who is sufficiently educated can become “socially white.”⁴⁵ With respect to the Mexican context, I do not deny associations between phenotype and how people are identified as racialized beings; however, I expressly resist the idea of “race” as phenotype, and signal how “social whitening” is sometimes achieved through the accumulation of cultural capital.

Clark focuses on how educating Indians produced them as national citizens: “By definition Indians were seen as ignorant, because it was assumed that Indians who were educated would automatically become mestizos”⁴². Roberts¹⁷ writes about the entanglement of raza and class relations, indicating that

…disentangling class and raza would do damage to an ethnographic understanding of care relations in Ecuador. Identifying the kinds of food ingested or care received as social markers of class, misses the way that raza is produced within economic relations.¹⁷

This article develops the concept of racial i(nter)dentification as a way for thinking about the syncretic nature of racialized identities.^28,29 Racial i(nter)dentification is a tool for analyzing the multiple variables contributing to the immediate, often unconscious, mental calculus that occurs during quotidian encounters of difference, which in turn structures how individuals interact, including during medical encounters. In these moments, “race,” class, education, and other forms of cultural capital are folded into one another to produce social constructions of gendered racial identity that include and supersede phenotype. Racial i(nter)dentification explicitly attends to the amalgam of non-biologic elements that are folded into notions of “race.”

Furthermore, instead of deploying the concepts of “race” and racism, I am pointing to how racial i(nter)dentification unfolds in and through processes of gendered racialization. That is, throughout this article, I resist the reification of “race” and instead use ethnographic observations to critically analyze intersectional processes of gendered racialization. My approach builds upon a hefty literature on “intersectionality” - the study of how dimensions of inequality co-construct one another, an intersectional way of thinking about the problem of sameness and difference in relation to power, a foundational logic of interlocking oppressions, and an examination of systemic domination that overlaps sexuality, race, gender, economic class, etc.^46,47 According to Granzka, scholars of “strong intersectionality” (as opposed to “weak intersectionality”) engage in constant self-reflexivity, wielding the concept as an analytic tool that critiques power and privilege, and producing counter hegemonic knowledge about marginalized and subjugated groups.

Kimberle Crenshaw’s analogy of the increased likelihood for injury due to crossing traffic at an intersection elucidates how black women in the United States sometimes experience gender discrimination in a similar way to white women, other times they experience racial discrimination similarly to black men, and still other times they are discriminated against as black women - not the sum of racism and sexism, but something that supersedes these individual categories and cannot be described as a derivative of white women’s or black men’s lives. Crenshaw emphasizes gender discrimination against women who are already marginalized due to race and/or class, and argues that while racialized women face some of the same obstacles that more elite women face, they also encounter obstacles that are unique to them.⁴⁸

My research provides many examples of the “class apartheid” to which Gayatri Spivak refers-the class divisions within individual nations that lead people of the same “culture” to live divergent realities.⁴⁹ One of the aims of this article is to draw attention to the complex ways class is embedded in gendered racialization processes, and vice versa, to create multivalent social categories. Among gendered individuals, one may ask if “race” is doing the work of class or if class is doing the work of “race.” This article adds complexity to the story by describing how gender, race, and class intersect and are mutually imbricated: that is, among gendered individuals, race does the work of class and class does the work of race. Racialization and class, as well as resulting categories like education level and geographic location, are mutually imbricated and compounded in people’s lives. That is to say, people cannot experience their positionality in society through only one of these factors; they necessarily structure their identity and their relationships with others through the combination of these intersectional factors.^37,46,50,51,(⁵²

While my description of different positionalities within Mexican society can be compared to Bourdieu’s habitus,⁵³ I have developed racial i(nter)dentification as a way of simultaneously acknowledging the readily visible phenotypic differences between the haves and have nots. I insist that multiple, overlapping, structural inequalities are unfolding; thus, I offer racial i(nter)dentification and intersectionality as multivalent conceptual tools because I refuse to disregard the blatant visual discrepancy between institutional representatives and Oportunidades program recipients across Mexico. “Race,” gender, and class in Mexico are intimately imbricated, kaleidoscopic categories. Processes of gendered racialization collapse and incorporate a multitude of social factors, yet reducing these processes to a discussion of habitus would obscure apparent phenotypic gaps readily observed throughout my ethnographic research.

In this article, I primarily examine the “race” axis of intersectional forms of oppression. That is, I aim to explore the racialization aspect of gendered racialization. I am by no means elevating racialization to the most significant criteria for analysis-socioeconomic class, education level, gender, geographic location, etc. are important, intersecting units of analysis. However, I am suggesting that analyzing racialization in this article will point our attention to how colonial legacies continue to shape identities. Furthermore, by placing emphasis on racialization as an analytical lens, I am questioning how a history of colonialism continues to mold the contemporary transnational order.⁵⁴

Racial i(nter)dentification and the Mexican government

Citizenship is a fertile terrain for negotiation between indigenous women and the Mexican government. These women are recruited into Oportunidades and required to give birth in government hospitals. While my observations at times coincided with those of Smith-Oka⁵⁵ in that some indigenous women eagerly seek biomedical attention while giving birth - this author argues that Oportunidades shapes these poor indigenous women into obedient mothers and “modern” citizens - I interviewed many others who resist mandates due to prior experiences of racial discrimination.

Despite persistent evidence of marginalization of indigenous peoples and examples of profit-seeking around constructed images of indigeneity, I am attentive to Clifford’s point about dynamism^56,57 - I am careful not to deny indigenous informants and friends of their agency by portraying them only as victims. Thus, I am concerned not only with how indigeneity is portrayed by non-indigenous ethnomedicine enthusiasts, but how indigenous individuals portray their own ethnic identities.² I suggest that while indigenous people have suffered from centuries-long structural violence, they have also devised strategies for leveraging their indigeneity and, at times, view their indigenous heritage as a source of pride. My perspective does not sanitize the effects of violence and long-standing exclusion, nor does it diminish the agency and dynamism of indigenous individuals; rather, I aim to cast indigenous informants as agentive, proactive people who experience their indigeneity both as a source of marginalization and also as a valuable resource.

The very different ways indigenous women engage medical care undermines ubiquitous arguments for “interculturality” among medical and public health sectors in Mexico. Interculturality in Mexico aims to reduce the effects of xenophobia by incorporating indigenous cultural elements into government-provisioned services. In the following pages I return to how my framing signals the inadequate attention of “interculturality” to gender, racial discrimination, and political economic factors. My concept of racial i(nter)dentification questions the reification of cultures upon which “interculturality” is premised.

Deadly consequences of gendered racialization

When I attended a training workshop for traditional midwives given by Mexican Institute of Social Security in Zongólica, Veracruz, I witnessed a striking moment when a single woman’s body became a site of contestation about race, class, gender, and power. The room was divided into two glaringly distinct spaces: male doctors with white coats stood in front of the room, and traditionally-dressed indigenous midwives sat in the audience. An elderly midwife, Paloma, stood up in the very last row. Paloma told a story about how the neglect of medical doctors and staff led to the unnecessary death of an indigenous woman’s baby. The pregnant woman had arrived at the hospital in active labor, and the nurses refused to attend to her. The desperate mother rushed to the restroom and gave birth to a stillborn child. The dead infant was born into the toilet. Having never been assigned a hospital bed, she left pools of blood on the hallway floor, and the nurse scolded her for making a mess and forced her to clean up the blood. Paloma ended the wrenching tale by yelling, “I, too, could put on a white coat! [Translation from: yo también puedo ponerme una bata blanca.]”

The hospital director asked Paloma the name of the community worker involved in the case. When she answered him with the female, indigenous community worker’s name, he nodded, as if to say, “Ah, yes,” and stated aloud that this community worker has been involved in several unfortunate cases. If the community worker had succeeded in getting the birthing mother to the hospital sooner, he suggested, the case would not have ended tragically. He promised Paloma that he would reprimand the community worker. While this seemed to appease Paloma somewhat, I was less satisfied with this resolution. In a matter of seconds, the female, indigenous community worker became the scapegoat for a health system that is failing at multiple levels. The medical personnel at the hospital were, by a sleight of hand, let off the hook. The hospital director quickly directed the workshop attendees away from this “disruptive” anecdote and toward other matters. However, the incident lingers in my mind. The woman’s hemorrhage and the infant’s life-that-never-was had been the site of contestation, but they were not the real objects of the debate.

This anecdote bolsters the analysis and critique of Nazar-Beutelspacher’s⁵⁸ assertion that in Mexico, the approximation of institutional services to indigenous populations is an encounter between two cultures, and is embedded in unequal relations with respect to the value of knowledge and distinct medical practices. My ethnographic observations suggest that indigenous and mestizo cultures unfold and evolve through engagement with one another, and are, thus, co-constitute. Indigenous informants contest and shape how their medical practices are valued, at times leveraging “indigenous” knowledge in entrepreneurial ways. At the same time, social collectivities are differentially nested in geographic places and even “racially” segregated in clinical spaces, signaling how material disparities result from structural inequalities.

The incoherency of Oportunidades

One particularly elucidative pathway for understanding the relationship between the Mexican government and indigenous groups is through detailed examination of Oportunidades conditional cash transfers. Paloma acquiesced following public dispute with the hospital director in Zongólica. However, throughout my research, I observed many midwives’ disparate behavior in public and private realms. Traditional midwives and indigenous Oportunidades recipients performed obedience in workshop settings while enacting resistance to government mandates in their daily lives. Program successes “front stage” (like widespread attendance to Oportunidades-mandated workshops) did not easily translate to changes in social behavior “back stage.” Molyneux goes as far as to argue that Oportunidades puts mothers at the service of the “new poverty agenda” and inadvertently exacerbates gender inequality when it holds mothers accountable for their childrens’ well-being, excuses fathers of responsibility toward their offspring, and provokes marital discord (and potentially domestic violence) by putting cash stipends in the hands of women amidst widespread unemployment of male “providers.”⁵⁹

According to Rodrigo, a physician turned Mayan rights advocate and board member of an indigenous association in Chiapas, training workshops offered by the state are meant to reinforce inequality in existing power structures. While the Oportunidades program has been lauded within the realm of public health,⁶⁰ I argue that the conditionality of cash transfers evidences differential valorization of knowledge and medical practices while also serving to extract obedience from Mexico’s racialized “Others.” From Rodrigo’s perspective,

Oportunidades is really [an example of] the dominant society practicing coercion over indigenous people. [Translation from: el programa Oportunidades es en realidad [un ejemplo de] las prácticas coercitivas infligidas a los indígenas por parte de la sociedad dominante.]

As an outspoken critic of biopiracy and a proponent of indigenous knowledge, he argues that while traditional midwives’ resistance to biomedical methods is deemed “backwardness” by medical professionals, traditional midwives are not interested in learning new techniques because they are confident about the effectiveness of the techniques they have been using for generations. He explained that while traditional midwives may attend training programs in order to continue receiving cash transfers and other government-provisioned services, they often do so with no intention of changing the methods they employ in their everyday practice of midwifery.

Rodrigo’s assertions are supported by traditional midwives like Yanira who, during an in-depth interview, explained that women’s participation in cash transfer programs has resulted in changes to what she reveals about her practice to authorities, but has not altered the substance of her midwifery. That is, women who receive support from Oportunidades tell her,

Don’t give me a birth certificate. I am going to say that [I couldn’t make it to the hospital in time] and gave birth alone at home. I am going to say that I was not attended by a midwife. [Translation from: no me des un acta de nacimiento, yo voy a decir que [no llegué al hospital a tiempo], y que di a luz sola en casa, y que no me atendió una partera.]

However, my ethnographic research did not point to wholesale resistance. While indigenous informants often complied with Oportunidades mandates in ways that suggested engagement at the level of form instead of substance, I also observed how Oportunidades mandates structure the rhythm of indigenous womens’ daily lives.

During my first trip to Zacatochin, I joined Francisca as she completed the requirements for her two-week “field practice.” Among the requirements was to deliver a workshop to the villagers, educate them about reproductive health, and document the number of attendees as a measure of her “impact.” Francisca went to the municipal offices to sign up to have her workshop announced throughout the village. Since there are no telecommunicative services in the village (no telephone, internet, etc.), announcements are made via an old Volkswagen Beetle that drives slowly along the winding mountainous pathway, blasting information through a megaphone attached to the roof.

The next day, Francisca and I went to the gathering place where community-wide workshops are held - cement basketball courts covered by corrugated metal, built with government funds to foster “community development.” We waited, and no one arrived. Francisca decided to wait half an hour past the announced start time, and two women arrived. Disappointed in the meager turn out, Francisca half-heartedly delivered the workshop materials she had prepared, and then we walked back to our host’s home.

That night, Francisca reflected on the disinterest in her workshop, and she decided that if villagers were uninterested in learning information that was to their benefit, they would have to be coerced. Furthermore, she refused to return from her “field practice” to report that the impact of her workshop had been the delivery of educational materials to two people. The next day, while I was at the village clinic interviewing the médico pasante [medical intern], Francisca returned to the municipal offices to announce another workshop. This time, she identified herself as someone who was coming to the village on behalf of the state-level Secretary of Health and that her workshop was mandated by Oportunidades. The next day, we returned to the basketball courts and prepared for the workshop. This time, over one-hundred and thirty members of the community, mostly women, attended. At the outset of the workshop, Francisca announced that at its conclusion she was going to take roll by asking to see each participants’ voting registration card and cataloguing each person’s name. This list, according to what she told participants, was going to be reviewed by the authorities at Oportunidades to determine compliance. In this way, Francisca insured that her audience remain captive until the end of her workshop.

As a professional midwifery student, Francisca was trained in medical terminology, and the intention of this “community engagement” experience was to allow her to develop the skills necessary to practice intercultural midwifery in rural settings. Francisca’s presentation of reproductive health was littered with biomedical terms that were incomprehensible to workshop attendees and she failed to explain underlying physiological properties. The workshop “participants” stared blankly at her during most of the workshop. At the conclusion of the workshop, attendees lined up as Francisca took their identification cards one by one to write down their names.

This anecdote clearly highlights Francisca’s abuse of power, evidencing how women with relatively greater privilege can also act as agents of structural inequality against other women. Moreover, it points to how conditional cash transfer programs like Oportunidades extract obedience from women recipients on the basis of their poverty and dependency on government-provisioned stipends. When the workshop was not a requirement for continued receipt of Oportunidades stipends, community members were almost universally disinterested. Subsequently, threat to Oportunidades stipends elicited compliance from village members. During private conversations, informants have expressed their annoyance at having to their daily routines disrupted and dictated by Oportunidades mandates. One mother reported feeling like “a ball, bouncing from one place to another.” Instead of validating the intended positive effects of obligatory social services, the Oportunidades recipients I interviewed pointed to their frustration with the conditionality of the cash transfers and with forced compliance. I argue that programs like Oportunidades are shaped by notions of “interculturality” that are valuable in theory, but contradictory in practice.

Interculturality

In Mexico, “interculturality” had emerged as a buzzword in government offices, academic circles, and a few hybrid clinics to describe respect for cultural differences through the merging of traditional indigenous medicine and biomedical methods. “Interculturality” is explicitly mentioned as a priority in the second article of the Constitución Política de los Estados Unidos Mexicanos⁶¹ [Political Constitution of the United Mexican States], which guarantees an increase in scholastic levels and favors intercultural education. The article states,

The nation has a pluricultural composition originally based in the indigenous peoples who are the descendants of those who inhabited the present-day territory of our country at the start of colonization and who preserve their own social, economic, cultural, and political institutions […] Awareness of their indigenous identity should be a fundamental criteria for determining to whom regulations regarding indigenous peoples applies. [Translation from: La nación tiene una composición pluricultural sustentada originalmente en sus pueblos indígenas que son aquellos que descienden de poblaciones que habitaban en el territorio actual del país al iniciarse la colonización y que conservan sus propias instituciones sociales, económicas, culturales y políticas [...]. La conciencia de su identidad indígena deberá ser criterio fundamental para determinar a quiénes se aplican las disposiciones sobre pueblos indígenas.]⁶¹

The article goes on to state that, in an effort to ameliorate the rezagos [backwardness] in indigenous communities, authorities are obligated to assure effective access to health services that make the most of traditional medicine, as well as support the nutrition of indígenas through food programs, especially for the child population (Article 2, Section B III). Furthermore, authorities are obligated to foster the incorporation of indigenous women into development through support for productive projects, the protection of women’s health, and granting incentives to boost women’s education and participation in decision-making related to community life (Article 2, Section B V).

I argue that notions of “interculturality” are ubiquitous in Mexico, and are thus woven into development programs like Oportunidades even when not explicitly stated. The Mexican government engages with its indigenous population through the (supposedly) benevolent and equitable framework of “interculturality.” However, I examine the textual politics³⁸ of “interculturality” to uncover how this concept has been authored from positions of power as an approach to communities that are presumed inferior. The use of the word rezago in the Mexican constitution while describing various “intercultural” strategies points to the contradictory way interculturalidad in Mexico purports to equitably grant citizenship-based rights to indigenous community members while simultaneously casting indigenous people as “backward.”

To try to understand the concept of “interculturality” better, I shared my observations and compared experiences with Jaime Breilh, Director of Health Sciences at Universidad Andina Simon Bolivar. He explained to me that in Ecuador, interculturality emerged as an indigenous movement, originating from the indigenous people. It has transformed not only into a political juncture, but an intellectual one as well. The people of Ecuador began applying their critical perspective to a colonial past, and the result was an epistemological and philosophical proposal for the future. In contrast, in Mexico “interculturality” did not originate from indigenous people; rather, it emerged as a theoretical debate in academia and a bureaucratic strategy in public health policy and development.

My ethnographic fieldwork suggests that “interculturality” is a powerful force for producing racialized subjects, arranging them hierarchically, and extending the material effects of those hierarchies. I am arguing against a naïve reading of “interculturality” - a liberal formulation that creates a utopian vision of a world of harmonic difference that exists apart from power. That is, “traditional” medicine and biomedicine do not come together on a level playing field, penetrating each other equally and evenly. The expert knowledge of physicians and traditional medicine doctors are not equally valued, they are not equally renumerated, nor are they equally supported by healthy policy and infrastructure. Often, when “interculturality” is celebrated, a series of persistent inequalities are ignored. I am wary of how unequal power dynamics, disparate perceptions of value, and ongoing racial discrimination can potentially be masked by emphasis on “interculturality,” whether it be at the level of academic debate, or public health policy.

When performing fieldwork, I spoke to a variety of people in order to think through how “interculturality” is put into practice. A physician turned NGO leader and traditional medicine advocate spoke to me about different “intercultural” clinics around the country where traditional medicine is “butchered” and decontextualized, de-authenticated techniques are applied in isolated and incoherent ways. For example, in La Riviera Maya, one hospital installed hammocks in the waiting area as a “intercultural” strategy, while nothing was done to make the actual delivery of health care and therapeutics more culturally appropriate.

Meanwhile, efforts to develop more substantive forms of interculturality encounter obstacles when seeking funding. These obstacles stem from the fact that, despite the rhetoric of “interculturality” within policy, the legitimacy of counter-hegemonic models are severely questioned. One midwife, an adjunct professor at the Universidad Intercultural de Quintana Roo, told me “intercultural models are not respected at all. [Translation from: los modelos interculturales no se respetan en absoluto.]” The university at which she works is part of an emerging university system that attempts to incorporate indigenous knowledge into university-level education and requires students to study the Mayan language and learn about traditional medicine alongside biomedical methods. Nonetheless, the intercultural university model struggles to be acknowledged and valued within Mexican academia.