Jak state healthcare and yanomami transformations by Rafael Moreira

State Healthcare and Yanomami Transformations

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State Healthcare and Yanomami Transformations A Symmetrical Ethnography José Antonio Kelly

The University of Arizona Press •

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The University of Arizona Press ÂŠ 2011 The Arizona Board of Regents All rights reserved www.uapress.arizona.edu Library of Congress Cataloging-in-Publication Data [to come] Publication of this book is made possible in part by the proceeds of a permanent endowment created with the assistance of a Challenge Grant from the National Endowment for the Humanities, a federal agency.

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En ciudad no se puede vivir seguido, principalmente en [Puerto] Ayacucho, porque falta el agua, falta para hacer conuco y tener mañoco . . . Sólo cuando vivi con el papá de José [Husiwë], entonces yo estuve un poquito bien. Quien sabe si no lo hubieran matado, yo no me habria escapado. Talvez sólo cuando llegaban los blancos. De todas maneras, yo le decía así mismo a él, que me quería ir y él me decía que bueno, pero que llevara a mis hijos para que se volvieran napë. —Helena Valero (1971) in Valero (1984:18) One cannot live long in the city, mainly in [Puerto] Ayacucho, one is short of water, unable to work a garden and have manioc flour . . . Only when I lived with José’s father [Husiwë], then I lived a little bit okay. Maybe only when the Whites arrived. In any case, I would tell him that I wanted to leave, and he would say okay but that I should take my children along for them to become napë. —Helena Valero (1971) in Valero (1984:18) (my translation) Os brancos desenham suas palavras porque seu pensamento é cheio de esquecimento. Nós guardamos as palavras dos nossos antepassados dentro de nós há muito tempo e continuamos passando-as para os nossos filhos. As crianças, que não sabem nada dos espíritos, escutam os cantos do pajés e depois querem ver os espíritos por sua vez. É assim que, apesar de muito antigas, as palavras dos xapiripë sempre voltam a ser novas. São elas que aumentam nossos pensamentos. São elas que nos fazem ver e conhecer as coisas de longe, as coisas dos antigos. É o nosso estudo, o que nos ensina a sonhar. Deste modo, quem não bebe o sopro dos espíritos tem o pensamento curto e enfumaçado; quem não é olhado pelos xapiripë não sonha, só dorme como um machado no chão. —Davi Kopenawa (1998), translated by Bruce Albert (Kopenawa and Albert, 1999) Whites draw their words because their thought is full of forgetfulness. We have long ago been keeping the words of our ancestors in ourselves, and we continue to pass them down to our children. Children who know nothing of the spirits listen to the chanting of the shamans, and then they want to see the spirits for themselves. It is in this way, that, despite them being very ancient, the words of the xapiripë always become novel again. It is these words that augment our thoughts. It is these words that allow us to see and know things from afar, the things of the ancients. This is our study, what teaches us to dream. This is why, s/he who does not drink the breath of the spirits has a short-sighted and clouded thought; s/he who is not looked upon by the xapiripë sleeps like an axe lying on the ground. —Davi Kopenawa (1998, translated by Bruce Albert into Portuguese [Kopenawa and Albert, 1999] my translation into English)

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Contents

List of Figures

List of Tables

Acknowledgments

xiii

List of Abbreviations

xvii

Introduction

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1 The Upper Orinoco Yanomami and Their Context

2 Particularizing the Upper Orinoco Health System

3 Epidemic Diseases, Criollos, and the Morality of Being Human

4 Becoming Napë and the Napë Transformational Axis

5 Making Kin, Making Society, and Napë Potential Affinity

6 Being and Performing Napë and Yanomami

111

7 Doctors and Shamans

140

8 Two Meetings and a Protest

164

9 Changing Tides and Mixed Feelings

200

Conclusion

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Contents

Notes

233

Bibliography

239

Index

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Figures

1.1 1.2 1.3 1.4

Map of Yanomami territory in Venezuela Layout of the Ocamo cluster Layout of the Ocamo village Map of the Upper Orinoco, with its main rivers and communities 3.1 Yanomami socio-political space 4.1 NapĂŤ transformational axis: Ocamo perspective 5.1 Congruence between napĂŤ transformational axis and Yanomami conventional space

15 20 21 22 57 86 106

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Tables

4.1 Analogies between Mythical and Historical Transformations 4.2 Correspondence between Shamanism and Yanomami-Criollo Relations 4.3 Elements of NapĂŤ Transformational Axis

77 89 91

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Acknowledgments

Many institutions and people have played a part in the production of this book. My initial research in the Upper Orinoco was funded by FONACIT (Fundación Nacional de Ciencia y Tecnología) in Venezuela through its agreement with the Cambridge Overseas Trust. Support from CAICET (Centro Amazónico de Investigación y Control de Enfermedades Tropicales), a tropical disease research center in the Ministry of Health (MoH) in Amazonas, was key to facilitating my entry in the field, as was the continuous support of all their technical and research staff throughout my stay in Amazonas. I wish specifically to thank Nestor Villamizar, José Cortez, Carlos Botto, and Magda Magris. I also found the hospitality and patience of all the doctors working in the Upper Orinoco Health District invaluable. From 2004 until the end of 2006, I worked on different projects for the Ministry of Health, all of them in Amazonas. My last two years were specifically dedicated to the Yanomami Health Plan, aimed at expanding and improving the network of health services among the Yanomami. During this period, the unwavering support of then-Minister of Health Francisco Armada, the newly created Indigenous Health Bureau of the MoH, and, again, CAICET was fundamental in teaming people, efforts, and resources for the improvement of the health system in Yanomami land. The friendship and dedication of colleagues such as Noly Fernandez, Aime Tillet, Javier Carrera, Maria Teresa Quispe, Johanna Gonçalves, Douglas Perdomo, America Perdomo, Carlos Botto, Alejandro Reig, and German Freire were instrumental in achieving the improvements, however meager, xiii

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we could manage at that time in Yanomami healthcare. It has been a great pleasure to work with them all. After leaving Amazonas in late 2006, I spent seven months in Paris under the kind auspices of the EREA/CRNS (Centre Enseignement et Recherche en Ethnologie Amérindienne), a crucial period that allowed me to plunge back into some of the academic issues I had left behind when working as a public servant in the Ministry of Health. This great opportunity I owe to Anne-Christine Taylor and Jean Pierre and Bonnie Chaumeil. It was only in mid-2007 that I decided to embark on a writing project based on my doctoral dissertation and supplemented with my work experience in the MoH. This effort was only possible with the generous support of the Wenner Gren Foundation’s Hunt Fellowship. The almost two years I spent at the Museu Nacional at the UFRJ (Universidade Federal de Rio de Janeiro) were most enjoyable and stimulating, and here I wish to thank teachers and colleagues who either read parts of my text or commented and provided ideas on so many formal and informal occasions. I am very much indebted to Aparecida Vilaça, Eduardo Viveiros de Castro, Marcio Goldman, Tania Stolzte, and Carlos Fausto. During this period and after in Brazil, the special friendship of Bruno Marquez, Indira Caballero, Bia Matos, Edgar Bolívar, Virna Plastino, and Nicolas Viotti made life and work all the happier. In 1998 I arrived at Cambridge as an electronic engineer wanting to do a master’s degree in social anthropology—a subject of which I knew nothing. Here I was fortunate to be supervised by Stephen Hugh-Jones to whom I owe most of what I know about anthropology, about writing, and about teaching. I hope this book serves as a decent testament to his steadfast and generous guidance through thick and thin during and after official student-hood. I am also greatly indebted to Eduardo Viveiros de Castro for his continuous support and stimulus over the years. From him and from Steve, I have learned much about Amazonian Indians, peoples for whom we share a common passion. Both my parents, John and Magalí, were not only unwaveringly supportive of my work in the field and after, but they also contributed to this book in specific ways. My mom helped with the transcription of many of the interviews done in Spanish, and my dad read through a first final draft, making many editorial and grammatical suggestions that substantially improved the quality of the manuscript. For all this work and support I am most grateful.

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Acknowledgments

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Finally, I wish to thank all the Yanomami I have had the pleasure to know and work with. Our paths crossed in late 1999. The amazement, admiration, and enthusiasm I have for their creativity, joy, and life; their tackling of modernity and their standing up for a way of life; the ways they invent new lives for themselves in the harshest of health circumstances; all of this is a sure guarantee that this bond will never be severed. My hope is that this book lets some of their creativity come through in its own light. Awei kĂŤ!

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Abbreviations

AD BANDES CAICET CISPI CODESUR COPEI FIDES INHRR IVIC MSDS NTM ONAPRE ORPIA PUAMA SENIFA SUYAO

Acción Democrática Banco de Desarrollo Económico y Social de Venezuela Centro Amazónico de Investigación y Control de Enfermedades Tropicales Coordinación Intercultural de Salud con Pueblos Indígenas Comisión para el Desarrollo del Sur Comité de Organización Política Electoral Independiente Fondo Intergubernamental de Descentralización Instituto Nacional de Higiene Rafael Rangel Instituto Venezolano de Investigaciones Científicas Ministerio de Salud y Desarrollo Social New Tribes Missions Oficina Nacional de Presupuesto Organización Regional de los Pueblos Indígenas de Amazonas Pueblo Unido Multiétnico de Amazonas Servicio Nacional Autónomo de Antención Integral a la Infancia Shaponos Unidos Yanomami del Alto Orinoco

xvii

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State Healthcare and Yanomami Transformations

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Introduction

I arrived in Ocamo, a Yanomami village in the Upper Orinoco, in August 2000 to study Yanomami political transformations. I wanted to examine their integration into the Venezuelan state as it had become more intense and complex. Having initially dealt mainly with missionaries, the Yanomami were now part of a broader political field that involved not only missionaries but also political parties and indigenous organizations. How did these institutions of supra-local influence interface with Yanomami intercommunity political relations? At the time, I thought this would provide a good institutional focus for an analysis of what I saw as Yanomami experiences of integration into the Venezuelan state. As often happens during the process of establishing the necessary contacts to enable a proposed work, my project was reoriented. Having struck a collaborative relationship with a tropical medicine research center, CAICET,1 I arrived in Ocamo to negotiate the required permits with communities and stayed in the house of the local clinic doctor. Late in this three-week period, a community meeting was held. By this time, the complex relations I had noted in the health post and my firsthand observation of the dire health situation in Ocamo had shifted my interest toward the study of the health system among the Yanomami.

Issues in the Field In Ocamo I found the relationship between doctors, Venezuelan urban middle-class graduates on their mandatory one-year service to the state, 1

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and Yanomami unexpectedly complex. Doctors, I thought, in an area with such poor health indicators (see chapter 9), must surely be seen as a redeeming feature of the engulfing society that had presented Yanomami with more ambiguously interested agents such as extractivists, missionaries, anthropologists, and politicians. Why was this relationship problematic? It became apparent that what was most relevant in this relation was that doctors, more than being doctors, were napë, non-Yanomami whites, and that Yanomami, more than being patients, were Yanomami. This became the prominent issue in my field study and the subsequent subject of this book: the study of Yanomami-napë relations, the meaning of being and becoming “Yanomami” and “napë” for Yanomami people and whites alike. Doctors in communities represent one end of a network that includes other professionals, such as higher-level health authorities; other sites, such as the Regional Health Bureau in the capital of Amazonas State, Puerto Ayacucho; and other state institutions, primarily municipalities and the armed forces. So to speak of Yanomami-doctor relations is immediately to speak of the articulation of Yanomami with the health system at large and Yanomami-state relations. This project is, then, also an ethnography of the health system among the Upper Orinoco Yanomami and an exploration of an aspect of Yanomami experiences of integration into the Venezuelan state. My passage from focusing on politics to health certainly entailed a change in the network that would circumscribe my analysis. The Yanomami-napë relation, because of its weight in determining Yanomami transformations and the character of relations with the state, would nonetheless have revealed itself as prominent, regardless of the network that I may have chosen to explore. But what is the character of relations within the health system in the Upper Orinoco? It is clearly not a matter of resisting something alien or imposed: Yanomami thoroughly engage with the health system, as with many things from the world of whites. The general context of the articulation is the very opposite of what the resistance-dominance analytic conjures. There is a mutual interest on the part of Yanomami and those in the health system in improving and expanding services among Upper Orinoco communities. Nevertheless, these interests, however reciprocal, constitute only partially overlapping projects or trajectories that are inflected by important cultural biases. The Yanomami interest in the biomedical state health system is not driven solely by their experience of constant epidemics and high mortality rates with which their medical resources alone cannot cope. Ever since

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the establishment of more permanent relations with whites in the early 1950s, the Yanomami have been tentatively interested in transforming their body/habitus; procuring and circulating manufactured objects; experimenting with whites’ foodstuffs; using clothes and soap; learning to speak Spanish and becoming literate. Because the arrival of whites intensified the incidence of epidemic diseases, access to their medicines also became crucial. Later in this process of contact, Yanomami interests began to broaden, as did their desire to have more control over the sources of knowledge and objects that they had begun to consider necessary to sustain their transformation. In the Upper Orinoco this ongoing transformation can be referred to as napëprou, meaning “becoming napë” in Yanomami. In Spanish they say they are “civilizados.” Yanomami speak of becoming napë as a historical transformation and a trajectory into the future. They speak of it as a progression, but one that has also brought the onslaught of epidemic diseases that they call shawara in its train. The health system is thus fundamental because the worthiness of becoming napë as a historical choice and option for the future rests partially on its good functioning. Becoming napë involves a constant assessment of ways to put white culture at the service of reproducing Yanomami society while minimizing the downsides of the intensifying exchange with whites. In other words, in this indigenization of modernity (Sahlins, 1997), whites’ objects and knowledge are subservient to the making of Yanomami kin and communities. The uneven distribution of white goods and services among the hundreds of Yanomami communities also gives becoming napë an important differentiating potential, deployed among Yanomami themselves to different political effect. The Yanomami’s relationship with whites is imbued with ambiguity in all contexts. In matters of health, whites are simultaneously seen as disseminators of disease and as keepers of knowledge capable of curbing its effects. Whites are called napë—foreigners or others—a term that, according to Yanomami socio-political theory, connotes distrust, potential enmity, and anti-sociable (non-kin-making) behavior. Whites have thus become the epitome of alterity as it is conceived in Amerindian sociocosmological regimes, dangerous but necessary (Overing, 1983–84). Thus, the sustenance of a civilized life, the effort to benefit from both white and Yanomami worlds, demands a good measure of white domestication. The health system is part of this history and web of understandings. Doctors and health authorities are unknowingly inserted in this Yanomami trajectory of transformation that has a momentum and direction of its own.

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White field doctors and those higher up in the health system are also interested in providing health care for the Yanomami. This requires an expansion of the network of services available in other parts of the country across Yanomami land and, concomitantly, the establishment of rules of engagement with communities and the management of resources under territorial-administrative criteria. A civilizing process of sorts is inherent in the state’s project of providing healthcare, for it unavoidably advances the systematicity of an expanding state apparatus. It also promotes specific forms of social, economic, and political relationships with the state. In this regard, the health system is one agent among others to which the integration of Indians into society at large has been delegated in what constitutes a shifting and incoherent civilizing effort. The encounter between whites/state and the Yanomami can thus be described as the articulation of these motivations that I have loosely called “projects” or “trajectories.” The articulation itself revolves around the homonymy of “civilization” and, within that frame, a number of other homonymic affinities of interest such as “health.” (Homonymy here involves words or projects that sound or look the same but actually mean different things for whites and Yanomami.) Motivation stems from both the desire to advance the party’s project and to resist the interests of the opposition. What are the typical points of friction between the non-congruent aspects of Yanomami and health system projects? Which are the issues that, according to Yanomami and doctors, encumber their smooth articulation? From the Yanomami perspective, common complaints include the following: the high rotation rate of white personnel that prevents the establishment of convivial relations; the negotiations about the place and type of patient treatment in which Yanomami hope to maximize the benefits of simultaneous biomedical and shamanic therapies; the need for doctors to show concern for patients resulting in quick and in situ attention; the access to and use of health post resources like boats, motors, gasoline, and the distribution of a handful of salaried posts; the difficulty of managing the pressures of kin and political obligations, given the kind of institutional relations the system demands from its Yanomami workers. For their part, doctors’ situations are marked by constant efforts to organize the activities of the health post and establish rules of engagement with the Yanomami as individual patients and political collectivities or communities. A sense of negotiation pervades all aspects of their work: determining the place and type of patient treatment; deciding where and how long to stay when visiting upper river communities; disentangling the health crew’s institutional objectives from kinship ones; fending off

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requests for personal goods and health post resources; holding seemingly repetitive meetings; dealing with the experience of having their medical interventions controlled by patients and their relatives. The congruous side of their projects finds Yanomami and doctors calling for the expansion and improvement of the health system. These initiatives include building posts in distant areas, increasing the frequency of medical visits, and improving regularity in the supply of medicines and logistical resources, as well as establishing better infrastructure and communications, better salaries, better treatment in the Puerto Ayacucho hospital, and better training of Yanomami health personnel.

Controlling the Account If we as anthropologists are to convey our findings and experiences to our colleagues, we must organize what is, by nature, messy data. If this presentation of material is not to be seen as contrived or invented, one must control the organizing effort to avoid exercising free play with what structures other people’s lives (Wagner, 1981; Strathern, 1987). This restriction on our creativity finds guidance in both our fieldwork and our theoretical preoccupations, and at this point, I wish to spell out what controls this account. First, the field circumstances of my study called for a political anthropology. The general character of the health system’s articulation involved the accommodation of only partially overlapping projects. Relations between different categories of napë and Indians, whether between doctors and Yanomami, or between Yanomami themselves, were permeated with efforts to control another’s behavior and efforts to overcome resistance to this control. A second research imperative was to treat Yanomami and doctors symmetrically as subjects of analysis. Since so much of Yanomami-white or Yanomami-state dynamics are about different kinds of misunderstanding, the relation between—to paraphrase Roy Wagner—our misunderstanding of them and their misunderstanding of us is a fundamental issue to be tackled. Finally, the examination of a network that stretches from government ministry offices in Caracas to hinterland Yanomami communities requires ethnographic study at different locations. In short, the field circumstances yielded a political, symmetrical, and “networky” study.2 Two objectives controlled my efforts as literature, fieldwork, and writing became intertwined. On the one hand, I wanted to treat a diversity of actors (doctors, Ocamo Yanomami, upriver Yanomami, health authorities) across diverse contexts (medical and non-medical relationships, interpersonal and

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collective events, upriver and downriver scenarios) within a single analytical language, and one that would be close to Yanomami and white experiences. On the other hand, I was interested in elucidating the meaningful world in which the health system was inserted, for whatever Yanomami made of the health system it could only be made of their meanings (cf. Viveiros de Castro, 1999). Wagner’s (1981) The Invention of Culture served as a formidable stimulus. My description of Yanomami-white relationships draws heavily on Wagner’s distinctions between the conventional and the inventional aspects of symbolization; the innate and the artificial realms of phenomenal totality; collectivizing and differentiating action, and the dialectical figureground relation that holds between these realms of experience, modalities of symbolization and action. A crucial move in comparing white and Yanomami perspectives is to recognize whites’ commitment to ascribing the realm of convention to that which is available to human agency, so in this sense artificial, and to correspondingly relegate the particular, incidental, or inventional to the innate or given component of the phenomenological totality. In this respect, Yanomami make a fundamental inversion, assigning to the conventional the quality of innate or given and viewing invention or the particular as that which is accessible to human agency. For whites, nature epitomizes the realm of the innate, and culture—a gamut of social and cultural conventions—is then seen as the product of human activity. Yanomami and many Amerindians generally find in culture the innate or given component of lived experience and hence dedicate their efforts to making the particular. In Robbins’s (2002:6) apt phrasing: “In a shorthand way, we might put it that we assume the individual and make society a problem; they assume society and make the individual a problem.” As this binarism might appear obsolete, it is worth noting that Wagner does not deploy these distinctions in either an absolute or an evolutionist manner but rather in a sophisticated way that threads everyday symbolic action—common to all peoples—with more overarching metaideological commitments distinguishing the ways of inhabiting the world of, say, Amerindians and middle-class doctors. The difference is at once slight, for it refers to the arrangement of modes of symbolization, and fundamental, for it renders not just different ways of thinking but different ways of being in the world. As “overarching distinctions”—Wagner’s wording—their virtue lies in their capacity to substitute for other oppositions such as real vs. symbolic; quotidian contexts vs. contexts of cultural change; intra- vs. intercultural relations. This substitution is particularly useful for thinking about Yanomami change and cross-cultural relations

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in a new light, for it can express these phenomena in terms that are not coextensive with them. What about the need to convey Yanomami experiences in terms of their own meanings? How are Wagner’s abstractions to be translated into an Amerindian idiom? Through Viveiros de Castro’s theorizing on kinship and perspectivism, the specificities of Yanomami experiences of becoming napë and their engagements with the state can be couched in the more general terms of Amerindian ontology. But there is more to this process than providing Amerindian attire for an abstract theoretical body. Both Wagner and Viveiros de Castro advocate the need to realize indigenous creativity as alternative meaning rather than as variants of our own meaningful world. This means that an ostensibly outside perspective from which to experiment with our own concepts and culture can only be inside another culture; there is no common ground (e.g., nature) from which we can evaluate cultures. Anthropological inquiry with these premises puts cultures in direct relation (they mediate each other) and becomes a translation of the questions different peoples pose to themselves, as opposed to answers to the questions that we might think interesting to pose to them (cf. Wagner, 1981; Viveiros de Castro, 2002c). In a recent elaboration of this issue, Viveiros de Castro (2004a) calls attention to the way these premises resemble those of Amerindian perspectivist ontologies. An anthropology that hopes to elicit alternative meaning is guided not by the concept of synonymy (the existence of different ways to name a single thing, the premise on which multiculturalism rests) but the concept of homonymy (the existence of different things named in the same way, the premise on which perspectivism rests). I subscribe to this awareness of homonymy, what Viveiros de Castro calls a “method of controlled equivocation,” to illuminate the unawareness of homonymy that generally holds between whites and Yanomami in their engagements. This unmanaged or misrecognized equivocation and the ways it fosters and hinders the articulation of meaningful and different worlds for Yanomami and whites is the central theme explored in this book. To speak of mutual misunderstanding and misrecognized equivocations is not a reference to mistakes on the part of whites, Yanomami, or anthropologists. These are not negative concepts. In the hybrid social environments that have arisen with the presence of state institutions among the Yanomami, arrangements for living in society are always worked out that may or may not lead to the recognition of alternative meaning. Living together or, as more often happens, alongside one another is no guarantee of acquiring an awareness derived from a particular stance, or a permeability to

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foreign concepts, or even a certainty that one does not understand the basic premises that inform the lives of others. As a disposition, then, awareness of alternative meaning is not the privilege of natives or researchers; neither does it suggest the impossibility of understanding across cultures. Rather, it speaks to the nature of this understanding that “involves the relationship between two varieties of the human phenomenon; it aims at the creation of an intellectual relation between them, an understanding that includes both of them” (Wagner, 1981:3). As such, an anthropological exercise may well be seen as the passage from a state where “my misunderstanding of them is not the same as their misunderstanding of me” to a state where we can describe the “intellectual relation” between two modes of life and creativity.

Amazonianist Social Anthropology and Medical Anthropology This study of Yanomami and white relations within the health system draws from and participates in Amazonianist and medical anthropology. Regarding the former, it converses with the literature on interethnic and Indian-state relations. Regarding the latter, it engages the issue of the articulation of medical systems. My analysis of health policies for the Yanomami, as well as the ethnography of the health system and the “Indian issue,” crosses both fields of literature. My general concern, nonetheless, is closer to Amazonianist than to medical anthropology, and there are good reasons for this. I want to call attention to the need for more serious consideration of indigenous cosmological and sociopolitical concepts and dynamics, beyond the realm of things medical, in order to gain a comprehensive understanding of the articulation of a biomedical health system within a network of indigenous communities. This is why I have left such topics as ethnomedicine and historical epidemiology aside and why I have not pursued a wider comparative exercise beyond Amazonia. The comparative value of this study is the light it may shed on other types of Amerindian engagements with their respective states, such as participation in the educational, political party, or market systems. Let me now situate this study within the pertinent literature. As ethnographic accounts of Amazonianist social anthropology have grown in number and detail, so too has the possibility for synthesizing what appears to be—as Lévi-Strauss demonstrated with mythology—a system of transformation of principles common to lowland South America. Viveiros

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de Castro’s synthesis of Amerindian kinship systems (1993b; 2002b) and his description of Amerindian perspectivist ontologies (1996a; 1998; Lima, 1996) most clearly represent these integrating moves. This theorizing has for some time been available to be put to the test, so to speak, in its ability to account for engagements with the state and the political and economic systems stemming from a globalized world. The present study is an extensive demonstration of how this Amazonianist theory can account for relations with the state. As such, it hopes in the following ways to extend the work of authors who have already walked this path, such as Gow (2001), Vilaça (2006), and Gordon (2006): first, by providing a detailed account of what it means for doctors to be Indians’ “potential affines”—a concept proposed by Viveiros de Castro to account for the productivity of affinity in Amerindian socio-cosmological regimes and that Gow has suggested is the relational “slot” where whites fall in Piro socio-cosmology; second, by elucidating the continuity between the dynamics of kinship and the mutually implicated processes of becoming napë and domesticating whites; and third, by theoretically engaging with the issue of mutual misunderstanding in interethnic Amazonia. Analysis of biomedical and indigenous medical systems in Amazonia has, by and large, emphasized indigenous notions of illness, healing, and the body to explain Amerindians’ reactions to biomedical systems.3 Accordingly, themes like ethnomedicine, etiology, therapy, and its itineraries are explored in order to highlight their discrepancies with biomedical tenets. With the notable exception of Garnello (2003), the issue of the articulation of medical systems is thus kept within the realm of the medical. This study moves beyond these limits, viewing the inscription of relations with doctors and the biomedical health system in general in a wider Yanomami trajectory of transformation. In so doing, it reveals that to remain within the realm of the medical is to misrepresent the experience of both doctors and Yanomami in the Upper Orinoco and perhaps elsewhere in indigenous Amazonia. On another front, however, I also hope to add to critical medical anthropological approaches, of which Briggs’s (2003) work is the clearest reference in an indigenous and Venezuelan context. Critical approaches seek to trace the connections between community health outcomes and regional, national, or globalized power relations and their sustaining ideologies. I accompany this line of analysis with an examination of the ideologies of state multicultural health policies, yet with a greater emphasis on Yanomami socio-cosmo-politics. This critical gesture extends analysis not into the space of global capitalism but of Amerindian cosmologies, looking

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at the ways in which they too shape the health system for indigenous communities. This reading remains within the realm of the political, complementing a Western political economy of health with an Amazonian “symbolic economy of alterity” (Viveiros de Castro, 1996b).

Fieldwork, Other Work, and the Limitations of this Study I have been involved with the Yanomami in different ways since the year 2000. Here I wish to make my relation to them and the state clear, and to comment on some of the considerations involved in producing this book. My initial fieldwork stretched from July 2000 to April 2002. The central aspects of this ethnography stem from that experience. Most of the Yanomami interviews presented were conducted in either the Yanomami language or a mixture of Yanomami and Spanish. Yanomami speeches were transcribed and translated with the aid of different Yanomami collaborators. Interviews with doctors and other health personnel are also from this initial period of doctoral fieldwork. In the transcriptions offered throughout the text a single backslash (/ ) indicates a break in the flow of an interviewee’s conversation, while ellipses ( . . . ) indicate an editorial deletion of part of the person’s speech. Unless otherwise indicated, I conducted the interviews from which the extracts were taken, and occasionally, the text of my questions in interview dialogue is presented, identified with my initials “JA.” Even if admittedly limited in protecting individuals’ identities, I have changed all Yanomami and doctors’ names, and left certain dates somewhat imprecise. The only names that remain unchanged are those of public personalities. During 2004 I visited the Upper Orinoco several times as a consultant to the Onchocerciasis Control Programme. Next, throughout 2005 and 2006, I had the opportunity to direct the Yanomami Health Plan—a flagship health initiative implemented by the Ministry of Health (MoH) in the Upper Orinoco. This work within the health system furnished countless opportunities to verify some of my analytical interpretations with different Yanomami. Moreover, it helped me nuance my argument and realize where it needed greater geographical and historical specificity. I have become more sensitive to how the history of exchange with Salesian missionaries, as well as the health system and political parties, shaped Yanomami discourses, preoccupations, and attitudes toward the state. In particular, I would note the affinity of Upper Orinoco Yanomami ideas about becoming napë and

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Introduction

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the discourse of modernity to which they have been exposed for the last decade or so as deriving mainly from mainstream political parties. This is not to say that my arguments are limited to communities directly influenced by this melange of agents and discourses—which would defeat the position I defend throughout this book. What it does mean is that they are more representative of a particular conjuncture of Yanomami and state social and cultural forms. Hence, elements of what I assert characterizes this relation may be found emphasized or de-emphasized in areas where the historical process has been different. Rifts between traditionalists and modernists exist within and across Yanomami communities, as in many Amerindian societies. Local histories in Amazonia often reveal how an individual or a community has swung from one position to the other. Upper Orinoco Yanomami collective investment in this trajectory into the future is imbued with not only excitement but also caution and uncertainty, readily observed in upriver Yanomami youth when they begin to engage with things and people from the world of whites. Becoming napë is an experiment of inventive creativity, a gamble, if you will, very much intertwined with the few survival options the Venezuelan state has left the Yanomami. It is also a matter of intellectual reflection, especially when the social costs of increased engagement with whites, their values, and their institutions become more visible. Testament to this kind of assessment is Davi Kopenawa’s (2010) profound reflection on his personal journey and the history of his people: a unique reverse anthropology from a place where the division between Indian and Western concepts is internal to the Indian world rather than Western anthropology. Directing the Yanomami Health Plan allowed me to influence health delivery among the Yanomami and exposed me to the upper echelons of policy-making within and beyond the MoH to which I had no access during my initial fieldwork. In this position I participated in the growth of the MoH’s Indigenous Health Office (IHO), the implementation of the Yanomami Health Plan, and the public service substitution program deployed when President Hugo Chávez expelled the New Tribes Missions from Venezuela in October 2005. All these events are of historical relevance, and a detailed account of them enriches the ethnography of the Venezuelan state and the history of the indigenous issue in Venezuela. Since I was participating in these processes not as a researcher but as a public servant, I have nonetheless limited my analysis of these events. It is also the case that the full consequences of several state initiatives, in particular, efforts to increase its presence south of the Orinoco, are still far from visible, and any predictive exercise here would be unadvisedly adventurous. I have

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Introduction

not refrained, however, from a critical analysis of the issues I judge fundamental to progress for Yanomami and indigenous peoples’ health, having experienced the shortcomings of the health system from all the positions in the network that it constitutes. The Yanomami have been the subject of much and varied controversy within and beyond anthropology. It is also true that Latin American governments have often used arguments about indigenous culture and morality or claimed “shared responsibility” with Indian communities to cover up for their inability to provide them adequate healthcare. The Venezuelan state’s chronic inability to provide the Yanomami with adequate healthcare is without doubt the major factor in their having some of the country’s worst health indicators. All this has been an ever-present cause for pause in my writing. While steering clear from controversy and sensitive to the precarious health situation of the Yanomami, I have written an account thoroughly committed to producing an understanding between Yanomami and doctors and of the health system in general. To this end, I focus on crosscultural misunderstandings, measure the affinities and contrasts between Yanomami and state projects, and seek to relate fundamental concerns of the Yanomami, whites, and the state. In so doing, I hope to shed light on matters close to Yanomami and whites alike, and I hope to suggest, through theoretical argumentation and practical application, ways to articulate Yanomami creativity in a manner that can harmonize radically distinct, meaningful worlds without subsuming the one into the other.

Some Final Clarifications on Layout and Term Usage This book covers a range of issues that belong to subfields within anthropology that keep somewhat to themselves. It is also organized in a nonlinear fashion. Chapters 1 and 9 deal with the latest developments in policy for Indians in Venezuela and the particular case of the Yanomami. These chapters deal with the wider context for the operation of the Upper Orinoco health system. As such, they will appeal to readers interested in indigenism and can be read as relatively stand-alone discussions. Chapter 2 is an ethnography of the Upper Orinoco health system. Direct interactions between doctors and Yanomami are primarily developed in chapters 6 and 7. These three chapters may be singled out by readers with a specific interest in medical anthropology. Chapters 3 through 8 constitute the core of the book, which speaks most directly to the Amazonianist anthropological tradition.

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Of course, these subject matters overlap and a segmented reading of the book would defeat one of its purposes which is to call attention to their interdependence. It is my contention that medical anthropologists and health professionals need to be more sensitive to indigenous sociality and cosmology and thus will benefit from a deeper engagement in the debates proper to Amazonianist anthropology. Within Amazonian social anthropology itself, the concerns of those who focus on the state’s regard for Indians and those who privilege the study of native socio-cosmologies must also be bridged. Finally, those who feel that theoretical or philosophical anthropology is difficult to reconcile with applied or engaged work may find in this study an example of communication across this divide. Regarding the usage of certain terms, the term for non-indigenous people is “criollo” when Yanomami speak Spanish, as is the case in all of Amazonas State, where the term stands in opposition to “indígena.” I too use this term to mean non-indigenous, except when making more general assertions about relations between indigenous and non-indigenous people across Amazonia, where I refer to “Indian-white” relations as I do in this introduction. It is important to note that this Amazonas usage contrasts with the way the term is deployed in urban northern Venezuela, where criollo refers to things or people being Venezuelan as opposed to foreign. It should also not be confused with the term “creole” in English, which has specific meanings in linguistics and the anthropology of the Caribbean. Lacking any economical alternative and aware of its limitations, I refer to doctors’ or state representatives’ ideologies as “Western” or “Euro-American.” Since the work of the linguist Migliazza (1972), the Yanomami have been divided into four linguistically and culturally related groups: Yanomami (Yanoama, Yanomamö), Yanomam (Yanomae), Sanema (Sanima, Sanuma) and Ninam (Yanam, Shiriana, Xirian). A number of names designate different Yanomami subgroups.4 The term “Yanomami” has become an umbrella designation standing for either the whole group or, in non-academic environments, any of the subgroups, and it is used most in national and international forums. Henceforth, I use the term “Yanomami” to designate the sub-group living in the Upper Orinoco on which this book is based. Occasionally, the term will refer to all sub-groups in Venezuela or both Venezuela and Brazil. The few specific references to other sub-groups, such as Yanomam or Sanema, are indicated accordingly.

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cha p te r o n e

The Upper Orinoco Yanomami and Their Context

The first two chapters situate the reader in two ways: this chapter provides the general context of Yanomami-state relations; the next narrows the focus to the operation of the state health system in the Upper Orinoco. A panoramic view of the Yanomami living in the Upper Orinoco is followed by a description of the cluster of communities known as Ocamo. I end with a review of the profound, yet still under-reported, political developments affecting the different sectors of Yanomami society. In addition to providing context, this chapter describes a gradient of exchange with criollos and state institutions, the different worlds connected yet differentiated in a network of Yanomami communities increasingly affected by the influence of criollos and their institutions.

Yanomami in Venezuela The Yanomami people live on both sides of a long stretch of the Venezuelan/ Brazilian frontier. The area inhabited by the Yanomami in Brazil, some 96,500 km2, corresponds to the officially demarcated Yanomami indigenous territory. Were the Yanomami in Venezuela also to gain rights to their ethnic territory, it would add a comparable area, totaling some 192,000 km2 of continuous land between the two countries (Colchester, 1991:12; see fig. 1.1). In Venezuela basic demographic information on the Yanomami is very poor. The population reported for the different Yanomami groups in the last two indigenous censuses add up to some 15,000 14

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Figure 1.1. Yanomami territory in Venezuela, including the Upper Orinoco, or Alto Orinoco (Map by Pascual Estrada)

Yanomami, but this figure included a considerable population in the State of Amazonas that was estimated and not directly counted (5,882 estimated in the 1992 census and 5,000 in the 2001 census). In Brazil census data is more precise, with 2005 figures reporting 15,568 Yanomami.1 As mentioned in the introduction, the Yanomami have been divided into four linguistic sub-groups: Yanomami, Yanomam, Sanema, and Ninam. Nonetheless, ethnographers and linguists still debate the degree of internal difference among the dialects (Lizot and Mattei-Muller, 1981; Albert, 1985:43–45; Ramirez, 1994:26–36). Further divisions within each dialect have also been proposed, and linguistic affiliation is particularly imprecise (Ramírez, 1994).2 It is important to note that while the Yanomami share a common cultural substrate, there is considerable social and cultural variation beyond linguistic differences in kinship conventions and naming restrictions (see Lizot, 1977; Ramos and Albert, 1977), the funerary ritual complex (see Lizot, 1996a; Albert, 1985), and architecture, for example. In Venezuela Yanomami live in some two hundred fifty communities, the Yanomami subgroup being by far the most numerous. Its communities are found on the Upper Orinoco and Siapa watersheds, including the main tributaries of the Orinoco: Padamo, Ocamo, Mavaca, Manaviche,

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Chapter 1

Orinoquito. In geopolitical terms this population falls within the Alto Orinoco (Upper Orinoco) and Rio Negro municipalities in the State of Amazonas. The territory inhabited by the Yanomami is ecologically diverse. The most marked contrast appears between the Parima highlands with several clusters of communities, considered the Yanomami ancestral heartland, and the upper Orinoco River course, also with several community clusters around Salesian missions. The first region consists of rolling hills at an altitude of 800 to 1200 meters whose mean temperature is between 21 and 23°C; watercourses are small, and savannah vegetation is interspersed with forest (see Huber et al., 1984). The second is a largely flat evergreen lowland forest, 100 to 200 meters above sea level, crossed by medium and large rivers and considerably warmer (mean temperature between 26 and 28°C). Owing to these environmental differences, a range of aspects impinging on daily life, such as diet, agricultural and hunting possibilities, and epidemiological profiles, vary widely between these Yanomami communities. The history of the Upper Orinoco Yanomami is well documented.3 I focus next only on relations with state institutions or emissary organizations, briefly touching on what has already been reported and concentrating on the latest, lesser-known developments.

State Presences Missionaries The first missionaries to establish themselves permanently among the Yanomami were the evangelical New Tribes Missions (NTM), spearheaded by James Barker, who settled in Platanal with a community called Mahekoto theri in 1950 (Ferguson, 1995:248).4 Since 1956 other NTM missionaries began contacting Yanomami and Yekuana communities on the Padamo and Cuntinamo rivers. In 1958 they established a mission base at the mouth of the Metacuni River with a group known as the Koshirowë theri. The next missionaries to settle permanently among the Yanomami were Salesian Fathers Cocco and Bonvechio, who established a permanent mission at the mouth of the Ocamo River with the Iyëwei theri in 1957. From this period onward, both missionary organizations shifted the location of their bases and areas of influence. In the long run, the uneasy coexistence of missionaries with different policies vis-à-vis the Yanomami saw the NTM retain its presence on the Padamo River while retreating from the Orinoco and ceding control over this area to the Salesians. The NTM later established

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strongholds in the Parima highlands in 1968 with the Niyayopë theri and subsequently in a mountainous region between Parima and the Orinoco, along the Orinoquito River and alongside the Koyowë theri in 1973. The Salesian enterprise in the Upper Orinoco, initially paternalistic and of an assimilationist tenor, underwent a policy change during the mid-1970s unifying its approach toward the Yanomami, which had previously depended on the personal orientation and projects of each mission’s head priest. A philosophy of assimilation aligned with the state’s general agenda for Indians, for whom Salesians acted as delegates, was superseded by a more multicultural paradigm. Since 1976 Salesians have run intercultural and bilingual schools; there are now four such schools in Ocamo, Mavaca, Mavaquita, and Platanal. In 1986 Salesians also fostered the creation of the first Yanomami economic cooperative, United Yanomami Shaponos of the Upper Orinoco (SUYAO).5 SUYAO operated in the communities along the Orinoco and main tributaries and, with the continued support of Salesians and anthropologists, took on a political representational role until its influence waned early in the first decade of the 2000s. Salesians were also active in healthcare provision, contributing to record keeping, vaccination, and primary care until the mid-1980s, after which medical doctors became an increasingly permanent presence in Orinoco communities.

The Health System Apart from missionaries, the first institutions involved in providing different kinds of medical assistance in the Upper Orinoco were the malaria, dermatology, and infirmary services of the Ministry of Health (MoH). The Malaria Service began activities in the area in the late 1950s. After opening a base at the mouth of the Mavaca River in 1959, it relocated several times, initially to Platanal, next back to Mavaca, then in the vicinity of La Esmeralda. Today it has trained Yanomami personnel in microscopy in several communities and additional, mainly Yekuana, personnel based in La Esmeralda. The Service of Sanitary Dermatology set up a base in Mavaca in 1975–76 in response to the discovery of onchocerciasis foci (also known as river blindness) in the Parima highlands. Permanent presence was terminated in the early to mid-1980s when the control program was taken over by CAICET, an MoH tropical disease research center based in Puerto Ayacucho, the capital of Amazonas. Today the onchocerciasis control program is run by CAICET in conjunction with the Upper Orinoco Health District. Each of these services had a specific task—malaria control, onchocerciasis control, primary care—and oscillated between harmoniously collaborating

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Chapter 1

with and critically accommodating Salesians in the provision of primary care. Each had one or more bases from which it visited nearby communities and made intermittent visits to communities on the higher courses of the Orinoco’s tributaries. With the exception of certain periods when doctors lived in Ocamo and Platanal, previous to 1985 there were no resident doctors in the area. Researchers and itinerant doctors based elsewhere in Amazonas were the only professional doctors available (Semba, 1985; Armada, 1997). In 1985 the Parima-Culebra Programme, implemented by a group of young doctors, began regularly serving the area. Doctors would spend one year in the Upper Orinoco fulfilling their compulsory year of state rural service. These doctors took over the primary care role from Salesians along the Orinoco, working from rural clinics in La Esmeralda, Ocamo, Mavaca, and Platanal. This program was legally constituted as a foundation that through diverse fundraising activities contributed medicines and equipment to supplement those supplied by the Amazonas health authorities. This joint arrangement ended in 1993 with the creation of the Upper Orinoco Health District, meaning that the Regional Health Bureau of Amazonas would assume full responsibility of healthcare provision in the area. The functioning of the Health District is treated at length in chapter 2. The last significant landmark in this history was the implementation, as of 2005, of the Yanomami Health Plan, an MoH initiative to improve and expand health services among the Yanomami. During the 2005–2008 period, this plan, that we get to know better in chapter 9, improved service availability and regularity for many Yanomami communities, even if the health situation of the Yanomami people as a whole remained poor. Although this health plan still exists, it has withered in terms of investment, efficiency, and overall force, and it is uncertain how much of the progress it made will be sustained in the future.

Armed Forces Two military bases were built in the early 1990s in response to the tide of wildcat gold miners (garimpeiros) flooding into Yanomami territory in Brazil, a phenomenon that reached a critical peak in the late 1980s (Alès, 1995:217). One base, built in Parima B, is run by the army, and another smaller post, in the Mount Delgado Chalbaud area near the sources of the Orinoco, is run by the National Guard. Situated within kilometers of the Brazilian frontier, both uphold national sovereignty, threatened primarily by illegal gold mining. However, apart from initial operations to

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disable clandestine landing strips, these ill-equipped posts have proved to be all but totally ineffective. La Esmeralda, the main air and fluvial entry point into the Upper Orinoco, is host to another base of the National Guard, which controls the flow of people, goods, and fuel farther upriver. During the 1999–2002 period, the National Guard took on an active social development role under an initiative called the Plan Casiquiare 2000. This plan was the Amazonas version of a nationwide flagship governmental program, Plan Bolívar 2000, involving the armed forces in the implementation of community development. Its activities for the Yanomami were mostly confined to the delivery of food and tools, and a mass distribution of boats and outboard motors. This period constituted an important peak in the flow of goods into Yanomami communities, comparable only to the outlays of the Upper Orinoco municipality (to be discussed later). Plan Casiquiare slowly died out in 2002 in the midst of the national political crisis surrounding the April coup d’état. The military’s involvement in Upper Orinoco affairs returned to its basal level until 2006 when their numbers and activities increased in the wake of the expulsion of the New Tribes Missions. Every state presence surrounds itself with a network of influence. Health and education services as well as access to manufactured goods are concentrated around the Salesian and NTM missions, around which clusters of Yanomami communities have grown—Ocamo, Mavaca, Platanal, and Parima B, for example. The regularity of services and the quality of goods circulating in Yanomami exchange networks decrease as you move away from these clusters. Gauging this gradient of exchange with criollos and state institutions is important, for the unequal distribution of criollo goods and services forms the spatial and material context for the Yanomami transformations explored in this book. To these concerns we turn in the next section, where readers will become acquainted with the community cluster of Ocamo, the site of my initial fieldwork, and travel up and down the river, viewing the range of contrasts in the contemporary life of Upper Orinoco Yanomami.

The Ocamo Cluster and the Gradient of Exchange with Criollos Santa Maria de los Guaicas—known today simply as Ocamo—was the name of the Salesian mission located at the confluence of the Ocamo and the Orinoco, founded in 1957 by Fathers Cocco and Bonvecchio with two

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Chapter 1

San Benito Lechoza Shashana Tumba

Orinoco

Clavo

Ocamo Mario

Rayaito Barrio Nuevo + Barrio Viejo Yohoopë

Figure 1.2. Layout of the Ocamo cluster, 2001

Yanomami groups—the Iyëwei theri (the blood river people) and the Rihu una theri (the chigger people). At the time, the Iyëwei theri were engaged in a progressive westward movement owing both to conflict with other Yanomami groups and the lure of exchange with neighboring Yekuana groups richer in manufactured goods. Their establishment on the mouth of the Ocamo around 1955 was a deliberate strategy to make themselves visible to criollos traveling on the Orinoco (Cocco, 1972:111–14). The original population of both groups totaled 59 Yanomami. The mass provision of manufactured products persuaded the Iyëwei theri to stay at this location and fostered the accretion of relatives who had been living higher up the Ocamo and the Padamo. By 1972 the population of Ocamo had grown to 139 Yanomami (Idem.:479; see fig. 1.2). Today Ocamo refers to a cluster of ten communities in the close vicinity (within a 10-minute boat ride) of the Salesian mission and the health post. Most are the product of internal fission of the original communities. Community size in 2001 ranged from 7 to 75 people, together totaling some 370 people. Among these communities, Barrio Nuevo and Barrio Viejo stand out for actually being within meters of the mission and the health post, meaning that they interact most with doctors and missionaries (see fig. 1.3). Members of other communities in the cluster must walk or travel by boat, albeit short distances. Ocamo has a permanent health service and the Salesian’s intercultural bilingual school that runs up to sixth grade. A growing number of Ocamo youths continue their education in the interethnic high school

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300 meters Ocamo River Port

Port Barrio Viejo

Mission hut

Mission

Chapel

Football and playing area

Watota SUYAO

Derelict Environment Ministry building School diner

clinic

School

Mission fuel depot and electric generator

Hospitalization hut

Barrio Nuevo

Doctors` residence

Air strip

Anthropologist´s hut

Figure 1.3. Layout of the Ocamo village, 2001

that Salesians run in the town of La Esmeralda. In addition to the primary school and the health post, Ocamo hosts a branch of SUYAO, the Yanomami economic cooperative. Here Yanomami can exchange indigenous products like baskets and arrows for machetes, pots, cloth, fishing nylon and hooks, soap, lamps, and such. Yanomami items are then sold externally in Puerto Ayacucho or Caracas. All these items can also be bought with cash, an option available to a growing number of Yanomami who earn salaries or are related to those who do. Some women of Ocamo also work sewing cloth to make shorts and T-shirts or weaving nylon hammocks in the Watota, a female side of the cooperative. Ocamo is also a node of criollo-oriented political activity. Criollo politicians, as well as criollo representatives of state institutions, are obliged to include it in their itineraries and hold meetings there, as it represents a block or sector, a Yanomami decision-making unit vis-a-vis the state. Let us now move up the Ocamo River (see fig. 1.4). About one hour upriver is the mouth of Iyëwei kë u (blood creek), a right-margin tributary of the Ocamo. In the wet season, two or three hours by outboard motor will take you to Harurusi, a community of about a hundred Yanomami and an outpost of Misión Padamo. Half an hour farther upriver is Fëritha kë u (river of magic plants), a left-margin tributary with three communities adding some eighty people, the first of which is reachable in four hours from the mouth of the Ocamo. Back on the Ocamo River, there

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Chapter 1

Figure 1.4. The Upper Orinoco, or Alto Orinoco, with its main rivers and communities (Map by Pascual Estrada)

is a group of five communities upriver between two and three and a half hours. Altogether, they amount to approximately 150 people. The next set of communities includes two on the Puutha kë u (river of honey), another left-margin tributary, and another higher up on the banks of the Ocamo. These are the “distant” communities in the health post’s area of influence, home to another 120 people approximately. Higher up the Ocamo River and into the forest in all directions, dozens of Upper Ocamo communities have yet to be reached by health crews.

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Data from 2001 illustrates various differences among these communities. In the Ocamo cluster there were thirty-six shotguns and sixteen outboard motors; most children go to the mission school; and most youth speak Spanish with varying degrees of fluency. There is radio communication at the health post and mission, and also at the house of one of the Yanomami leaders. Television sets can be found in a couple of houses, audio and sound equipment in more. Always short-lived, electric generators come and go in several communities of the cluster. Most, if not all, men have been to La Esmeralda; many go regularly. A considerable number have been to Puerto Ayacucho and even other cities in the north of the country. Many Yanomami also participate in local party and indigenous politics. Others have been trained as nurses, microscopists, and the like. Maweti, a community three hours upriver from Ocamo, has an outboard motor and a boat, two shotguns, and a radio, but there are neither television sets nor other audio equipment, and electricity is provided by a solar panel solely for the communications radio. Several here have been to Puerto Ayacucho; one has gone to Caracas. Many youths have visited La Esmeralda, and several know other mission clusters. They occasionally participate directly in politics but otherwise rely on Ocamo leaders to represent them. Maweti has no daily school, and just a few Yanomami here have only a very limited command of Spanish. Health crews visit Maweti once or twice a month. An upriver community like Pashopeka on the Puutha kĂŤ u (six to eight hours upriver) has no shotguns, no outboard motors, no radio communication, and no electricity. No one speaks Spanish. School and health crews from Ocamo visit irregularly, about four times a year. Most people have some clothes and personal steel tools and pots. Politics is poorly understood and not directly participated in. Only two people have been as far downriver as La Esmeralda (the closest multiethnic and criollo-style town); only a few have been to other mission clusters; and nobody has been beyond the Upper Orinoco. A three-day walk from Pashopeka lies a group of four communities in a sector known as Maiyo theri. Here pots and clothes are fewer than in Pashopeka, and steel tools are worn down. No one speaks Spanish, and there is no school. The first health crew to visit this sector since 1996, when it was reached for the first time in response to an epidemic, arrived in early 2008. Although some youth have been to mission communities like KoyowĂŤ, most likely none has been to La Esmeralda. Criollo visitors to this area in the last decade can be counted on the fingers of one hand: an anthropologist in the late nineties, an NTM mission worker who passed by a few years later, and the health crew in 2008.

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At the other end of the river network is La Esmeralda, the closest criollostyle town, with over 500 people of mixed ethnic origin. La Esmeralda is about two hours by boat from Ocamo, three from Mavaca, and four and a half from Platanal in the wet season. A long, narrow town on the margin of the Orinoco, it is distributed on both sides of the huge waterway that makes it the main point of entry to the Upper Orinoco. Many Yanomami frequently visit La Esmeralda for gasoline and criollo food and goods. Political meetings are also held in this capital, the seat of the Upper Orinoco municipality. Depending on the nature of the event, Yanomami representatives may be called upon or brought downriver to participate in greater or lesser numbers. Increasing municipal employment in the last few years brings many Yanomami and their families regularly to La Esmeralda to collect their pay. Political events and paydays attract hundreds of Yanomami to the town, most of whom stay a few days. Owing to the infrastructural upscaling in La Esmeralda—a new hospital-like clinic, expansion of the military base and river port facilities, and housing developments—the number of Yanomami youth spending varying lengths of time working on construction sites or doing odd jobs in La Esmeralda has also grown. Puerto Ayacucho, the capital of the State of Amazonas and seat of the regional government and ministries, is a two-hour flight by small aircraft from La Esmeralda or a two-day trip by river. A sector of Upper Orinoco Yanomami—mainly local government workers, teachers, and health personnel—travel frequently to Puerto Ayacucho to collect paychecks, negotiate contracts, participate in regional indigenous gatherings or missionary events, or buy products either unavailable or much more expensive in La Esmeralda. Here sits the state hospital to which patients from the Upper Orinoco are flown if necessary. In addition to a vast and graded middle ground, this swift journey along the Upper Orinoco also helps reveal the world of experiential difference between the Maiyo theri people in the hinterland and the Orinoco Yanomami who regularly camp in La Esmeralda waiting to convert their salaries into manufactured foodstuffs and goods. The contrast does not mean communities do not communicate or share in a common culture. On the contrary, travel and all sorts of marital, material, and symbolic exchange support inter-village networks covering vast expanses. In these circumstances, the inter-village sociopolitics of ritual feasting, funerary ceremonies, community fission and relocation, alliance negotiations, ritual dialogues, and conflict management blends in with support for specific political parties or candidates, participation in meetings with state representatives, allocation of government program resources, and attendance at sporting events.

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Yanomami Political Participation Having gained a perspective on the different types of life that pockets of criollo goods and services engender among Yanomami communities, we now turn to the main developments in recent Upper Orinoco history. The penetration and spread of party politics in the Upper Orinoco since the mid-nineties is perhaps the most transformative force in recent Yanomami history. Previously a federal territory administrated by the central government in Caracas, Amazonas was elevated to the status of a state in 1992. With its newly acquired statehood, Amazonas was later divided into seven municipalities, each with its own budget, administrative responsibilities, and elected authorities, as befits any municipality in the country. Amazonas’s enhanced status encouraged its full integration into the geopolitical and administrative state apparatus. At this time Acción Democrática (AD) was the main political force in Amazonas to gain control over the Upper Orinoco. Originally left-wing, AD, together with its main rival the Christian Social Democrats (COPEI),6 dominated Venezuelan politics, eventually deteriorating into a populist ideology-impoverished power-sharing that came to an end with the election of Hugo Chávez in 1998. Nevertheless, AD has been very influential in defining Venezuelan political culture. One of the ways that culture spread in the Upper Orinoco was through the cultivation of a political base to capture votes for local and regional authorities in exchange for privileged treatment in the allocation of state resources—goods, services, and salaried posts. This was the initial impact of politics on the Upper Orinoco Yanomami. In 1994 the first Mayor was elected, a Yekuana Indian from the Padamo region, who was raised under NTM influence and who aligned himself with the AD party. He quickly established Yanomami patronage, an initial cadre of Yanomami politicians whose communities were compensated for the support they mustered in elections. The main Yanomami clusters—Parima B, Ocamo, Mavaca, Mavaquita, Platanal, and Koshirowë—became centers of episodic electoral activity and nodes of political negotiations. Through Mayor Jaime Turón, AD controlled the Upper Orinoco municipality well into the 2000s, even when AD’s national presence was severely diminished with the rise of the Chavismo, for which AD was an archrival that represented all the past evils of the country. AD progressively lost control of the Upper Orinoco as a number of parties aligned with President Chávez began to emerge. In the early 2000s the municipality leadership was highly unstable, owing to accusations of corruption and a temporary

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conviction of Mayor Jaime Turón. For several years now the municipality has been under Chavista control.7 This change in power, however, has left the character of political relations with the Yanomami unaffected; if anything it has become more intense as the flow of goods and services has increased. The number of government posts has also risen dramatically. According to an influential Yanomami politician, the ten or fifteen Yanomami initially employed by the municipality in the mid-nineties had grown by 2008 to more than one hundred sixty. Participation in local, regional, and national elections and referendums has been fundamental in the intensification and spread of party politics among the Yanomami: more than ten election processes have occurred in as many years (1998–2008). During this period, the number of Yanomami who vote has risen greatly. In 1998 the Upper Orinoco municipality had an electoral register of 1,636 voters; the Mavaca parish—all of whom are Yanomami—had 197. In the 2006 presidential elections, Upper Orinoco registered voters had risen to 3,937, and those in the Mavaca parish to 943.8 There are currently more than 1,200 registered Yanomami voters in the Upper Orinoco, which constitutes about 10 percent of the estimated Yanomami population in the state. This means that a considerable percentage of the Yanomami population in Amazonas is in some way involved or affected by the dynamics of party politics. Another constant of municipality policies has been the promotion of “progress,” a contrast with culturally sensitive policies promoted by the Salesian missionaries and the regional indigenous organization ORPIA.9 From education to territorial organization and housing styles, the municipality has always promoted criollo/standard or nationwide policies within a rationale that equates these with social inclusion, equality with criollos, and the advancement of civilization. This is yet another way in which the municipality enacts what has long been a directive of political culture in Venezuela. From the early twentieth-century promotion of European immigration in the hope of racial “whitening” to the transformation of oil wealth into development in the post-1920 petroleum era, much of Venezuela’s rulingclass and government efforts have been cast in terms of escaping backwardness and achieving modernity (Carrera Damas, 2006; Coronil, 1997; Wright, 1990). AD candidates in Upper Orinoco and Amazonas explicitly promoted themselves as emissaries of progress (cf. Lauer, 2006:62). The rise of party politics has also displaced the focus of Yanomami leadership from the defense of indigenous rights. Despite breaches of their basic rights to health, intercultural education, and a demarcated territory, electoral and resource allocation activities largely do not address these issues. In the early 1990s, SUYAO, the Salesian-sponsored economic cooperative,

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assumed the political representation of the Yanomami within regional indigenous politics and national forums due to its supra-local articulation of Orinoco communities, but it never gained much of a presence in the Parima highlands. As opportunities for political engagement increased, participation in party politics and indigenous organizations virtually became rival projects, a confrontation of the modernist approach of the municipality with the more culturally differentiated efforts of Salesians and ORPIA. Today the representational capacity of SUYAO has all but disappeared. Municipality posts have a free-gift quality insofar as salaries are gained for little or no work other than political allegiance and participation in public events—a powerful disincentive to join more grassroots projects, whose personal and collective rewards can hardly compare. Lauer (2006:71) reports that the municipality received roughly US$ 10 million from government funds for development projects during a nine-year period and that its 2005 annual budget was approximately US$ 1.6 million. The lure of rich constituencies persuaded ORPIA itself to branch off into mainstream politics ostensibly in the hope of wielding greater influence on the welfare of indigenous people. It created a political party, United Multi-ethnic People of Amazonas (PUAMA),10 which has been successful in securing some of Amazonas’s municipalities; however, ORPIA lost its presence and force in the defense of indigenous rights. As their participation in party politics increases, Yanomami experience a certain degree of emancipation from missionary tutelage and begin to partake of the inter-institutional rivalries that inform the Upper Orinoco and Amazonas political scene. Additional causes for factional disputes within and among Yanomami communities have flourished as a consequence. The diversification of funding sources—municipality, regional government, special state funds for development—has also spurred competition for resources among communities. Politics has thus fuelled fragmentation in blocks of communities whose relations have been intensifying ever since the arrival of the missionaries.

Yanomami and Amazonian Territories Amerindians often live in frontier and resource-rich areas of their respective nation-states. Where this occurs, policies toward Indians are inextricably entangled with the state’s national sovereignty and development policies. This is precisely the case of the Yanomami in Venezuela and Brazil, whose lives have been very much affected by the history of their respective state’s territorial management agendas. In the following account I sketch out,

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in the broadest of terms, changes in the Venezuelan state’s position on its Amazonian territories, a subject that has already arisen in my discussion of Yanomami political participation and will recur in our exploration of the state’s institutional response to the expulsion of the NTM in late 2005. The so-called Conquista del Sur, “Conquest of the South” (CODESUR),11 a massive development plan only partially implemented during the early 1970s, constituted the first serious and sustained effort of the Venezuelan state to maximize the benefits of its Amazonian territories and propel their integration into the economic life of the nation. Within the framework of CODESUR, a number of environmental and mineralogical studies were conducted in Amazonas to gauge its economic potential. Communication infrastructure plans were considered, and a number of roads, airstrips, and health posts were constructed. A series of economic development ventures for indigenous communities were also set up. While the undertaking was still in its infancy, however, a change of national government resulted in the project’s termination in favor of a more environmentally sound policy for Amazonian territories. Colchester (1995:161) suggests that a combination of factors encouraged this abandonment: on the one hand, oil wealth inhibited any real need to develop the interior of the country, and on the other, Brazil’s Amazon development policies were quickly being recognized as inappropriate models to adopt. Pressing proposals for the creation of territories that would protect the Yanomami—a large and until then comparatively isolated people—from an excessively speedy integration into national development were a direct response to the Brazilian state’s development projects, begun in earnest in the mid-seventies with road building and then mining in Yanomami land. The mining surge in Brazil inaugurated a new era of environmental and social destruction for many Yanomami communities, a period that at its peak in the late 1980s found many thousands of garimepeiros on Yanomami land. In the face of this threat to Yanomami survival, indigenists in Brazil fought for the demarcation of Yanomami territory. This struggle was also taken up by Yanomami spokesperson Davi Kopenawa; together they succeeded in establishing an officially recognized territory of more than 9.6 million hectares in 1992.12 Even though some spilling over of the mining boom in Brazil affected many frontier communities, the Yanomami in Venezuela were not nearly as badly hit by mining. The devastation in Brazil nonetheless triggered concern among indigenists in Venezuela who also sought territorial demarcation. Since 1979 several territorial proposals, varying in juridical nature and size, were drawn up, none coming to fruition. During the early nineties,

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international pressure on the Brazilian government to deal with the mining devastation provided a more favorable international context in which to revisit these proposals in Venezuela. This precipitated the creation of the Upper Orinoco-Casiquiare Biosphere Reserve and the Parima-Tapirapeco National Park in 1991.13 From a legal standpoint, the biosphere reserve and national park are environmental units and not indigenous territories. The decrees that created them, however, refer explicitly to the protection of the Yanomami and Yekuana and impose restrictions on development and non-indigenous colonization. The Upper Orinoco-Casiquiare Biosphere Reserve, some 83,000 kms2 (Huber, 2001:1633), includes a good part of Yanomami and Yekuana territories; the limits of the Parima-Tapirapeco National Park, some 38,000 kms2 (Ibid.), were established with the Yanomami territory in Amazonas in mind. The biosphere reserve was also intended as an integral territorial management unit, articulating environmental protection with health and education services as well as self-management and ethnodevelopment. Sadly, no management plan for the area has ever been officially approved (Huber, 2001:1637), and despite initial efforts in 1995 and 1998 involving an agreement between the European Union and the Ministry of the Environment (MoE), the role of the biosphere reserve as territorial management framework has since all but disappeared. The 1999 constitution provides firm ground for the creation of indigenous territories in Venezuela. Article 119 recognizes indigenous peoples’ “originary rights” over the land that they “ancestrally and traditionally occupy” and recognizes the existence of their “habitats.”14 Constitutionally, it is the role of the national executive to “demarcate and guarantee the right to collective ownership of their land, which will be inalienable, permanent, closed to all encumbrance, and intransferable.” During the 2005–07 period, collective ownership land titles were granted to thirty-two indigenous communities or groups of communities. Most of these titles are relatively small land allotments, all of which lie above the Orinoco, and none of which constitute continuous ethnic territories. These contrast with the work of several indigenous peoples in Venezuela who, with the aid of non-indigenous allies, have developed sophisticated demarcation projects that fulfill all legal requirements. A salient case is that of the Yekuana and Sanema in Bolívar state, who have not only drawn a detailed map but have also designed and implemented a management plan for the area (Colchester et al., 2004). The approximately 4 million-hectare demarcation project, approved by the MoE in 2006, has since been awaiting presidential approval.

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In general, all land demarcation processes in Venezuela have, at different moments and to different degrees, suffered from poor coordination among government institutions, lack of consensus concerning procedures, and underfinancing (see Silva, 2007). Those who have followed the demarcation efforts of different indigenous peoples agree that the bottom line is feeble political will. To date, President Chávez seems unconvinced about the benefits of granting extensive land rights to indigenous peoples. He has publicly stated his disagreement with such large demarcation projects on the grounds of national sovereignty, despite the constitutional duty of the National Executive. Given this wavering and half-hearted political will, it is of little surprise that the Yanomami in the Upper Orinoco, relative newcomers to the concept of indigenous territorial rights, have made relatively little progress in assembling a demarcation project. To my knowledge, land demarcation workshops were held in 2002, and anthropologists in coordination with the MoE and the Orinoco Yanomami drew up maps in 2005, but a general slowing down and halting of demarcation efforts by the state has impeded further progress. We cannot close this discussion without remembering that on Yanomami land in Venezuela and Brazil, illegal gold mining continues to be a critical problem in social, health, and environmental terms, one exacerbated by the fact that the price of gold on the international market has more than tripled in the last ten years from 2000 to 2010. In Venezuela, north of Parima B and in the Delgado Chalbaud areas, as well as on the lower Siapa River, Yanomami communities report the fluctuating presence of garimpeiros. Even though commercial mining is prohibited in Amazonas and more than 50 percent of the territory is environmentally protected (Huber, 2001:1637), miners in the well-known mining zones are only episodically flushed out and unfailingly return. The state’s inability to enforce these laws and promote coherent management strategies is painfully costly not only for the Yanomami but for all Amazonas’s people. We now turn to the latest significant state policy on its territory south of the Orinoco, one very much related to these problems of state absence.

The Exit of the New Tribes Missions and Its Consequences On October 12, 2005, the Day of Indigenous Resistance (formerly Columbus Day), President Hugo Chávez, citing the mistreatment of Indians

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and threats to national sovereignty, announced the expulsion of the New Tribes Mission from Venezuela. Shortly after, a decree gave organization members ninety days to leave indigenous areas as pressure mounted on different ministries to produce a substitution plan that would replace the various services—education, health, and air logistics—NTM provided in the indigenous communities where they evangelized. The Ministry of the Interior oversaw this effort, while the armed forces assumed charge of the plan’s design and implementation. What started as an NTM substitution strategy quickly grew into a more ambitious project to increase state presence south of the Orinoco, as well as in the states of Apure and Delta Amacuro, frontier states with large indigenous populations where NTM were operating and all the area that could be considered Venezuelan Amazonia. The primary objective of this plan—National Plan for the Defense, Development, and Consolidation of the South (PNDDCS),15 or simply Plan for the South—was to increase the presence of state institutions in Amazonia to better control the incursion of guerrilla groups, drug trafficking, and illegal mining (gold and diamonds) as well as the associated industry of fuel smuggling. For decades illegal mining has been devastating the headwaters of Venezuela’s main rivers (Orinoco, Caura, Paragua, Caroni) while fomenting serious social disruption and disease among indigenous people. Fuel smuggling is a lucrative business that flourishes in Amazonas and Bolívar states, and guerrilla groups operate in and out of sectors of Apure and Amazonas (the frontier with Colombia)—areas inhabited mostly by Indians. With a considerable initial investment, this plan has thus far established the logistical infrastructure that will allow it to serve as a platform for the numerous planned “military-civic nuclei of endogenous development,” namely, enclaves of state institutional personnel that would combine a defense and security role with the provision of local development. This has meant an upgrade at Puerto Ayacucho’s and La Esmeralda’s air force bases. A new military airborne group with nineteen aircraft and hundreds of personnel was created, and military personnel from all forces have set up base in La Esmeralda, which will serve as a logistics hub for the plan. The number of military flights to La Esmeralda has increased significantly because of the building requirements for new infrastructure and the growth of numerous government social programs. Even if subservient to the wider agenda of the Plan for the South, the health system in the Upper Orinoco benefited considerably from this renewed logistical capability. With the support of the air force, the Yanomami Health Plan managed to expand services, albeit irregularly, into areas of Yanomami territory

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previously completely unattended or acutely underserved. Hundreds of helicopter flight hours were clocked in vaccination campaigns airlifting patients, health personnel, and equipment. In Yanomami territory itself, NTM missionaries in Parima B and Koyowë left in early 2006. Misión Padamo, the more radical evangelicals working among the Yanomami, managed to remain at their base in Koshirowë. Once NTM missionaries left, in addition to the existing army post in Parima B, small military posts were set up in the Yanomami communities of Koyowë, Yahanama, and Koshirowë, posts of five to ten men constructed in extremely rudimentary conditions. This military personnel was meant to serve as a support platform for multidisciplinary teams, envisioned as “citizenship rights vessels” that a coordinated inter-ministerial effort would send to each ex-NTM base. The only ministry to respond rapidly to the replacement of services was the MoH, which managed to open a new rural clinic in Koyowë in the infrastructure left by the NTM and to upgrade its existing operation in Parima B and the Padamo River. Yanomami of Koyowë and Yahanama have expressed their disapproval of the permanent military posts, arguing respectively that the posts fulfill no function and that initial aid offers were never met. The Yanomami Health Plan did its best to support the Yanomami in this regard. Arguments opposing the increase of military bases in Yanomami land were expressed repeatedly: two ill-functioning bases already existed, and the health system required no military ground presence to operate. The Yanomami and the MoH preferred that armed forces stick to air logistics, leaving the doctors and Yanomami health personnel to do their work in the communities. The full consequences of this plan, which has already had its ups and downs, falling in and out of favor with different ministerial cabinets, are yet to be seen. It is difficult to predict whether these currently weak bases will grow and consolidate into “military-civic” units or just disappear. The logistical upgrade in La Esmeralda, however, certainly constitutes a strong platform for the expansion of government social programs into the Upper Orinoco as well as enabling whatever new development or security plans may be implemented in the future. This chapter has provided an overview of many dimensions of the heterogeneity within the Upper Orinoco Yanomami that stem from the unequal distribution of state presences, services, and resources, together with shifting and conflicting state policies toward Indians. I have also reported on more recent and fundamental changes in Upper Orinoco history, events and developments that are already part and parcel of Yanomami life. From this discussion emerges the image of a gradient of exchange with criollos,

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their goods and ideas that characterize contemporary Yanomami social geography. Such is the context to which our attention will soon turn, when we explore in-depth how the health system is immersed in, and has contributed to, this gradient. We must first, however, get to know the health system and its doctors better, a subject addressed in the next chapter.

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cha p te r two

Particularizing the Upper Orinoco Health System

Our focus in this chapter turns directly to the health system and the doctors working in it. I begin by describing the organization of the health system in the Upper Orinoco and continue with a review of doctors’ motivations and their first-impression accounts. The usually taken-for-granted figure of “the doctor” is thus particularized in the circumstance of fresh graduates from Venezuela’s urban middle class, working among the Yanomami. Getting to know these doctors seeks to counter a trend that, by and large, has invested greater analytical effort in the indigenous side of interethnic relations (Thomas, 1994:13). The chapter closes with an examination of some of the critical shortcomings of this health system as seen from the standpoint of doctors, on the one hand, and its compatibility with the Yanomami conditions of conviviality, on the other.

Functioning and Organization of the Health System The Yanomami of the Upper Orinoco have a state-run health service with six rural clinics (Parima B, Koyowë, Ocamo, Mavaca, Mavaquita, and Platanal) attending exclusively to Yanomami communities. Ideally, this type of clinic, known as Ambulatorio Rural Tipo II (AR II), is staffed by a rural doctor, normally a recently graduated physician working his/ her compulsory rural year of service to the state, along with a Yanomami nurse, a Yanomami malaria microscopist, and a motorist who drives and maintains the clinic’s boat and motor. Every ten weeks or so, a final-year 34

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medical student joins this group for eight weeks, although in recent years this arrangement has been more sporadic. Two Ambulatorio Rural Tipo I (AR I) clinics, staffed only by a Yanomami nurse, are also in operation, one in the Mavaca area and one in Sejal, a community on the Orinoco close to the mouth of the Casiquiare Channel. AR I clinics have more basic equipment and medicines. All these health posts work alongside mission bases, Salesians along the Orinoco, and ex-NTM in Parima B and Koyowë. Orinoco Yanomami also make frequent use of the clinic in La Esmeralda, the municipality political seat and the health district headquarters (see fig. 1.4). Yanomami nurses, auxiliares de Medicina Simplificada, are trained in the Simplified Medicine Programme, a community health-worker project pioneered in Venezuela in the 1960s to expand health services in rural areas. Training consists of a course in Puerto Ayacucho lasting six to seven months. A first generation of three Yanomami nurses was trained in the late seventies and early eighties, and a second of another four Yanomami from the mid-nineties until to 2002. Since 1995 shorter courses have been used to educate microscopists in malaria diagnosis. Missionaries have also provided a few Yanomami of ex-NTM communities with informal and basic health training. Each health post is assigned responsibility for communities according to their distance from the post by boat—or on foot in the cases of Parima B and Koyowë—and the frequency with which they should be visited by the clinic’s health team. On the Orinoco and Mavaca rivers, communities classified as close are within one hour’s boat ride. Distances on foot in Parima B and Koyowë are greater. Ideally, the health post’s team should visit each community once a week. Communities classified as intermediate are anywhere between one and five hours by boat. In theory, these are visited every two to four weeks. Distant communities, those located at more than five hours by boat and often requiring additional hours or even days on foot, are supposed to be visited three or four times a year. These are only rough approximations, however, for distances vary from one post to another, and travel times change considerably from wet to dry seasons. These schedules are extremely variable, more frequently breached than observed, depending on a number of factors such as the presence of a doctor on hand in the clinic at a particular moment, the regularity of fuel supplies, and the health situation among the close communities. Rural clinics constitute the operational level of the health system, engaging daily in mostly curative primary care activities and executing nation

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or statewide disease control programs. The most relevant programs are for the control of malaria, onchocerciasis, and tuberculosis, alongside the immunizations program. The referral of patients to the hospital in Puerto Ayacucho and epidemiological registering and reporting are other key elements of the clinic’s routine. The malaria program involves early detection, diagnosis, and treatment by health post staff. On a quarterly basis, malaria service crews visit close, intermediate, and some distant communities to fumigate and fog different forms of insecticide-based vector control, diagnosing and treating as they go. The onchocerciasis program involves the delivery of ivermectin (antifilaric, antihelminthic) two times a year to all communities and periodic evaluations to monitor progress. Immunization activities are organized throughout the year in the hope of reaching all communities at least three times a year. In the intermediate and distant communities, this involves the swift movement of health teams into different areas with iceboxes and vaccines. The Tuberculosis Control Program consists of continuous surveillance (i.e., passive and active case detection) and supervised treatment of active cases (by local health personnel or relatives). In organizational terms, most of the Yanomami communities in Amazonas are part of the Upper Orinoco Health District, coordinated by a head of district from La Esmeralda who is the link between rural doctors, Yanomami nurses, and communities, on the one hand, and the Regional Health Bureau in Puerto Ayacucho, on the other. A number of Yanomami communities on the lower Siapa River and on the Casiquiare Channel fall under the administrative responsibility of the Río Negro Health District, whose seat is in San Carlos de Río Negro. The Regional Health Bureau is the MoH’s representation in the state. The flow of information, be it epidemiological records or programmatic guidelines, follows the AR I, AR II, head of district, Regional Health Bureau route, a hierarchical chain of increasing authority and responsibility. It is crucial to note that relative to the Yanomami population as a whole, the health system’s coverage is limited. And although in operational terms, it is convenient to speak of close or distant communities, this language converts a relational category of distance into an absolute quality, a label that quickly transfers responsibilities from the state to “faraway communities.” It is more appropriate to classify communities as unattended, underserved, or regularly served. In the early 2000s, approximately 70 percent of this population was estimated to be unattended or acutely underserved, while only 20 percent was regularly served.

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Daily Life of Doctors in Ocamo In all health posts, doctors and medical students share a house. In Ocamo this house lies in the part of the community farthest from the river, beside the airstrip just where the forest begins. At this distance, doctors enjoy some privacy and can live to some degree a life of their own. The daily life of the community—eating, fishing, hunting, family life, and some community gatherings—unfolds at a certain remove, and doctors learn of events mainly through the mediation of those Yanomami who visit them on a daily basis. Doctors’ engagement with the people of Ocamo is limited primarily to the clinic, their house, and some other public sites like the mission and the riverbank. Beyond this, doctors rarely visit houses unless seeing a specific patient. Depending on their interest and time spent in the community, doctors may be invited to attend reahu funerary ceremonies. This does not trouble Yanomami as long as no photographs are taken. Doctors, for their part, welcome such invitations as signs of community acceptance. In general, however, napë contexts color the physician’s encounters with the Yanomami. The daily routine normally begins with a messenger advising the doctor at his house of arrivals at the clinic. When school is in session, those who feel ill begin to arrive around 7 a.m. because they can use the mission’s school boat to travel to the clinic. Most of the morning is spent treating patients with minor problems—headaches, body pains, conjunctivitis, diarrhea, asthma, fever, parasites, skin diseases, etc.— for which either a number of pills, syrups, or injections are administered. All fevers are treated as possible malaria cases, requiring a blood sample and adequate treatment if the test result is positive. Respiratory issues often involve several sessions with a nebulizer, an electronic device that creates a fog of broncho-expansive medicine the patient inhales for several minutes using a mouthpiece. Both these cases (malaria and respiratory issues) require a longer stay in the clinic. Drawing people from all the surrounding communities, the facility itself becomes a social space where people meet and exchange news or gossip. A visit to the clinic may also be an opportunity to meet a relative. The clinic tends to be a largely female setting since, for the most part, mothers or female relatives bring in the children. Nevertheless, young men are also frequently found in the clinic, listening to radio calls, engaging in gossip, or helping the doctor with translation. Busy and crowded, the clinic also provides a setting amenable to discreet exchanges between lovers. In these simple ways, the health system’s physical structure is integrated into the

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everyday life of Ocamo as a social center, a place where time is spent sharing with others. Moreover, since transport to the mission is free (i.e., it does not require an investment in gasoline), some will claim to be ill just to go visiting. Similarly, every time a doctor hops on a boat to visit a community, someone will want to go along. Attending to patients in Ocamo is, by urban hospital standards, disorganized. Even when there is a waiting room, the area where patients are examined and treated is, more often than not, open to others in the clinic. Relatives are usually present, simply observing what is done to patients or helping to explain their problems. A visually arresting or grave patient always attracts a small crowd of commentators on the doctor’s procedures and the patient’s illness: the possible diagnosis, cause, future treatment, etc. All these concerns are discussed in the Yanomami language, excluding the doctor altogether. During the first part of the morning, several activities occur at the same time: people talking on the radio, the doctor tending to patients, others translating, mothers having children nebulized, the microscopist examining malaria slides, a fairly hectic scenario that tends to settle down somewhat by 11 a.m. Most of the work in the clinic is performed by the doctor, the student, and an unofficial nurse, David, who has worked with the doctors for several years and has learned several nursing activities but has not taken the Simplified Medicine Programme. The attendance of the official nurse, José, has been erratic, having tired of a job that he has done for twenty-five years and having moved to a community beyond Ocamo (ten minutes away). And as one of the community leaders involved in party and indigenous politics, he has occasionally been busy campaigning for himself or others and attending indigenous congresses. It is also the case that with a doctor and a student in the clinic, there is little to occupy him, apart from translation and other minor tasks that are not terribly motivating. José is nonetheless an important voice of the community with respect to the running of the clinic, and his opinions carry considerable weight. The clinic’s young microscopist, while valued for his technical skills, has been repeatedly suspended due to misconduct. This problematic relationship is compounded by the inability of the health system to provide him with a regular salary. Years of makeshift contracts and delayed payments are the main arguments he expounds when criticized for his unruly behavior.1 School schedules and prevailing epidemiological conditions affect the clinic’s routine. Because no school boat is available during vacations, patients arrive at various times throughout the morning. Afflictions that spread easily in the community, such as diarrhea and respiratory disease, make certain

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periods of the year considerably hectic—extremely so with the outbreak of an epidemic. During the December through January period of 2000–2001, a coqueluche (whooping cough) epidemic swept across the Upper Orinoco, beginning mildly in Ocamo and hitting Mavaca and ultimately Platanal with greater force. In a two-week period in Mavaca, fifty-four cases of coqueluche were recorded; according to the doctor, not a single child of the Mavaca cluster remained unaffected. During such times, several patients invariably become gravely ill and require 24-hour attention. The usually tranquil flow of activities then transforms into a highly tense, stressful, and overwhelming work period for doctors. A Platanal doctor recalled an episode illustrative of the frenzy and exhaustion experienced during this epidemic: What’s more, there was the physical tiredness of not sleeping. I was alone [no medical student], and the children would become seriously ill at 3 o’clock in the morning, a time when you could not call on the radio [for a plane to fly the patient to the hospital], and they would die at 6 a.m. . . . All that emotional load . . . And the epidemic was something that I would feel that however hard I worked . . . What about the nebulizing sessions? I had around sixteen hospitalized patients [staying in the rural clinic] all with intravenous solutions, all needing nebulization, then the queue for the nebulizer. [Patient speaking:] “I have already had two sessions.” [Another:] “I have had three.” . . . Then the nurse would help me with the nebulizing, and I would osculate a patient and would have to write down: On such and such a person I heard this [type of lung sound] because then the next time I wouldn’t remember because I needed to osculate sixteen patients . . . so I had to prepare sixteen injections, the dosages . . . Some needed [antibiotics] every eight hours, some every six. It was too much work. One night I woke up [thinking], “Gee it’s already 3 a.m. I didn’t wake up at 2 or 1 a.m. when I had to administer [an antibiotic dose] to someone. No, of course, I woke up, or was that yesterday?” I had to go to the community and ask [the patient], “Look, did I just come here?” “Yes, doctor.”

During normal circumstances, at midday the doctor will go to the house and prepare her/his lunch together with the medical student, occasionally joined by some Yanomami. The preparation of food and eating are a favorite spectacle for young Yanomami who peer into the house through its extensive open windows. Some doctors dismiss this; kids leave on their own once their curiosity is satisfied. Others cannot tolerate being observed in this way and ask people to leave or shout at them. They do not like serving

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as theater for Yanomami entertainment. Youths leave laughing only to come back again the next day. The group of onlookers is always rotating; Ocamo residents sometimes even bring along upriver visitors. Communities of the Ocamo cluster are typically visited in the afternoon. These are also opportunities when some doctors get more involved with the communities and stay to chat with friends. Medical students arrange exchanges of arrows or ornaments or pay for a paca that will be eaten at the doctor’s house. During the early evening, doctors communicate with each other and the head of district by radio. In addition to the necessary reporting of information and coordinating activities, they benefit socially from the opportunity to converse with doctors in other clinics. Company is always a welcome remedy for the sense of isolation. By nightfall doctors are back home preparing dinner. Evenings have a cozy air; doctors and students chat about the day’s medical cases, the community gossip, Upper Orinoco anecdotes, etc. During the night, there is always the possibility of an urgent call to see a patient, and it is not unusual to spend long hours in the clinic dealing with seriously ill children with respiratory diseases, high fever, or dehydration. These can be the more distressing moments because it is not possible to make radio contact with other doctors or call for an airplane if necessary. Patients usually require medicine (normally antibiotics) during the night. The doctor and student will take turns on these shifts, visiting particular houses with their flashlight and stick in hand to locate patients in their hammocks and fend off angry dogs. Upriver visits are organized periodically or in response to news of illness in a specific community. These trips are a change of pace in the sometime tedious routine of the bases, as the clinics are known. Upriver communities are considered more traditional and provide opportunities to experience aspects of Yanomami culture less conspicuously present in Ocamo. Vaccines need to be refrigerated with ice to remain effective. Visiting several communities while coping with the pressure caused by melting ice is rushed, hard work, often calling for staff to work into the night after a long journey. Some doctors are keen to travel upriver and enjoy the different environment; others—especially when long walks are involved—shy away from the hardship, minimizing the frequency and length of their visits.

Getting to the Upper Orinoco Having gained a general idea of the operational character of the health system in the Upper Orinoco, we now learn more about the doctors who

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go to the Upper Orinoco. The following are firsthand accounts of how and why different rural doctors arrived in the Upper Orinoco. I had graduated sixteen days ago. Well, ever since I was in med school I have been attracted by Amazonas, not because of / not a clue of what the hell Indians were, indigenous people. [I had] heard of the Yanomami but not / I mean the real context of the ethnic group as such / neither of any other. I was attracted by Amazonas because of its remoteness, the jungle, the animals because of [my] contact with INPARQUES [a national park service where he worked for a period] . . . that ecological aspect, to know things that no one / the things you see on TV. But actually there is a great difference between what you see on TV and what you now see here . . . [Speaking of how he learned of the job options in Amazonas:] Well, I was at my graduation party, and a woman came to me with a newspaper clip saying Amazonas was requiring six doctors. Then after my graduation-day event . . . I went to Caracas to do all the paperwork related to registering the degree certificate; while I was doing this, I saw on a billboard, over there in the ministry, that doctors were needed for the areas of Upper Orinoco / Amazonas in general. . . . [Once in Puerto Ayacucho:] I came all ready with my things, without knowing much of the reality. I looked on a map where La Esmeralda was . . . Well, I came thinking that it was going to be in the complete jungle, a camp like one of those, I don’t know, of one of those African films. . . . When I got here, the regional health director told me there was also the possibility of working in Ocamo . . . that I should think about it. . . . I said, “Well, I have no problem. I really don’t know either place. It’s the same for me . . . ” [On motivation:] I was not into meditation . . . neither ecologist nor spiritualist, nothing of the sort. I was going there because I had a vocation of service, because I thought . . . that if I could serve in a rural community where it was really needed I was going to be able to fulfill my legal requirement [rural year] as it really ought to be done. Well, it all began ever since I was studying medicine. I had the wish of doing my last internship rotation in Amazonas, a bit for the experience of knowing another culture, knowing another geographical area, more for knowing other things and how medicine at a rural level is managed . . . in a really rural place. Hence I had the wish to go to Amazonas. [In university he was part of an outdoors group that organized excursions:] Well, one of those trips was to Amazonas to a community not too

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far from Puerto Ayacucho; it is a Hiwi [an ethnic group] community . . . Of course, I saw that as a jungle, as “the jungle” . . . We were almost two weeks there. Relations with the people were very special. So considering that I have always liked the outdoors . . . I thought the best place to do the rural year was in Amazonas.

Tellingly absent in these statements are any references to Amerindians or the Yanomami. Given the newly gained visibility of Venezuelan indigenous peoples in the national constitution, as well as the continuous growth of indigenist movements in Latin America and the prominence of the Yanomami in international circles concerned with Amerindian rights, it was surprising to learn that doctors were all but oblivious to Yanomami or indigenous affairs. It is this absence, this invisibility of Amerindians in the urban middle-class Venezuelan imagination, that requires some explanation, an important topic I introduce here and revisit when we turn to Venezuela’s official discourse on identity and nationhood in chapter 9. There are references in these accounts to culture, but the “other” in other cultures is an unknown other, part of an otherness evoked by Amazonas as a place in Venezuela rather than Amerindians as a people in Venezuela. The general appeal of Amazonas as an imagined composite of otherness helps account for the specific absence of Indians in doctors’ statements. References to “the remoteness of the jungle” or the desire to work in a “really rural” place reflect prevailing perceptions of Amazonas as a backward frontier of civilization, an unknown wilderness, a largely natural space known only through the mediated experience of television. The fact that parents often object to their sons or daughters working in Amazonas reflects the boldness of this choice. It is also common to find two or more friends who decide to go together, boosting each other’s determination to take this plunge into the unknown. Moreover, for some, it is the first long period away from their families and urban environments: “When I arrived . . . crying because our parents didn’t agree. Our parents don’t agree! We were [saying], ‘We are going! We are going! We are going!’ . . . We are really like children of mom and dad, very delicate. We don’t know anything of, for example, cooking, of having to wash [clothes], or anything, none of those things. This is a reality we are going to live here . . . However, we took the step.” “We are children of mom and dad” is a common way of saying “well off, pampered.” This account is taken from an interview with six newly arrived female doctors who considered this year away a passage to adulthood, an entry to “real life.” Another doctor, after a month’s stay, affirmed

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this opportunity for growth: “I have lived in one month everything that in twenty-seven years I did not live. I had never been in an airplane, never been in a helicopter. I had never been in an aluminum motorboat. I had never walked in a jungle, never in my life.” Briggs (2003:182), interviewing a rural doctor during the cholera epidemic in the Orinoco Delta, came to a similar conclusion about how this experience is framed: “Campins tells his story . . . in terms of a coming of age as a professional.” Another doctor, who admittedly preferred not to leave his home region but was left with no option, was interviewed by a psychologist after having been persuaded to choose Amazonas: [Talking to the psychologist:] “Okay,” I said, “with things put in those terms, I think I will pick Amazonas but very conscious that I think that I will not like it. I mean, I am going to the jungle. This has nothing to do with me, I mean, my comfort, my television, my things . . .” And the psychologist said to me, “Try it out, and if not [if you don’t like it], well, we’ll see what we can do. Quit.” [The psychologist asked:] “How do you picture yourself in that area?” “Well, I see myself eating weird things. I see myself on a chalana [barge]. I see myself bathing in a river.” “And what does that make you feel?” “Well fear! . . . I mean I never / what’s more I don’t know Amazonas State.”

For many, the passage through the Upper Orinoco constitutes a dramatic “coming of age,” personally as well as professionally. Working in Amazonas is an emotionally charged experience that stirs up fears and insecurities but also a desire to rise to the challenge: “Try it out, and if not . . . Quit.” Among the many professional possibilities afforded by the Amazonas experience is the commonly cited opportunity to practice “another type of medicine”: health promotion and prevention, epidemiology, disease control programs, and a host of public health activities not a part of the graduates’ previous hospital-centered experience. For some, working “away from the hospital” had been a goal, not just an inclination. In other cases, it was a matter of avoiding the “hospital regime”—a rejection of the conventional medical power structure. After several months working in private clinics, another doctor returned to Amazonas, disgusted with the way private medicine worked: “The first day I arrived to work in a clinic I was horrified when I heard these things . . . These are normal commentaries, like ‘Gee! I hope to receive people with insurance so I can hospitalize them straight away and get the commission’ . . . It’s awful to receive a patient and to have to ask if s/he is insured.”

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Wanting to be in a “really rural place” also suggests an uncommon appreciation for a particular kind of socially oriented vocation. Those graduate doctors who share a taste for public health, a curiosity about other places and cultures, and a desire to serve in “backward” areas are a very slim minority. Most fresh graduates prefer to do their obligatory rural year close to home, minimizing the disruption to their normal lives. Another complication noted by doctors and students is that a year in places like the Upper Orinoco is a form of professional stagnation that does not allow you to keep up in a highly competitive race for post-graduate courses; the pathologies common in the area are considered unchallenging. These are symptoms of a more profound issue I can mention only in passing, namely, that university curricula in medicine are geared toward a curativist, hospital-centered health system. Accordingly, public health occupies a marginal place in curricula and is not highly regarded by medical students as a career choice (Castellanos, 1986; Barreto, 1992).2 Final-year medical students from the Central University of Venezuela arrive every ten weeks in Amazonas and are distributed among the state health posts, many being assigned to the Upper Orinoco. They spend eight weeks at a time there as part of their last-year rotating internship.3 Unlike doctors, most students have their mind set on going specifically to the Upper Orinoco. During my initial stay with the Yanomami, assignments to health posts in Amazonas and the Upper Orinoco were highly coveted. Student eagerness was such that they spent substantial sums of their own money to cover food and other expenses, such as appropriate waterproof clothing and boots. Students found the Yanomami and the jungle appealing, inspired by the fantastic stories older students told on their return from these “life-changing” experiences. As one student remarked: “Well, basically, everybody who has come here [the Upper Orinoco] has told me this experience has changed their lives, everybody . . . All the people who have come to the Upper Orinoco have told me—my life before and after . . . And I wanted to live that, live whatever there is here that divides everybody’s life into a ‘before’ and an ‘after.’ ” Although students also speak about the less romantic hardships of the Upper Orinoco, their descriptions of beautiful places, particular friendships with Yanomami, shamanic curing, fishing, and hunting tend to portray living with the Yanomami in exotic and challenging terms. These tales create an imagined Upper Orinoco that becomes almost a checklist of “musts” that exploit the full potential of “the experience.” In addition to their professional enthusiasm, students are often keen to join the Yanomami fishing, hunting, and visiting upriver. They also seek out communities that appear more traditional. Activities such as taking photos and exchanging or

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buying arrows, feather ornaments, and basketry give student internships an element of cultural tourism. Still, only a minority of these same students choose this first sojourn as a trial with a view to returning for their rural year. They typically see the whole affair as the chance of a lifetime and, subsequently, as a matter of “been there, done that.” That said, these medical students have historically made significant contributions to the Upper Orinoco health system, sometimes assuming responsibilities beyond those expected at such an early stage of their careers. We have now gained some perspective on the plurality of interests that bring people to the Upper Orinoco. In Amazonas, doctors are influenced in varying degrees by a diffuse sense of otherness in geographical, environmental, cultural, and professional terms. Students, on the other hand, are attracted to specific ideas of place and people derived from the accounts of senior students. For either new or soon-to-be graduates, this challenging experience has an experimental component animated by both apprehension and curiosity about the unknown. For most doctors and students, the Upper Orinoco constitutes a waypoint of professional maturation, but a side step as opposed to a first step in their careers.

First-Impression Accounts: The Naturalized Indian Learning about their motivations gives us some sense of the background of rural doctors. Now let us consider doctors’ accounts of meeting the Yanomami, first impressions colored by their backgrounds. One image of the Yanomami commonly stands out when doctors recount their first few days in the Upper Orinoco: the positively-valued, naturalized Indian. Impressions of the natural Indian as a type are manifest in a proclivity to view things considered Yanomami in a positive light in contrast to a negative evaluation of things considered Western. This propensity is commonly expressed when Yanomami practices, such as wearing Western clothes, smoking, or eating canned food, are deemed “our contamination.” The frequent requests for goods are considered the result of missionary or political paternalism, an outside influence, not a “Yanomami thing.” The simple life, opposed to the hectic city, is frequently admired. The following student’s statement reflects some of these points: “You see how the Yanomami see the world, and you realize that the strangers here are us, the ones who are seriously mistaken here are us. It is not them who are mistaken; it is us who are mistaken; it is us who wear clothes. Hence, the belief that we have of greatness, that we are the unique beings of the universe, changes. We are completely mistaken!”

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A doctor familiar with Guajiro (Wayuu) Indians expected something similar of the Yanomami. The following is an account of his arrival at the port in Ocamo, where it is common to find a small gathering of Yanomami summoned by the noise of an approaching motor: The motorist . . . was the first Yanomami I met, but he appeared / since he was dressed and all, I mean nothing like, / well, he had his indigenous features . . . because the Guajiros don’t dress like Guajiros anymore but rather as any one of us . . . They are Indian because they have Indian features and come from their ethnic group . . . They are already part of a totality and probably that was what I was / what I expected to find . . . But when I saw that [people in the port] . . . I was impressed by the fact of finding Indians in that way, women without their thing [no shirts] . . . Gee, how good with their children.

Being in the city and not wearing their traditional Indian dress renders the Guajiros less Indian and more like “any one of us” than the Yanomami. The image of partially naked women carrying their children after a journey into the jungle is one of unadulterated nature itself, an image accorded positive value, as revealed in the exclamation, “How good with their children.” In general, the us/them divide is an axis of interpretation that places Indian and Western at opposite ends of a continuum with static/good/ nature at the Indian pole. Movement is possible in only one direction: worse/West/future. Indians are themselves a part of nature, and nature is the source of what is good in them. Departure from the source—either geographically or in terms of increased mediation (clothes, manufactured objects, etc.)—is an index of degradation in the Western direction. Moreover, to become more Western is to lose something Indian: cultural change is invariably cultural loss. The common use of temporal markers like “still” or “not yet” in utterances like “they still do X or Y” sometimes expresses a belief in the inexorable Westernization of Indians. At other times, it assumes a social evolution that makes Indians our contemporary ancestors. The essentialist naturalization of the Yanomami in the new doctor’s imagination occurs not in isolation but all over Puerto Ayacucho, where Yanomami are the prime image of the Indian in nature. At the airport, most restaurants, hotels, and tourist sites, Yanomami are conspicuously depicted in paintings and photos as naked bodies in traditional adornment, often with birds or other wild animals. There is another aspect to the initially positive disposition of doctors: making room for cultural differences. In the following example, two new

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doctors were treating a baby who required an intravenous solution. Having encountered resistance from the mother, they performed only part of the treatment. The following morning one doctor attempted to remove some clinical tape from the child’s arm. This morning when I removed it, she didn’t let me again. She put water on it first . . . and she took it off . . . It was stuck—the tape is very strong—so she poured water on [the arm] . . . She let me do the last part. [Other doctor:] She is giving me an example, I mean, [paraphrasing the mother’s thoughts:] “You must realize that it’s hurting. There are other ways of doing it. Let’s pour some water on it. Let’s rub lightly, okay?” . . . In the city one is used to doing everything fast . . . So undoubtedly I think of the richness [of experience] I am going to take [from here].

A potentially difficult mother is seen as a caring mother who, through the delicate treatment of her child, teaches these physicians that there is no need to be rough; if avoiding pain takes more time and gentleness, then so be it. The doctor’s observation speaks to the loss of humanity in the bustling urban hospital and transforms the mother’s action into an unwitting cultural critique. I have chosen to dwell on these impressions because, beyond illustrating the common and problematic features of naturalization, evolutionism, and primitivism in the Western construction of Amerindians (see Ramos, 1998; Conklin, 1997; Albert, 2000), we follow some of these images as they are transformed with experience and become an integral part of the Yanomami-criollo relation. If nature here takes the form of a marked physical presence—such as naked Indian bodies, animals, and forest—over time, doctors’ accounts tend to align the Yanomami with another complementary aspect of our conceptualization of nature, more an unmarked absence of society: chaos and a lack of conventions and predictability. Learning about rural doctors clarifies our picture of the front end of the health system. The rest of this chapter presents some of the system’s main limitations, focusing first on this front-end interaction at the community level and then higher up the network.

Problems and Limitations of the Health System Due to the high turnover of doctors and students, the health system’s operational level is a slow learning curve. Each new doctor spends several

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months learning how to run the clinic, manage people, treat patients, and speak the rudiments of a new language. Doctors normally observe that only toward the final months of their stay did they manage to have things under control. As soon as a new person arrives, relationships must be made anew; the method of doing things changes; the same mistakes reappear; personal methods are tested; and finally some way of working stabilizes, but not for long. The significance of this discontinuous process should not be underestimated because it is incompatible with the importance Yanomami place on co-residence (and other forms of mutuality) in the construction of affect and trust. Moreover, the ever-changing personal policies in running the clinic contribute to a confrontational relationship between doctors and the communities they serve. Consider, for example, the management of clinic resources (e.g., motor, gasoline, and boat). One year a doctor might exercise relaxed management of these resources, typically lending them to a group of friends, helpers, or influential Yanomami. The next doctor may attempt to strictly control resources and monitor Yanomami health personnel. One doctor might be inclined to share with the Yanomami and encourage friends to join in meals and chat at the residence. The next could adopt a “no Yanomami in the house” policy. Treatment can also differ in crucial ways. One doctor may personally administer every dose of long-term treatment to ensure they are completed. The next might think it necessary to delegate this responsibility, giving patients whole sets of pills to take home without supervision. One doctor may love visiting upriver communities as regularly as possible. The next might not be so inclined, making less effort to comply with the optimal visitation schedule. In short, the particular style of the doctor rotating through the clinic determines important aspects of the system’s front end, such as the frequency of visits, area of coverage, resource management, and administration of medicine. Because both doctors and students are transient, a sense of belonging— to a system, to a project with a goal—is often hard to attain and progressively erodes. The physicians’ sense of accountability is weak; indeed, they often criticize the health system as though they themselves were not a part of it. The high turnover rate of doctors and students compounded by a systemic lack of institutional memory (medical and otherwise) also confers on the health system a quality of stagnation. Each doctor passes on aspects of his or her year’s experience, but important events, people, and innovations of the past fifty years often remain unknown to the rural doctors. As a result, the health system remains in perpetual infancy among a people who, in contrast, grow old and face the same episodes over and

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over. Forced to relive its cyclical incipience, it is the Yanomami who can see the system as a historical process. Finally, we should not underestimate the fact that rural doctors have little experience of unsupervised medical practice. Inexperience handling ethical decisions when negotiating with Yanomami relatives, particularly in critical and life-threatening situations, is the source of much anxiety. It is hard to imagine a more radical change from a supervised university environment to one requiring the assumption of full responsibilities for patients in such unfamiliar circumstances. Add the fluctuating feelings of loneliness, the loss of urban facilities, the frequent sense of abandonment within the health system itself, and one can see how the Upper Orinoco can become overwhelming. Although most doctors I spoke to remember their time with the Yanomami in a positive light, none would deny the emotional toll of periods of anxiety, insecurity, despair, depression, and frustration. All things considered, it is a difficult foray into the “real world.” We close this chapter by taking a step higher up the scaffolding of the health system’s organizational structure. This is a strictly contextualizing analysis, an effort to continue examining the issues that most immediately impinge on the Upper Orinoco health service and those who work in it.4 If high personnel turnover is a problem at the community level, ever-changing personnel throughout the larger health system’s organization also impedes the consolidation of a stable and efficient working relation with communities: during the 2000–2005 period, for example, the Upper Orinoco had five heads of district, and Amazonas had five regional health directors. During the Chávez period, health ministers have lasted an average of less than two years. In these circumstances, a knowledge of Amazonas’s diverse geography and population, an ability to monitor plans and programs, and a capacity to uphold specific agreements with communities and other state institutions are all lacking at one stage or another, hampering a coherent response to health problems. These effects are exacerbated by the fact that health districts have a more nominal than institutional existence, no assigned budget, and a complete dependence on the regional level of the system in technical and administrative terms. Incoherency and discontinuity become the hallmark of a chronically incipient system tasked with a health panorama of extraordinary cultural and epidemiological diversity, occurring across a vast area with little communications infrastructure. Given this complexity, a duly coordinated collaboration among several state institutions is always in order. Yet the necessity of multi-institutional solutions, while theoretically sound, increases uncertainty, for it relies on

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appropriate networking among institutions with different agendas and priorities. Two of the most common alliances are sought between the MoH regional authorities and the municipal and regional government, on the one hand, and the MoH and the armed forces, on the other. Regional and municipal governments have at their disposal personnel and financial resources that should be invested in health-related activities. The armed forces have a logistical platform—airplanes, helicopters, boats, etc.—far exceeding that of any single ministry. Local and regional governments, however, tend to distribute their resources and configure their priorities in clientelistic terms and with electoral timing. Rarely does this dynamic correspond with what sound public health policy would suggest. The armed forces too have duties and agendas of their own; rarely can their logistical resources be made available to the extent that the health system requires. Even though the armed forces have assumed a much more prominent role in supporting social programs during the Chávez administration, balancing these activities and the fulfilment of their standard security and defense duties is a challenge. Statewide inter-institutional units for pooling resources and information have been implemented several times but proven fragile because they depend on the drive of key individuals and the fluctuating political harmony of interested and often competing parties. The harshness and chronic problems of fieldwork for doctors, coupled with an unattractive salary structure within the MoH, all work against the prospect of more permanent, high-quality professionals, either for work in the field or for the training of local health personnel. Pretty much a deadend street, the field of indigenous health offers no career path for criollo professionals, and those who choose to stay do so at the expense of submitting to a far from unproblematic, missionary-like ideology. Discontinuity and incoherency, institutional fragility, and inter-institutional dependency are all interrelated. They are also tied to the historically small relevance of Amazonas in the Venezuelan nation-building and consolidation project, very much oriented by the needs of the oil economy that drove attention to the northern part of the country for the better part of the twentieth century. In Amazonas itself, the indigenous, rural interior of the state has been historically neglected in favor of the criollo (mostly urban) component of the population living in Puerto Ayacucho and its surroundings. Over time, urban and hospital-based investment has been privileged at the expense of the rural primary-care network, a parameter that ties in directly with an indigenous-criollo divide. A preliminary study of health expenditure in Amazonas revealed that from 1984 to 1996, on average,

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the rural clinic sector received 20 percent of the investment. The hospital in Puerto Ayacucho absorbed, on average, 74 percent of investment (data from Toro, 1997:330â&#x20AC;&#x201C;32). In terms of coverage and investment, the Amazonas health sector has traditionally favored the needs of the criollo population over those of the rural and indigenous communities. In this chapter, we have become familiar with the operational level of the health system and put a face on the criollo professional who works with the Yanomami. While providing the context that enables our understanding of fundamental relations in the health system, I have also introduced some issues that will be revisited later. In particular, we consider the changing character of the Yanomami nature in the doctorsâ&#x20AC;&#x2122; regard. We also examine the radical incompatibility of the rural-year regime, its high rotation of doctors and students, with the permanence and co-residence the Yanomami require to develop affect and trust for outsiders. Our focus now shifts to the Yanomami and the relations they forge with criollo health professionals in a network of communities.

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cha p te r thre e

Epidemic Diseases, Criollos, and the Morality of Being Human

This chapter explores key aspects of the historical relationship between Yanomami and criollos, with a particular emphasis on epidemic diseases. Drawing on Albert’s (1988) analysis, we follow the innovative transformation of the Yanomami conception of shawara from a type of “war sorcery” to an ontologically criollo form of disease. This conceptual shift corresponds to the path of Yanomami redefinition of criollos from ghosts to enemies to friends/allies, all in accordance with the Yanomami sociopolitical space as described by Albert (1985). The discussion will compare engagements with early extractivists and missionaries as negative and positive respectively—determined by the degree of conformity to a Yanomami “morality of being human.” This chapter and the following one form a pair. Here we concentrate on how the Yanomami “domesticated” criollos, the concepts, choices, and practices they deployed to reduce criollos’ inherent alterity. In the next chapter we consider the complementary process by which Yanomami derived alterity from relationships with criollos, their own other-becoming. In this way, we first see how criollos became quasi-kin and then see how Yanomami became napë, others themselves.

A Baseline Before beginning this analysis, I must provide some basic ethnographic descriptions to enable our understanding. Given that these topics have been treated extensively in the literature (Lizot, 2004; 2007; Albert, 1985; 52

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Albert and Goodwin-Gomez, 1997), I will limit myself to summaries. When referring to the constituent parts of the person and etiology, I will draw more closely on Lizot’s accounts because his ethnographic reference is the same as mine (Upper Orinoco Yanomami). When discussing the relationship between illness and socio-political space, my reference will be Albert (1985; 1988), given that he has developed this topic thoroughly with the Brazilian Yanomam.

Constituent Parts of the Person A major distinction in Yanomami conceptions of personhood is an external-material/internal-immaterial dichotomy: pei siki, “skin, any envelope,” and pei mi ãmo, “the center of something.” The pei mi ãmo is a vital immaterial aspect of the person, a “vital force, life” in Lizot’s terms (2004:2214). Each part of the body can have its own vital principle that is only visible to shamans. A person cannot live long without the pei mi ãmo, which is eminently vulnerable to being devoured or stolen by supernatural agents; if stolen, shamans must recapture and reinsert it in the person. When a person dies, his/her pei mi ãmo becomes a soul (no porepi) that ascends to live in the celestial sphere above the earth alongside its dead relatives (Lizot, 2007:292). Also a vital and immaterial part of the person, the pei no uhutipi is a “reflection, emanation” (Lizot, 2004:275). Unlike the pei mi ãmo, a passive vitality, this aspect can actively attack others and is common in humans, animals, and objects. Some alimentary taboos are based on the aggressive nature of the pei no uhutipi of game animals. When a person dies, this aspect of his/her person becomes a ghost, or “pore,” that roams in the forest causing illness and death in humans (Lizot, 2007:292). The pei noreshi, a person’s animal alter ego, lives in remote parts of the forest so as to preclude encounters with its person. The animal and individual share a common physical fate: if either becomes ill, gets injured, or dies, so does the other. Noreshi designates images, such as photographs, drawings, and figurines. In other areas, the favored term is “no uhutipi.” The pei mishia refers to a person’s breath, but in shamanic contexts, it is associated with life itself (Lizot, 2007:224). Accordingly, people can speak of the pei mishia as that which has been taken from an ill person and needs to be recovered by a shaman. I was told in Ocamo that the pei puhi indicates a person’s thoughts. The term “puhi” can also signify wanting something or having feelings for someone. It can be found in many compound verbs that denote conscious, mental, or emotional activity.

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Using Albert’s (1985:164) distinction and based on my observations, let us distinguish the biological body, pei siki, from the ontological one referring to its vital immaterial aspects—the pei mi ãmo and pei no uhutipi— and pei noreshi. All illness, beyond temporary and minor discomfort or pain, compromises the integrity of a person’s ontological constituents. The most commonly recognized causes of illness and death involve the dissociation of any of these components by abduction or injury from material or immaterial objects, such as darts, burning, or predation. Altered states of consciousness indicate such dissociation and suggest the proximity of death. More speculatively, abnormal breathing is also a similar index of proximate death. The later stages of respiratory diseases, very common in children, are marked by serious breathing difficulties that cause great alarm. The last element linking the ontological and the biological bodies is the blood, pei iyë. Albert (1985:348–51) has argued that blood is “the fundamental biological substance” and therefore constitutes the principal agent of physiological activity. In illness, the dissociation of the ontological body corresponds to the “corruption of the [body’s] flesh envelope that is essentially that of the blood that impregnates it” (350, my translation). In short, all alterations of the ontological body have a biological manifestation. Blood, consciousness, and breath are bio-psychological indices of ontological health and integrity.

Etiology Most illnesses recognized by the Yanomami can be explained by the following causes:1 1. Supernatural abduction of an aspect of the person, typically the pei mi ãmo or pei no uhutipi: The more common agents of these aggressions are the following: (a) yai, Yanomami for demons or evil spirits (b) pore, ghosts of the dead (c) hekura, spirits of the forest (animals, plants, and some natural elements), the shaman’s helper spirits that he can direct to attack the pei mi ãmo. Hekura have specific abilities and tools that enable a shaman to perform particular tasks in curing, defending the community, or attacking enemies. 2. Harm to the noreshi: The animal alter ego of a person may be wounded or killed (e.g., hunted by Yanomami who live in unknown territories). The noreshi of small children is associated with a particular lizard. Occasionally this noreshi that, unlike an adult’s noreshi,

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lives near them, goes missing, and must be recovered by Yanomami women to save the child from dying. 3. Shawara: Also referred to as ni wari, these are another class of supernatural beings, which the shamans see as burning lights and describe as tiny demons that consume blood and flesh. They are responsible for a series of epidemic illnesses. Many infecto-contagious diseases such as diarrhea, flu, whooping cough, pneumonia, and measles are classified as shawara alongside malaria, which also spreads and affects collectivities (cf. Albert and Goodwin-Gomez, 1997:49). 4. Hëri and manipulation of people’s objects or footprints: Hëri refers to a group of magical substances derived mainly from wild or cultivated plants but also from insects or animal hair. They have a range of adverse or beneficial effects: illness or death (with a variety of symptoms), sterility, love magic, etc. Hëri can also be used on children to prevent certain illnesses or make them grow fast. Prepared as a concoction that can either be drank or rubbed over the body, they are also used as plant medicine to reduce symptoms of illness. Hëri used for harm is normally applied to darts blown from small blowpipes by sorcerers hiding in the forest. One can also be struck with hëri while visiting another community. For example, adding hëri to a personal item like a tobacco wad or earth from a footprint can cause illness or death. According to Albert (1985:251), hëri burns the pei no uhutipi and dries up the blood. During shamanic curing, the hekura counter the hëri’s action, burning it in turn with special substances (cf. Lizot, 2007:291). 5. Breaking of taboos: The breaking of certain alimentary taboos, the non-observance of the unokai killer, female first menses ritual, or sexual interdictions related to funerary ceremonies, birth, and postpartum can all lead to a number of illnesses such as diarrhea, respiratory difficulties, etc. Even accidents like snake bites or other poisonous bites can be interpreted as having an intentional agent behind them: a hekura commanded by an enemy shaman or a yai spirit has placed the snake in the unfortunate person’s path (Lizot, 2007:272; 275). Albert (1985:164–87) distinguishes two main phases of morbidity. The first is spoken of in terms of localized physical symptoms without apparent cause. If the person’s condition degenerates, an explanation involving the ontological body is sought. Characteristic of this phase, Albert explains, is the progressive alteration of consciousness, normal perception, and corporeal sensation (168). Illness and dying is a process of inverting the

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normal healthy situation in which the conscious pei puhi is in control and the “soul-to-be” (pei no porepi) is dormant. As the ontological body suffers dissociation or injury, the dormant pei no porepi progressively takes over as the person begins to become a ghost, a pore, the final outcome if death occurs, when the pei no uhutipi liberates the ghost of the deceased.

Illness and Socio-Geographical Space To complete this account, I connect these etiologies with the Yanomam classification of social-political space as described by Albert (1985). Separating human from non-human aggression on the ontological body is a major distinction in this classification. Attacks by supernatural beings, such as the yai, pore, or shawara, “demons of disease,” are non-human aggressions and expressions of maximum social alterity, beyond the spheres of human alterity that Albert describes and which I now summarize. The innermost sphere of sociality is that of co-residents (Y. yahi therimi), an ideally independent, endogamous social-political unit, “a type of ideal sociological self, cemented by a network of dense intermarriages and by a system of generalized economic reciprocity (quotidian exchanges of food and services) between affines” (Albert, 1985:202). This is the center of sociopolitical space to which no illness-causing human aggressions are attributed. The next sphere is the “ensemble multicommunitaire,” a group of proximate communities of friends whose political alliance is fostered by intermarriage, a necessary practice because of the impossibility of maintaining the ideal, endogamous group. These communities linked by affinal ties engage in constant visits and exchanges of goods. They are also co-participants in the cycles of funerary reahu feasts, where a balanced reciprocity is maintained through the ritualized exchange of goods and ceremonial dialogues that surround the preparation, distribution, and consumption of the ashes of the dead. To this social sphere, Albert links what he calls “alliance sorcery” of three types: (a) love magic (b) “common sorcery” that causes “somatic or psychological troubles . . . associated with conflict involving economic, matrimonial or ceremonial exchange” (1985:240) and (c) equally motivated “footprint-taking sorcery.” All these actions involve a wide range of hëri substances. Common contexts for this type of sorcery are feasting and other intercommunity visits. This type of sorcery causes illness but should not be lethal, although shamanic intervention is required for its cure. A higher lethal potential is attributed to footprint-taking, associated with enemies who, aided by an ally associated with the victim, obtain the steppedupon earth or personal object to be manipulated.

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Enemies (Y. napë thë pë) constitute the following sphere, more distant communities characterized by negative economic and matrimonial reciprocity (Albert, 1985:218). These can also be targets of war raids and accused of war sorcery, which has a number of modalities. Enemy sorcerers may secretly approach the community to blow darts with hëri at an unsuspecting person or simply blow hëri dust on the victim’s head, hoping to cause death. Hëri may also be mixed with something the victim consumes, such as plantain soup. Another modality, related to shawara, involves burning a specific hëri in the vicinity of an enemy community, releasing a pathogenic smoke that causes epidemic-like disease and death. The next group, “ancient or virtual enemies,” is comprised of vaguely known communities at such a remove that no real material or matrimonial exchange occurs, only mutual exchanges of symbolic aggression (Albert, 1985:219). Here “aggressive shamanism” is active: enemy shamans command their hekura spirits to attack people’s vital images. The last realm is that of “unknown enemies,” whose approximate location and existence are known only by rumor and with whom only symbolic aggression transpires (Albert, 1985:220). To this even more diffuse category of people is attributed the injury or killing of animal alter egos. Based on Albert’s (336–38) summary, figure 3.1 illustrates the directionality of social alterity and lethalness of each sphere.

1. Co-residents: Pathogenic powers: none.

2. Friends and allies: Pathogenic powers: love magic, common sorcery and taking of footsteps (on behalf of an enemy).

4 Context: Visitation or feasting.

3 2

Illness credited to this sphere but not deaths. 3. Enemies: Pathogenic power: war sorcery. Context: secret incursions into enemy communities.

1 Illnesses and deaths credited to this sphere. 4. Ancient or virtual enemies: Pathogenic power: aggressive shamanism. Context: hekura spirits commanded by enemy shamans. llinesses and deaths credited to this sphere. 5. Unknown enemies: Pathogenic power: injury or killing of the noreshi animal alter ego. lllnesses and deaths credited to this sphere.

Figure 3.1. Yanomami socio-political space

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The addition of all the recognized non-human agents expands the socio-political and cosmological space of the community (Y. shapono). Geographical and social distance increase in tandem. In the outward direction, as real material exchanges decrease, symbolic ones increase as does the lethalness of the pathogenic power associated with each sphere. This model pattern will constitute our baseline throughout the book, and for the sake of simplicity, I call it the Yanomami conventional space.2 Having provided this important background material, I will now proceed to give an account of the origin of shawara before discussing its role in the interpretative trajectory of criollos.

Shawara (Epidemic Disease), Napë, and Manufactured Objects Long ago when Õmawë and his brother lived in this region there were no epidemics. It was when they turned into two malevolent beings that sickness and epidemics appeared; they created them. No, during the childhood and adult life of the twins there was no sickness. There were no diseases caused by spirits, only those caused by people who were familiar with certain magic plants which they burned to make one another ill. That was all there was. Õmawë and Yoawë engendered the spirit Õmêyêri and the rainbow; that was the origin of epidemics that appeared everywhere. That was when the epidemics came. —Lizot in Wilbert and Simoneau, 1990:423

Stated emphatically in this narrative is that epidemics, referred to in Lizot’s (1989:253) Yanomami text version as ni wari kë ki or shawara kë ki, are not of Yanomami origin. They are the creation of yai demons, extreme expressions of social alterity, beyond the spheres of Yanomami (human) sociality. In Ocamo the yai are always described as aggressive to human beings, whose vital aspects they abduct with force and lethal intent. Yanomami also claim the rainbow and red twilight skies are omens of shawara epidemic diseases (cf. Lizot, 2007:275). In the same Yanomami text, the “magic plant” mentioned is a very powerful type of hëri called oko shiki, literally “crab guts,” prepared by women purportedly to attack all the community’s men. When the concoction is burnt, the wind blows its odorous smoke toward the enemy group. Both substance and method correspond to one of the three types of war sorcery that Albert (1985:295) identifies with the enemy sphere. This type of sorcery is specifically meant to cause collective epidemic-like disease

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and death via pathogenic smoke called shawara wakëshi or wakeshi a wayu (296). The myth seems to suggest that the closest indigenous reference to the shawara demons of disease created by the yai is this type of sorcery that is caused by enemies, has collective impact, and uses odorous smoke as its vector. Another myth suggests a similar yet alternative origin to shawara diseases. Õmawë’s son-in-law was skinning a bird whose feathers fly away. As he chased them, the bird feathers cried “skin, skin, skin.” The son-in-law returned in fear to Õmawë, who recognized this as “the voice of an evil creature,” a yai demon. Then Õmawë and his brother traveled far downstream to a place where the Orinoco disappears under the ground. “From then on, that was where they lived. At that moment the twins turned into supernatural beings [yai] who sent the spirits of sickness and epidemics” (Lizot in Wilbert and Simoneau, 1990:418–19). “Down-river where the Orinoco goes underground” is almost certainly a reference to the land of criollos, for they came from down-river. When I inquired about the origin of shawara in Ocamo, many suggested that epidemic diseases arrived with criollos. Given the predatory nature of shawara, it is not surprising that these narratives locate its origin in anti-sociable3 yai demons or at the limits of the known world, red lights on the horizon or “where the Orinoco goes underground,” being spatial equivalents of the anti-sociable. Having discussed the origins of shawara epidemic diseases, I will now use Albert’s (1988) charting of the interpretative trajectory of whites (called brancos by Indians in Brazil), epidemics, and manufactured objects among the Brazilian Yanomam to show the process by which shawara became associated with whites. According to Albert (1988:94–96), in a period of indirect contact, the Yanomam knew nothing of the existence of whites. They knew only of themselves and surrounding Amerindians from whom they got metal for making cutting tools. Epidemics from 1850 to 1920 are attributed to enemy war sorcery, quite in line with the previous myth. At best, whites are rumored to exist as bald, white specters at the edges of the earth.4 During the period of initial contact (the first decades of the twentieth century), exchanges between white extractivists, expeditionaries, and government officials increased. Epidemics spread, always following Yanomam visits to white encampments in search of manufactured objects. Initially, the appearance and the inability of whites to speak Yanomam confirmed rumors of pale, bald ghosts on the frontiers of the known world. However, Albert continues, their lack of toes (shoes), their capacity to change their skin at will (clothes), their hairy and white appearance, and their possession

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of extraordinary objects suggested to the Yanomam that they could actually be evil spirits found at the limits of Yanomam land. At this stage, epidemics, objects, and whites became linked. Fumes expelled by boxes of machetes and other items penetrated Yanomam bodies and made them ill. Whites were thus considered evil spirits whose manufactured products were pathogenic objects with foul fumes that spread epidemics. This interpretation is based on the Yanomam association of strong odors with pathogenic power, as explained earlier (Albert, 1988:96–98). Contact and interaction with whites intensified, as did possibilities of temporary work. Migration patterns were reoriented toward communities that had regular exchanges with whites. Albert argues that although the association of whites with evil spirits was transformed, their association with epidemics was reinforced given the number of severe epidemics that struck the region from the twenties through the sixties. Conflict between Yanomam and visiting whites increased. From the latter’s perspective, Indians were not easily put to their service, pestered them with demands for objects, and would not provide them with women. The Yanomam, on their part, disdained whites’ avarice. The theory of whites-objects-epidemics was reoriented, associated with economic and matrimonial troubles between communities. Epidemics were now suspected to be white vengeance in an adapted version of war sorcery, and combustion became the main source of lethal fumes. Whites’ association with forms of Yanomam sorcery was at the same time their incorporation into the realm of humanity, even if only into the sphere of enemies (napë thë pë) (Albert, 1988:98–102). Consider the following account of an Ocamo man I interviewed: [On the punapiwei theri habit of stealing:] . . . But now there are no punapiwei theri. All that shapono disappeared. They are finished. This is what my grandfather says: “Those were the Colombians. Those were the Colombians because the punapiwei theri took their gear, torches, nylon and machetes. They took all of it.” Well, I don’t know, but my grandfather says that those Colombians had a poison [Y. hëri, Sp. veneno], and they would also burn gasoline. They set fire and burnt that poison, and with the smoke, they all got ill. They died . . . They all died.

Extractivists: Criollos as Enemies Consider the following tale a Yanomami told Lizot. The events described date from 1940 to 1945. A group of latex extractors had camped by the

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river near a community. The Yanomami spotted them and, after initial observation from the forest, approached them, lured by their manufactured goods and dogs. We bartered fruits and manioc and, squatting down a safe distance away from the big kettles full of heavily bubbling latex, we would throw pieces of wood and balls of earth against their sides, which rang out with a terrifying noise: tin, tin . . . From their insides rose a worrisome smoke: It gave birth to the shawara demons who make their way into human bodies where they inflict pain, provoke disease and shortly death if the shamans are powerless to cast them out. Several of our children died; we knew it was because of the kettles and the whites (Lizot, 1985:3–4).

Later, the Yanomami devised a trick to steal one of the dogs, pretending to exchange it for one of their sons who would work for the foreigners. On the night after the exchange, the child, as planned, escaped his masters and returned to the community. Fearing retaliation, the Yanomami kept their distance for some time. They then planned a more serious attempt at stealing the criollos’ goods, having judged them selfish for not offering them any. This episode ended with a Yanomami being injured by gunshot when the criollos requested their goods back, having caught the Yanomami red-handed. Some time later, a Yanomami ran into the criollos while hunting and shot an arrow through one’s throat in retaliation for the previous injury and the death caused by the shawara they spread (Lizot, 1985:4–5). These incidents not only speak of smoke as a vector of predatory disease but also tell us of the nature of initial encounters between extractivists, scientists, and Yanomami. Most of these narratives recount theft, deception, tense and fearful exchanges, and, quite frequently, abduction and killing (Cocco, 1972:59–73). Let us pause on Lizot’s passage because it clarifies certain underlying moral circumstances that to this day pervade relations between Yanomami and criollos, doctors included. First, there is little or no verbal communication between the extractivists and the Yanomami, who sit at a distance and observe. Doctors today generally have only the faintest knowledge of the Yanomami language and often rely on interpreters to communicate with patients, especially on upriver trips. Occasionally, patients leave the rural clinic in anger because they cannot make themselves understood. Patients also frequently nod in agreement when detailed instructions are given to them in Spanish, even when they do not understand. Nodding gives the doctor the impression

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that patients have understood everything when in reality their medicine is taken home and left unused. Second, there is a mutual judgment of amorality. The Yanomami consider the extractivists stingy; the latter clearly disapprove of having their objects stolen. For the Yanomami, the negation of exchange is the moral equivalent of theft for the criollos and equally disturbing. To share what you have is a prime moral dictum for Yanomami, stinginess a terrible amoral behavior. It is the one condition considered when a dead person’s soul ascends to the celestial sphere where souls live happily. The miserly must take another path toward a huge blaze, the shopari wakë (cf. Lizot, 1985:184). I also agree with Alès (2000) in highlighting the ethical value the Yanomami place on helping their suffering relatives. It is ethically proper to ameliorate your relatives’ pain, hunger, sadness, or hardship: Many actions of a person, in the give and take of everyday life, are thought of in terms of how “not to suffer” . . . In circumstances both banal and serious, then, close kinspeople and friends must mutually avoid making one another suffer . . . This is why one has to give happiness to, and be generous with, one’s peers . . . Consequently it is difficult to refuse to satisfy someone who is lacking tobacco, food, or an implement—or company, or a wife . . . All these actions are marks of attention, affection and amity; they are constructive of everyday life, sociality and conviviality. (135, 136)

Non-sharing is anti-sociable, signifying a desire not to enter into convivial relations. For extractivists and doctors alike, the entrenchment of private property is an essential right, a condition to “live in society.” Under these premises, theft is an equal negation of the desire for conviviality. We see in chapter 6 how today’s relations with doctors raise the same underlying moral issue in the management of the rural clinic’s resources (boat, gasoline, motor) as well as the doctors’ food and other personal items. Yanomami criticize doctors and students for being stingy (Y. shi imi, Sp. mesquino), particularly during the initial period of their stay, stressing that doctors need to be concerned (Sp. preocupar) with people’s suffering (Y. no pre-, Sp. sufrir). These words are among the first in the doctor’s Upper Orinoco vocabulary. For their part, physicians complain about frequent minor thefts, calling youths petty thieves (Sp. malandros). The final parallel I want to draw between these early encounters and current relations with doctors is the context of visiting in which they

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occur. Many instances of alliance sorcery using hëri transpire during visits, and hence visitors are always seen with a degree of suspicion. These circumstances resemble those of the ever-changing doctors, who seldom stay in Ocamo for more than one year, and the students, who rotate every ten weeks. Doctors are not going to be suspected of sorcery, but their real intentions, their commitment to help, and their ability to do so are often questioned. Yanomami political discourse on doctors and students emphasizes their impermanence and associates it with a lack of genuine concern for the Yanomami (chapter 8). In short, poor communication, mutual assessment of amorality in the exchange of goods, and deception are frequent aspects of relations with today’s criollos, which doctor and student impermanence exacerbates. The origin myth of plantains illuminates the character of interaction with strangers or outsiders and works as a metaphor for relationships with criollos.5 Several versions of this myth have been recorded. I will highlight only what is relevant to this discussion, following a version reported to Cocco (1972: 464–67) by the Iyëwei theri headman at that time, which was also told to me by one of his sons.

The Morality of Being Human The myth speaks of a Yanomami called Pore, a name that means “ghost of the dead.” Pore lives far away, alone with his family. Pore is the only person who knows how to cultivate plantains; at that time Yanomami ate only wild fruit, game, earth, or rotten wood. One day, when far from their shapono, a small group of Yanomami run into unknown footprints that they follow to Pore’s house. Initially hesitant, concerned about the possible hostility of the unknown resident, they finally decide to enter the shapono. Pore’s son tells his father to offer the Yanomami banana soup: “Don’t you see that they are very hungry?” Pore refuses to give the visitors any plantains—about which the Yanomami knew nothing—even though he had plenty in his house and a garden full of ripe fruit: “No,” said Porehimi [i.e., Pore] in an ugly voice.” Here, in an aside to Cocco, the myth teller explained that “Porehimi was giving an example to those Yanomami living today who are stingy” (Cocco, 1972:464). The Yanomami, who are finally given some plantains to taste, then return to their own shapono and tell others of their encounter. When they visit Pore a second time, he again refuses them plantains but grants their request to show them his garden—a trick for the visitors to learn the way

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to his garden and later steal from it. In the garden, Pore initially refuses to provide shoots for the Yanomami to grow their own plants, but ultimately he feels sorry for them and gives them a few shoots of only a couple of species. The Yanomami leave once more but soon return and secretly steal from Pore the shoots of the species he had denied them. Some time later when visiting the Yanomami plantation, Pore becomes aware of their theft. He enters the shapono, scolds the Yanomami, and calls them thieves “with his ugly voice.” He never visits again, leaving his own shapono and garden to live even farther away. Given the centrality of plantains in the Yanomami diet, the myth dramatizes the negation of a fundamental cultural item. But the myth relates this to two aspects of Pore’s behavior: his isolation and his inability to speak well, his “ugly voice.” The interrelated triad of meaning is stinginess, isolation, and poor communication. Such behavior is not unexpected of Pore, who is a ghost, not a human being. As we have seen, however, these are also some of the salient aspects of relations between criollos and Yanomami. Doctors in particular stay with the Yanomami for only short periods, returning to live far away in their cities. Distance, lack of communication, and stinginess all point to the same negation of social exchange, suggesting the congruence between morality and humanity. In this sense, outsiders, epitomized in myth by Pore the ghost and today by criollos are less human/moral.6 In this section, we have established some parallels between the behavior of early extractivists and today’s doctors. Outsiders (Yanomami or criollo) are, above all, potential enemies, people whose deception and distrust are expected and reciprocated. The pattern of “visiting strangers” adopted by doctors and students works to reinforce these meanings. The moral implications of non-co-residence and the inability to communicate properly or to engage in exchange continue to be obstacles for doctor-Yanomami convivial relations and are important factors in doctor-patient rapport (both topics will be treated in chapter 6). Now we explore the opposite pole of relations with criollos, exemplified by the early Salesians in Ocamo. In contrast to the extractivists, Father Cocco and several nuns remained for a long period in Ocamo and were extremely generous with food, labor opportunities, and manufactured goods. They generally behaved much more like kin to the Yanomami, speaking the language and using kinship terms. Their example set an enduring standard of behavior for fostering the development of a quasi-kinship relation with the Yanomami. The same “morality of being human,” not behaving like Pore the ghost, makes all the difference between the extractivist enemy and the missionary co-resident.

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Missionaries: Criollos as Friends Albert (1988:102–4) describes how the first permanent missionary posts were established among the Yanomam during the late fifties and early sixties. In view of their continued assistance and permanent co-residence, their initial status was redefined to incorporate them into the socio-political sphere of co-residents, who are not suspected of sorcery aggression. My informants in Ocamo agree. Father Cocco and Bonvecchio arrived in 1957, generating a hitherto unseen influx of manufactured objects in and along the Ocamo. From 1960 to 1972 Cocco reports the following flow of goods: machetes batteries axes loin cloths pots fabric for clothes fishing nylon glass beads fish hooks cups torches plastic plates

3850 14,000 620 7350 m 2850 6500 m 260 kg 280 kg 759,000 2616 750 1020

As Ferguson (1995), Chagnon (1997), Albert (1988), and Cocco (1972:377) himself have shown, this substantial inflow of objects had, and continues to have, an important impact on Yanomami socio-politics. But what most interests me is how the people of Ocamo comment on their relations with missionaries. On the one hand, they stress permanence, sharing, and caring; on the other, they raise two issues of historical importance: a trade-off between the benefits and the disadvantages of living with criollos, and the “Edenic” generosity of the early missionaries as a standard of good criollo behavior.

The Trade-Off The Iyëwei made a historical trade-off when settling with the missionaries: a beneficial exchange of Western goods, education, some healthcare, and the “word of God” set against the collateral disadvantages of suffering the shawara that missionaries produced with the combustion of Western

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products and the use of motors and electric generators. The following account recreates the type of conversation typical during the period of initial co-residence: “Before, we did not know the criollos, the napë, when we were free, we never got ill or anything. Now that we know the napë, and they bring shawara, what are we going to do? We are already dying out [Sp. acabando] because of diarrhea, hepatitis, measles, and we are bit-by-bit going to wear out [Sp. gastando]. So let’s escape. Let’s speak well with the missionaries. Let’s tell them we will be back in two or three months. Let’s speak well so they don’t get worried.” This is how they talked. This is what my mother used to tell me . . . [Meeting with Cocco, they would say:] “Father, please, we cannot live here all the time because of shawara. You came and brought shawara with the motor—because when you start the motor, smoke comes out. When you drive it, smoke comes out, you see—with that smoke we get shawara. We are going to go upriver where we used to live for some three months, and then we will be back.”

The Iyëwei theri’s option was to reside next to Cocco but flee upriver to ancient gardens when epidemics hit them. At some point after the mission provided an electric generator for the Yanomami, it was seen as a source of shawara, as recounted by this Ocama man: When they started the motors, you know when you start the motor, smoke comes out, then they would say / first they would ask: “Are these not shawara?” [A missionary’s response to alleviate Yanomami anxiety:] “No, this is smoke, smoke of gasoline.” [Another would ask:] “Are they not poisonous? No! he would say.” The same happened with the electric generator, but that one was different. Yanomami used to say that with the smoke of the generator we got ill, but not with the smoke of the motor . . . They thought they got ill with that [generator] when they started it. There were two generators for the community, so when they turned them on [they would say:] “No, don’t get close to where the smoke is, that is shawara” . . . Then in a few days they would get ill, since there was so much shawara around here. Our parents would tell us: “No, no, no, that is shawara, get in the house” . . . The shapori would say, “These napë here are burning garbage. The ones that burn cans, they spread shawara that is making us ill, and then there is the smoke of the generator.” But they didn’t call it “generator,” they called it

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mi shiipirima . . . “smells like shit” . . . Children didn’t get close to it or any other when they started it. At that moment people got into their houses. When the smoke ended, they would come out again.

While there must have been a number of competing and changing hypotheses as to the different types of smoke (generators, motors, burning garbage, etc.) and their pathogenic qualities, it was evident that the Iyëwei people were suffering from criollo-introduced shawara. To this day, a number of people consider the burning of garbage by missionaries and doctors an activity that produces disease. If missionaries were considered co-resident friends, living with them had its price: shawara. JA: Why are the Yanomami not angry with the napë if the napë brought shawara with the motor? A long time ago they were angry. The Yanomami were angry a long time ago: “Why are they always bringing shawara? Let’s kill them!” they would say. Today they don’t say this. [Now they say:] “Okay, it doesn’t matter.” Why do they say this? Because now they say: “They bring stuff, clothes, trousers. If we don’t treat the napë well, where will we get this?” This is how they think nowadays.

Clearly, the Yanomami interpretation of criollos is first and foremost relational. Changes in the nature of their relationships led the Yanomami to reinterpret potential ghosts as human enemies and then as friends. This relational nature of social categories is what gives the “Yanomami conventional space” its performative (Sahlins, 1985) and dynamic character.

Cocco’s Quasi-Kinship and Making Kin The establishment of Father Cocco in Ocamo set a standard for what one could call ideal criollo relationships. Subsequent missionaries never matched his seemingly limitless generosity in exchanging food and goods for work. Yanomami would have to wait for the advent of the Upper Orinoco municipality in the mid-nineties to experience the abundance that they recalled from those early days. Cocco, the source of the earliest bounty, engaged in local criollo mediation between the Yanomami and an inexhaustible supply of Western goods and food. In different periods, he not only kept pigs, sheep, chickens, and the like but also promoted the rice plantations and exchanged grated manioc with neighboring Yekuana.

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In light of this precedent, all resident criollos have been seen as comparatively stingy and hence less moral, particularly today’s missionaries. As an Ocamo man commented: “The Yanomami from here, the Iyëwei theri, how do they say now? These missionaries who came after [are] stingy, very selfish. This is what they say. First lived Cocco [here], he was very generous. He really was generous. Now they still say this. They remember . . . That’s what the people say, what the elders say.” The following two accounts highlight the Yanomami emphasis on the missionaries’ provision of food and their permanent residence: After they began making grated manioc [Sp. mañoco], manioc cakes [Sp. casabe], and the Father would buy, buy [from neighboring Yekuana]. People worked here. We were short of nothing while people had mañoco, casabe, sardines we had / The priest had a garden of rice . . . He planted rice, noooo way! . . . People worked . . . They would go to the mission and then the Father would say, “Well, this rice is for you. Don’t ask for food. This rice is yours”. . . Nooo! A lot of rice! And then lived [in Ocamo] Father Fernandez, not a year but rather three or four months . . . Then came Father Aguilar . . . I was around ten. I was already beginning to realize things [Y. puhi moyawë], little by little knowing, seeing how the missionaries would come and then leave. Father Cocco no, he never left, not at all . . . Sister Felicita helped the Yanomami a lot . . . With her food we grew. She would give food. She helped a lot. That’s why we loved Sister Felicita a lot, and she lasted many years working.

Cocco behaved as a father to all the Iyëwei theri, proper behavior that must have not only humanized the missionaries but also expressed their desire to be kin, albeit of a strange kind. These statements resonate with what Gow (2001:7) explains of the Piro in the Peruvian Amazon. Memories of being fed and cared for by your elders forge kinship. Vilaça (2002:352) succinctly expresses what many now agree is the basis of kinship in Amazonia: [On the Piro specifically:] Proximity and living together are so decisive in determining kinship that genealogical kin who live far away may be excluded from this kin circle . . . [In general:] It should be noted that this is not a purely formal or terminological assimilation, but a true process of consubstantialization, generated by proximity, intimate living, commensality, mutual care . . . To become kin, it is necessary to desire

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to be kin and to act as such: for example, by living together, respecting alimentary taboos . . . calling people by kin terms, and so on.

In not behaving like kin, today’s resident criollos are inadvertently rejecting a kind of kinship in the eyes of the Yanomami. Notably, the two nuns of Ocamo refer to the Yanomami with kin terms that evoke affection, such as naka (daughter/younger female), moka (son/younger male), and ihiru (son/infant). Doctors rarely do this, tending to call people by name or often simply wãrõ (male/man) or suwë (female/woman). To further understand the significance of behaving like kin, consider the following extracts of a striking conversation I had with a 45-year-old friend, who as a child was taken to the capital, Caracas, and the large regional city of Maracay by a pilot who arrived in Ocamo. He said he stayed there for about one year: “I was still young when he took me. I didn’t remember my father or my mother anymore . . . when we got there [Maracay]. I only cried for two days, and then I forgot everything.” For Yanomami, the idea of not remembering your parents, of not harboring an awareness about your family, is unthinkable; only the dead must be forgotten, and at great ritual expense. I suspect the casual tone in which this story was narrated to me ironically conveyed his incredulity at the unthinkable, as if to say: “Can you imagine such immoral behavior?” He continued: “And his [the pilot’s] wife treated me well, as if I were her son. Then I would call her ‘mother,’ and to the man, I said ‘father,’ and then to an old man . . . ‘grandfather.’” Describing his use of kin terms once in the city and living with a new family was his way of conveying to me that he was becoming napë; forgetting his parents, he was becoming kin to others. Then my father and mother here [in Ocamo] were thinking about me: “Where has he gone? Is he lost or did the napë steal him? [They eventually asked Cocco to communicate with the pilot and tell him that they were dying of malaria to prompt the child’s return.] . . . The man [pilot] said: “You have to go to Ocamo, but you will not stay. You stay only for a week, and then I will pick you up . . .” Then, when I arrived in Ocamo, I said: “But who are these people? I don’t have a clue who they are.” I didn’t understand the Yanomami language . . . and then my father, when he recognized me, he took me, and I would say: “No, no, no, shami! shami! dirty! dirty!” I didn’t say “shami” [the Yanomami term]. I said “sucio” [the Spanish term:] don’t touch me . . . Then Cocco would explain, “No, these are your father and your mother.” And I would say, “Really?”

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“You are Yanomami,” Cocco would insist, and I would reply, “No, what do you mean Yanomami? I don’t know who the Yanomami are.”

Spatial and cognitive distance from Yanomami parents and mutuality with criollos had made this boy napë. Hence he evokes his alterity precisely with the markers of non-humanity: not speaking the language—emphasizing it was Spanish that he spoke—not remembering he was Yanomami, and deploying a typical criollo stereotype: dirty Indians. This episode that reiterates the transformative power of continuous social exchange merits some discussion. First, kinship is about making people similar, intentionally behaving morally as kin. These conditions make Cocco, a criollo (Italian actually), quasi-kin. Significantly, the “construction of kinship”— to use Viveiros de Castro’s (2001) expression—and what we can call the “domestication of outsiders” involve the same efforts and practices. Second, consider the following parallel, a Piro myth of mortality recounted by Gow (2001:35). A man was “tired of living with his kinspeople” (a reference to death) and “went to live under the earth”—the land of the dead. A man in the underworld asked him whether he wanted to live there and “he said he did,” after which he shed his worldly clothes, was given animal skins, and began to live “just as in his world” but in the underworld. At one point, though, he got homesick and went back to fetch his kin, but now the world looked strangely red, and he did not recognize the way to his house. Wearing animal skins—he was now a peccary, the form the dead take on earth—he was rejected by his wife but accompanied by his son back to the underworld. This is a good example of Amerindian perspectivism (Viveiros de Castro, 1998) at work: changing your body you become another type of being, acquiring its perspective on the world. But the human (Indian) perspective is the way all species with souls see themselves. The man in the underworld provides animal skins to enable a visitor of this world to live normally in the underworld just like he had as an ordinary Piro. When the visitor returns to this world in animal form, though, he sees it from a peccary’s perspective, hence the red sky. He then loses his way, and his wife rejects him. In this way bodies encode relationships and provide perspectives on the world. This comparison illuminates how changing clothes/skins is a timecompressed version of behaving like kin, living together, speaking the same language, using kin terms, conditions the Ocamo boy fulfills to “forget” his parents and become napë. When he returns, he cannot recognize the Yanomami or his parents, just as “the man who went to live under the earth” cannot make his way home. The Ocamo boy calls the Yanomami “dirty” from a criollo perspective, similar to the wife who rejects the man

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who went under the earth, seeing him from a human perspective as an animal, not a human being. The only difference is that, unlike “the man who went to live under the earth,” “the boy who went to live in the city” is not a myth. Thus, if making kin is about producing similarity by behaving like kin, the body is the site where these relations of similarity are made visible: as long as bodies are alike, people are kin because they reciprocally make each other. This entails the body being seen as a habitus, as Viveiros de Castro (1998:478) suggests, “an assemblage of affects or ways of being” including, for example, eating habits and language but, by implication, also that gamut of moral behaviors we have called the morality of being human (cf. McCallum, 2001:66–67). Following Vilaça (2002), I refer to this intentional production of bodies and perspectives via the morality of being human as simply “making kin.” If the perspective-altering transformation of bodies (typical of the realm of the extraordinary in myth and shamanism) is of a kind with behaving like kin (typical of the quotidian), that is because everyday life involves a constant interplay of producing evidence of one’s effects on others. This is important to note, for we see in subsequent chapters how these modes of action, testing one’s impact on others, are as common among Yanomami as between Yanomami and doctors. Early missionaries’ behavior fulfilled the conditions for the development of trust, affect, and memory. In Ocamo, when I asked about the past, people spoke almost exclusively about Father Cocco and the early missionaries despite the subsequent presence of a number of other agents of national society. This abiding interest in Cocco, Ocamo’s arguably selective memory, points to the highly significant role he played in transforming these people into what they are today, as they would put it, civilized Yanomami. Nevertheless, Cocco’s kinship was of a curious kind. Missionaries were clearly not from Ocamo and did not marry Yanomami, yet they behaved as kin to all the Yanomami (a point to which I will return in chapter 5).

Shawara Today: Ontologically Napë Today shawara is generally associated with the napë, having been introduced by them and spread by their forms of combustion and smoke-producing transport. When I was not yet born . . . it is said the elders did not get ill . . . They wouldn’t get ill. It was just like that. Nowadays shawara really comes

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strong. Given that a lot of shawara has fallen on us, we are becoming less. A long time ago, when there was no shawara, peeemeee! They say there were many, many hearths . . . Why did shawara come to us? Because they [napë] burn garbage in Puerto Ayacucho. They also burn the tires of cars. There are also the motorized pumps, smoke comes out. There is the smoke of cars. Airplanes also fly back and forth . . . It is this that causes shawara epidemics to fall on us, one after the other.

Yanomami belief in a generalized and indomitable spread of shawara is likely based on their experience of huge numbers of criollos who habitually use smoke-producing technology and their concurrent experience of the epidemics that have afflicted all Yanomami. But the criollo nature of shawara exceeds its immediate technological source. At least in some cases, shawara even speaks Spanish and mimics the sounds of its origin in factories. The following narration also refers to shawara odors but in a shamanic context where shapori are able to identify aggressors by their characteristic smell. JA: How does the smoke make you ill? Do you know, or does the shapori know how is that? No, no, we don’t know. The shapori know. JA: And how do they know? They smell, they take it oaaa! They smell, and say it smells of paper, of plastic pots. JA: So is it like dirt inside you? No, no . . . the plastic pots and that stuff, it’s as if a napë were talking, not the pots. Okay, so that garbage was burned. The shapori says: “This is garbage. There it is.” [The speaker is imagining a shamanic session in which the shapori sees the causes of illness:] “The shawara is speaking napë . . . From where they are fabricated, it sounds, those machines . . . those machines have to make noise where the shawara is.” Then the shapori says: “That’s what they are burning. That is why we are always with shawara here. Here you can listen to it: all the machines go ‘kan, kri, kran’ . . . Shawara, it speaks Spanish, gnaganganga. It complains/moans [because it is being attacked by the shapori].” So then the shapori’s helper spirit says: “Look father,7 this shawara is from the napë. We have to make it flee. We have to make wind blow so that it takes it somewhere else. Then this shawara, we have to break it . . . We have to send it down there [to the lower cosmic sphere]”.

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This extract is highly evocative of some of Davi Kopenawa’s conceptualizations of Yanomami relations with whites. Kopenawa, a renowned shaman/spokesperson for the Yanomami, combines elements of shamanic knowledge with his knowledge of the criollo world, incorporating aspects of environmental discourse as a strategy to defend his people. For Kopenawa, the spread of shawara is at a maximum owing to the combustion of the earth’s minerals in factories. Ultimately, shawara affects not only the Yanomami but all people in the world: whites call it “pollution” (Albert, 2000:360). This chapter has shown how the “morality of being human” guides the passage of criollos through Yanomami conventional space. The more you behave like kin, the more human/moral (co-resident) you become, while the more you depart from these conventions, behaving like Pore the ghost, the less human/moral (enemy) you become. As ideal types, extractivists elicit the “enemy” side of relations with criollos: distrust, deception, theft, violence. Early missionaries embody the “friendly” side: provision, care, protection, instruction. Today’s relations with doctors exhibit elements of both. Never reaching either extreme, doctors start out as strangers and end up as quasi-kin, albeit faint versions of kinship à la Cocco. In their initial months they are met with distrust and disregard, yet their departures draw tears, leaving behind not only memories but also artifacts such as clothes, radios, and even Spanish children’s names, which they were asked to recommend. We have also demonstrated how co-residence, sharing, speaking the language, and using kin terms all promote trust and affect. This process of domesticating outsiders makes the constant rotation of doctors in the rural-year system incompatible with the circumstances that can foster convivial relations with criollos. Finally, we have established a continuity between the construction of kinship and the domestication of outsiders: both involve the same intentions and practices for the production of similarity through moral relationships. If missionaries were somehow becoming quasi-kin, by implication, because of the mutuality of making kin, Yanomami were simultaneously becoming napë. The details of this process are the subject of the next chapter.

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cha p te r fo ur

Becoming Napë and the Napë Transformational Axis

The previous chapter discussed the trajectories of criollos and shawara according to the conventional relations that constitute the Yanomami socio-political space. According to Wagner’s (1981) theoretical framework, the conventional, when innovated upon, becomes to some degree particularized. Inevitably, however, the innovation becomes recognizable, known, and in turn conventionalized. This is a constant dialectic between convention and innovation, meaning that, in using the conventional Yanomami space to interpret criollos, it is modified, producing a new set of conventional relationships. The relationally constituted notions of Yanomami and napë are transformed as interethnic exchange intensifies. Much more than a semantic expansion, a new context of interpretation of relations, I will argue, has emerged. This napë transformational axis coexists with what Albert (1985) has described, but its defining parameter is not enmity but a historical transformation into napë. This axis must be understood as a context: a set of concepts and practices that constitutes a network of conventional relations contextually uniting or separating different categories of Yanomami and criollos. I call this axis of interpretation either the “napë transformational context” or “the Yanomami innovational space” to remind us of its qualities and its relation to the Yanomami conventional space. This network-context is fundamental to recognizing relations within the health system as one aspect of the Yanomami’s more encompassing management of relations with criollos. The first part of this chapter is devoted to the analysis of becoming napë as a historical transformation that frames Ocamo people’s understanding of 74

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themselves in relations with criollos and other Yanomami. This historical process involves a body/habitus transformation and the acquisition of criollo knowledge, the two critical gains of becoming civilizado, as Spanishspeaking Yanomami would say. Yanomami idioms for becoming civilized closely resemble those of the Peruvian Piro, so well described by Gow (1991; 1993; 1994). The particular focus on body/habitus is also common to the Wari’ of Brazil when they speak of becoming white (Vilaça, 1999; 2006). I draw on both these authors in my analysis of Yanomami becoming napë. Engagement with the world of criollos is essential for maintaining a civilized life in Ocamo. All “interface” Yanomami (bilingual, missioneducated community representatives) manage relations with this outside world. This mediation has two components: translation of the criollo world and control of criollos and their resources. In this mediative role, interface Yanomami on the napë transformational axis fulfill the “foreign affairs” political role of shapori in the Yanomami conventional space. The second part of the chapter is devoted to the analysis of current relations among the Yanomami on the napë transformational axis.

Becoming Civilizado, Becoming Napë Ocamo narratives of the missionary and recent past describe transformations of relations with criollos. One set of ideas refers to changes in habitus, corroborating Vilaça’s (1999) analysis based on a perspectivist notion of the body, of interethnic contact as metamorphosis. Another set of ideas describes the acquisition of criollo knowledge. Both these modalities of recounting the past establish a link between “how we used to be” and “how the people upriver still are.” I will treat both of these in turn.

Becoming Napë: A Change of Body/Habitus The following is representative of Ocamo narratives of encounters with the early missionaries: Cocco would help. He also gave things, loin-cloths. Because before there were no loin-cloths, only wãõ, penis sheaths, only that then / Before the Yanomami were afraid. They were afraid. They didn’t know the napë . . . Here Father Cocco lived with the Iyëwei theri . . . Before they didn’t have their clothes. Before they wandered naked. In the first time, they

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were naked . . . The missionaries helped the Yanomami. They gave clothes. They allowed them to become like the napë with shoes. There was also the school and the church . . . So they got to know the missionaries well. They used trousers, T-shirts, all.

Such accounts often stress the movement from being afraid of the napë to getting to know them, a passage accompanied by changing body habits. Getting to know the napë well implies becoming like them: dressing, eating, and living like them. Extracts from an interview with a man from Karohi, a community on the Manaviche River, describe a similar process: “The napë would make the ancients fearful, and they would flee . . . A long time ago the ancients/ When the ancients lived in the mountains, they did not live like napë . . . Nowadays lots of us are becoming napë. We are living in houses with zinc roofs. When we obtain napë food, we eat it.”1 Relocating from far away in the forest to near the napë along the Orinoco is a common marker of historical change. This man also mentions napë habits such as living in houses with metal roofs and eating napë food (typically rice, pasta, and sardines). All this refers to a transformation from living as the ancients did to living as Ocamo Yanomami do today. And as Gow (1991) discovered with the Piro, the transformative process is not without consequences—notably, shawara—but the Ocamo people consider this nonetheless an achievement. Vilaça suggests that in the process of interethnic contact “indigenous sociology is above all a ‘physiology,’ so that in place of ‘acculturation’ or ‘friction,’ what we have is transubstantiation, metamorphosis.” She continues: “Thus, when the Wari’ say that they are turning into whites, this is a way to say that today they eat rice and pasta, that they wear shorts and wash with soap . . . Clothing is a constituent part of a set of habits that form the body” (1999:255, my translation). The Yanomami also describe the experience of change in precisely these terms. But I want to add that the expression “because before, the ancients didn’t have x” or “didn’t know x” is common to both historical narratives of transformation into napë and myths involving the acquisition of cultural items such as plantains and fire. Occasionally, as in the earlier narrative related about Father Cocco, speakers refer to the pre-missionary period as “the first time,” or they mention “the first ones,” the equivalent of pretransformation ancients in mythical narratives. Following Gow’s (2001) lead, I want to describe the context in which I was told the myth of Pore (chapter 3) as well as the context in which the Ocamo headman told it to Cocco. In an interview with a 35-yearold friend, he told me about Father Cocco, his generosity in the form of

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goods, food, assistance, and education. When I changed the subject and asked him for a myth about the origin of the Yanomami, a tale of the no patapi, the ancients, he recited the myth of Pore even though he, the son of a great shapori, must have known the Yanomami origin myth well. I suspect the sequence of our conversation led him to tell this myth. We were speaking about the time of Cocco, a highly transformative period when the Ocamo people see themselves beginning to become civilizado. My informant’s choice may have suggested that, just as the acquisition of plantain has been an essential aspect of being Yanomami since mythical times, the acquisition, through Cocco, of a criollo habitus, has been essential to how Yanomami feel about themselves today. These contexts of myth telling to criollos and the similarity of narrative forms indicate that Yanomami in Ocamo can speak of their historical relations with criollos as time-compressed events of habitus transformations, as repetitions or instances of events occurring in mythical times (see table 4.1). What Gow (2001) has said about the Piro, that they experience the world as a “system of transformations” where myth and lived world echo each other’s intrinsic transformational nature, is true, I believe, of the Yanomami. Further supporting the idea of transformation or metamorphosis is the use of the particle -pro- in the term “napëprou,” the common way of saying “being civilizado.” According to Lizot, -pro “connotes the idea of transformation and, when suffixed to a noun [like napë], [it] verbalises it, indicating a change of nature, of state, of form, etc.” (1996b:83). Moreover, -pro- indicates the final phase of a process that is still happening, the perfective -prariyo- is used when the process is complete. So “napëprou” means in fact “becoming napë.” Mythological transformations, themselves metamorphic events, are also linguistically marked by the pro/prariyo form. To be napëprou is to imagine yourself in an ongoing state of transformation

Table 4.1 Analogies between mythical and historical transformations

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Mythical context (becoming Yanomami)

Historical context (becoming napë)

Pre-transformation

Ancient Yanomami (lacking culture)

Yanomami

Post-transformation

Yanomami, animals, natural features

“Civilized” Yanomami

Acquisition

Yanomami culural items (e.g., fire, cultivation)

Criollo cultural items (e.g., clothes, metal tools)

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into napë. This sense of napë as a limit—a point you approach but never reach—is consistent with Yanomami representatives’ political discourse that portrays today’s Yanomami “as walking the napë’s path” (i.e., progress). But we must return to the issue of shawara, for it too indicates a transformation of habitus. I asked a friend whether shawara would disappear if we removed all the motors, combustion, and criollos from the Upper Orinoco: “No, it will not disappear. It has already been formed, you see. It doesn’t go, never! That shawara / those have already become shawara forever.”2 Others mentioned that there was no point in retreating back to the deeper forest away from criollos because shawara is everywhere now, and it will never disappear. Criollo-produced shawara has infested all the forest, another habitus transformation produced by contact afflicting Yanomami bodies. A final instance of body transformation was related to me by a trained Yanomami nurse. In technically sophisticated language, this account describes an internal change in the Yanomami body, a consequence of changed nutritional habits: A long time ago, our culture lived / they lived in the headwaters. When the Yanomami didn’t know medicines, neither did they know headaches. There was almost no sickness [Sp. enfermedad] because they didn’t know how to eat what the napë make. Our blood is now too blended with the vitamins of napë food and the vitamins of the food we eat in the headwaters. That vitamin doesn’t have enough resistance. It has no potency . . . Nowadays . . . when a child is still young, it already has hepatitis. They get ill early because they have very low vitamin levels. They are already accustomed.3

This theory would certainly appear plausible to many Yanomami. That criollos are weak is evidenced in their feebleness in the forest and their quickness to complain about their suffering. Hence, in becoming napë through acquiring their eating habits, the statement suggests Yanomami have become weaker, more vulnerable to disease. Another friend spoke of “already being accustomed to living with sickness.” To be “accustomed” implies the irreversibility of a process. You cannot go back and undo what has been done, recovering your original state, just as animals cannot “de-transform” themselves into ancient Yanomami. Whether you see the forest as shawara-infested or see your body as feeble and accustomed to certain habits, the results are the same: Orinoco Yanomami are napë now, civilizado. They accept the costs and try to reap the benefits. Irreversibility recalls the notion of napë as a limit, a direction of historical transformation-progression that informs the political

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discourse of current representatives: the only way to improve is to continue the napëprou trajectory. This process does not entail living in cities, marrying criollos, or abandoning shamanism but rather being dual Yanomami/ napë with readier access to healthcare, education, and manufactured goods, and with greater control over these criollo resources (see chapter 8).4 We have so far explored the notion of becoming napë as a change of body/habitus. Following Vilaça’s lead, I revealed this to be a metamorphosis of such significance that it can be rendered in mythical terms. This alternative—which coexists alongside more matter-of-fact ways of speaking about past relations with criollos (cf. Hugh-Jones, 1988:140)—prefigures change as a repetition, a transformation, an other-becoming (cf. Gow, 2001:309). But when listening to the Yanomami, a second component of napëprou becomes apparent: the acquisition of criollo knowledge.

Becoming Napë: Acquiring Napë Knowledge Like many other Amerindians, the Yanomami are interested less in accumulating Western goods than in controlling their distribution. Motives for this involve relations with national society and relations with other “deeper” indigenous communities, mixing elements of an economic and political leveling with criollos and the procurement of a favorable economic and political position among Yanomami communities themselves. In this context, education, in particular the acquisition of the criollo language, Spanish, is essential to communicate with the resident missionaries and facilitate access to, and distribution of, Western goods. Today, many Yanomami speak Spanish, have traveled beyond the Upper Orinoco, and have become increasingly involved in regional politics. The flow of missionary Western goods has declined, but other wealthy sources have appeared in the form of local and regional governments and governmental social programs. Epitomized in the ability to read and write, education, not just the ability to speak Spanish but a broader conception of criollo knowledge (mathematics, politics, travel, etc.), is now fundamental for the Yanomami to secure for themselves Western goods found beyond the Upper Orinoco. I always say, “Before when Cocco taught us, when he was teaching us, before he would give gifts . . . He would bring all sorts of things, pots, loin cloths, nylon, hooks. He helped. He cooked wheat . . . He gave food, grated manioc . . . So they [elders] still think, “Why don’t today’s missionaries do like those missionaries?” Then I say, “No, he first taught us. He helped

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us because we didn’t know the language of the napë since we were really Yanomami, really waikasi. He would help us. Now there is no help. Now we know how to speak. We know how to study, and now we have to think how we are going to find money by working . . . It isn’t as it used to be.

This view is representative, I believe, of politically uninvolved Yanomami. For those Yanomami engaged in indigenous or criollo politics, a notably broader criollo knowledge is essential for the defense of their rights (healthcare, education, political participation, and land) and to liaise with criollo politicians (mayor, governor, and other officials) when generating votes for themselves or other party members and requesting the allocation of goods for one’s community. Spanish-language competency and a sixth-grade education were compulsory until recently for any individual seeking training as a nurse in the health system, criollo knowledge being thus a precondition for any community wanting more control over their health situation in the form of nurses. With Gow (1991:229), I argue that criollo knowledge has become complementary to shamanic knowledge. While shamanism is key for the management of socio-political relations in the Yanomami conventional space, education is key for the management of relations on the napë transformational axis, a necessary requirement for maintaining the civilized lifestyle of Yanomami along the Orinoco. Shamanism is a technique of mediation with the spirit world (hekura, yai, shawara demons, etc.) and the invisible image/ aspect of everything (no uhutipi), connecting ordinary Yanomami with this complementary world via shapori; a broad-scope education is a technique of mediation with the napë world, connecting ordinary Yanomami with another complementary world via the educated or “interface” Yanomami. If shapori have the ability to take the Other’s point of view, the perspective of spirits, as a requisite for engaging them in coordination, negotiation, dialogue, and aggression, then interface Yanomami have a similar faculty, namely, the capacity to assume the position of napë in order to manage relations with them, thereby rendering the napë world comprehensible to those Yanomami who have less experience of criollos (translation) and putting criollo resources at the service of the community (control).

Reading/Writing and Seeing If sight is the privileged capacity of the shapori, who sees what no one else sees, then reading and writing are the eyes of those who mediate with the

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criollos. Suggesting precisely this association of ideas, an Ocamo friend once chose to translate for me the notion of the hekura helper spirits descending on the shapori in the following terms: “[The hekura] arrives where the Yanomami are and gives his capacity [to the shapori].” The other context in which he frequently used the term “capacity” was when speaking of people like himself, a mission-educated Yanomami. Thus a knowledge not properly their own makes both shapori and educated Yanomami “capacitados.”5 This is but one instance of how the criollo technology of reading/writing resembles the shamanic technology of seeing, a matter I develop more extensively in chapter 7. The recent spread of party politics in the Upper Orinoco and the even more recent development of government social programs have reinforced the importance for the Yanomami of being able to read and write. Through their writing skills, many Yanomami expressed their needs to military agents during a memorable visit of President Chávez to La Esmeralda (2000). Months later an unprecedented number of outboard motors and boats were officially delivered to Yanomami communities. Some time prior to a second visit in April 2001, anticipating that the president would again supply goods, a number of Yanomami approached me for help writing up “community projects,” lists of material needs supported by criollo-amenable motivations. Some associate reading/writing and paper documents with the criollo ability to produce trade goods. I once asked a young friend from Maweti (three hours upriver) about the project that had provided Ocamo with insecticide-saturated nets as a malaria control measure. He responded: “Aaah! Those mosquito nets . . . the ones on the paper, they draw them [write on paper]. They all write for the doctor . . . Then she made many nets in plastic bags. Then she sent them. They arrived in Ocamo. Then she distributed them to the communities . . . Lechoza, Yohoopë . . . When I arrive over there in Ocamo . . . I always draw too, asking for many nets, many T-shirts, trousers. I have written for everything.” The power of paper in the Upper Orinoco is not limited to the procurement of goods. These documents also enable or disable other processes such as regional/national elections, where national identity cards are a requisite for participation. In short, reading/writing and the related ability to produce paper documents constitute the knowledge Yanomami need to control the flow of goods (drawing up projects), to improve healthcare (producing health personnel), and to defend themselves from conniving outsiders (cf. Hugh-Jones 1997; Gow 1993).

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Translation and Shamanism Let us now consider the Mavaca Yanomami conference of 2001, a site where the mediating/translating role of interface Yanomami (missioneducated and politicians) was most evident. Their mediation/translation subsumes my discussion of becoming napë as body transformation and knowledge acquisition while making explicit the equivalence between criollo and shamanic knowledge: writing and seeing. On stage in front of a diverse audience of community representatives with varying degrees of experience with the missions and health system, an Upper Orinoco nurse devoted most of his speech, his first address at the conference, to explaining the purpose of this event for the upriver Yanomami present: “This congress looks different. It is not like taking yopo [collective sessions for taking hallucinogens] . . . because it looks different. There are big hanging letters [a large banner behind the platform read “National Yanomami Conference, Shakitha 2001”]. There are also secretaries. You see, it looks different because it is napë. The ancients don’t know about this!” The speaker was wearing a T-shirt, belted trousers, and shoes; those in the audience from upriver were clothed in shorts, loincloths, ragged criollo attire, and traditional adornments. As a nurse, he also had a stethoscope around his neck and a notebook in his hand. The “dress code” of napë clothes points to a napë body; the “accessories”—a stethoscope and notebook—point to napë knowledge. Before even uttering a word, this man conveyed being napë. While highlighting how the conference looks different from a yopo gathering, he links the conference as a form of political congregation with a yopo session, a Yanomami event where important matters are discussed. But by insisting it is not a yopo session, he is translating quite the opposite, making the conference resonate with the yopo session in such a way that upriver people can see this as a napë form of taking yopo. Rendering difference as analogy is possible only for a Yanomami/napë able to see like a napë and see like a Yanomami. Subsequently, he refers to the writing on the banner and the secretaries, a few Yanomami taking notes on the proceedings. The only two remarks about what is visibly different are both related to writing: the banner and the secretaries. That writing is at least one of the sites of the speaker’s privileged knowledge is underlined. Finally, the difference is explained: it is a napë procedure, something with which the ancients are not familiar. Locating difference in the napë-ness of the event simply reiterates in words what has already been said in form, such as the nurse’s style of dress and accessories.

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Let me stress that I am not arguing the Yanomami perceive interface Yanomami as shapori; in fact, I am quite sure they do not. I am maintaining, however, that the possibility of their mediation is grounded on the same ontological premises as shamanism: true knowledge comes from becoming an Other and taking that Other’s point of view (Viveiros de Castro, 2004b:468). Mediation between worlds is possible for those people who have a foot in both. In the same way that shapori are Yanomami/ hekura, people from places like Ocamo are Yanomami/napë. This is the aesthetic form by which mediation is indigenously recognized and validated. Carneiro da Cunha (1998:12–13) reminds us of how, particularly in the context of encroaching colonial situations, “shamans, travellers in space and time” are prime translators making the unknown resonate with known through correspondence. I am suggesting that we flip this argument of shamanism as translation on its head and see translation (mediation) as inherently shamanic in form. Here I want to invoke the words of Davi Kopenawa cited in Albert (2000:357) in a section appropriately named “See, know.” Having experienced firsthand the destructive nature of gold mining, Kopenawa links the predatory nature of miners to their ignorance. They are ignorant of what the shapori see when they take hallucinogens and ignorant of the “vital image” of the forest. “[In this way], he [Kopenawa] underlines the irreducible antagonism between two forms of knowledge, that of the ‘foreign enemies,’ that has its roots in writing, and that of Yanomami, based on shamanic vision/ knowledge . . . ” (357, my translation). In asserting that true knowledge is shamanic, Kopenawa is also positing a white counterpart, acquired through writing on paper in schools, “the realm of manufactured objects and machines, from which the Yanomami are excluded” (249). This affirms the complementarity between the white knowledge/world and the shamanic knowledge/world. The missionary encounter as a collective transformation of mythical dimensions and the shamanic mediation of interface Yanomami between criollo and Yanomami worlds are congruent renderings. One is a historical collective metamorphosis that allows for the dual Yanomami/napë character of Orinoco Yanomami; the other is the enacting of this dual nature through mediation. If myth and shamanism are in constant interplay updating and validating each other, on the napë transformational axis, a sense of becoming napë and mediation (translation and control) also support this dialectic. Thus far, I have presented the historical becoming napë of Ocamo Yanomami as a transformation in body and knowledge that allows for a dual Yanomami/napë being, described as being civilizado. I will now

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develop the synchronic dimension of this becoming. This aspect of napëprou exists because of the internal gradient of contact among Yanomami, prolonged differential exchange with missionaries, health personnel, and other agents of national society. It constitutes a network with Ocamo Yanomami situated midway between a Yanomami pole and a criollo pole, a positioning key to sustaining their duality.

The Napë Transformational Axis Played Out on a River The use of the terms “Yanomami” and “napë” reveal the coexistence of two socio-political frames of interpreting relations. In the first one, napë has connotations of alterity in terms of enmity. Its simplest meaning is foreigner, non-Yanomami, and hence potential enemy, as reflected in a series of derivative terms, such as napëmai—“to hate, to detest or have aversion for someone”—and napëmou—“to threaten, to show hostility” (Lizot, 2004:250). Yet the semantic field of napë has another side that refers to criollos: napëai, “to begin to know the criollos, to imitate them, to have their objects” (250); napëmou, “to behave like criollos; to speak Spanish”; and napëprou, “to become criollo.” In both cases, napë is a strictly relational concept referring to how one person or group stands relative to another. The napë semantic field encompasses the historical shift in relations with criollos, from enemies to sources of criollo bodies and knowledge. The fact that criollos are still called napë reminds us that the innovation is an extension and not obliteration of convention: there remains an enemy-like aspect to criollos. I will now focus on the second set of connotations in order to describe the napë transformational axis. Recall the material and experiential difference between upriver and mid-river Ocamo Yanomami that I outlined in chapter 2. Exchanges between upriver and Orinoco Yanomami send manufactured products upriver (metal tools, clothes, mosquito nets) and indigenous ones downriver (yopo, tobacco, plantains). Reahu funerary feasting and other visits are plentiful along the Ocamo River. Yet there are some altogether novel relations. Ocamo Yanomami accompany doctors upriver as helpers, interpreters, and nurses. Ocamo politicians venture upriver to rally support for themselves or their party. Some influential Yanomami hire upriver people to clear the bush around their houses or clear the forest for their gardens. People in Ocamo occasionally provide lodging for upriver relatives’ children while they study in the school. Occasionally,

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upriver Yanomami need treatment in the rural clinic, and during this period while they are being put up by Ocamo relatives, the local youths make fun of their ignorance about the criollo lifestyle of Ocamo. All these relationships play out in the napë transformational context and involve two positions: napë, characterized by the presence of criollo habitus and knowledge, and Yanomami, characterized by the absence of such. On the napë transformational axis, people in Ocamo consider themselves Yanomami, and the category of napë refers to resident missionaries, doctors, and anthropologists, along with all non-indigenous people who live beyond the Upper Orinoco. With reference to themselves only—the Yanomami that is—the neighboring Yekuana are also referred to as napë. Historically, however, before the transformative encounter with criollos, the Yekuana could also be said to be Yanomami—a judgment based on their body/habitus. When the context involves non-indigenous people, all Indians can be seen as Yanomami. Only in a mythical context can criollos be considered Yanomami, for they too are the result of transformations of ancient Yanomami.6 Beyond this, in no context are criollos considered Yanomami, and in this sense, they are napë yai, true napë. The term yai (Sp. propio) connotes “real, essential, true.” Although Ocamo people share being Yanomami with people upriver, they also acknowledge upriver Yanomami as being real Yanomami, just as in comparison to the Yekuana, criollos are napë yai. “Waikasi” is a somewhat mocking term that conveys this sense of being real, true Yanomami and connotes the state of being like the ancients, of being uncivilized like the upriver Yanomami. Likely local to Orinoco mission communities, the term may lose currency in time, for it is derived from the extension of an older criollo term for the Yanomami that connoted fear-inspiring savage. However, “waika” is a Yanomami term for designating others, forming a geographical and sociological oppositional pair with shamathari. For any given group, the waika are northern Yanomami while the shamathari are southern (Lizot, 1994:227). Despite its potentially ephemeral status, waikasi conveys a necessary reference that would be otherwise expressed if this term did not exist. Consider again a friend’s account to me of how he explained to the elders why the missionaries are no longer generous: “Then I say, ‘No, Cocco first taught us. He helped us because we didn’t know the language of the napë. Since we were propio Yanomami, propio waikasi, he would help us . . . Cocco taught us. We are already civilizado, and we can do as we wish.” Before becoming civilizado, Ocamo people were waikasi like the upriver Yanomami. “Being like ancients” is correlated with a lack of

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Waikasi

Napë yai Yanomami

Degree of access to health and education services, involvement in supra-local indigenous and party politics, access to high-value manufactured goods and frequency of travel beyond the Upper Orinoco are indicated by the darker or lighter tones of grey (darker indicating more access, travel, etc.).

Napë

Ocamo Yanomami/napë

Directionality of synchronic napëprou: increasing napë habitus and knowledge Upriver

Mid-river

Down river

Puerto Ayacucho, Caracas, Other Countries

Figure 4.1. The napë transformational axis: The Ocamo perspective

napë habitus and knowledge. Those in-between, mid-river people are midway between waikasi (upriver) and Yanomami/napë (Ocamo). Figure 4.1 summarizes some of the aspects of the napë transformational axis we have thus far encountered from the vantage point of Ocamo. The following series summarizes markers of being real Yanomami and real napë from the Ocamo vantage point. Real (upriver) Yanomami do not know how to eat criollo food; they always lack manufactured objects, and hence people in Ocamo may occasionally say they do not want to go upriver because they always end up giving away desirable items. Real Yanomami also live “pa’ dentro,” “deep in” the forest and at a distance from large rivers. Similarly, there are markers of being “real napë.” When pressed to contextually distinguish those who are more criollo than others, Yanomami would probably use the expression napë yai. As with the description waikasi, were this not the expression of choice, the need to distinguish real from less-real criollos would lead to the use of some other term.

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Let us consider then the existence of an outer sphere of sociality, that occupied by the napë yai who represent an outside with fertile resources necessary for the reproduction of the local, of the community. Both creative and destructive, the extreme power of the napë yai sphere can work to either benefit or harm Yanomami interests. As such, it is an instance of the widespread Amazonian ambiguity toward the outside in its sociological and cosmological expressions (Overing, 1983–4; Viveiros de Castro, 1993b). Like McCallum (2001) and Gow (2001), I contend that this sphere is the source of that which makes a Yanomami/napë life possible. Dependency on the outside makes the management of relations with the napë yai on the napë transformational axis equivalent to the shamanic management of relations with extreme alterity in the Yanomami conventional space. The management of the powerful yet dangerous outside also frames relations with doctors, which we consider at length in chapters 6, 7, and 8. Napë yai find their ultimate expression in criollos who live beyond the Upper Orinoco yet wield some significant influence in the Yanomami environment. Among these important individuals are the nation’s president and ministers as well as the state governor and higher officials of local institutions, such as the regional health director. Powerful sources who enable becoming napë, they can manage considerable quantities of goods, procure massive amounts of gasoline or food to support meetings, implement nursing courses, mobilize helicopters in epidemics, and influence territorial demarcation. But these are only some of the ways that criollos convey their ambiguous power/danger. Let me summarize some other examples. Criollos are associated with the extraordinary requisite knowledge for the production of awe-inspiring technological items ranging from motors to remote controls. For example, people recognize the hospital in Puerto Ayacucho as a site of higher technology and knowledge than the rural clinic. In the words of an Ocamo man addressing the hospital director: “We Yanomami think that you will save us in the larger hospital with the technological devices [Sp. aparatos] here. In the Upper Orinoco there are rural clinics, but there are no aparatos to save the Yanomami, and there is not enough important medicine. But here, here in the center in Puerto Ayacucho is the big hospital and the specialist doctors who know more about all the diseases.” For others, though, the hospital is a dangerous place inhabited by unknown criollos with inscrutable intentions. People are conscious of the fact that some trips to the hospital end in death. Even when local criollos produce shawara, often it is said to originate much farther away in “lands of the criollos”: “That shawara, I don’t know where it comes from. Other shapori say: ‘Look that shawara . . . it comes

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from where the napë live the other / Brazil, that shawara is from Brazil’ . . . The other shapori says: ‘Shawara from around here comes, but it only lasts a bit, but the really strong shawara comes from . . . another country.’” A special place in the Ocamo imagination is occupied by the figure of the malandro, an urban criminal ranging from a petty thief to a murderer. I was struck by the tales of Yanomami experiences in Puerto Ayacucho. It seemed that no one had escaped an encounter with a malandro. This figure epitomizes the danger of the city, a violent, reckless kind of napë walking the streets to see whom they can attack. Men describe being robbed, attacked, and chased by the city’s malandros. Others speak of encounters between malandros and the police, shoot-outs, knife stabbings, beatings, etc. In summation, criollos have become archetypal outsiders subsuming a synthesis of meanings that speaks to a mix of creative and destructive powers. The napë yai epitomize the ambiguous nature of criollos: possessors and creators of manufactured goods; creators and disseminators of disease; sometimes dangerously violent malandros; at other times, helpful supporters of the Yanomami (e.g., missionaries and doctors). All resident criollos are domesticated versions of the real thing. One of the consequences of the criollo’s ambiguous image is the apparent need for protection against the criollo’s intrinsically deceiving nature. This aspect of managing relations with them has became more prominent since the intensification of party politics in the mid-1990s and the concomitant increase in interinstitutional rivalry.

Awakening One Yanomami politician and supporter of the then-mayor spoke of this new stage in Yanomami political life as an eye-opener, a liberation from the protective umbrella of the missionaries: Now the Yanomami are awakening a bit because of politics, you see. Because politics allowed the Yanomami to awaken. I say this because before they didn’t know how to make meetings. They didn’t know how to criticize. They didn’t know how to tell the good one [person/project] from the bad one. They didn’t know! They would just live like that, without thinking about anything else in another world. Now we know the people. We know the ideology of the person, of the doctors, of the Salesian mission, and of you the anthropologists . . . This is why today the Yanomami are awakening to defend [ourselves]. Prior to 1996 the Yanomami were very immature.

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Table 4.2 The correspondence between shamanism and Yanomami–criollo relations Shamanism

Yanomami–criollo politics

Role

Mediation: control of resources of the invisible world for benefit and defense of the community

Mediation: translation and control of criollos and their resources for the benefit and defense of the community

Capability

Knowledge of the hekura who enable the shapori to “see”

Criollo knowledge epitomized in reading/writing

Condition

Dual Yanomami/hekura

Dual Yanomami/napë

Orientation

Outer spheres of Yanomami conventional space

Napë yai (resident or outside criollos)

This is part of a wider feeling of awakening common with many Yanomami representatives. The very term “awakening” implies that the Yanomami as a people have historically been deceived by innumerable criollos, but they now have the knowledge and experience to realize who is who and identify their actual intentions. One more aspect of the napë transformational axis remains to be analyzed: the question of what makes a Yanomami napë from different Yanomami perspectives. We are now in a position to synthesize some of the analogies we have been discussing within the Yanomami conventional and napë transformational contexts (see table 4.2).

Napë and Yanomami Positions in the Context of Exchange From mid- and upriver perspectives, Ocamo Yanomami in certain contexts are considered napë. One feature stands out as defining degrees of napë-ness throughout the river communities: possession or provision of manufactured goods. In Maweti (mid-river) when I asked whether the people in Ocamo were napë or Yanomami, I received the following response: “No, they are not napë . . . In La Esmeralda it’s napë [it’s a napë’s place]; in Ayacucho it’s napë; in Ocamo it is not napë. If they were napë, they would bring lots of [material] help here.” This statement nicely depicts the spatial gradient of napë-ness. Its source, a man who frequently visits Ocamo and sees himself on more or less equal napë footing with them, illustrates the mark of being real napë, which entails, beyond the possession of goods, the provision of them.

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Referring to a leader known for always saying he is like the napë, an influential Ocamo man elaborated: “‘If you want to be napë, that’s okay, but then what are you going to give me if you become napë? Nothing!’ That’s what the Yanomami say . . . ‘Okay you want to be napë, but where are you going to produce [Sp. fabricar] fishing nylon, hooks, machetes?’ That’s how they speak.” Here napë, beyond provision, is production. In short, the gradient of napë-ness moves from possession to provision to production of manufactured objects. In this context of exchange, anybody who has objects to give stands in a napë position vis-à-vis one who lacks such items or receives them, a Yanomami position. The napë yai (producers) and waikasi (always receivers) constitute opposite poles of a continuum of relations. All those in between (Ocamo and mid-river people) are, in their condition as middlemen, Yanomami/napë. From a downriver perspective, they are Yanomami (receivers); from an upriver perspective, they are napë (providers) (see table 4.3). This chapter has explored the historical and synchronic dimension of a single process of becoming napë. Let me underline what becoming napë means from the Yanomami perspective by contrasting it with what criollos think of this process. The acquisition of napë body/habitus and knowledge does not modify the Orinoco Yanomami focus on making kin; what has changed is that they are now aspiring to make Yanomami/napë kin. Napëprou is thus the result of both a Yanomami desire to become Other, which I argue in chapter 5 is a properly Amerindian way of conceiving their being in the world, and the need to make the most of the historical conditions in which Yanomami find themselves, for napëprou is inextricably tied to the spread of epidemic diseases. If, on the one hand, napëprou is subservient to a desire for differentiation, it is, on the other hand, subservient to a desire to remain Yanomami, that is, to remain human and create communities of people who live according to the morality of being human. Strikingly similar to the Piro meaningfulness of being civilized (cf. Gow, 1991:2) is the Orinoco Yanomami use of the term “civilizado,” which evokes the history of their own transformation, how that contrasts with other Yanomami who live upriver, and how they—rather than resident criollos—now have the means to mediate their relations with the criollo world. Being civilizado does not diminish the status of being Yanomami. A friend recounted to me an episode that occurred when he accompanied his sister to the hospital. Angry because the doctors were not treating her well, he decided to confront the hospital director: “I am Yanomami from the Upper Orinoco. I am not Yekuana. I am not Piaroa. I am not Guahibo. I am Yanomami. I am person!” This was a powerful statement,

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Table 4.3 Summary of elements of the napë transformational axis Waikasi

Yanomami

Napë

Napë yai

Space

Upriver or deep in the forest

Mission community conglomerates

La Esmeralda and beyond

Ayacucho, other cities, and countries

Napë body/ knowledge

Fewer clothes and objects. Few or no high-value items (motors, shotguns, radios)

Regular use and access to clothes and objects. Some high-value items (motors, shotguns, radios)

More criollo lifestyle reflected in houses, food, and clothes

Complete criollo lifestyle reflected in houses, food, clothes, cars, televisions, etc.

No Spanish speakers or schooling Do not know how to eat criollo food Strong bodies: do not get tired or hungry

Spanish speakers and schooling Eat some criollo food regularly

Better Spanish speakers and schooling

Creative knowledge of technology Weak bodies: non-resistant, quickly tired and hungry

Strong bodies: do not get tired or hungry

Exchange of manufactured objects

Only possession

Possession and provision

Provision

Production

Relation to criollos (first two columns)

Easily tricked

Awakened, not easily tricked

Conniving, suspected of hidden agenda

Relation to Yanomami (last two columns) Example

Mediated by Ocamo Yanomami

Upriver communities

Unmediated

Disseminators of shawara Ocamo

Yekuana and criollos in La Esmeralda, other indigenous people in Amazonas

Criollos like doctors and missionaries and all those who live beyond the Upper Orinoco

uttered in the city in Spanish by a fully-dressed, mission-educated Yanomami. He did not assert “I am a person” to stress the need to treat people with humanity but rather to make a categorical distinction between being human and being less so, being an animal or a yai spirit, for example.

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We can see how this sense of becoming napë differs from the doctors’ implicit discourse of the static naturalized Indian, whose adoption of criollo ways is contaminating. What Orinoco Yanomami see as a trajectory into a better future many criollos see as a degeneration, a loss of culture. These impressions, so common in the discourses of criollos and anthropologists alike, are sustained by a number of biases common in Western societies, assumptions that have long inflected our understanding of indigenous peoples’ changes: the valuation of identity and authenticity (Conklin, 1997); an objectified and zero-sum notion of culture whereby every gain must implicate loss rather than addition or transformative substitution; the notion that indigenous cultures crumble in the face of their Western counterparts; the opposition between tradition and change (Sahlins, 1993); the idea that the history of indigenous peoples is coterminous with Western colonialism and can be explained only in relation to the expansion of the West (Gow, 2001; Sahlins, 1999a). These presuppositions not only create a series of anthropological problems, they create practical ones too, particularly when they inform public policy-making for Indians, as I discuss in chapter 8. I must also clarify that I have refrained from calling the “dual Yanomami/ napë being” of Orinoco Yanomami a “dual identity” because in the napë transformational context Yanomami and napë are meaningful positions performed so as to effect difference from others rather than a sameness with a self. Yanomami are also conscious of others’ perspectives on them. So the duality refers to the alternatives of differentiation available to everybody and the perspectives people have on each other, also known by everybody. Along the performative spectrum, the Yanomami-napë oppositional pair works like a sliding scale distinguishing any pair persons or collectivities as either Yanomami or napë. I have purposely left some aspects of the discussion here in this chapter and in chapter 3 open. Chapter 5 will then advance a single theoretical framework for this conversation that will serve as the analytical stepping stone for the rest of the book.

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cha p te r fi ve

Making Kin, Making Society, and Napë Potential Affinity

This chapter is devoted to putting the arguments I have presented thus far in conversation with Amazonian anthropological theory. In so doing, I provide a theoretical framework for interpretation and a basis for analysis in subsequent chapters. Comparing the napë transformational axis with Gow’s analysis of circumstances for the Piro reveals many similarities but also important differences. What underlies the similarities? Gow’s (1993) own following of Taussig’s (1987) lead offers a first clue. The diverse colonizers of the region deployed a fertile imagery of “wild Indians” echoed in the written history of the area. Gow’s task was to explore how such “imported” imagery was used pervasively by contemporary Indians themselves and played a role in their self-definition. Ocamo use of the term “civilized” is a good example of this phenomenon. The term “waikasi,” in its mocking Ocamo use, is also derived from the criollo use of the Yanomami term “waika.” But while many of the idioms deployed on the napë transformational axis are in this sense imported, their dynamic in everyday circumstances involves a constant interplay between indigenous and criollo forms of action and discourses. Albert (1993:351), in the context of interethnic political discourse, suggests this interaction: “The image that each [interethnic] actor construes of the other and of the representation that the other has of him/herself is essential to their self-definition” (my translation). I wish to move beyond the sphere of interethnic discourse and consider how such reverberation, not just of images but of motivations and actions, occurs in daily exchanges between criollo doctors and Yanomami as well as in meetings—the more typical sites of political discourse. First, however, 93

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we must furnish ourselves with a theory that enables us to analyze this network of relations among criollos, Yanomami/napë, and waikasi within a single framework. This is the subject matter of this chapter.

The Givens and Human Agency Historical analysis illuminates not only what changes but also what remains constant, and one gets the impression that had this historical encounter in the Upper Orinoco been different, many aspects of today’s relations with doctors would still hold. I propose an argument based on what is constant in the historical outline. We have in the term “napë” a register of change in stability. The term’s semantic field passed from referring exclusively to enmity to including criollo abilities and attributes. Yet its relational nature persists: one cannot be napë on one’s own; one is napë only with respect to another. Napë also retains its outside direction: the prototypical enemy lives far away, beyond the sphere of friendly communities, kinship, and daily interaction. The prototypical criollo also lives beyond the Upper Orinoco. If shapori and interface Yanomami are managing relations with the outside in the same way and for the same reasons, then a constant is apparent in the Yanomami’s relation to exteriority, and if historical relations with national society have not yet changed this, this is because this relation to exteriority is prior to and beyond human agency. Consistent with Wagner’s (1981) and Viveiros de Castro’s (2001:19) descriptions, this relation is (non-intentionally) constructed as given or innate: the outsider will always be a dangerous but necessary Other. Human agency can either domesticate outsiders or keep them at a distance. Domestication involves a movement from alterity to identity. Individual people can travel such a path, like the early missionaries and doctors in their first months, but individual passages neither affect the nature of the outside nor completely remove the trace of their origin—ambiguous creative/destructive power. Also constant are the forms of domestication. Becoming closer to a community or failing to do so has always been predicated on the morality of being human: living with and defending kin, sharing food, speaking the language, using kin terms, marrying affines, participating in funerary ceremonies, and so on. These cultural conventions define the moral path to be laboriously hewed in the domestication of outsiders. The Yanomami moral conditions of humanity, like their relation with exteriority, must be beyond human agency and thus constitute another given experienced as the nature of being human.

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Observing this historical process leads us to two conclusions that Viveiros de Castro (1998) has reached by other means: culture is the given nature of being human, and the space between complete (given) difference and close identity is the site of human agency. On kinship Viveiros de Castro (2001:25) writes: “Since affinity is the fundamental state of the relational field, then something must be done, a certain amount of energy must be spent to create pockets of consanguineal valence there. Consanguinity must purposefully be carved out of affinity, made to emerge from the affinal background as an ‘inventional’ (i.e., intentional) from universally given difference” (2001:26). He then equates this “carving” to the “construction of kinship” or more broadly a Amazonian “theory of generalized relationality,” the principles of which are equivalent to those required for the domestication of outsiders and what I have called the morality of being human. Let us retain this proposition for further discussion. When I refer to culture as the given nature of being human, I mean culture in the anthropological sense subsuming cultural and social conventions: rules, language, morality, and socio-cosmological order. All the constitutive relations of society are given and hence need not be made. What needs making are kin, be they Yanomami or Yanomami/napë. But we must take a step back to Wagner’s (1981) theorizing because in the givenness of the conventional, there lies a most crucial distinction between Yanomami and the criollo doctors that will enable our understanding of their relations. For Euro-American middle classes, culture, that gamut of conventions different groups of people share in varied contexts (e.g., an association, a country, a family), is generally conceived of not as given but made. We deliberately “collectivize” by making conventions: we make rules, schemes, organizations, corporations, bureaucracies, standards, etc. because our given is the world of “natural incident” (Wagner’s wording) and the particular. In this case, individuals are innate, while society and culture need to be made through considerable collectivizing (connecting) efforts. Rules, morality, and all sorts of conventions are produced to make social life among individuals possible. Here the form of the (differentiated) given that needs to be collectivized through the intentional multiplication of conventions is nature, of which humans are a part. People such as Wagner’s Daribi, the Yanomami, or many Amerindians, on the contrary, are not collectivizing traditions but differentiating them. Once the collective is given, one strives to particularize oneself against a background of similarity; people focus on “knocking convention out of balance” (Wagner, 1981:88). They strive to differentiate themselves from

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others, similar to poets who aspire to originality. Here, the form of the (collective) given is culture—equated with humanity and the possession of a soul—and intentional action strives to differentiate. Not surprisingly, Viveiros de Castro (2002a:233), in his analysis of Amerindian kinship, comments how “[t]he gradient of distance is the performative terrain par excellence, of the interaction between norm and action, structure and history . . . Here the ‘game’ of rules is part of the rules of the game” (my translation). Both Amerindians and Westerners engage in collectivizing and differentiating action, but since all action operates within a meta-premise of what is given and what is available to human action, in this sense, the Amerindian’s choice is a complete inversion of the Westerner’s. A Western poet deliberately developing her own style is an example of differentiating action in a collectivizing tradition. Her innate creativity, however, will be perceived as engendering her style. Ritual, where the moral is explicitly performed or evoked, is an example of collectivizing action in a differentiating tradition. The ritual specialist, however, is often but a vessel for the powers of the cosmos and, in this sense, embodies the collective and is not an author in the same sense as the poet. For example, in curing, it is a Yanomami shapori’s helper spirits who in fact effect the cure, so that in becoming them, he connects ordinary Yanomami with a collective of vital images. Some clarification is necessary before we continue. As Wagner (1981:104) is careful to underline, this distinction between general conventional orientations (collectivizing or differentiating traditions) has no evolutionary underpinning, for there is nothing particularly primitive or particularly developed about either. These are overarching distinctions whose usefulness will become clear in forthcoming chapters. It will also become clear as we progress that the circumstances of encounters between doctors of the health system and Yanomami communities tend to pit the conventionalizing aspect of the criollo’s endeavors against the differentiating quality of the Yanomami’s. A variation of what Wagner (1981:xiv) suggests occurs in class societies, we have in the Upper Orinoco a distribution of symbolic labor, a dialectic between the two halves of the composite Yanomamicriollo socius. I now turn to summarizing some implications of these highly relevant distinctions.

Making Criollos, Making Society, and Making Kin The inverse distribution for Yanomami and criollos of what is given and what is available to human activity impinges profoundly on this relationship.

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Ever since Cocco established his mission in Ocamo, Yanomami became interested in making Yanomami/napë kin. This process is napëprou, becoming napë, and what today is referred to as having become civilizado. Missionaries were also interested in civilizing, a project that had two distinct ways of transforming the Yanomami. One effort of the early missionaries, the inculcation of Western and Christian models of life, could well be called “making criollos.” It placed particular emphasis on the body and more generally the transformation of the Indian habitus by promoting clothes, hygienic habits, and single-family housing, and by having criollos live in the villages to demonstrate the benefits of criollo lifestyle. All these are civilizing in the sense of instilling compatibility with criollo codes and standards of living. The flooding in of manufactured goods, particularly in the village of Ocamo, was at least partially conceived as a preparation for the Yanomami to better receive the Christian message, persuading the body with Western amenities in order to better convince the soul. Yanomami were keen on this aspect of civilizing, for it converged with the process of becoming napë that we have been discussing, namely making kin with napë body/habitus and criollo knowledge. This mutual interest in civilizing is a “working disagreement” of the type Sahlins (1981) has famously described in the case of the Captain Cook-Hawaiian encounter insofar as each party’s distinct project is advanced despite being informed by radically different cultural criteria, categories, and values. A second and more profound way of civilizing continues to this day. It is also integral to the operation of the health system and in fact any incorporation into the state’s structure. This component of the civilizing project is about making society, not kin, because for criollos, society was missing and needed to be made. Missionaries and other state agents produce fixed leaders and communities as a necessary form of engagement. Regardless of the Ocamo headman’s status before Father Cocco’s arrival, his subsequent privileged relationship with the missionary surely made him more powerful. This encounter defined Ocamo as a stable community even though to this day a number of lines of fracture and supra-local connections exist and come to the fore in different contexts. Captains and communities are the simplest and most visible forms of introducing organization. The establishment of the school and the church introduced a number of routines and rules. The economic cooperative SUYAO is an organization whose rules over time aimed at supra-local political representation—a higher level of organization. Making society involves instilling conditions for engaging fruitfully with Yanomami

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communities in a context that appears overwhelmingly chaotic to most missionaries, doctors, and criollos in general. Criollos engage in considerable collectivizing to create rules that allow living in society with Yanomami. This is a well-known aspect of missionary activity along with other efforts at promoting incorporation into the state: states attempt to reproduce their own forms among indigenous peoples in order to better relate to them, and in essence this propagation is about making society, as is the health system, only less evidently. Chapter 6 will explore how the efforts of doctors to create order, rules, organization, responsibility, etc. are at odds with the innate conventional social order of Yanomami, which, on the napë transformational axis, places criollo doctors in a specific position with a synthesis of positive and negative meanings. This civilizing via making society is less convergent with the Yanomami project of becoming napë: First, the criollos’ making society is not applied in a social vacuum. A socio-political organization already exists among the Yanomami, but their conventional orders are generally not recognized by criollos who, for the most, see chaos or anarchy—the absence of society. Second, because making society pits state agents’ acceptance and promotion of political dominance against socially disperse forms of Yanomami political control (Clastres, 1977), running the new criollo-Indian socius is a bumpy ride. But most important, making society is intrinsically collectivizing (making conventions) and becoming napë is intrinsically particularizing (unmaking conventions). As a result, doctors and Yanomami constantly resist each other and are in turn motivated by such resistance. As Wagner (1981:51) writes: “A people who deliberately differentiate [Yanomami] as the form of their action will invariably counterinvent a motivating collectivity [a social order of which criollos are a part] as ‘innate,’ and a people who deliberately collectivize [doctors] will counterinvent a motivating differentiation in this way [disorganized Yanomami]” (my emphasis). Doctors enter the Yanomami’s world as part of an innate conventionalized order (culture); Yanomami enter the doctor’s world as innate particularity (nature). Each constitutes the motivational substrate for the other’s action, and hence they mutually want to do something about each other. In short, in the civilizing project, Yanomami and criollo interests intersect. A mutual misunderstanding about the significance of civilizing serves at once as a hinge for the advancement of making criollos and napëprou, and as motivational resistance between making society and napëprou. I suggest that in the convergence of these partly overlapping projects resides the most encompassing mutual interest and misunderstanding for Yanomami and criollos and, arguably, for Indian-white relations throughout

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Amazonia. The centrality of this type of relation will become evident at several points in the coming chapters.

Becoming Napë and Domesticating Outsiders If Yanomami consider the conventional innate and are constantly trying to differentiate themselves from it, then napëprou is the prime form of differentiation that Ocamo Yanomami have at their disposal against a background of Yanomami similarity. Several anthropologists have noted that the Amerindian lived world points more to a constant becoming than a stable being: “For the Araweté, the person is inherently in transition; human destiny is a process of ‘other becoming’ ” (Viveiros de Castro, 1992:1). For the Araweté, this is about becoming Maï gods, who stand in the ambiguous position of being post-mortem destiny but also cannibal enemies. For the sixteenth century Tupinamba, becoming was a matter of “enemy becoming” (1). Gow’s analysis of Piro historical relations with whites argues that the Piro’s lived world is a “system of transformations” where myth and lived world echo each other’s intrinsic transformational nature: The shifts . . . in styles of clothing, shamanry or ritual life over the twentieth century are genuine changes, and must be understood as so by the analyst. They are understood to be so by the Piro people. But they do not raise, for Piro people, the problem of continuity and change, for Piro people know that they are transformations of transformations. For example, “ancient people’s clothing” and “white people’s clothing” are certainly different, but they are transformational versions of the same transformation that all clothing effects. Gow (2001:309)

Ocamo Yanomami can non-problematically see their civilized being as an instance of mythical transformation. When differentiation is the name of the game, transformation is what happens in time. In chapter 3 we considered the domestication of criollos that results in quasi-kinship à la Cocco. In chapter 4 we examined becoming napë. What relationship is there between these two transformations? Differentiation is one important convergence, but crucially, the first happens in the context of the Yanomami conventional space in accordance with the morality of being human; the second occurs in the napë transformational context. Napëprou is an acquisition of knowledge and body/habitus transformation intentionally made or wrought upon the innately Yanomami

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condition. Hence the dual condition of Yanomami/napë is referred to as becoming napë; being Yanomami is an unmarked, taken-for-granted state. Being Yanomami, as an innate/human/moral condition, collectivizes civilized Ocamo Yanomami with their upriver compatriots and collectively differentiates all Yanomami from criollos. The napë side of civilized Yanomami is artificial and the site of continuous differentiation from mid- and upriver Yanomami. It also collectivizes civilized Yanomami with criollos, each in their contexts. Domesticating criollos is better explained by the conventional theory of generalized relationality. The process involves artificially removing innate alterity by behaving like kin and becoming more human/moral—becoming Yanomami. Insofar as criollos acquire a Yanomami/napë duality, it is their artificial Yanomami-ness (speaking the language, for example) that can collectivize them with Yanomami. This is particularly relevant in the treatment of gravely ill patients, as we see in chapter 6. Their innate napë side, however, the unmarked taken-for-granted status, in most contexts differentiates them from all Yanomami. These two trajectories generate a performative spectrum along the river network all the way into the city environment, where people are contextually differentiating and collectivizing themselves in exchange relations, medical upriver visits, meetings, etc. What effectuates both becoming napë and domesticating criollos is obviation. The concept of obviation is part of Wagner’s (1978; 1981; 1986) complex theory of symbolism. My use is inspired by his explanation (1978:31–32) of the two senses of the word “obviate.” To obviate is to make certain associations of a symbol immediately apparent and prominent at the expense of other associations that are by implication overlooked. Moreover, obviation is “the process by which the realm of human responsibility must forever be created out of the innate, and the realm of the innate must be constituted out of that of the artificial” (31). Regarding the domestication of criollos, to obviate is to artificially/intentionally stress sameness through everyday co-residence, speaking the language, using kin terms, etc., and in certain ritualized contexts “overlooking” the innate danger and otherness of criollos. In reference to becoming napë, obviation takes place when Yanomami stress napë-ness, overlooking their innate Yanomami condition in upriver contexts, or when they stress Yanomami-ness, overlooking the napë side in relations with criollos. Civilized Yanomami can also stress either Yanomami sameness among their upriver counterparts or criollo sameness among criollos. Given that napë is associated with the provision of objects, the context of exchange probably most readily evokes obviation and differentiating action.

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This context evidences a certain indigenous mode of action that, simply put, seeks to compel others to action, a topic developed in greater depth in chapter 6. In this way, someone wanting to receive an object will press another into giving, presenting oneself as in need, which amounts to seeing oneself from a napë point of view. This assuming of another’s perspective in self-presentation occurs the entire length of the river network. When I asked an elder in Pashopeka about the differences between napë and Yanomami, he replied: “I do not speak mixed-up/twisted . . . We speak straight . . . Me, I am waikasi, that’s who I am. We don’t wear clothes and stand in a straight line looking white [wearing white clothes], don’t you see?!” His response underscores the weight of correct speech as a maker of being Yanomami. But also revealing is the waikasi self-reference. If we recall Lizot (1994:227), this term designates others, not oneself. I think when being interviewed by myself (napë yai), in the company of Ocamo people, this man saw himself from the Ocamo perspective. Consider the translation offered by my Ocamo assistant: “I am a propio Yanomami. We are not using T-shirts. We are not standing all together in criollo T-shirts.” Ocamo Yanomami display the same ability when they attempt to make visiting criollos or officials feel guilty by presenting themselves as pobrecitos— “poor, helpless things” who “know nothing”—and seeing themselves as the criollos see them—disadvantaged Indians needing help. Both cases, then, are instances of presenting oneself from the napë point of view. Intentional obviation gives the napë transformational axis its performative character in which context determines whether one performs Yanomami or performs napë. I mean performance not as false theatricality—which is how criollos see this—but rather as action with the intent of producing some effect on another, for example, extracting a coveted object from a doctor or making a Yanomami patient “collaborate” in her curing. My notion of performance here is of a kind with Strathern’s (1979:246–47) analysis of body decoration in Mount Hagen. The performance is a test of one’s abilities to ratify a claim that cannot be institutionalized and must therefore be constantly produced in the eyes of others. Because the performance relies on a particular aesthetic requiring others to recognize the assumed position as napë or Yanomami, its outcome is always uncertain. Regardless of whether the performance is intentional and strategic, conventionalized and unconscious, or even—as is the case with doctors— recognized by Yanomami, it reveals a napë-Yanomami relational configuration between parties that may both be Yanomami or Yanomami and criollo. This notion of performance is central to our analysis of doctorYanomami relations in medical and non-medical contexts.

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Criollos and Potential Affinity Ocamo Yanomami are becoming napë and simultaneously relating to real Yanomami upriver in all forms of exchange because napëprou is not a loss of culture, that is, it is not dehumanizing. Yanomami is an innate condition, a thread of moral continuity that runs from Ocamo to upriver, enabling the coexistence of the Yanomami conventional space and the napë transformational axis. Domesticating criollos ends only in quasikinship in the best of cases because the key step to real kinship is never taken. Relegated to the fringes of kinship, criollos are never fully human/ moral and thus fundamentally separate from the Yanomami. Following Gow’s (2001) lead, I propose that criollos in general assume the role of potential affines as defined by Viveiros de Castro (1993b; 2002b). In chapter 3 I discussed Cocco’s curious kinship with the Yanomami as nonrealized affinity resulting from a process of domestication: co-residence, provision, speaking the language, using kin terms. In chapter 4 I stressed the dependency on the outside for social reproduction that, in the context of the napë transformational axis, translates to the necessity of the napë yai’s powerful outside sphere for the sustenance of a civilized way of life. Combining these two aspects of the interethnic situation, we reach the equation between “dangerous but necessary others” and affinity in Amazonian anthropology (see Overing, 1983–4; Rivière, 1984; 1993; Viveiros de Castro, 1993b; 2002b). Affinity always has an ambiguous value. It both connects (as a channel for economic, political, marital and ritual exchange) and separates (as a root source of community friction and fission). In Albert’s (1985:221–35) analysis, in-marrying outsiders from allied communities, subsumed under the extensive category of classificatory or potential affines, become real affines, and in this situation of effective affinity, they are subsumed alongside consanguines as real kin. This obviation of alterity is common to other Guianese Amerindians in their effort to equate a cognatic kindred with co-residents (Rivière, 1984:69–71). It is precisely this process of successive obviation of alterity, from the extreme outside to close identity, that places the domestication of criollos and the construction of kinship on a continuum. Viveiros de Castro (1993b; 2002b) has synthesized a generally applicable notion of potential affinity that best fits the kind of relation between Yanomami and criollos. With a potential affine, one exchanges things like rituals, deaths, names, souls, heads, etc. This relationship is “collective and generic,” involving exchange with the exterior of the sociable but no effectuation of real affinity. Potential affinity “qualifies relations between

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generic categories: compatriots and enemies, living and dead, humans and animals, humans and spirits . . . [it] is a politico-ritual phenomenon, exterior and superior to the plane encompassed by kinship” (2002b:159, my translation). Notably, the normal term of address between certain criollos (e.g., long-time malaria personnel) and Yanomami in Upper Orinoco is shori, “brother-in-law.” In his analysis of the historical relations of the Piro and whites, Gow (2001:305–6) suggests that the position of potential affine, indigenously understood primarily as a “possessor of objects,” has been occupied by different waves of outsiders who could better fill this role for the Piro. This history includes indigenous trade networks, debt bondage relations with white bosses, missionaries, hacienda owners, and the current white patrones. The semantic shift of the Piro word kajitu/kajine from the context of trade to its current meaning of “whites” suggests its correspondence with the concept of potential affinity. My argument is the same, but the ethnography yields a variation. The use of the term “napë” for criollos indicates that the indigenous reference here is enmity. Shawara, as a criollo form of predatory aggression, emphasizes criollos’ simultaneous status as potential enemies and providers of objects, hence the equivalence between Albert’s outer spheres of enemies who prey on Yanomami on the Yanomami conventional space and the outer sphere of napë yai on the napë transformational axis. The shift is, then, from one type of enemy to another. But what about domesticated resident criollos such as missionaries and doctors? These weaker versions of napë yai correspond to Viveiros de Castro’s “included thirds,” ritualized relationships with individual representatives of the category of potential affines who fulfill a mediating role between the opposed us/them groups, between the local and the exterior, foreigners, enemies, etc. (2002b: 162). Viveiros de Castro draws many examples from the ritually elaborate expressions of affinity in warfare relations between killer and killed. This is the case among the Tupinamba, Araweté, Wari’, and Jivaro. But this special relation is also representative of formal friendships (Descola, 1997 for the Achuar), long-distance trading partners (Overing, 1983–84 for the Piaroa), or certain godparent relations between Indians and white patrones (Hugh-Jones, 1992; Gow, 2001). In this mediating role, we also find classificatory affines. Albert (1985:524–68) has demonstrated that Yanomam drawn from this category of non-realized potential affinity fulfill two important mediative roles during reahu funerary ceremonies. On the one hand, potential affines in performing the funerary

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services obviate the distinction between consanguine and affinal kin— internal to co-residents—and the distinction between co-residents and nonco-resident “guests”—internal to the group of allied communities. Such an obviation symbolically dissolves differences in favor of the ideal local group (with no affines) and the ideal community of allies (with no outsiders). When we consider the wider system of symbolic exchanges, potential affines are assimilated in the socio-political category of allies and mediate between kin/co-residents (mourners) and non-kin/enemies (predators). In other words, the deliberate obviation of alterity is necessary to produce the image of the ideal local group set against that of the enemy—the ideal locus of predatory alterity. In time, in accordance with the ritual reciprocity among allies, potential affines contribute to the sustenance of “an armature of symbolic transactions constituted by cycles of deaths, mourning and funerary services” (Albert, 1985:548, my translation). Included thirds mediate between different levels of alterity and the local group by way of obviating their own alterity, enabling a social reproduction, symbolic or real, that depends on an innately dangerous yet powerful outside. In the case of Ocamo criollos, the early missionaries epitomized by Cocco fulfilled the mediating role enabling civilization. Today, in addition to missionaries, institutional criollos like doctors partially fulfill this role. Politically uninvolved Yanomami try to make resident criollos either community or personal “thirds” when they attempt to make a lessthan-communitarian use of clinic resources (boat, motor, radio, gasoline, etc.). On the other hand, every cure achieved by a doctor is an instance of the necessity of criollo capabilities that can be tapped into by domesticating a localized and allied version of the generic criollo. Civilized Yanomami, however, are increasingly assuming this role. The efforts of representatives and politicians to control criollo resources are manifestations of this mediation vis-à-vis their communities. All Ocamo people in their relations with upriver communities fulfill the mediation between criollos and waikasi. In chapter 6 we see how health meetings, in which doctors and community leaders play the key roles, are a matter of obviating the outsider meaning of doctors, encouraging the community to live well or work well with its doctors. Meetings are in this sense analogous in the napë transformational context with reahu feasting in the Yanomami conventional space. But an important difference remains between criollos and Yanomami in the position of included thirds. Criollos do not intermarry with Yanomami and hence have no real obligations to any specific group. This is the character

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of their potentiality: generality. They are metonymic extensions of the napë yai and cannot avoid their innate condition of potential affines as “providers of objects and (curing) solutions.” In contrast, civilized Yanomami are always real kin with specific people. It is hard to balance between institutional obligations to all, the kind of potential affinity criollos represent, and genuine kinship obligations to some. Nurses, boat motorists, or politicians, all working for constituencies that exceed their personal perspective of kinship obligations or even allied communities, are constantly criticized for misusing clinic resources, not tending to everybody properly, distributing political posts only among their group, etc. Doctors also note that Yanomami personnel’s interest in helping a given community often depends on the presence of absence of relatives there. At this point let me recapitulate the transformative substitutions between napë transformational and Yanomami conventional contexts. Napë yai are potential affines, both producers of objects—in a more general sense “solutions” in the form of systems such as healthcare and education—and producers of predatory shawara. They are one of the three categories of enemies who engage in reciprocal symbolic predation in the Yanomami conventional space. Included thirds are resident criollos with whom, through a degree of domestication, sociable yet ambiguous relations are sustained. Not managing many resources, they are less capable of either assistance or injury. Alongside them are interface Yanomami, who translate the criollo world and attempt to control criollos and their resources. Both these groups, generally allies of the community, would correspond roughly to the category of allies and friends even when their relations are marked by tension. Ultimately, a community like Ocamo, even when fraught with internal factionalism, becomes a united Yanomami group in opposition to criollos. The same solidarity can subsume all the Yanomami of the Upper Orinoco in one collective position against criollos. These groups correspond to the innermost sphere of co-residents (see fig. 5.1). The napë transformational axis, then, yields a relational field that resonates with Albert’s tertiary distinction, generalized by Viveiros de Castro (2002b:152) for Amazonia.

Reciprocity with the Napë Yai Having established correspondences between the Yanomami conventional space and the napë transformational axis, I will now focus on important differences. The first involves the nature of reciprocal relations between

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Domestication of criollos

Direction of increasing removal of alterity by obviation of given difference

Napë yai

Resident criollos and interface Yanomami Only Yanomami Space of ideal real kinship

Space of ideal included thirds

Space of innate potential affinity and predation

Enemies

Allies

Co-residents

Figure 5.1. The congruence between the napë transformational axis and Yanomami conventional space

criollos and Yanomami. In Albert’s model, relations with enemies are of reciprocal predation (warfare and mystical attack). How do the Yanomami reciprocate, if at all, the generalized predatory shawara of the napë? To my knowledge at least, in neither private nor public discourse do the Ocamo people advocate any form of reciprocity. Moreover, even when they acknowledge criollos as the source of shawara, demands for improving healthcare are not couched in terms of accountability (as with the Waiãpi, cf. Gallois, 1991; 2000). We must recall the irreversibility of the generalized spread of shawara and the historical trade-off of “accepting” shawara for access to manufactured goods. The demand for a unidirectional flow of solutions offsets a flow of disease in the same direction. Refraining from predation that would cut them off from criollo solutions, the Yanomami community consumes criollo goods even as shawara consumes the Yanomami. Consumption of manufactured goods is seen not as retaliation but rather as a means

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of becoming napë, which in its healthcare manifestation means seeking greater control over the system’s operational level, i.e., demanding more nurses and microscopists, and expanding the network of services (see chapter 8). So one driving force behind the voracious demands encountered by all criollos could be the Yanomami’s enduring need to make the historical trade-off worthwhile, a force tied to becoming napë. Another possible incentive involves the limited domestication of criollos, for whom the possibility of closer kinship through intermarriage is generally curtailed. They are also excluded from participation in ritual verbal exchanges (wayamou, himou) as well as funerary feasting, reahu. In the absence of matrimonial, ritual, and verbal exchange, the exchange of criollo goods and food is the only avenue available for criollos to become sociable. In short, a worthwhile “becoming napë” requires a degree of sociability with criollos that leads to their domestication. These processes are mutually implicated and enabled by a delicate balance: excessive consumption and conflict with criollos (e.g., doctors) and the system breaks down; too little demand for solutions and napëprou ceases to make sense (e.g., too many ill people).

General and Powerless Criollo Potential Affines I want to pause briefly on the exclusion of criollos from marriage exchange. Restricting criollos to domesticated potential affines strikes me as a strategic choice in the successful management of resident criollos. Ocamo Yanomami strongly disapprove of intermarriage with criollos. One unspoken motivation could be its neutralizing effect: criollos lacking genuine kin ties remain accessible to all Yanomami, who maintain an equal stake in them and their goods. Moreover, nobody is obligated to defend resident criollos with the moral force attached to real kinship. Hence, a criollo potential affine is essentially powerless. Resident criollos have no one to defend them against deceit, theft, and threats; the likelihood of retaliation is almost nil. Two qualifications regarding their status should be noted. In their generality, resident criollos differ from some cases of included thirds that involve interpersonal relations (e.g., Tupinambá captive-killer pair, Piaroa trading partners, or Achuar formal friends). In their powerlessness, they resemble the Tupinambá captive in an enemy’s group (see Viveiros de Castro, 1992), and they differ from white patrones in Northwest Amazon, who have the upper hand in their economic dealings with Indians. Powerlessness is not, however, a feature of interface Yanomami in their

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role of mediation. Indeed, translating and controlling the criollo world are empowering activities, a key ingredient of modern leadership. In this sense, resident criollos are their political capital. So we have two types of local potential affinity: resident criollos (generalized and powerless) and interface Yanomami (generalized, but with some difficulty, and powerful). These two qualities of resident criollos, generality and powerlessness, function as a political substitute for reciprocal predation of the outside. This type of potential affinity constitutes the appropriate means for controlling criollos in the delicate politics of becoming napë, the local solution to the Amerindian problem of balancing autonomy from and dependency on the modern outside world.

A Linear Component in Concentric and Diametric Dualism In addition to reciprocity, the napë transformational axis differs from the Yanomami conventional space in another crucial way: the inequality inherent in Yanomami-napë relations. Albert’s socio-political space is socio-centric and isomorphic. Enmity and alliance are reciprocal relations between equals. Some communities may be larger or stronger than others with a temporary military advantage, but nothing intrinsic in the relation of enmity generates a structural disequilibrium. This is not so in relations that sustain Yanomami-napë positions. In the context of exchange, Ocamo Yanomami have the upper hand in controlling the flow of scarce and valued goods upriver. In more general terms, the progressive-cumulative nature of becoming napë—acquiring goods and knowledge—introduces a linear hierarchical element to the classic form of concentric and diametric dualism in the Amerindian theory of general relationality in Viveiros de Castro’s (2001) analysis. The interplay between concentric and diametric dualism in Viveiros de Castro’s synthesis of Amerindian kinship combines the categorical consanguine/affine contrast with an analogic socio-spatial gradation. At the local group level, consanguinity obviates affinity. As we enter the supralocal scene, affinity and consanguinity are balanced, and at a greater socio-spatial distance, affinity reigns un-obviated. The maximal distance finds cannibal predation underlying the whole range of relationality. If we substitute the pair consanguine/affine for Yanomami/napë, the relational field from the Ocamo point of view outward in the criollo direction is equivalent (affinity equals “napë,” and domestication is a matter of obviating innate napë-ness).

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However, if we look around in the upriver direction, we have people defined by a greater lack of napë body/knowledge. Here, napë-ness needs to be added rather than removed. Difference ceases to be the innate condition and becomes the inventional site of human endeavor, hence becoming napë. Because the direction and limit point in the napë transformational context is napë, a linear hierarchy runs through the field of concentric and diametric dualism dissolving its isomorphism. Partially echoing Turner (1991:297) on Kayapó relations with the Brazilian state, I maintain that the napë transformational context continues to be sociocentric, but the social totality includes a wide variety of criollos. Civilized Ocamo Yanomami are situated at more of a middle point in a linear network than at a center in a concentric space, hence the term “axis” rather than “space” for the napë transformational context. In this chapter we have provided a theoretical framework for the napë transformational axis in both its historical and synchronic dimensions. This analysis corroborates the usefulness of an Amazonian theory developed in traditional contexts for the interpretation of modern relations with members of national society. The congruence between Albert’s socio-political spheres and the napë transformational axis, between construction of kinship and the domestication of criollos, demonstrates the need to understand interethnic relations as transformative substitutions rather than solely a matter of cultural erosion. The coexistence of a concentric space with a network linear space; the simultaneity of egalitarian and unequal relations embedded in a body/knowledge gradient of contact; the sharp moral discontinuity between Indian and criollo; and the fragile negotiation of becoming napë and domesticating outsiders inherent in interethnic politics all find parallels in many scenarios of contemporary Amazonia. I want to stress the relevance of what is phenomenologically innate and what is open to human agency, what is collectivizing and what is differentiating. The duality of civilized Yanomami is based on an innate/moral Yanomami aspect and a “worked upon” (body/knowledge) napë aspect. Napë and Yanomami become context-dependant performances creating a range of collectivizing/differentiating possibilities throughout the network of relations in which the heath system is embedded. When confronting Yanomami and criollo civilizing projects, we have seen that “becoming napë” and “making Indians” feature a mutual interest in body/habitus transformation. For Yanomami, however, becoming napë is a matter of making kin (since society and culture are innate), while the varied criollo projects for civilizing Yanomami undertaken by missionaries, doctors, or planners, for example, invariably focus on making society (since individuals

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are innate). Much of the character of Yanomami-criollo relations in the Upper Orinoco results from the variable degrees of progress and resistance experienced by these actors in an ever-changing balance between the converging and diverging aspects of each otherâ&#x20AC;&#x2122;s civilizing. In the following chapter I analyze everyday relations of Ocamo doctors in both medical and non-medical contexts, a discussion that will put some ethnographic flesh on this theoretical skeleton.

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cha p te r si x

Being and Performing Napë and Yanomami

Having proposed in chapter 5 that criollos be considered potential affines on the napë transformational axis, I now provide an ethnographic description of what this entails. Chapter 6 is divided in three parts. First, I examine the different aspects of doctors’ potential affinity, namely, their being providers of objects, their generality, their powerlessness, and the consequent social dynamic of doctor-community relations. I argue that this dynamic resonates with Yanomami cycles of village creation and fission and that it plays out the meeting between doctors’ efforts to make conventions and Yanomami efforts to mark themselves off from those conventions. All this analysis revolves around non-medical contexts. Next, I will explore the implications of doctors’ potential affinity in medical contexts. Two situations are presented, each featuring different aspects of being napë for doctors: the treatment of gravely ill patients and the negotiations with relatives and patients regarding the place and type of treatment they receive. Of particular importance here is the way doctors inadvertently convey meanings in a complex dialectic of signification that finds its points of reference in both Yanomami conventional and napë transformational contexts. The need to control doctors’ medical performances, a function that interface Yanomami take upon themselves in their role as mediators, also illustrates the ambivalent nature of napë signification that doctors embody. The third section explores how medical trips constitute opportunities for “civilized” Ocamo Yanomami to differentiate themselves from their “real Yanomami” counterparts upriver. This discussion concerns how Yanomami convey meanings of being napë made 111

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possible by the reconfigured, yet essentially the same, dialectic of references to the Yanomami conventional and inventional contexts. I would like to clarify one point before we enter the body of this chapter. After visiting the Upper Orinoco for several years, I must note that the episodes I recount here, which occurred during the 2000–2001 period in Ocamo, were heightened by a tense political division between the two main communities of the cluster. This division itself had intensified with the advent of party politics. That one of the acknowledged community leaders and a youth with similar aspirations were part of the health crew also aggravated relations between the community and the doctors at the post. None of this is unique to Ocamo: all Orinoco clusters experience political divisions within and across communities, and in several cases, Yanomami health personnel take on community representation roles in more or less active and public fashion. Still, the period from which I take my examples was, I believe, particularly confrontational, and I want to stress that on a quotidian basis, the community’s relations with doctors are more harmonious than the following accounts suggest. As political tension in Ocamo subsided, so did tension with resident criollos (doctors and missionaries). I have nonetheless chosen to retain some examples of extreme cases because of their potential to elucidate underlying qualities of Yanomami-criollo relations that would otherwise remain veiled.

Doctors as Napë: Non-Medical Contexts Doctors as Providers of Objects The primary function of doctors in the Ocamo cluster is to provide medical assistance. As criollos, however, they cannot avoid conveying meanings ascribed to them as a category of people, the most relevant being their status as sources of desirable goods. In this regard, they become a focus of Yanomami attention in three ways. First, they manage the health system’s operational equipment such as outboard motors, boats, and fuel; second, they bring with them personal goods necessary for living in Ocamo, and every two to three months, they replenish their food supplies; and third, beyond the fixed salaried posts of microscopist and nurse, which require long-term training, doctors offer a few job opportunities such as clearing the bush and washing clothes. In charge of clinic resources, doctors become the focus of requests for fuel, the outboard motor, and the boat. Officially, the clinic does not give

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gasoline away. Chronic shortages that impede the fulfillment of visiting schedules leave none to spare, but in cases of the gravely ill or of those who can return fuel (e.g., leaders and salaried workers), gasoline is provided. This practice does not preclude doctors, however, from having to engage in lengthy discussions as to why they are not free to dispose of the gasoline that is “for everybody.” The same discussion arises with the motor and boat. Even so, some doctors establish a special friendship with a few Yanomami whose requests are considered in a more favorable light. Doctors and students invariably exchange clothes for arrows, ornaments, or basket-work. Criollo food—consisting mainly of rice, pasta, sardines, sugar, salt, and oil—is either given away or exchanged for glass bead necklaces, baskets, smoked fish, or garden produce. Doctors leaving on holiday (approximately ten days every three months) normally take with them a number of requests for items, including watches, radios, clothes, or glass beads, and for other special favors, such as the framing of course-completion diplomas. Yanomami seek doctors’ knowledge of Spanish and institutional conventions when writing letters or drafting projects. They are also often asked to suggest Spanish names for small children. Daily social interaction with doctors contributes in important ways to the criollo expertise of the Ocamo population, teaching the community about criollo customs and morality, and thereby how to manage criollos more effectively. As the vehicle for providing criollo goods, food, jobs, and daily interaction, doctors have become one of the alternatives that facilitate the dual Yanomami/ napë life of Ocamo Yanomami in both body/habitus and knowledge.

Potential Affinity: Generality and Powerlessness Exchanges with the doctor usually occur in private to avoid publicity. But this subterfuge almost never works: all Yanomami know who has got what from the doctors. In matters of personal items, and especially that of lending the boat or fuel, doctors are under pressure to provide for all and vulnerable to accusations of favoritism. Without real kin-based obligations, everybody has the same “right” to benefit from doctors’ resources. Many doctors give items to those who come asking first, but eventually things are refused to others on whatever grounds. Similarly, people complain of favoritism if minor jobs (e.g., cutting grass) are always assigned to the same persons. This is a difficult balancing act. While denial of food is most often inconsequential because people are simply probing, at some point, doctors will mistake real necessity for this probing, in which case the moral recrimination of stinginess rears its head. Misjudgments of this kind, for instance,

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denying a request for gasoline to fetch a shapori for a patient, also trigger recriminations. A strict rule never to lend anything only prolongs tense relations, and doctors who never share items, exchange food, or welcome people in the house are less popular. In short, a doctor who closes her/ himself off to exchange is considered anti-sociable and is less appreciated. Having no kin to defend them, doctors are easy targets for petty theft and trickery on the part of youths (Y. huya) who know they can misbehave with no fear of retaliation. In Ocamo, doctors’ clothes or other personal items were at risk of disappearing if left lying about. On a couple of occasions during upriver visits, the doctors’ house was broken into and food taken. As we see, doctors have none of the Yanomami conflict-aversion or resolution devices at their disposal, this being the essence of their disempowerment. To examine whether any pattern resulting from the doctor’s position as a potential affine can be discerned, I will consider detailed accounts of three doctors who rotated through Ocamo and then compare their relationships with those that prevail between the two sides or factions of Ocamo.

Doctor-Yanomami Relations as Factional-Affinal Ones At the beginning of 2000, two new doctors, Carlos and Alejandro, arrived in Ocamo. Carlos took care of clinic resources while he and Alejandro shared all other activities of primary care. Carlos recalls this first incident involving clinic resources: Apparently, they [Yanomami] had got used to asking the student [in Ocamo before the two doctors had arrived] for gasoline . . . Apparently, he conceded in everything . . . He would give them the gasoline of the clinic, the gasoline for upriver visits, for the generator . . . [The new doctors had orders from the head of district not to give anything to anyone. One day the wife of an influential villager, Daniel, asked for gasoline and Carlos denied the request:] . . . The woman went back to her house and then Daniel came . . . I had already some appreciation for Daniel because we had been on two trips with him as motorist . . . I thought he was coming to say hello, but he came walking fast and [vehemently demanded:] “Doctor why will you not give me gasoline? . . . All the doctors here give gasoline!” . . . What was I supposed to do? I hadn’t been a month here. [Unsure whether Daniel was really angry or not, the doctor relented:] “Well, take the keys then, take your gasoline!” [Daniel responded with laughter.]

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This was one of a series of problems that Carlos encountered. Alejandro, the other doctor, with hindsight suggested that some of the Ocamo leaders were purposefully discrediting Carlos. He was criticized for sending feverish children to bathe in the river as part of treatment, for supposedly administering inappropriate medicines and the like. He was also involved in a controversial case of a dehydrated child in one of the communities. After three months, during a meeting with the regional health director in Ocamo, community leaders requested his removal. Carlos himself was also frustrated because Ocamo people seemed to make his life difficult for incomprehensible reasons. He left Ocamo in April to work in elsewhere in Yanomami territory. He got on well with the Yanomami there and built long-lasting relations with the communities. After Carlos left Ocamo, Alejandro was left to run the clinic: “And then the Yanomami didn’t bother Carlos anymore. They began to bother me with the small thefts . . . One put water in the gasoline tanks . . . I couldn’t leave anything at all outside because it was stolen . . . You had to be everywhere, in the house, in the clinic . . . Every time you went upriver I thought about what could be happening in Ocamo.” Fed up, he decided to hold a meeting with the leaders and health personnel, threatening to leave the community because it was clear they did not want a doctor. “I cannot live in a jail. I feel that you have me in a jail,” he declared to them. That week Alejandro was informed that the community had decided they wanted him to stay, assuring him things would improve. “Well, if I lose anything I will leave!” he responded. “And then I would leave things outside on purpose and nothing would happen . . . Ocamo became something different, a peaceful village . . . I don’t know to what point there was something of a [decision:] We will not bother the doctors anymore.” This exemplifies the delicate politics of domesticating outsiders, even those deemed beneficial, like doctors. This kind of brinkmanship—which Chagnon (1997:15–19) describes having occurred with him—is part of conventional relations with criollo potential affines. Community leaders try to steady this relationship, for pushing beyond the limit, which is different for each person, will be detrimental to the community if the doctor leaves. By the time I arrived in August 2000, Alejandro had a harmonious relation with the community, and his medical decisions were no longer challenged. He struck balanced agreements for treating patients—moving to and from the clinic and the community, alternating shamanism with biomedicine. He had also balanced the management of clinic resources. Yanomami were frequently sharing coffee or a meal with Alejandro in his house; he was often eating in Yanomami homes and was invited to reahu funerary ceremonies.

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In January 2001 Dr. Lucia arrived and would face some of the problems Carlos and Alejandro had encountered. She was initially overwhelmed by requests for clinic resources until things threatened to get out of hand. Minor impasses in the clinic aside, all was progressing well in the medical context. Lucia wanted to instill some order in the clinic, making the nurse and the microscopist arrive every day at specific, agreed-upon times. This created some friction that worsened after she had several arguments with the motorist, the microscopist, and finally the nurse. When the head of district visited Ocamo, some of the issues were discussed in a small operational health meeting at which the motorist resigned. Tension mounted, and a community meeting was held at the house of Manuel—one of Ocamo’s faction leaders and the main rival of the nurse, the other faction leader. Manuel supported the doctor’s position against the apparent misbehavior of the motorist and microscopist, who, in turn, criticized Lucia. Throughout the meeting, Manuel appealed to the community to be more helpful: huya should help out, translate if necessary, and fetch water from the river if needed. Ocamo should work together with the doctor and not against her: “She helps cure us. We should help her too.” The key words asserted here were “collaboration” (Sp. colaboración, Y. payeriprai) and “work well in the clinic,” avoiding petty problems. Lucia’s next problem involved the escalation of an incident in the clinic. After a misunderstanding with the nurse, she shouted at him, resulting in a commotion with a crowd gathering around the arguing pair. With the microscopist supporting the nurse and Manuel supporting the doctor, voices were raised on both sides, and finally the nurse called for a meeting with all Ocamo communities to expel Lucia. That afternoon, however, it was decided she would stay. These three cases reveal a common pattern. During the first months after new doctors arrive, the sector of Ocamo that most relates to criollos—health personnel, huya, and some leaders—push the envelope to determine how far the rules of the clinic and their own engagement with criollos can be stretched in favor of personal, kin-related, or community objectives. This probing hinders doctors’ efforts to uphold established conventions of clinic resource management, to organize an apparently messy working environment, and to establish a good rapport with the community. When a number of incidents accumulate, one or several meetings take place focused on reinstating known conventions and promoting a convivial environment. Following these meetings, harmonious relations ensue, though in time, rules begin to be overlooked, and some flexibility prevails. In the medical context, trust in the doctor grows, and balanced negotiations with

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patients and relatives are normally struck. This cycle repeats itself with the arrival of the next doctor. I contend that this pattern resembles one that was internal to the village dynamic of Ocamo itself. Barrio Viejo and Barrio Nuevo are home to two factions whose friction had recently been intensified by political party divides. Tension was manifest in the mutual accusations of theft, malicious gossip, and huya “bothering” women.1 In several meetings toward the end of 2000, the need for unity beyond party divisions was stressed by Manuel, one of the faction leaders and an AD party local representative, whose constant appeal—“We have to be together!”—was often expressed in explicit opposition to the missionaries or politicians. People from both sides began to talk of moving from Ocamo to another site to defuse tension. In November 2000 a special meeting was held to discuss the huya bothering women. The situation had gotten out of hand. Elders emphasized restraint, the need to “live well” and “live calmly” without womanizing, fights, and malicious gossip. Soon after, the nurse began making a new garden farther upriver in order to move from Ocamo. He did not want his daughters, who were coming of age, to be embroiled with the huya. These relocations consolidated a now numerous community a few minutes upriver on the Ocamo. This situation seems to have been reproducing in a modern form the traditional Yanomami village dynamics previously described. The two factional leaders in Ocamo are classificatory affines. According to Lizot (1994:215–16), ideally, a community is composed of two or more factions, each with a cognatic core with common ancestry. Relations are consanguineous within a faction and affinal across factions, as is the case in Ocamo. Hence, factional friction is affinal friction. Albert (1985:198–206) found that each group of co-residents tends to have a cognatic core based on a series of repeated matrimonial exchanges. The accumulation of marriages outside this dominant core progressively strengthens adjacent lines that, either by choice or necessity, will separate to form a new community where the adjacent then becomes the core cognatic group. That huya should avoid illicit relations is a known convention of Yanomami sociality. Nevertheless, this is an ideal standard that few probably maintained in youthful practice. Elders complain about the disharmony the younger generation causes but remember well their own personal adventures. People know equally that gasoline is for patients, not for everybody, and that you should not steal from doctors. When things have deteriorated over time, a communal meeting is convened. Moral order is then brought to the fore, and relationships tend to a workable equilibrium.

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Interaction between factions resembles that with doctors because both relations require outsiders for social continuity. Doctors share this outsider condition with affines, a commonality that I have demonstrated is expressed in temporal cycles of relationship quality (harmony-disharmony). Just as Yanomami speak of “living well,” among themselves they speak of “living well with doctors” or “working well in the clinic.”2

Collectivizing Doctors, Differentiating Yanomami, and Obviating Meetings Let me consider this dynamic in the theoretical framework proposed in chapter 5. Doctors are oriented to organize, make rules, establish conventions, and standardize procedures in order to make the collective. They are constantly trying to regulate the management of resources, defining clinic working hours, treating people in order of arrival at the clinic, etc. Establishing a workable environment is their everyday orientation. In this context, Yanomami are seen as disorganized, “each trying to be first” in the clinic. Impatient, “they do whatever they want,” not as they are told or as agreed. Yanomami do not “collaborate;” their behavior hinders work in the clinic. Yanomami, on the contrary, huya especially, are constantly distinguishing themselves from this fabricated collective. Their bending of clinic rules or attempts to gain access to clinic resources are forms of learning the extent of their individuation (power), in this respect, not unlike the differentiation of huya through their amatory adventures. In sustaining secret relations with women, adolescents respond to their passions but do so conscious of the consequences, which may include an exchange of club blows with offended husbands or at least public verbal reprimanding. This is a period of life when Yanomami, depending on the extent of their courage and their community support, see how far they can manipulate convention, learning the manner and the extent of their individuation. Differentiation can take many forms, however. A simple example is the use of criollo items in body decoration. Once in Pashopeka (upriver), a woman asked me for toilet paper, which she tore in long strips and placed in her ears. A few minutes later, all the women wanted paper to match her original display. In differentiating actors from the group, bending clinic rules, secret romances, and toilet-paper body decoration are of a kind. This individuation is also the road to leadership. The all-important difference is that clinic conventions are fabricated, not innate in the same sense as criollo potential affinity. This encounter, then,

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pits innate Yanomami conventional potential affinity against doctors’ fabricated rules of engagement, producing the cyclical dialectic just described. Only when things get out of hand are the doctors’ collectivizing endeavors matched by Yanomami intentions, which occurs in the “ritual” meeting. Running counter to people’s normal orientation to differentiate, rituals are collectivizing moments when the moral conventional order is explicitly performed (Wagner, 1981:chapter 4). The Yanomami reahu, as we saw in chapter 5, is a collectivizing scene where the ideal of the local group without affines, co-residents without outsiders, is stressed by the symbolic obviation of the consanguine/affine and co-resident/guest distinctions. Ocamo meetings, in which elders and leaders recall the virtues of moral life, of living well, are ritual in their collective moral orientation. Seeking to calm internal factional divisions, they are also a matter of obviating innately present alterity even among co-residents (affines and outsiders). Meetings with appeals to live well with doctors, to collaborate, are equally obviating devices that reduce the intrinsic friction with criollo potential affines. They are attempts at making the doctor a valuable included third, an ally not an enemy, thereby securing a valued criollo resource—healthcare. Obviation is an overlooking rather than a permanent cessation. The innate antagonism never ceases. Hence communities experience fission over and over, and at meetings the same issues are discussed time and again.

Where is Society? Relations with doctors, unlike internal village dynamics, lack means for resolving conflict, yet another aspect of the powerlessness of doctors as potential affines. One of the objectives of the elders’ morning and evening harangues, patamou, is to persuade younger people to take the path of moral behavior (Lizot, 1994:216; Alès, 1990b: 223). Periodic wayumi fruitcollecting treks in the forest, where factions may go their own ways, also relieve tension. Feasts, with their ritualized dialogues, material exchanges, or organized combats, contribute to the regulation of conflict and increase peace between communities (Lizot, 1994). On an individual level, what tempers excessive individuality are obligations to defend your kin. Doctors, who have none of this at their disposal, occasionally despair as they are unable to punish damage or theft. No laws, police, or higher authorities make people accountable. Some try closing the clinic until the culprits appear. When conflict arises, the most common response is to appeal to community leaders, those ostensibly in a position to wield authority. However, as so many have stressed (Lizot, 1994; Rivière, 1984;

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Clastres, 1977), leaders themselves can appeal only to moral persuasion, and results often fall short of doctors’ expectations. Unless things get out of hand, bothering napë, I would argue, is considered a trivial matter, and precisely because of this, even influential men may find themselves relatively powerless in curbing its occurrence. A Mavaca doctor visiting an upriver community recounts this incident with a huya: I called for the Captain [headman] and began to complain. I told them I would not come again . . . “It cannot be that one comes to help and you don’t collaborate, and these things happen and you say nothing” . . . [Motorist’s response:] “Doctor, never mind, you know huya are like that, very hoashi’ [troublesome, undisciplined]. And I said, “Oh! That’s fine then. He is very hoashi’!” . . . [She looked next for the headman, who was off in a collective yopo session:] I go to the house where all the elders were, but no one paid attention claiming they didn’t understand Spanish . . . “I don’t know if you are understanding me or not, but I am telling you I will not come here again.” [Someone’s response, translated by her motorist:] “He says it’s okay. They understand, the doctor won’t come. That’s fine, don’t come. We will be patient.”

This is a severe example of Yanomami not collaborating, experienced by the doctor as helplessness, a lack of power and means of enforcement. “Huya are like that, very hoashi” expresses how they are expected to be troublesome. Their discipline is not in the response of a village leader but in measuring the consequences of their actions; the “power of society” is the readiness of an offended opponent to stand up for himself. The doctor, faced with the futility of appealing to the “captain,” issues an empty threat never to come again. We are here reminded of the sixteenth-century missionaries on the Brazilian coast trying to convert the Tupi. Viveiros de Castro (1993a; 2002a) stresses that the real enemy of conversion was not devotion to another creed but rather the Indians’ lack of any doctrine at all, hence “reunion, fixation, subjection, education. To inculcate faith, it was first necessary to provide the people with law and king” (190). Images of the Yanomami as unruly, “doing whatever they want,” converge with the often futile appeals to leaders for stable conventions that will ensure the minimum for living in society. The constant need for meetings rehashing the same issues makes them seem pointless. As the Yanomami are fickle in their agreements with doctors, not only the missionaries need law and king to do their job.

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Yanomami: “spoiled,” “ever-changing,” “unpredictable”—the “inconstancy of the savage soul” all over again For doctors, the apparently fruitless meetings combined with the Yanomami’s proclivity for doing their own thing, their constant need to control the community, their endless requests, and their brinkmanship all conjure images of dealing with children. A lack of collaboration, childishness, and irresponsibility are conflated and conveyed in the term “malcriado,” meaning spoiled, a common way of typifying Yanomami. Evoking inappropriate, non-social childish behavior in an adult who should conform to societal rules, the term encapsulates the criollo perception synthesized from numerous behaviors, a true equivalent of “the inconstancy of the savage soul” ascribed to the Amerindian peoples of Brazil (Viveiros de Castro, 2002a). Other frequently employed adjectives register inconstancy. They are “ever-changing”: Rapid changes in demeanor that the Yanomami deem normal baffle doctors—their swift passage from anger to laughter, from confrontational behavior to wanting to share a friendly coffee, from profuse displays of sadness in mourning to an upbeat visit when visiting the doctor’s house the next day. As a friend remarked, “They are ever-changing in character and feelings.” Yanomami are also “unpredictable”: After an important protest involving the health system in La Esmeralda, the head of district was particularly affected, having been publicly criticized by many he considered friends (see chapter 8): “At this moment, I feel more than ever that Yanomami culture . . . is something totally cryptic, totally indecipherable, incomprehensible . . . There is no way you can predict their behavior.” Lack of persistence is another common feature highlighted by missionaries in the Upper Orinoco. The following statement paraphrases the sentiments of missionaries who have “tried everything” in terms of productive projects for the Yanomami, none of which caught on for long: They are keen to learn, which is good, but left alone, they quickly lose interest. “We are the jungle,” an expression of an Ocamo doctor equating criollos and the forest as mere sources of Yanomami needs, encapsulates a common self-appraisal of doctors from the Yanomami perspective: “[Yanomami think] they are doing us a favor . . . We are here because of them.” Alternatively, “they will always see criollo doctors as ‘shomi’ [different] and in greater or lesser degree as a source of things; doctors may be of use healthwise, or to obtain gasoline, or some kerosene, a can of oil,

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pasta.” “[Criollos are] people whom Yanomami can get something from in a given moment . . . They have us to live off of without giving in return.” Let us recall the image of naturalized Indians that doctors have when they arrive in the field. This discourse of inconstancy continues to associate the Yanomami with nature, but no longer as a positive physical continuity with the forest they inhabit but rather a tacit presence of a brute natural state indicated by absence of society, conventions and predictability. Prefigured as natural, Yanomami enter the doctors’ world as disorder, which, as nature itself, needs to be worked upon to counter its innate entropy. Inconstancy compels the need to make society, to civilize in this sense. But the statement “we are the jungle” reflects doctors’ perception of their being controlled by a Yanomami agenda. But this assumes Yanomami people’s relation with nature is analogous to that of Westerners, as doctors come to see themselves as a form of inert use value, producing the paradox of (Indian) nature harnessing (criollo) nature. It is timely here to recall another inconstancy, for doctors tend to be oblivious to the ever-changing character of the health system as seen by the Yanomami, who have experienced myriad doctors, a long succession of beginners struggling with an unknown world. This occurs through no fault of the medical personnel themselves, it must be added, since the system’s inconstancy is structural. Nevertheless, no criticism is more penetrating than the Yanomami observation that “they come here to learn with us and then leave to take care of their own people.” This is not to say that Yanomami are simply reacting to the system’s capricious nature; my discussion of the meaningfulness of napë potential affinity and napëprou is an effort to demonstrate the opposite. Given that the meanings of being napë are inherently ambivalent and that conforming to the morality of being human can eclipse the alterity implicated in napë-ness, the system’s inconstancy, I contend, exacerbates rather than mitigates alterity and its consequences. Thus far, we have seen how doctors’ generalized and disempowering potential affinity finds daily expression when their efforts to make conventions confront Yanomami efforts to differentiate. Each resisting the other’s intentions, they become reciprocally motivating. In “ritual” meetings community leaders mediate the cycles of harmony and conflict, seeking to expel alterity from the local scene. This process resonates with the Yanomami village dynamics of conflict accretion, resolution, and fission. Affines are necessary for maintaining Yanomami village continuity in the same way criollos are essential for propelling a trajectory of becoming napë. Having discussed this process in non-medical circumstances, in the

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second part of this chapter, I examine the impingement of being napë in more explicitly medical contexts.

Doctors as Napë: Medical Contexts Doctors Performing Yanomami In this section I narrow my focus to morality in doctor-patient relations to foreground the performative character of being Yanomami or napë in medical contexts. One of the attending physicians in what we call the “Ocamo case” recounted the following narrative concerning a dehydrated baby in one of the Ocamo communities: They came to fetch us [doctor and student] in the afternoon because the son of Clarisa had a lot of diarrhea. The boy had already been to the clinic a few days ago, and we had given him oral rehydration sachets [ORS] . . . When we arrived in the shabono, it was dark. We realized the floor was covered with sachets . . . They hadn’t provided the ORS. The baby was seriously dehydrated. I was alarmed . . . His veins were collapsed. I couldn’t catch the vein [for an intravenous solution]. When I finally could catch one . . . the student lifted the solution and involuntarily pulled the catheter out . . . This caused some complaints . . . Well, they were really bothered when I tried to catch the external jugular on the neck. They didn’t like it. They were saying, “Why, if you had already caught a vein on the foot? It was all the student’s fault.” . . . So we prepared syringes [needleless] to give some rehydration orally to see whether we would expand the veins a bit to then attempt an IV again, but when we would turn our backs, the women would toss the glasses and the oral rehydration behind us. I still don’t understand well why . . . Well, they didn’t want that. They didn’t let us give him ORS, so I asked to be taken back home [Ocamo]. The next day someone came to say that the baby was really seriously ill . . . Remembering the scene of the previous night, I said I was not going to go, that they should bring the baby . . . The messenger said, “There is no gasoline.” [The doctor responded:] “But why did you use gasoline to come on your own instead of bringing the baby?” They left [after another attempt to have the doctor go to the community] . . . At six in the afternoon, they decided to bring the baby but in a huge canoe with almost all the community, around twenty people. The people

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came shouting. They were angry . . . [The doctors treated the child in the clinic amid a great commotion. With a nasogastric sound, they managed to rehydrate the child, but] . . . we couldn’t make ourselves understood to the mother because apparently she couldn’t understand us. She [apparently] spoke only Yanomami, and it happens that in a moment of anger she got up and said—[in Spanish]—“Pinching, pinching, pinching [to catch a vein]. Now I am really angry. If you kill my child, I will kill you!” . . . All those days trying to communicate with her . . .

A case so extreme is rare, but it illustrates what frequently happens to a lesser degree in dealing with seriously ill patients. It must be stressed, however, that most medical interventions, normally involving common ailments, are unproblematic. The first issue I want to address here is one that physicians find paradoxical, namely, that people ask for doctors but then will not let them do their job properly. They do not, as the doctors say, “collaborate.” I must first underline that, in the case above, both doctor and student, as newcomers, were likely to be encounter some distrust. It is also important to note that many Yanomami do not believe in the efficacy of ORS simply because it does not stop diarrhea, and some complain it produces more diarrhea and makes children vomit. That said, intravenous solutions are widely accepted because they “make you strong,” “clean you inside,” or “prevent you from drying up.” This is why the women do not use the ORS yet allow the doctor to attempt the IV procedure. But this explanation still falls short of accounting for the lack of communication and collaboration. Let us first pause on the subject of illness and the emotions this condition elicits. Seriously ill Yanomami tend to disconnect from normal social life. They retire to their hammock and hardly speak to anybody. As seen in chapter 3, non-engagement in social exchange recalls the behavior of the ghost of the dead, pore, characterized in myth as someone who lived in isolation and refused to provide the Yanomami with plantains. Yanomami depict the seriously ill as suffering a generalized loss of sense and ability to think straight, speak coherently, or recognize relatives, captured in the expression “not to feel oneself to be a person.”3 Since the dead liberate ghosts, dying is a ghost-becoming, an other-becoming with corresponding behavior, closing oneself off to social intercourse. Relatives of patients and the patients themselves feel anger, frustration, and sadness all at once. Death provokes more similarly mixed emotions. During certain stages of the mourning ritual, people visibly express profound grief, yet at other stages, they incite each other to take revenge if an

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enemy is thought to be behind the death. The Yanomami term hushuo means both “to be angry” and “to be mourning a death” (Lizot, 2004: 119). Being hushuo is also an other-becoming. Angry people resemble pore in their social detachment4 and, in extreme cases, can lose control altogether. A Yanomami friend once described to me his occasional fits of anger. When he sensed an episode coming on, he would urge his wife and mother to leave the house for fear that, in the heat of the moment, he would not recognize them as relatives or human beings and strike them. He blamed his bizarre behavior on the jaguar hekura he harbored in his chest that would overcome him in his anger and cause him to see people as prey. The negation of social exchange during periods of both illness and anger or sadness is nonetheless amoral: when ill or angry, you are less human/moral. The second issue to address is a mode of action whereby people cajole or tease one another into responding. I here take my lead from Wagner (1981) and Strathern (1979; 1990). If conventions are innate and prior to human agency, it follows that conventionalized relationships are also innate, for example, the avoidance a son-in-law practices vis-à-vis his mother-in-law. The establishment of a relationship is then seen as the revelation or drawing out of something that was already there. In this context, people are constantly pressing each other into actualizing moral relationships. When an offended man challenges another to an exchange of blows, he is compelling him to respond morally; to refrain shames the person so challenged. Yanomami men say they do not speak to their mother-in-law because of shame (Y. kiri; Sp. pena). In Wagner’s words: “People shame each other into responding, doing, giving, receiving. The elicitation of male roles through female ones (and vice versa), the initiation of a collective task or undertaking, the presentation and acceptance or rejection of wealth in ‘reciprocity’ are all acts of explicit or implicit shaming, or moral challenge and response. ‘Are you a real man (woman); are you a genuine human being? Then respond morally to this moral situation!’ ” (Wagner, 1981:95–96). In chapter 5 I spoke of performance as action intended to produce specific effects on others. The status of the person who acts is always revealed by the other’s reaction. In Strathern’s wording, this revelation is also a matter of self-knowledge (1990:36). In avoiding a mother-in-law, one knows oneself to be a good son-in-law. The typically Amerindian idea that if one mistakes a supernatural being for a human, one becomes that kind of being reflects this well: responding to this being, I must be one too. The Yanomami speak of the yawari, supernatural forest beings undistinguishable from common Yanomami, who have a reputation for using magical

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substances to seduce or persuade lone Yanomami into following them to their underwater communities in forest lagoons. A victim who is not alert will be overpowered by the yawari’s subjectivity and, following them underwater, become a yawari who forgets any previous human status. On several occasions when I responded in Yanomami “I am not a doctor” to children or elders who called me such, their reply was “Ah! So you are Yanomami, then? Why not say, ‘Ah, you are just a common napë, then?’” I suspect that even if spoken in jest, this statement is a way of saying: “Responding in Yanomami (morally) to me (I know myself to be Yanomami), you are also Yanomami.” As Viveiros de Castro’s perspectivism suggests (1998:483), in responding to another in a moral way, you share a point of view, an assertion that, I believe, applies equally to myself and my young Yanomami interlocutors, as it does to lone Yanomami and the yawari. Such revelations have a performative aspect in that they constitute a measure of one’s efficacy. For instance, Yanomami often speak of advice as “let us see if s/he accomplishes my word.”5 That is, if the advisee behaves as suggested, the advisor, whose word will have been actualized, will know him or herself to be effective. In this light, many actions can be seen as personal assessments of one’s ability to influence others. The brinkmanship we noted earlier, often expressed as relentless requests for goods, and other forms of confrontation test not only criollos in order to actualize a conventional relationship but also test oneself and one’s ability to make a relationship manifest. The last point to recall is the ambiguous meanings criollos convey. The doctor is a powerful yet dangerous and inscrutable figure whose knowledge and ability are not assumed but rather must be demonstrated. We can now propose an explanation for these paradoxical circumstances. Seriously ill patients and relatives experiencing anger and sadness are in an ambiguous state between humanity/morality and non-humanity/ amorality. The healer’s performance must reduce this uncertainty by evoking their humanity. Doctors can do this by reducing their napë ambiguity, performing in a Yanomami moral way; patient and relatives, in turn, know themselves to be human and are prompted to act morally, to communicate and collaborate with the doctor. In the Ocamo case just outlined, the doctors did not perform morally in the sense I have just explained. First, they were speaking Spanish, which discouraged the mother from communicating—not because she failed to understand (at the end of the account we learn that she understood everything) but because she either refused or could not bring herself to communicate in Spanish. I discovered that this reaction was not uncommon

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with ill or angry people. Not speaking Spanish closes an external door to social exchange. Had the doctors spoken in Yanomami, they would have succeeded in communicating, not because people would have understood but because speaking in Yanomami is moral and evokes moral/human responses. Speaking Spanish in the tense circumstances surrounding death evokes alterity and distrust, the antisociability of pore, of ghosts. This account of actual antisociability recalls a Yanomami tale imparted by Lizot concerning a child whom a group adopted after a raid. One day in the forest, the child kills and eats a young companion. Upon his return, when asked about his friend, the child hits his teeth with his finger indicating what he has done: “It should not surprise us that someone who behaves like this [like a cannibal] should not know how to communicate and who, instead of replying when queried, hits his teeth with his finger” (Lizot, 2007:317, my translation). Cannibalistic and non-communicative, this child is perceived, of course, as a stranger, an outsider. The doctors in the Ocamo case, in addition to not communicating in Yanomami, further alienated themselves by trying to use the oral rehydration sachets that relatives had rejected and discarded. The women present, who elected in turn not to communicate in Yanomami, toppled the glasses instead as if to say: “You should be aware that we don’t think this is good!” According to conventional Yanomami wisdom, ORS is not useful in these cases. Lacking this understanding of convention, like not speaking Yanomami, is a sign of non-humanity that raises doubts and causes negative meanings of napë to come to the fore: “Can this person be trusted? Does he know what he is doing?” The student’s mishap in pulling out the catheter only compounded these anxieties. By displaying his ignorance of convention, the doctor failed to perform morally and thus failed to evoke a moral response. Toppling the glasses was an effort to compel the doctor to take what the women considered the conventional next step—the use of the IV. The doctor’s attempt to access the boy’s jugular vein further enraged the observers, who did not trust this unfamiliar procedure to a newcomer they were unable to make do the conventional: “Get the IV hooked up! Not the jugular or more ORS!” The amoral, that is, the non-conventional performance of the doctors, is reciprocated with equally unconventional/non-human communication. Instead of speaking, the women topple the glasses, similar to the outsider child who communicates his response unconventionally, signaling his cannibalism by banging his teeth with his finger. In general, “performing Yanomami” helps establish doctor-patient rapport. In this way, doctors obviate napë meanings, promoting humanity and

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trust. The effect is an equal obviation on the patient’s part of the ghostly meanings of being ill or angry. Rapport is achieved by collapsing two types of alterity—napë and ghost—at a “being Yanomami” point. When this fails to occur, when conventions are not performed, the ensuing friction can develop into frustration and anger that impairs the efficacy of the medical intervention. This does not mean that doctors should perform as shapori. That would appear foolish. Doctors must retain particular aspects of their napë meaning by competently identifying the illness and the correct remedy. Yanomami recognize certain procedures in the doctor’s performance as validating displays of criollo knowledge (see chapter 7). Doctors must act with napë knowledge but in accordance with Yanomami morals. “Performing Yanomami” establishes a moral continuity fomenting moral relationships; what must be obviated is napë amorality, not napë knowledge of curing.

Controlling Doctors The Ocamo case, in which “almost all the community” descended upon the clinic, also exemplifies how doctor-group relationships can be as important as doctor-patient relationships. Relatives often attempt to negotiate patient procedures step by step. The close scrutiny of doctors’ performances in grave cases is rooted in outsiders’ ambiguity. Yanomami are also aware that medicines can be detrimental if misused (cf. Alès and Chiappino, 1985:39). Consider the following statement made to a Yanomami audience by a young teacher at the 2001 Mavaca Yanomami conference: “My son also got ill. With my own gasoline, I brought him downriver [to be tended by the doctors], but they didn’t give him medicine. Sadly, they gave me the medicine [to give to the child back home], to me, to someone who doesn’t know how to inject! I do not inject people. If I were to unfortunately kill my child, then what? Am I supposed to do the killer’s ritual?!” The following circumstances are most likely to require increased Yanomami control over doctors: when patients are flown to the hospital in Puerto Ayacucho; when upriver patients are taken to Ocamo; and when patients are being treated by new doctors. Every patient is sent to the clinic or hospital with a companion, typically a relative whose greater understanding of the criollo world enables her or him to mediate. These companions help the patient secure food and translate, for example, but their mediation goes beyond facilitating communication. As delegates of the patient’s home group, they try to ensure that doctors’ performances do not harm the patient. Due to the Yanomami health personnel’s knowledge of

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medical and criollo matters, they are considered responsible for controlling performances, not simply helping with medical procedures. Let me now illustrate some of these circumstances. A friend, for example, having accompanied a patient who ultimately died in the hospital in Puerto Ayacucho, warned his people upon returning home: “The doctors / sadly, they attack/harm/kill. So when you get ill, if the doctor says, ‘Over there, far away [hospital], you will get better,’ don’t go.” Because going to the hospital is a gamble with life or death stakes, companions need to be particularly alert.6 Clearly, the intentions and abilities of unknown doctors are not simply assumed to be beyond reproach. My friend continued his account of how he was questioned back home: “‘Why were you not close?’ [to the patient/doctors], they asked. We were both lying on the bed [he and the patient] . . . Since I thought that liquid [IV solution or blood]7 was correct/good/normal, I didn’t speak. ‘Don’t you know how to speak Spanish?!’ [they responded] . . . I was oblivious to what was happening. Since I thought with that liquid he might recover, I was only staring, I said. ‘Given this is the way the napë harm/attack, don’t go far away [to the hospital]’ . . . said the elders.” The hospital is peopled by criollos who have not been domesticated by trust-infusing co-residence as have the Ocamo doctors and missionaries. It is a site where Yanomami must behave with heightened assertiveness, adopting a conventional attitude toward unknown criollos on a continuum with the Yanomami’s more public and hence political engagements with criollos, circumstances in which they are called upon to “speak without fear” (Sp. hablar sin pena/miedo). Speaking without fear is a phrase Yanomami use frequently. Although not a speech category or a ritualized style itself (like elders haranguing, patamou, or the wayamou ritual dialogues), it is a requisite ability for leaders when defending their communities against criollos. Recall, for example, my earlier description of a Yanomami friend who had accompanied his sister to the hospital, where he became angry with the doctors’ treatment—as often happens in Puerto Ayacucho. He eventually decided to explicitly adopt this form of expression, addressing the hospital director without fear: “I am Yanomami from the Upper Orinoco. I am not Yekuana. I am not Piaroa. I am not Guahibo. I am Yanomami. I am person! I am not going to speak with shame/fear [Sp. pena]. No, Yanomami have strength. We have to speak with no fear. Well that’s so you get scared, so in the future you attend the Yanomami who come over here properly.” This episode reflects the expectation that speech can influence others. Also of import is the fact that the doctors were not treating a relative, in this

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case, a sister, well. Criollos’ typical amoral behavior demands that Yanomami speak assertively. Criollo concern for Yanomami cannot be taken for granted, so one must instill fear to garner moral treatment. Yanomami speaking without fear seeks to actualize a moral relationship with criollos who resist Yanomami agendas. Another friend from Ocamo told me of a classificatory elder brother from upriver who came to the Ocamo clinic with a gravely ill child. My elder brother told me, “Younger brother, my son has diarrhea. He is also very feverish and has breathing difficulty.” Then they nebulized the child. They hooked up an IV. They injected him to lower the fever. I was there so I told him: “Elder brother, it won’t happen [he won’t die].” My brother replied, “Keep an eye on him” . . . “Don’t worry, brother. I will be watchful” . . . I was asking all the time: “Doctor, what is that for? Is it to lower the fever?” [Doctor’s reponse:] “Yes.” “But you lower the fever to cure the diarrhea with blood?” [Doctor’s response:] “Yes.”

The following example involves new doctors and students. After a fight, several people from Padamo River arrived at the clinic bashed and wounded. Of particular concern to the doctor and student was a man who was developing a pneumothorax (misplaced air between the lungs and the pleura impeding the lungs’ normal functioning by collapsing them) because his lung had been perforated by a harpoon-like thrust to his chest. The doctors feared he would suffocate and die if the pressure was not released. It was too late to request a same-day flight to the hospital, and he was not expected to make it through the night. They began to improvise a contraption with medical material (an empty solution container, catheter, and adhesive) to perforate his chest to release the misplaced air. The nurse, microscopist, and motorist explained to the man and his relatives the doctors’ intentions. After some discussion, the nurse said the man did not want his chest perforated. He felt he could survive the night. Amid the clinic commotion, the doctors’ desperation was noticeable; they feared the worst and were being prevented from carrying out what they considered a simple procedure. The microscopist later observed, “He can’t do that. We have never seen that done here.” And the motorist added that had the doctor been the head of district, older, and trusted as a “real doctor,” they would have allowed the unusual procedure. Finally, in keeping with the responsibility of mediators, the patient’s relatives warned the nurse that if the procedure went wrong, he would be held responsible. The man did survive the night and was flown to the hospital the next day.

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Experienced Yanomami health personnel have an important role— inspiring trust. When the nurse is alongside the doctor, people trust that the latter’s performance will be beneficial. The nurse will not allow procedures with which he is not familiar or considers dubious. He will explain to the doctor what he can and cannot do on behalf of patients and relatives. This Yanomami control of doctors, according to conventionalized procedures learned through years of negotiating a medical presence, is an aspect of the management of criollos that guides the trajectory of becoming napë. In this sense, doctor-group relations in medical contexts are political acts like those that occur at many meetings, where Yanomami are also seeking to harness criollos as they seek to direct their own destiny.

Patient Negotiations The last typifying feature the Ocamo case exhibits is the negotiation of where to treat the patient. For multiple reasons, Yanomami wish ideally to be treated in their communities or as close as possible. First, in the case of small children whose body-soul integration is fragile, separation from the safety of the house can be detrimental because of the threat of spiritual aggression. Second, a shapori, normally granted the primary curing role, must treat gravely ill patients. Relocating a patient outside the community reduces the availability of a trusted shapori. Third, given the chronic shortage of gasoline in the clinic, upriver patients waiting to return home can spend long periods in Ocamo separated from family. During this time feelings of isolation and hardship can quickly develop. If forms of mutuality create bonds of affection, then separation triggers intense sadness and concern. Fourth, people from other communities might be reluctant to stay in Ocamo, fearing some kind of sorcery aggression. Of course, some Yanomami, aware of the advantages of close doctor supervision and advanced technology, willingly go to the clinic or hospital. But finding companions and convincing patients to make this trade-off is normally a long negotiation. Doctors’ motives for treating patients in the clinic are also multiple. Long-term treatments and/or twenty-four hour supervision are only possible in the clinic. In the Ocamo cluster, arrangements to and from the community or clinic are simple, but for upriver patients, travel is logistically difficult. Nevertheless, the clinic, stocked with medical supplies and electricity-dependant equipment, offers more and better treatment options than in situ treatments upriver. Also, the upriver situation crucially lacks Yanomami health agents with whom treatments can be left behind, their

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use to be monitored by subsequent radio communication. Consider the following doctor’s comments on an upriver visit when she encountered several sick children: You want to help them, but they don’t let themselves. It’s very hard . . . [After failing to convince a patient, the motorist would say:] “Doctor, be patient. If they don’t want to go, what can we do about it?” . . . I would like to bring those children to Mavaca to feed them and make sure the medical treatment is carried out because the mothers might not do so themselves. I would give the children the quinine, and they would vomit it, and again . . . I had to inject Irtopan [anti-vomit medicine] to prevent the child from vomiting, wait half an hour . . . [to verify the medicine was not vomited], then give him the medicine again . . . Who guarantees that a mother is going to do this? . . . That quinine is so bad [very strong and sour tasting to children].

Doctors prefer the Ocamo clinic because of superior working conditions (e.g., better light, bed, radio to call for help) and the quick availability of medicine and equipment. Also, when there are several gravely ill patients, the only way to treat them all properly is to have them in the same place insofar as possible. Finally, the clinic is chronically short of gasoline, and some Ocamo communities have their own outboard motors. Doctors sometimes consider it the Yanomami’s responsibility to bring patients to them. This is necessary, they would say, to counter a perceived passivity regarding their health fostered by criollo paternalism. In any case, the two opposed ideals of where and how to be treated set up a Yanomami-napë confrontation of variable intensity, particularly upriver, where the Yanomami motorist’s desire to help the doctor persuade uncooperative patients varies with kin connections and the quality of his relationships with the community. Nurses and motorists are also more sensitive to how highly the Yanomami regard individual autonomy, often advising doctors to let up: “She doesn’t want to come. Let her be. It’s her decision. Let’s try again tomorrow.” In their efforts to persuade, the doctors may respond: “But she is too ill!” or “We can’t come back tomorrow!” Personal autonomy, so highly valued in Amerindian societies, tends to work against the doctor’s best intentions. Yanomami often abandon efforts to overcome opposition to treatment at the clinic: “We can’t oblige her/ him,” reflecting the moral obligation to respect personal decisions whatever the outcome. Nowhere is this more troubling for doctors than in

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life-or-death situations. Doctors are trained to do everything to prevent death, but Yanomami may not agree on what “everything” entails. Taking a child out of the clinic to a shapori also causes considerable distress. Doctors will normally follow patients to their homes and continue working alongside shapori, the preferred arrangement for the gravely ill. Occasionally, shapori may also work with doctors in the clinic. All these terms are negotiated while proceeding to care for critical patients. I want to connect our discussion of agency and effectiveness in medical performances with the issue of patient negotiations. Given that doctors and Yanomami hold dissimilar ideals, every outcome is a perceived as the concession of one party, which credits the other with controlling power. Rather than deciding, one side succumbs to an agenda they resisted. Let us consider an analogous situation in which Yanomami attempt to convince doctors to do something they often resist: give. When asking for an item or service likely to be denied, Yanomami visit the doctor and speak of friendship or do some kind of favor before making the request. If it is denied, long negotiations ensue. The person who succeeds is credited with agency, the power to overturn the doctor’s initial denial. An object has been extracted (by a Yanomami) rather than given (by a doctor). As a Yanomami once complained to me: “Yanomami are always taking my manioc cakes from me for money.” What would seem to most a normal commercial transaction is experienced as a forced extraction. All these cases are tests of one’s ability to control another, akin to direct or fearless speech. In the napë transformational context, a Yanomami ratifies his condition vis-à-vis a napë who is ratified in turn as either stingy or a provider of objects. Convincing patients is a similar situation, but doctors here are in the active role, and it is the Yanomami who resist—“not letting themselves.” Resistance often has an element of not crediting doctors with the ability to control. Reluctant patients do not go (themselves) to the clinic downriver or city hospital, they are sent (by doctors), but only after long discussions. Doctors may react, resisting Yanomami control, but this is seen as “playing it the Yanomami way.” The clearest instance of this dynamic is when Yanomami do not acknowledge being patients, when they are treated without apparent reason in, for example, preventative programs in upriver communities. People might request something in return from the doctor: “You want to extract a tooth that is not bothering me? Give me soap!” I once accompanied doctors to a community with almost no active contact with physicians. While attention to sick people was welcomed, mass vaccination plans were thwarted by rejection of what was seen as a pointless and painful procedure for children. When the third child was

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being vaccinated, her father, gripping her as she cried in pain and fear, implored the doctor to give him something in return. Both these examples are attempts at switching from resistance, “not letting yourself,” to an active extraction of one’s own. Matching the other’s ability to overpower resistance, this counter-performance with a cancelling effect addresses the following question: “What (object) is my compliance (discomfort/pain) worth (substitutable) to you?” The doctor’s negotiation of the patient’s therapeutic path is received with variable degrees of understanding. The intense scrutiny of the physician’s performance can be understood as an inherent part of an intercultural situation that inverts the familiar doctor-patient power relation, as illustrated by the following student’s statement: For example, in the city . . . you more or less can take the initiative in the doctor-patient relation and guide it, and it is very easy, for example, to impose what you think and what you want to do . . . Here [in Upper Orinoco] the relationship is inverted. It is really they [the Yanomami] who lead the relation, and it is they who decide . . . what it is you are going to do and up to which point you will do it . . . Here you cannot come and impose what you want. They impose what they want, and they concede a bit, and you can go a bit further when they trust you.

Other doctors experience this form of control as an uncomfortable pressure they could do without. Particularly vexing are assertive performance inquiries from Yanomami with no health training, often interpreted as challenges or sabotage. If biomedical practice is an evident instantiation of Foucauldian bio-power, regulating bodies the state has molded into docility, here, where the doctor-patient relation is inverted, we find something like reverse bio-power (something akin to “reverse anthropology”). Controlling performances are equivalent “techniques of discipline” (Foucault, 1979) making “docile doctors” whose innate napë ambiguity is filtered by convention. The “normal” subject-object (doctor-diseased body) relation is in effect inverted: the diseased body is here a controlling subject, the doctor more like a tool. Doctors’ lack of control in medical contexts is rooted in the lack of state presence, akin to the absence of society already discussed in non-medical relations, compounding the experience of powerlessness. Hence, most doctors consider Yanomami “difficult” patients, the medical expression of their being malcriados, and they see themselves as “the jungle,” an objectified controllable use value. But doctors’ perception is a consequence of their ideological constraints. The doctor-group

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exchanges are subject-subject relations. Indeed, all negotiations, medical and otherwise, sustain “Yanomami” and “napë” as subject positions. This chapter has concentrated mainly on doctor-Yanomami relations. A final aspect of the health system’s contribution to napëprou that I wish to examine concerns Yanomami relations among themselves, in particular, the Ocamo Yanomami’s constant efforts to differentiate themselves from Yanomami of upriver communities.

Yanomami Performing Napë Ideally, doctors make fortnightly visits to intermediate communities and monthly visits to distant ones. Upriver visits again pit Yanomami and doctor agendas against each other. Doctors plan their visits on medical grounds to fulfill visit schedules or respond to news of ill people. Yanomami crews see more than a medical visit. For the motorist and his helper(s), the trip is always an opportunity to visit relatives, exchange news, negotiate political or marital alliances, and hunt. Yanomami try to impose their multi-purpose project on the doctor’s single-purpose medical trip. Consequently, doctors are constantly negotiating plans as they go, often stressing they are the bosses: “This is a health trip, not for you to visit your mother-in-law!” Again, boat companions’ diverse goals are seen as skewed priorities; health concerns should not compete with other objectives. Most doctors learn to amicably give and take, and most helpers will subordinate their desires to the needs of gravely ill patients, yet a subtle power-play lingers throughout the trip. Let me now address how boat-trip companions become mediators between doctors and upriver Yanomami, roles equivalent to those of political leaders who perform criollo control and translation at Ocamo meetings. At the same time they differentiate themselves as napë in contrast to their upriver compatriots. If Ocamo people feel themselves as Yanomami/ napë, their differentiation from both “pure” Yanomami and “pure” napë is necessary. Medical visits are opportunities to differentiate in the first way (in chapter 8 we describe circumstances for the second). The criollo-controlling role of traveling companions is most evident in the influence upriver people attribute to them. For example, in Pashopeka (6 hours upriver), the origin of manufactured goods that came from the Ocamo priest and his Yanomami helper through the SUYAO cooperative was ascribed to the helper, not the priest. From the upriver perspective, it is downriver Yanomami who control the flow of criollos and their products. The same view holds for medical visits, as suggested by the following

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comment from a mid-river community friend, criticizing the new Ocamo motorist (the previous one had resigned). When I asked what he thought of a particular doctor’s work, he responded: She used to work well, that one really worked well . . . When she came with Roberto [the previous motorist], she would help us well. She would inject us, give us medicine . . . We would tell Roberto: “We are ill. Give us medicine. We really want it!” . . . Then he would speak with the doctor and make her give medicine . . . So we would recover once the doctors had left . . . Juan replaced him . . . Then we would say: “Doctor, we are ill. We have malaria. We have diarrhea. We are coughing . . .” “No you are healthy. It’s because you are hungry. You are not really ill,” the doctors replied . . . “We are really ill,” we said in return, but Juan didn’t speak.

Overlooking the agency of the doctor, he criticized the new motorist for not interceding strongly enough on their behalf. If the doctor was not behaving, it was the motorist’s fault for not pushing her to do so. With the previous motorist, she “really worked well.” In their mediating role, boatcompanions are trusted to further the community’s health needs. This imposes a responsibility on them but also allows them to appear as powerful, controlling the actions of doctors. During visits companions do much to visually mark themselves as napë in contrast to their host communities. Invariably, they are fully dressed in trousers, shirt, shoes, and sometimes caps and sunglasses. Many also smoke cigarettes, a distinctly napë habit; Yanomami use tobacco wads. Standard possessions for companions include shotguns, and lamps and batteries, items that many upriver communities do not have and relish. Companions also eat with the doctors, an act that demonstrates they know how to eat napë foods. Moreover, in sharing food, they display mutuality and assimilation with the napë. There is also an element of subordination in a typical chain of command, a chain of decreasing napë-ness. Doctors direct the motorist as head helper, who will relay tasks like washing, finding wood, and portaging to other helpers. If collected on the way upriver, mid-river helpers are positioned at the bottom of the command chain, but they too might delegate a task to a local upriver child or huya. All these are napë traits that, added to companions’ abilities to operate motors and speak Spanish, constitute important differentiating markers. Ocamo companions deliberately perform napë, displaying napë body/ habitus and knowledge. They also exchange or give away manufactured

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products—willingly or reluctantly—putting them in the napë position of providers of objects (cf. Lizot, 1998:30–31). They retain, however, a dual Yanomami/napë image that enables companions to mediate on the community’s behalf while also stressing napë-ness. Performing napë, obviating one’s Yanomami-ness, in an upriver community might be met with a counter performance. Upriver Yanomami can see themselves from the Ocamo perspective as waikasi, “real Yanomami.” Their demand for objects involves performing Yanomami—who lack objects. Presenting themselves as in need, they also press Ocamo companions into giving, appealing to the ethic of alleviating people’s suffering. The Ocamo equivalent occurs when civilized Yanomami perform Yanomami to extract objects from doctors. This demands obviating napëness, presenting oneself as a needy Yanomami just like waikasi do upriver in relation to the more resourced and “civilized” Yanomami. A subtle but important affinity exists between the “ethics of care,” to use Alès’ (2000) term, and the napë point of view so strongly defined by Yanomami and criollos alike in the possession of objects. Finally, performances are acts of obviation not obliteration. Ocamo Yanomami perform napë, but their innate Yanomami side must remain for mediation to be possible, just as criollo doctors should artificially obviate their napë enemy signification but retain their criollo knowledge. In the same way, an effective shapori must alternate between being hekura (spirit) and Yanomami. In these cases Yanomami is a collectivizing moral continuity, while napë is a body/habitus/knowledge differentiation. I began by describing the dynamic of doctor-Yanomami relations in non-medical contexts, concluding that doctors’ collectivizing efforts met with Yanomami differentiating ones, generating a cycle of harmony and friction akin to internal village dynamics. Our analysis allows us to contrast Yanomami with doctors. Of import here, rather than simply the anthropological reputation of Amerindians for antipathy toward rules (Overing and Passes, 2000), is what functions convention serves for the Yanomami and for the criollos. For the former, it provides an innate background of similarity (humanity) that allows for differentiation. For the latter, it provides a motivational objective to organize and structure what appears inchoate. Hence, criollos and Yanomami experience each other’s intentions as motivational resistance: the more disorganized Yanomami appear, the more doctors strive to organize; the more procedures are standardized, the more ways to bend convention flourish. In this relation doctors and Yanomami enter each other’s worlds as forms of the innate. Doctors see Yanomami as part of nature: disorganized, ever-changing, unpredictable,

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uncivilized. In medical contexts, Yanomami are considered difficult patients, not domesticated by the state and, hence, not docile. Yanomami, on their part, see doctors as part of conventionalized culture, potential affines necessary for their becoming napë. As I suggested in chapter 5, this context of mutual motivation, where doctors’ efforts to make society are met with Yanomami efforts to become napë—make Yanomami/napë kin, results from the non-congruent aspects of Yanomami and criollo civilizing projects. Several aspects of doctorYanomami relations pit these partially overlapping projects against each other, which is why negotiation is constant. Doctors want to be only doctors rather than providers of objects and potential affines. They want upriver trips to be only medical—rather than political, economic, and kinship—trips. They want to control their patients and the community rather than being the object of control. They want to act institutionally rather than be caught in the dynamics of Yanomami internal politics. In short, doctors resist their napë meanings and their contributions to the becoming napë of Yanomami. This intercultural situation calls for considerable negotiating ability, a skill few of these doctors have achieved through their medical training or professional maturity. I must stress, however, that striking a balance is always possible, although the ever-changing face of the health system, its impermanence, militates against equilibrium and keeping napë alterity at bay. I have also tried to illustrate the dynamics of obviation in both medical and nonmedical contexts, involving both Yanomami and doctors performing Yanomami and performing napë. These performances combine aspects of both the Yanomami conventional and the napë transformational contexts. Yanomami entails being both human/moral and lacking criollo body/ knowledge. Napë entails being both enemy/less moral and provider of objects/knowledge. At the crossroads of these meanings, all performances, from curing to exchange to mediation on medical trips, combine Yanomami as collectivizing moral continuity and napë as differentiating body/ knowledge. Language illuminates this double-sidedness. To speak Yanomami or Spanish has moral and differentiating connotations. Exchange is also double-sided. To give objects is both moral and differentiating; it ameliorates suffering, and it makes you napë. I want to underline the continuity between everyday relations and those present at the more typical sites of political discourse. Patient negotiations and upriver medical visits that sustain Yanomami and napë positions are political acts similar to meetings with institutional criollos (the subject matter of chapter 8). This is consistent with Gallois’s (1991:202) suggestion that

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Waiãpi demands for healthcare must be seen as efforts to control whites. However, her argument is that biomedicine cannot “respond to the diagnostics made by Indians” either in etiological or therapeutic terms. In such emptiness, “the Indians have, as their sole alternative, the attempt to control—as passive acceptance or radical refusal—the introduction of therapeutic techniques that will be assessed as a function of the traditional logic of relationship with whites. This relationship today among the Waiãpi adopts the form of confrontation, or at least of political strategy” (202, my translation). Indeed, the introduction of biomedicine must be seen within the wider framework of the “traditional logic of relationship with whites.” I have tried to demonstrate, nonetheless, that the crux of the matter is not biomedicine’s capacity to provide explanations. Along the same lines, I only partially agree with Conklin’s (1994:162) suggestion that “the key to the comprehension of the Wari’ responses to Western medicine is found in the traditional medical system.” I have argued that it is necessary to go beyond the medical to explain doctor-patient relations and, more generally, the health system. The political character of criollo-Yanomami relations means doctors in places like Ocamo cannot be seen solely as doctors, precisely because Yanomami impose on them a holistic quality that links them to a wider socio-cosmological framework. Minor everyday things— managing gasoline and boats, negotiating an upriver visit plan, organizing the clinic, sharing food in the house, asking for medicine, shouting at people—are more relevant to the articulation of the health system within communities than the Yanomami’s and the doctors’ medical beliefs. To relegate study to the realm of the medical in order to explain relations within the health system would misrepresent the experience of both Yanomami and doctor. This narrow focus would also overlook the crucial napë potential affine connotations of doctors stressed throughout this chapter. The next chapter complements the analysis I have just presented. It explores the complementarity of shamanism and biomedicine from the Yanomami’s and doctors’ perspectives, discussing the conceptual and practical articulation of Yanomami and Western medical systems.

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cha p te r s e ve n

Doctors and Shamans

This chapter is devoted to the articulation of medical systems, exploring the practical place and conceptual fit of doctors, medicine, and biomedical procedures in relation to shamanism.1 I focus on the ways doctors and shapori work together and how Yanomami and doctors conceptualize their respective roles in curing. I will argue that there is an inverse distribution of the curing and caring roles between doctors and shapori from the points of view of Ocamo Yanomami and doctors. This supports the received anthropological knowledge that from the indigenous perspective, biomedicine supplements rather than competes with shamanism because the latter deals with causes of illness and the former only with its effects (Buchillet, 1991b; Albert and Goodwin-Gomez, 1997). An important qualification to this pattern will arise, however, from the analysis of the role of doctors and their medicine when treating illnesses considered shawara. Here I will argue that doctors are on an equal footing with shapori, as Ocamo Yanomami extend their notion of this local healer to include doctors as a criollo version. As we saw in chapters 4 and 5, interface Yanomami can be seen to assume the political role of shapori on the napĂŤ transformational axis. Criollo doctors and, to a lesser extent, Yanomami nurses correspondingly assume the curing role. If in the previous chapter I demonstrated how the divergent interests involved in making society and becoming napĂŤ fostered the need for constant negotiation, in this chapter I will show how the congruence between certain Yanomami and Western medical concepts facilitates the deployment of biomedical treatments. The ethnography will reveal that underlying the articulation 140

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of medical systems, in fact sustaining it, is a working disagreement, a coming together of overlapping aspects of the criollo doctors’ and the Yanomami’s projects, a point of affinity that serves as a useful hinge between napë and Yanomami worlds.

Complementarity of Biomedicine and Shamanism Close to the health posts, Yanomami along the Orinoco have three sources of therapy: shamanism, domestic medicine (in Albert’s wording, mainly the use of hëri, plant-derived substances used as medicine), and biomedicine. The specific route a particular person follows depends on a series of factors and may include, depending on the progression of the illness, any or all alternatives present. There is no definite pattern of preferences for either doctors or shapori, nor a set of diseases for either doctors or shapori. Choices vary from person to person and from case to case. Decisions are influenced by self-diagnosis, perceived efficacy, and seriousness but also by practical issues like the availability of a good shapori or transport to the clinic. As I discussed in chapter 6, the degree of trust a doctor has developed is influential. Regarding therapy selection, Yanomami appear to share the pragmatism evident with other Amerindians (Kroeger and BarbiraFreedman, 1992:140; Langdon, 1991:217; 1994:138; Buchillet, 1991b:35). No diagnosis rules out the intervention of doctors or shapori. In fact, it is normal for patients to be treated either separately or simultaneously by both. Many anthropologists have noted that biomedicine does not compete with shamanism but rather complements it.2 This is possible because in Amerindian schemes of etiology (causes) and therapy (curing and recovering), biomedicine enters only as an alternative therapy added to an existing arsenal of therapeutic options (Buchillet, 1991b:35). In an etiology that conceives of most illnesses as an aggression on a person’s ontological aspects (souls or vital images) by human or non-human agents, shamanism operates in the sphere of causes (aggressors), biomedicine in the sphere of effects (symptoms) (28–29). Shapori battle with aggressors, acting on the ontological plane to eliminate their effects, whereas biomedicine, unable to access the causal plane, only curbs effects. From the Amerindian perspective, these different sites of action—in fact, a different stage in a process and a place on the person—allow for the complementarity of shamanism and biomedicine. Referring to the Yanomami, Albert and Goodwin-Gomez (1997) argue that biomedicine, which can neither offer nor challenge shamanic explanations

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for illness, is supplementary to, and no substitute for, shamanism (cf. Alès and Chiappino, 1985). They also note that biomedicine is assimilated in the category of “empirical domestic medicine,” aimed at reducing symptoms of a disease and hence subordinate to shamanic cure. My next two examples illustrate this complementary relationship, allowing me to develop the less familiar discussion of how this articulation is actually seen from both Yanomami and doctors’ perspectives. Consider the case of Roberta, a 45-year-old Yanomami from Ocamo, who has been feeling bad for several days and for whom doctors have been providing different diagnoses and treatments. The doctor, Lucia, and the student think she has a non-metabolic problem. Suspecting that something is wrong in her household, they sympathize with her suffering but deem it beyond their scope. In the night, Daniel, Roberta’s husband, calls for Dr. Lucia, alarmed that he cannot wake Roberta up. In his house, he demonstrates Roberta’s lack of responsiveness as she lies in her hammock. Daniel explains that she has not woken up since lying down after eating fish and manioc in the afternoon. Manuel, Daniel’s brother, arranges to fetch Miguel, the shapori. In the meantime, an IV is hooked up, and Roberta begins to awaken. Miguel arrives, attracting the attention of other relatives, and is told that Roberta has just returned from visiting along the Padamo River. Not long after, I interview Miguel: JA: How did she get ill? Miguel: Over there at the rapids . . . They live at the rapids. The yai live there. Knives like this [exemplifying the size with his hands], they are stuck . . . Translator: When Daniel’s wife was [inaudible] / The shaman saw what was stuck/inserted inside [her], like a very small knife. These are really poisonous, and because of this she was fainting a lot. When you take them out, she recovers. JA: What was the IV for? Miguel: Those who hook up the IV, they only / a bit [Y. waisipi]/ They only soothe [Y. yaniki pëtao] . . . The hekura say, “No, these [knives/ darts], these are really responsible . . . When you extract them, then she will really become alive/well [Y. yai temiprariyo]!” So then they extract the darts, one, the other . . . The napë [doctors] don’t do anything using only the IV. Translator: Then the IV solution goes in, but it won’t cure like that. It is better to send the spirit [hekura] first. The spirit sees what is really poisonous. You have to take that out first. Only then you can hook up

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the IV. Then she will recover better. If you don’t get that out, it [knives/ darts] will calm a bit, but then it comes again. So says the shaman.

The second case involves Cristina’s two-year-old baby boy, who has accidentally eaten bitter manioc. After a messenger informs Dr. Lucia, she sends Juan Carlos, the student, to Cristina’s house. Later I meet Juan Carlos in the clinic with most of Cristina’s household. Lucia and Juan Carlos get to work. The baby is in a stupor, and Cristina is crying. His vital signs seem okay, but when left on his own, his eyes and head roll back. He seems almost unconscious. Lucia decides to do an internal cleansing using physiological solution. They also try to catch a vein to set up an IV, but the baby undoes two attempts with his movements. The nebulizer is used to ease breathing. Later Juan Carlos tries to insert a nasogastric sound, but Cristina protests because she sees that it discomforts her baby. I try to communicate with La Esmeralda by radio to seek advice from the more experienced head of district. Lacking the right substance in the clinic, Juan Carlos receives “plan B” instructions by radio to prepare a homemade antidote. Lucia continues to give the baby physiological solution orally, while others, deciding to take the baby home, go to fetch Miguel, the shapori. Juan Carlos tries to keep them in the clinic, but the grandmother grabs the baby and leaves. A vein has finally been caught for the IV. We leave the clinic and follow the crowd to the house. Juan Carlos goes to the doctors’ house to prepare the antidote. Miguel arrives in Cristina’s house as Lucia works closely on the baby— in his mother’s lap—with an air pump to prevent suffocation. Initially, Miguel is forced to remain at a distance from the baby because of Lucia’s efforts. Miguel begins to discern the path of the spirits involved in this event. Some time later Miguel gently nudges his way into the scene, and Lucia steps to one side. By this time, amid the noise of a concurrent yopo session, concerned commentators, and playing children, four weeping women have surrounded Cristina and her baby. Three quarters of an hour into the session, Miguel stands back, hands to his chest, holding something invisible that he gently puts into the baby’s chest: mai kë thë, “it won’t happen,” he says. He sits with the men in the yopo circle, and they continue to chat about other matters. Lucia remains ventilating the child and administering the homemade antidote orally. An hour later the child looks better. Miguel leaves, asking to be kept informed. Dr. Lucia: A man came to alert us about a gravely ill child. We went to the clinic. The boy was very depressed [physically] . . . Even though

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his vital signs were normal . . . Interrogating the family, we realized that he was intoxicated with bitter manioc. We immediately tried to catch the vein to administer a parenteral solution to dilute the effect of the poison, and we also administered rehydration solution orally to clean the digestive path. After stabilizing the general conditions of the patient, another group of women, but elder ones . . . wanted to take the patient to the house to be treated by the shapori. I told them that as soon as we had finished administering the medicine we would take him over, and this is how it was. We finished giving the treatment, and we went to the house with the manual air pump . . . Every now and then, we gave him oxygen, and we continued administering oral rehydration solution and then aluminium hydroxide for him to eliminate what was harmful . . . JA: What was the shapori doing? Translator: The shapori was hovering around the boy with other men. First they were speaking among themselves, and the shapori danced and shouted. Sometimes he sang something. It’s a song. It’s like a rite. While I was next to the patient, he wouldn’t get close. I was using the air pump because the child was a bit depressed, but when he was better, I distanced myself a bit . . . The shapori got closer to the patient and then he began as if/ he would touch him as if taking out something bad/harmful, and afterwards they left. I asked, “Why did he go?” because I still saw the patient being a bit poorly. They told me they already considered that the patient was better, that he would recover . . . Then the patient expelled via the rectum a lot of whitish liquid that I suspect was the manioc . . . After expelling [the manioc], he began to react better and from there on he got a lot better . . .

Interview with Miguel: JA: How did he get ill? Miguel: A pore [spirit of the dead] took his pei mi ãmo away. JA: How do you know what happened? Miguel: [A pore] took the mi ãmo away. The hekura recognize their trace. “This is the fault/trace of a pore!” they said. Then they followed the right path. They got the mi ãmo. They came back. They gave the mi ãmo back again [to the child]. Then he got well/alive again. That is what the hekura do. JA: What was the doctor doing?

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Miguel: What were they doing? Is that what you are asking? Those [doctors] who reduce symptoms [Y. horomaiwehei], it’s only this what they were doing . . . “No, not like that. This is not ni wari [shawara]. Can’t you see? This is the way that he will really become well/ alive [Y. yai temiprariyo] . . . He will awaken [recover],” I said. He is going to recover/be alive. Those doctors who were manipulating [the body], really that is all they were doing, manipulating the body [Y. yaiwë thë pë huri pëta kurahei],” I said. Translator: The doctor was there sitting down [next to the mother], but she is not doing anything. This is not malaria, nor shawara, nor diarrhea. This is not the case . . . When I do like this [as explained], I fix his soul again, then his soul will recover/be alive again.

These two accounts confirm our observations regarding the indigenous perspective on shamanism and biomedicine. In both cases, the prominent role is that of the shapori, who believes his actions cure the patient. In Roberta’s case, Miguel speaks of the doctors’ actions in terms of waisipi, “a bit”; yãniki, “to slowly recover”; and pëtao, “only,” “just,” or “in vain.” The hekura’s action, in contrast, is referred to as yai temiprariyo, “really become/transform healthy/alive.” The translators’ choice of words illuminates the supplementary role of the biomedical intervention: “but like that it won’t cure,” in reference to the doctors’ performance, and after the darts had been removed by the hekura spirits, “only then you can hook up the IV. Then he will recover better.” The same use of pëta- and yai temiprariyo occurs in Miguel’s description of Cristina’s case. Moreover, in Cristina’s case, Miguel refers to doctors as “those who reduce symptoms,” contrasting their less significant actions with his curative work and thus deploying the categorical distinction Yanomami make between domestic medicine (Y. horomai; hërimai) and shamanism (Y. nohi rëai) (cf. Albert and GoodwinGomez, 1997). But from the doctors’ perspective in Christina’s case, their work is more significant. They want to keep the baby in the clinic. Lucia tells the women they can take the child only once she has been given the medicine. She lets the shapori access the baby only when she believes that recovery has begun. These attempts to control the therapy illustrate her perceived prominence. It is the antidote, chest massage, and air pump that save the child. The role of the shapori is subordinate. The dispute about the distribution of roles becomes apparent only after the fact. On the one hand, relatives often debate the appropriate course of action. In Cristina’s case, as I learned later, child and mother had gone to

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the lake, where he became feverish and began to vomit. Back in the house, people inquired about the child’s state, and Cristina recalled the baby had eaten manioc (apparently mistaking bitter for sweet manioc), suggesting this was to blame. Some rushed to the doctors’ house initially to get sugar. The child’s aunt immediately thought of the shapori, while the father suggested the clinic. The grandmother then took the child back to the house for the shamanic session. In the end, sugar, shapori, antidote, and doctor all intervened. Because the cause of an illness may remain unclear until late in the therapeutic path, it is always considered advisable to have both shapori and doctor covering all possibilities. But what role do doctors/biomedicine play if shapori are prominent? Alès’s (2000) discussion of “care” is useful for exploring this issue. Recalling that it is ethically proper to ameliorate relatives’ suffering, be it illness, hunger, sadness, or hardship, let us consider some practical examples in medical contexts. When dehydrated babies need an IV setup, it can be extremely difficult to catch veins because they may be “collapsed.” Doctors may try unsuccessfully several times while children cry and kick about in pain. Mothers often reproach doctors for inflicting such pain and occasionally leave with their baby or forbid the doctor from further attempts. What they perceive as unnecessary pain triggers this reaction, as when Cristina rejected the nasogastric procedure. Yanomami may also complain how doctors have no kiri, “fear/shame,” when cleaning wounds. Their hefty scrubs are too coarse, “as if it didn’t hurt.” At the Mavaca Yanomami conference, a man gave the following account of a trip to the clinic to advise the doctor of a patient back home, one hour away: [Doctor’s reported speech:] “And why did you not bring the patient?” [His response:] “Damn it! If a person is gravely ill, how I am supposed to carry him? How am I supposed to make a seriously ill person suffer? My father-in-law is still suffering a lot because of pain in his eyes . . .” [Doctor’s reported speech:] “Well, I will go there on such and such a day.” [His response:] “Damn! When I explain about a patient, is this the way a doctor should respond? No! He should be concerned/worried.” Doctors are expected to feel—and show—concern (Sp. preocuparse), reflecting the morality of caring about another’s suffering. From the Yanomami perspective, then, doctors/medicine in their role of reducing symptoms should reduce suffering. Although supplementary to the shapori, they are nonetheless morally obligated to assist. From the doctors’ perspective, care is also a valued component in healing. In this sense, although they do not generally believe in their efficacy

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(except when they see no biological problem), many consider the shapori important. His relevance lies in his ability to provide psychological aid, in which the power of the mind can induce biological changes and create favorable conditions for recovery, minimizing disruption of the cultural context. Consider the following statements by doctors on their attitudes toward shamanism: I respect the shapori a lot, and I let them perform many times. But deep down, one respects them without believing the shapori is really going to cure you, or at least not believing the shapori is extracting a spell and curing. Maybe with the shapori / like a placebo effect, I don’t know, the patient is predisposed. S/he is going to get cured, and s/he does. I believe a lot in that. I was always very flexible with that [shamanism]. I thought it was primordial. For them, it is basic in the illness-healing process to be treated by their shapori . . . I would go at night [to patients’ houses] to administer treatments, especially if they were children and they wanted shamanic curing . . . and with the shapori / I would call them and say, “Help me out! I don’t know, this [patient] looks too seriously ill. Come and do shamanism on him/her . . .” [Commenting on a specific case of a lonely mother with a sick baby, she called for a shapori:] I did it so the mother would feel more protected, so she wouldn’t feel so alone.

“I let them perform” and “I was very flexible” are concessions granted on cultural grounds for the benefit of the patient, reflecting the authority ascribed to doctors to decide the course of treatment. When the doctor considers the patient is at risk, however, the imperative of patient welfare overrides this general concession. Asked about how she felt when critical patients were taken to the shapori, this doctor responded: Powerlessness [Sp. impotencia] and anger [Sp. rabia]. It cannot be that they can’t understand that they have to stay [in the clinic], that the medicine will cure them, not the shapori . . . It’s difficult because at that moment you are angry and you shout . . . Can’t they understand that if you take her/him, s/he is going to die? But then I think five minutes later: If I were Yanomami and all the beliefs and all that being Yanomami implies, how are they going to believe in the napë, in medicine, if they believe more in the shapori? And then you can understand.

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On the simultaneity of shapori and doctor interventions, another doctor observed: I liked that simultaneity . . . I felt that when that happened it was because it was a situation of a lot of trust both in myself and in the shaman . . . I felt good and happy in those circumstances. I thought it was the most successful thing. Of course, in the case when they decide to take the patient away . . . Well, in that case it is hard to accept. Of course, you are not going to be happy because if they take [the patient], it’s worse. But in the end, it’s their decision. The most you could do was to go with them too.

Another doctor recalled the case of a baby with a respiratory infection, the son of a shapori. Both he and the shapori worked together on the baby until its death, but even when the simultaneity was unproblematic, which is normally the case in Ocamo, his account reveals that he resigned himself to culture with little perceived benefit: Gee I am wasting time with the baby. I mean, as a doctor, as a scientist, [I think], “Damn it! You goddamn Indian [shapori]. What are you doing with that?” [Recalling another case:] We would go [over to the patient’s location] and that circle of crazy people [several shapori curing]. You are catching a vein, and all those guys on top of you. Sometimes they waste the time you have, and then there is the fear that you can’t work well because of all the people on top of you. I mean powerlessness (Sp. impotencia), basically that’s the word, powerlessness, surprise, anger, and even laughter . . . In their culture, they believe in that as I believe in my medicine, and possibly they don’t believe in mine [medicine]. And I, of course, don’t believe in theirs, but they are wasting time leaving a child to die.

Generally, simultaneous or alternate doctor-shapori interventions are unproblematic for doctors and Yanomami alike. Dropping the doctor in favor of the shapori in critical circumstances, however, inverts doctors’ perceived order of importance: first the doctor, then the shapori. In chapter 6 we discussed Yanomami controlling doctors’ performances. Here we see how doctors attempt to run the show, making certain cultural concessions and statements of resignation. In the end, doctors and Yanomami are controlling each other’s performances and choices. The environment of mutual allowance is favorable as long as both parties benefit from the

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presence of both healers and the place and type of treatment. Doctors’ and relatives’ thresholds of tolerance vary. Critical cases tend to foreground the inverse attribution of curing-caring roles that in less serious cases is inconsequential. Doctor-shapori interaction is frequent in the Upper Orinoco. I never witnessed doctors telling Yanomami not to go to shapori or refusing treatment to those who did, as reported by Briggs (2003:186) about doctors working among the Warao in the Orinoco Delta. The shapori also welcomes the doctor’s presence. When Ocamo had been without a resident doctor for a few months, Miguel, the shapori, expressed concerned about the amount of his work, intervening in a meeting with the head of district and the regional health director. Part of his simultaneously translated comments follow: “He [Miguel] said that when the doctor was here . . . the doctor cured, and, well, let’s see who has more power to cure the patient . . . He is thinking a lot about the doctors . . . This is why we are asking for a doctor to work here again . . . We can work together. He will help them with shamanism, and they can help him cure.” At the Mavaca Yanomami conference, several shapori from upriver called for doctors to visit their communities because they could not cope with the resilient shawara on their own. This brings us to the next important issue. Beyond reducing symptoms or aiding recovery, there are circumstances—such as shawara—where doctors’ efficacy seems to match that of shapori. Recall Miguel’s words about Cristina’s child, translated as the following: “This is not ni wari [shawara]. Can’t you see?”; “This is not malaria, nor shawara, nor diarrhea. This is not the case.” Such assertions designate shawara as the field of doctors’ curing efficacy. Consider the following statement by a Yanomami nurse addressing the Mavaca Yanomami conference. On the problem of salud, “health/healthcare,” he exhorts his fellow Yanomami: “Look! In order to make the shawara return on its path what are we / how are we going to think? Like this! [i.e., this is what we need to think about:] thing-for-makingshawara-turn-on-its-path [i.e., salud] for us not to die so frequently.” The Spanish term “salud” always refers to shawara, that is, diseases that are ontologically criollo. In a wider sense, problems concerning salud always have to do with the health system: doctors, nurses, medicines, and the like. Let me recapitulate. For the Yanomami, doctors’ curing competency lies within the etiological category of shawara; for illness caused by other agents, the doctors’ role is the reduction of symptoms and hence suffering (care). Shapori competence covers all these cases. Doctors, for their part, acknowledge the primacy of shapori when patients have no apparent

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biological problem (e.g., Roberta’s case). Otherwise, shapori are seen as only supplementary: doctors cure, shapori help. In many cases, each therapist credits him/her self with the primary curing role. Let us pause on some aspects of this discussion thus far. Our cases exemplify the existence of two simultaneous realities in the illness-healing conceptual context: the Yanomami’s shamanic reality and the doctors’ scientific reality. The separation is more than a doctor seeing an intoxication by manioc poison and Yanomami seeing a stolen soul-aspect. Note the lack of communication between doctor and shapori. Lucia knew neither about the Yanomami shamanic interpretation nor her subordinate role. Doctors are generally unaware of Yanomami diagnoses and evaluations. But mediating Yanomami also convey different information to doctors and shapori. Roberta ate this, then that, then fainted (version for doctors); Roberta has gone to the Padamo, where Yekuana live and demons are known to inhabit the rapids (version for the shapori). Cristina’s child ate bitter manioc (version for doctors); Cristina’s child ate bitter manioc, went to the lagoon, where she began to get feverish (version for the shapori). Outside the shapono, the lagoon is part of the forest, typically associated in Amerindian geography with the danger of evil spirits, in stark contrast to the safety of the village. Next, not only is shawara etiologically criollo, so too is everything surrounding it. For instance, Ocamo Yanomami when questioned about prevention mention hygienic practices, washing dishes, washing your hands, keeping houses clean, that is, criollo-consonant discourse. No one mentions food taboos about illness or children’s use of hëri necklaces to ward off specific diseases or make them “grow fast” as prevention. All Spanish health terms such as “salud,” “prevención,” and “enfermedad” refer to criollo diseases, institutions, and practices. Yai, pore, enemy shamans, and hëri are divorced from the discourse of salud. All these distinctions evidence the coexistence of the Yanomami conventional and napë transformational conceptual contexts, complementing the gamut of associations of being napë and Yanomami discussed in chapter 6. For their part, doctors generally believe that Yanomami do nothing to prevent disease, reinforcing the perception of irresponsibility mentioned in chapter 6: Yanomami do not take care of themselves. Yanomami divide the illness-healing conceptual space into equally real napë or Yanomami causes, therapies, and types of information (acceptable to doctors or not) and practices (e.g., prevention). Doctors, on their part, divide things more along the lines of real (biomedical) causes and

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therapies, and “beliefs” (Yanomami). Ocamo Yanomami generally know about doctors’ conceptual space, whereas the latter are normally oblivious to Yanomami classifications. This reflects the historical experience that Yanomami have of doctors who, themselves ever-changing, are perennially stuck with an incipient and coarse view of Yanomami conceptualizations. These matters are relevant in practical terms because doctors often believe Yanomami “don’t really believe in medicine” or see physicians only as dispensers of medicine. Congruent with criollos’ difficulty with the civilized being of Ocamo Yanomami—which they view as culture loss—doctors often assume that the alternative beliefs of shamanism and biomedicine present an either/or choice. You cannot be Yanomami and napë or believe in biomedicine and shamanism. My analysis reveals this is not the case: both caring and curing are important for Yanomami, who credit biomedicine with efficacy in both realms. But we must account for the efficacy of doctors in curing shawara, which appears inconsistent with earlier statements indicating biomedicine is supplementary to shamanism. This resounds with distinctions between “white” and “indigenous” disease that Amerindians often make, crediting biomedicine efficacy for treating the former (cf. Kroeger and Barbira-Freedman, 1992:141,150; Gallois, 1991:190 among the Waiãpi; Conklin, 1994:176 among the Wari’). But beyond the pragmatic adoption of a therapy that works, little else is said about this, and I would argue there is more here than what simple pragmatism can explain. Let us revisit Buchillet’s (1991b) distinction between the “sphere of causes,” dealt with by shamanism, and that of effects, dealt with by indigenous domestic medicine and biomedicine. Let us recall the division between the invisible/ontological and the visible/biological bodies (chapter 3). Shapori effectiveness requires access to what is both invisible and causal to undo a relation between an aggressor and the patient-victim. In this scheme, doctors cannot access this invisible causal plane. They are limited to curbing the effects of the aggressor-patient relation. Let me suggest, nonetheless, that doctors’ shawara-curing competence derives from their access to that causal plane in the same way as shapori. What distinguishes shapori is their being of a kind with the invisible world. Hekura helper spirits inhabit shapori bodies, and shapori become a number of hekura. Their unity is a multiplicity. Crucially, shapori assume a nonhuman perspective when they see the invisible aspects of persons as bodies. The claim that being of a kind is the necessary condition to access the causal plane and effect cures needs sustaining. To this end, I rely on

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Viveiros de Castro’s (2004b) arguments regarding shamanic knowledge. Scientific epistemology is objectivist. True knowledge is reached when the knower (subject) can discern what is his/her contribution in interpretation and what belongs to the known thing (object). Shamanic epistemology, in contrast, requires the knower to adopt the perspective of that to be known, becoming of a kind with it. Shapori do not objectify that to be known; on the contrary, they personify it, meaning the relation between the knower and the known is a subject-subject relation. As Viveiros de Castro writes: “The good interpretation is here the one which is able to see every event as being in truth an action, an expression of intentional states or predicates of some subject” (2004b:469). Because shapori can enter into social relations with non-human agents, they can regulate relations between them and other Yanomami. This sheds light on doctor’s shawara-curing competence. Shawara is criollo in nature and character, so are doctors; this makes them of a kind with shawara. Although this echoes the relation between shapori and illness-causing agents, Yanomami do not cite this as a reason for doctors’ effectiveness. Let us now discuss how Ocamo people speak of doctors as shapori to see how their practical associations are consistent with this analysis.

Doctors as Shapori and Vice-Versa Although Ocamo Yanomami constantly told me that doctors and shapori were “the same,” let us examine what doctors do and how Yanomami speak of them in order to identify both the similarities and differences Yanomami discern between doctors and shapori. Being in a field situation, doctors have at hand a limited set of procedures to diagnose and treat patients. This inventory includes ways of administering medicine—pills, syrups, creams, injections, oral rehydration, intravenous solutions, and nebulization—and procedures to identify problems, like the use of stethoscopes, thermometers, and microscopes. Patients are asked simple questions in Spanish or Yanomami: “How do you feel?” “Fever?” “Diarrhea?” “Pain?” Medicine is provided with simple instructions: “This pill is for the fever, this other red one for parasites.” “Take this in the morning, the afternoon, and the evening.” Doctors typically check correct dosages and schedules for treatment in pharmaceutical and other manuals. All these are conventional procedures in Ocamo people’s eyes.

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Doctors and the “Inside” In what way, then, are doctors and shapori the same? First, they are similar in that they have access to the person’s “inside.” Injections, IVs, stethoscopes, microscopes (having taken blood samples for malaria tests), X-rays (taken in the hospital) are doctors’ entry to where shawara is devouring a person—in the blood and the flesh. When doctors use a stethoscope to identify a type of respiratory affection they hear what shapori see. JA: Do they [shapori] say how they see the illness? Nurse: Yes . . . the shapori say that if there is shawara they break it and kill it first . . . little by little. If there is another illness, well, they kill it too. Doctors don’t, doctors don’t see it. They only hear it with the stethoscope. They only hear it. But shapori do, shapori do see.

In the same conversation with the unofficial Ocamo nurse, I asked whether napë and Yanomami thought differently about illnesses. My question was not entirely, but he responded: “Well, doctors are exactly the same [Sp. igualito]. They do exactly the same. As the hekura see it [shawara], the doctors also see it.” The shapori’s privileged capacity—seeing—is functionally transferred to doctors, not because they see as shapori, but because they both identify aggressive agents and act accordingly. When they use microscopes to distinguish among the three possible strains of malaria parasites before administering the appropriate therapy, they are discovering an aggressor. JA: When they take malaria slides what do they see there? Nurse: When they take blood from here [ear], they are going to look . . . then they are going to say, “No! You have vivax” . . . Next, doctors are going to give you medicine (pills).

Vivax is a type of malaria parasite. Tiny creatures visible in the blood under a microscope, parasites are easily assimilated with shawara, tiny bloodconsuming demons. An emphasis on injections and IVs in descriptions of doctors’ actions suggests these internal operations are considered particularly effective. A final typical analogy between doctors and shapori involves the use of books, as illustrated in the following two dialogues: JA: Those shapori and doctors, are they the same or different? Nurse: No, they are the same.

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JA: But do doctors call the hekura spirits like the shapori does? Nurse: No . . . the doctor doesn’t call [with his thoughts]. Doctors work but they call / with the book they know, [exclaiming:] “Aah! This is the cause. If this is the pathogenic substance/power/effect, with this one [a particular medicine looked up in the book], I am going to kill it,” the doctor thinks. Exactly like the shapori, in this same way the doctor is thinking. Nurse: Shapori recognize/know some types of shawara and some doctors recognize the pathogenic substance/power like the shapori does. JA: Do doctors call the hekura spirits like the shapori does? Nurse: No . . . they work with the book. They are going to search first, like the hekura, like when the hekura arrive. In the same way, they will search in the book. When they find it, [the doctor] will say, “This is the disease you have,” like when the shapori say, “This is the pathogenic substance you have.”

Coming to Know: Knowledge Ranking A shapori’s knowledge is acquired through the years. During initiation, elder shapori put a number of helper spirits (his sons) into his chest. In time, he learns about the different entities of the cosmos, their chants, paths, odors, etc. This happens in constant conversation with and imitation of elder shapori. Ocamo Yanomami are aware of doctors’ lengthy educations and how they learn to recognize diseases and provide correct medicines in hospitals in criollo cities, a process analogous to shapori’s lifelong learning. Ocamo Yanomami also see nurses, medical students, and rural doctors as representatives of different degrees of medical knowledge. Medical students and sometimes Yanomami nurses are compared to apprentice shapori. The Yanomami draw an important distinction between the fully qualified graduate rural doctors and the rotating medical students. Students do not know illnesses and medicines as thoroughly as the doctors. So while doctors are referred to as tairewë, “people who know,” students are taimirewë, “people who don’t know,” analogous to shapori of different power and status. Ocamo has one shapori who is considered the real or great shapori, and, for some Yanomami, the only shapori. His greatness resides in the hekura he commands; he knows all the levels of the cosmos and many illnesses. Of the other shapori in Ocamo at the time of my fieldwork, one was acknowledged as good, despite his inability to travel to the

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first level of the cosmos, where sun, moon, and other life-threatening yai demons live. He had accompanied the great shapori, Miguel, but was too physically depleted and afraid of the enterprise. In addition, an apprentice who accompanied Miguel in curing sessions was referred to as a medical student or nurse. Finally, some are considered false shapori, people who act like shapori but wield no power. This scale, which gauges the perceived efficacy of shapori performances and varies from person to person, is extrapolated as an interpretative basis for assessing doctors and medical students: “Well, there are medical students, pasantes, and there are Yanomami pasante shapori, those who are horemou [meaning to lie, trick, or deceive, with connotations of look alike or to do in vain.] . . . those [pasante shapori] are not real doctors. With pasantes [shapori] you are just doing like shamanism. It’s not proper shamanism, the illnesses won’t pass.” So while students may be compared to apprentices or false shapori, a doctor such as the head of district, a postgraduate whom Ocamo people know to have studied more than others, is the equivalent of the great shapori. He is doctoro yai or tairewë yai, the “real doctor,” “the one who really knows.” The manner in which people speak reveals that “shapori” and “doctor” have become synonyms, referring not only to a specific person but also to a state of knowledge. Functioning more like adjectives than nouns, “shapori” and “doctor” indicate real and true knowledge and abilities. JA: Those doctors, are they the same or different from shapori? : Doctors work like shapori . . . Some shapori are false. Some are real/ true. Some doctors are real/true. Real doctors are true. In the same way that there are medical students, there are also some shapori students, you see. Just as there are doctors, there are shapori. The powerful/important shapori and doctors are the same.

Shapori and doctor, in this intercultural medical context, become analogic alternatives for each other. This analogical construction is elicited in different instances and with different aspects of comparison, summarized in the following series: A unique capacity: seeing the inside of the person. This diacritical capacity of shapori is analogous to doctors’ ability to see inside a person’s body with tools such as the stethoscope and microscope. A mode of action: finding, identifying, then eliminating aggressors. Ocamo people’s descriptions of shapori and doctors’ activities are identical. Typically, the healer asks, searches around, and finally concludes,

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“Ah!, this is it!” Remedial action follows identification—fighting a demon, cutting the shawara to pieces, and sending its detritus to the underworld of the amahiri, in the case of the shapori; providing medicine to kill the shawara, in the case of the doctors. The source of abilities: In Ocamo they may say doctors are like shapori, while at other times, it is the shapori who are like doctors. Just like doctors, shapori are said to have aparatos, “technological devices” or tools supplied by hekura spirits who endow them with the specific capacity appropriate for the circumstances. Hekuras and their tools play a role similar to that of medical books, stethoscopes, microscopes, nebulizers, X-rays, and medicines, enabling doctors to identify and fight the cannibal shawara demons.3 Acquisition of knowledge and status: Shamanic learning through continuous apprenticeship with elder shapori is comparable to medical students learning from more knowledgeable graduate doctors either in hospitals or in the Upper Orinoco. The status accredited to different shapori—false, apprentice, real—is extended to medical students and sometimes Yanomami nurses when compared to graduate doctors.

Extending Multinatural and Multicultural Conventions One could dismiss these analogies as Yanomami efforts to render complex notions amenable to my understanding, a common tendency in relations with criollos. Most of these conversations, however, were held well into fieldwork when people understood I was not necessarily seeking criolloamenable explanations. In that light, then, let us connect this discussion with that of the last two chapters, reprising Wagner’s (1981) ideas and recalling the innate character of conventions among the Yanomami, that is, the innateness of culture. Viveiros de Castro’s (1998) perspectivism suggests Amerindians’ culture is the shared condition for personhood. In its innateness, it is equivalent to Western concepts of nature. Perspectivism tells us that many animals and beings credited with souls in Amerindian cosmologies see themselves as humans (Indians) with kinship, houses, and ceremonies, as to be expected if culture were shared. Animals with souls are typically ex-humans who, in mythical times, were transformed into their current state, souls signifying their contemporary non-evident human status. Members of different species do not see each other as persons because of their different bodies that endow them with a distinct perspective on the world. By virtue of a different body/habitus, a jaguar, for example, may see an Indian as prey (e.g., peccary), as Indians see peccaries—themselves

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seeing each other as Indians—as prey. A mono-culture, then, engenders a multi-nature, an inversion of the Western multicultural thesis that stipulates the existence of one nature and many cultures, that is, many ways of seeing the one world there is. My argument, admittedly speculative in this regard, is that Yanomami interpret doctors by extending a multi-natural, mono-cultural convention. Criollos are ex-Yanomami for they too are products of mythical transformations. As such, criollos partake of Yanomami culture, meaning they must have shapori in the same way many Yanomami assume criollos have food gardens in their settlements. Doctors are simply the form shapori take if you are criollo. Of course, criollos do not know about the hekura, their knowledge is criollo knowledge, epitomized in reading and writing, and the creativity needed to make technological objects. But the difference between Indians and soul-bearing animals is equivalent to that between doctors and shapori: a jaguar’s Indian is a peccary as a doctors’ hekura are books/tools/medicine. By extending the unity of culture, doctors are analogous to shapori in their curing—as opposed to their political—role. Every extension of convention is innovative. Hence, doctors and shapori transfer to each other some of their characteristics. In this way, people can speak of shapori’s hekura and their tools as criollo aparatos, and they can describe doctors accessing manuals as sources of knowledge in the same way shapori receive their faculties from the hekura. Note the key placement of books and reading, an emphasis consistent with the more general set of notions considered in chapter 4 situating formal education and knowledge at the center of the historical becoming napë. If doctors are napë shapori, then Yanomami are not excluded from biomedical practice and knowledge, Yanomami nurses being a testament to that. But to be a nurse, you must first have studied in school and completed a special course; you must become napë, and in this sense, only “civilized” dual Yanomami/napë become nurses. In chapter 6 I discussed how doctors could achieve a better rapport with patients by performing Yanomami. This was a matter of collapsing two forms of alterity, napë and ghost, at a Yanomami/human/moral meeting point. Here, I stressed the importance of doctors retaining a criollo identity, for their effectiveness is grounded in criollo knowledge, a command of which they must display to deal with shawara. Doctors must then sustain a duality of sorts, being morally Yanomami and obviating the immorality of being napë (bad communication and stinginess), yet stress napë knowledge (reading/writing and using aparatos) to kill their “own

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kind.” Doctors cannot perform shapori in terms of knowledge. Doctors are already napë shapori when they perform as doctors, and this is precisely and wholly their value. I suspect this argumentation may shed light on why some efforts to promote the institutional mixing of shamanic and biomedical practices tend to fail or be flatly rejected (Lobo-Guerrero, 1991:276; Gallois, 1991:203; Jackson, 1995b). These mixtures can run counter to the indigenous appreciation of Western institutions and practices as ways to become napë. If Western institutions “go native,” much of their value as differentiating options, as means to progress, and as political capital is lost. Regarding doctors and shapori, Westerners tend to extend their multicultural convention. Beyond the simple equivalence of both doctors and shapori as healers, we tend to see shapori as doing something different, working on the psychological or the symbolic plane, depending on our interests and inclinations. Physicians work on bodies, and their evocations of the power of the mind may ultimately find an explanation in psychoneuro-immunology, occasionally discussed by doctors in Ocamo. The extended convention here is that of a unique biology, a singular nature shared by all people, criollos and Indians alike. This premise assures them the efficacy of their medical science and allows them to respect the shapori culturally without crediting them with their own degree of curing efficacy.

Napërami and the Extension of the Invisible World Alongside the transference of qualities between doctors and shapori, the latter have symbolically incorporated criollos, expanding the invisible world they draw upon. Today criollo vital images of things coming from the criollo world (no uhutipi) and criollo hekura proliferate in shapori repertoires. Criollo items can be employed in both curing and attacking. A shotgun can be used to kill shawara or injure the vital aspects of enemies. Criollo transport such as boats and planes can be used to escape once an attack has been perpetrated. A shapori traveling to the burning first level of the cosmos may protect himself with ice. All these criollo items seem to be treated as normal hekura tools. And together with criollo items come criollo hekura. I learned of the napërami (hekura of criollos) through Yanomami friends who had seen them in shamanic sessions.4 Napërami attributes include their use of Spanish language and criollo objects. In some accounts they have mirrors, enabling shawara to be seen at a distance or enlarged in microscope-like fashion, facilitating its identification. In other accounts,

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the napërami are doctors who give medicine to the shawara, killing it or preventing it from reaching the community. The following is an account of a session in the Upper Ocamo: : Okay, the little napë shapori has to talk to him, with the shawara: “Look, why do you have to be here? You have to be over there where / in the places of manufacture [Sp. donde fabrican], so now I am going to inject you, and you will leave.” This is what the shapori says. JA: I am going to inject you?! : Yes! I have heard it in Pashopeka . . . They [Pashopeka theri] heard that around here [Ocamo] there was shawara, a great shawara . . . [In Pashopeka a yopo session begins and howler monkey-spirit comes followed by jaguar-spirit] . . . Then the rest [public], those who had heard that there was shawara around here, told the shapori: “Hey, shapori, they say there is a great shawara over there. Do us a favor. Over there give them medicine so that they don’t come over here.” . . . Then the shapori said, “Okay, so let’s prepare.” And then he began to speak Spanish, “ña ña ña ña ña,” . . . Then the shapori sent him [napë hekura] over here: “Okay, go with the airplane, get in, and go there.” And then the plane took off, fiuu! Heeeee. Then the shapori says, “Okay, all the doctors have gone.” And then they arrived where the shawara was, and then the shapori would take a small spoon, then he would prepare. He wasn’t preparing medicine but rather he was doing [gesturing as a person giving spoonfuls to another]. “This is for malaria,” he would say. “This is for cough. This is for injecting.” How many doctor shapori came! . . . [Shapori speaking again:] “Well, now no shawara will be here.” Now with the wings of the night owl . . . he is going to put himself like this [wings spread open but rising from the ground upwards] so the shawara hits against it, so it cannot pass over it, and now we will be fine. When the shawara comes, it will be short, only three or four days and then it will pass . . . [Later in the conversation, I ask how the shapori sees the shawara:] . . . They have like a microscope . . . For example, it is as if it were a microscope but large [illustrating with his arms by making a wide circle]. Then when they put the shawara there, they can see [the type of shawara].

In Ocamo I heard of the use of mirrors with similar functions. One informant noted how this type of knowledge is acquired through the teachings of criollo hekura: “For example, there is a shawara you cannot see.

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You can see like dust but can’t discern well. Then the shapori uses a mirror so that it can be seen larger. That’s what they say . . . [I ask if it was like this a long time ago:] Yes, it was like this before, you know why? Because of the teachings of the napë spirits. Don’t you see how the missionaries taught me how to write? In this way the spirits [of the shapori] also learned. Napë spirit and Yanomami spirit.” This man is referring to his uncles and grandfather, shapori too old to have attended even the first of the missionaries’ schools. They seem, nonetheless, to have benefitted in some measure from a similar educational process, learning from criollo spirits and acquiring the vital images of criollo technology. The final aspect in the extension of shapori practices is the inclusion of the clinic and hospital as sites of action. In Ocamo shapori often worked in the clinic, although this was clearly not their preferred environment. Shapori from nearby or upriver communities could also send their hekura to the Ocamo clinic or the hospital in Puerto Ayacucho, accompanying a patient who had requested this kind of aid. Alongside the doctor, then, the patient was confident that the shapori was practicing “long-distance” shamanism on them. Doctors are completely unaware of this spiritual assistance. This special service, in addition to providing the patient with reassurance, also eased anxieties back home, where the shapori’s reports on the patient’s state updated relatives. In summary, shapori, while epitomizing traditional knowledge, become napë in their own way. In their use of manufactured objects’ vital images, their occupation of criollo spaces, and their becoming napë hekura, they tap into the resources of an expanded world. In previous chapters I discussed the shapori’s dual function, healing and foreign politics, as being disaggregated in the persons of criollo doctors/Yanomami nurses and civilized interface Yanomami. Here we see shapori doing with the invisible parts of the criollo world what interface Yanomami do with the visible ones: putting them to the service of the community in both curing and foreign affairs. The healing-foreign politics divide is crosscut by the visibleinvisible divide.

Medicine as Hëri and Wayu Substance The different roles of cure or care ascribed to doctors depending on the patient’s category of disease—shawara or “the rest”—reflects the way people speak of medicines and medical products such as IVs. Sometimes expressions such as rohothomai, “to make strong”; payerimai, “to help”; nini mrai,

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“to eliminate pain”; iye iyë pë mrai mãõpë, “to avoid the depletion of blood” are used. Still, if an intrusive immaterial entity is not retrieved, an ill person will recover only slightly with medicine, and if a person’s vital aspect is not recovered, the person will die. In the case of hëri sorcery, medicines have only a temporary effect, and so on. With reference to shawara, however, medicine is also spoken in terms of shei or sheprai, “to kill,” or hoyai, “to throw away.” That is to say that it kills or eliminates shawara. Yanomami apparently assign medicines a type of efficacy according to disease etiology rather than the specific functions that doctors ascribe in their therapies (e.g., a pain killer reduces symptoms; antibiotics eliminate causes of disease). As noted above, medicines are associated with the hëri substances that Yanomami use as domestic medicine, sorcery, and some types of beneficial magic. Several aspects of medicines favor this association. First, some of their most common forms of application—swallowing or drinking, and rubbing on the body—are common modes of hëri use. Second, owing to their abilities to kill shawara and their sometimes strong side effects, medicines are acknowledged as wayu substances. “Wayu” designates any substance with powerful effects on the body like curare, hëri, yopo, or tobacco. It also means “pathogenic substance/power” causing illness or death (Lizot, 2004:477–78). Third, when asked about Yanomami medicine, Ocamo people spoke of hëri as medicines that are urihi hami, “in the forest,” naming a number of vegetable hëri and their applications in treating different afflictions (e.g., malaria, diarrhea, and respiratory difficulties). Thus if doctors are napë shapori, then their medicines are napë hëri. In chapter 6 we discussed relations between doctors and Yanomami, emphasizing the napë potential affine status of doctors and its relevance in both medical and non-medical contexts. Here, I have complemented that analysis with the conceptual and practical aspects of the articulation of medical systems, remaining this time strictly within the realm of the medical. I have suggested that doctors/biomedicine have the role of reducing people’s suffering (care) by reducing symptoms for all diseases except shawara, in which case they are ascribed a curing role equivalent to that of shapori. In most instances, however, doctors invert this distribution of roles. The shawara-curing efficacy of doctors is consistent with the same ontological premises as shamanism—being of a kind with the aggressors— and uses equivalent techniques—accessing the “inside” of people and the causal plane of disease. Extending the multinatural/monocultural convention, doctors are spoken of as shapori, but they are napë shapori, who draw on criollo knowledge and whose curing efficacy is limited to criollo

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diseases (shawara). This reiterates a conclusion reached in the previous chapter: doctors’ performances must be morally Yanomami but napë in terms of medical knowledge. Yanomami conventional extensions imply that doctors are “shaporified” while shapori are “napë-fied.” This transference of attributes is equivalent and, in fact, a part of the wider innovation of the Yanomami conventional space yielding the napë transformational context. The analogy between books and hekura as sources of medical knowledge/abilities is fully consistent with the argument that reading/writing is analogous to shapori’s sight and that the criollo world enters Yanomami cosmology as a form of alterity equivalent in several ways to the invisible spirit world. We have also complemented the accommodation of traditional roles among new actors. The transformative substitutes of the shapori’s political role are interface Yanomami; their curing role is found in the criollo doctor and the civilized Yanomami nurse. Cutting across all this, shapori retain both roles, doing with the invisible side of an expanded world what both doctors and interface Yanomami do with the visible. In chapter 5 I discussed how Yanomami place doctors in the position of potential affines and how the health system’s immersion in becoming napë was constantly negotiated by doctors who, guided primarily by medical and institutional criteria, are disentangled from kinship and intercommunity politics. Discussing the conceptual articulation of biomedicine and shamanism, we find a kind of mutual misunderstanding, an unrecognized one that does away with the need for negotiation. The two medical systems coexist without problems even though their articulation produces different pictures from each perspective: Complementarity is inversely ascribed by doctors and Yanomami. Mediating Yanomami distribute medical information according to each healer’s knowledge and world. Shapori and doctors infrequently communicate and do not share mutual evaluations. Conceptions of diagnosis and treatment are often not shared by patients and doctors. Yanomami extend a meta-convention of cultural continuity with natural discontinuity while doctors do the inverse with their multiculturalist extension. Doctors see shawara as naturally occurring infectocontagious diseases. Yanomami see epidemic diseases as shawara, social relations with cannibal demons. Most doctors and Yanomami are unaware of all these translations. Amid these profoundly distinct realities, shawara—an ontologically criollo aggressor whose form of action, predation of soul-aspects/blood, is wholly Yanomami—is a true pivot between worlds, falling within the competence of both shapori and doctor. The affinity between the tiny shawara

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cannibal demons and bacteria/parasites/viruses facilitates the convergence between the actions of doctor and shapori. In the wider context, shawara is the trade-off for becoming napë, working as a political hinge between Yanomami and criollos, defining the latter as both enemies and sources of solutions. I want to stress the way in which the conceptual articulation of medical systems reflects the same character of the wider Yanomami-criollo relationship: the transference of attributes between Yanomami conventional and napë transformational (innovational) contexts; the extension of inverse conventions producing parallel projects and realities; mutual misunderstanding hinging on selective affinities. We are again faced with a “working misunderstanding,” one that sustains the articulation of medical systems. It is narrower in scope yet, in its concentration on the body and its productivity for making kin, fully consistent with the congruence between becoming napë and making criollos—the overlapping aspects of Yanomami and criollo civilizing. The following chapter addresses direct relations between the state and the Yanomami by looking at a series of meetings held from 2001 to 2004. The ethnographic passage from interpersonal and quotidian to collective and political relations is nonetheless analytically continuous with the arguments I have advanced so far.

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Two Meetings and a Protest

In this chapter I take a step back, zoom out, so to speak, in order to analyze direct encounters between Yanomami and state representatives. I concentrate on occasions where health issues were prominent: a protest in La Esmeralda held in 2001; the first and only “Yanomami conference,” held in the Mavaca cluster also in 2001; and a meeting with national health authorities that also took place in La Esmeralda in 2004. These events move us from the everyday relations between doctors and Yanomami into the explicitly political realm, an analytical passage from interpersonal to collective Yanomami-criollo relations. Each event has been selected for a combination of historical and analytically relevant reasons. In this discussion, I nonetheless, return to issues we have encountered in previous chapters—Yanomami differentiating performances, napë potential affinity, mutual misunderstandings—to illuminate the continuities with the quotidian as well as the complementary relation of events along the river network between upriver Yanomami communities and downriver centers of political activity. These ethnographic examples will also serve to critique some of the current anthropological analysis of interethnic or identity politics. The final section hopes to demonstrate the relevance of our discussion thus far in the production of health policies for Amerindians.

A Yanomami Protest, La Esmeralda, 2001 In April 2001 a group of Yanomami protested on the occasion of the second presidential visit to La Esmeralda. Together with a number of boats 164

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and motors, six “fluvial ambulances” in La Esmeralda were waiting to be donated by the National Guard’s social program, Plan Casiquiare 2000. The ambulances and boats were a response to petitions Yanomami had made to President Chávez during his first visit the year before. Official deliveries were part of his visit’s agenda. Each ambulance was identified with a specific community’s name inscribed along its side: three of these read Ocamo, Mavaca, and Platanal. For some time, local health authorities had complained to the National Guard about the technical inadequacies of the ambulances—inappropriate for river travel, medically unequipped, motors too large for the shallow waters of the dry season, high fuel consumption, etc. Nevertheless, the ambulances were dispatched to La Esmeralda for distribution. The day before the event and after crowds of Yanomami had noticed them, however, the boats, acknowledged to be inappropriate, were reassigned and renamed for other towns in Amazonas. This sudden change, which occurred without consulting the Yanomami, instigated their subsequent protest. Let me summarize the events that followed. The day before the president’s arrival, some Yanomami leaders persuaded a large number of Yanomami to prepare a document for the president voicing their disapproval of the ambulance incident. Most Yanomami were in a provisional camp, lodging together under a single large roof. The next day, they remained in this area while the rest of La Esmeralda residents gathered in a crowd at the end of the airstrip about half a mile away, where the official reception activities and the president’s weekly radio program were held. The Yanomami deliberately remained at a distance to highlight their distinctness. In their shelter, they prepared to make an impact, gathering arrows and improvised clubs, and painting themselves black with charcoal. A handful in a coordinating role remained in criollo clothing, but most emulated warriors. Allowing the warriors to maintain their status as a visibly distinct group, other Yanomami joined the crowd fully dressed. They paraded down the road leading to the stage where Chávez was addressing the crowd. Not far from there, military personnel intercepted the chanting crowd of blackstriped, arrow-wielding Yanomami. As more military personnel, a few journalists, and others arrived at the scene, the protest quieted down and negotiations began. The head of district, attempting to explain the reasons for changing the boats’ names, was vigorously dismissed by the Yanomami: “Don’t let him speak!” “Get him out of here!” Next, senior military officers of Plan Casiquiare and the Presidential Guard (Sp. Casa Militar) attempted to spell out the problems, adding that they would buy them more adequate boats. One Yanomami

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leader responded: “We requested [the ambulances]. We suffer here for our people . . . We cannot accept more deceit . . . Now the Yanomami region is in need. First you have to be concerned.” “Now I will explain why [we made this decision],” intervened one military official, repeating the arguments. Then another Yanomami leader explained: “The headwaters of the Orinoco don’t have rapids as they do downriver . . . Gentlemen stop this! We work. We have died here to deliver our needs [a reference to the ambulances they had requested]. We have killed ourselves.” Realizing that appeasement efforts were failing, a military officer radioed for help. An elder from Ocamo stepped forward waving an axe and let the military men know in loud assertive Yanomami that he was a true leader. His words were then translated: “He says, ‘I am the one suffering [inaudible] and requesting the ambulances and the boats for where the health problem is greater.’ ” Finally an official voice clearly declared: “You want the ambulances? . . . Well, okay, I am going to give them to you . . . but remember, you will be responsible for the maintenance and operation, okay?” The excited crowd cheered triumphantly. Then yet another Yanomami leader read the formal document drafted earlier: “We are doubtful about what the representatives of the Plan Casiquiare 2000 did, without consulting the Yanomami . . . When the aid comes, they are changing things. This is why we the Yanomami are feeling sad about our ambulances!”1 Near the end of the demonstration, an Acción Democrática representative read another letter directed to the president but unrelated to the ambulances: “We want the military to respect our people because we understand that Plan Casiquiare 2000 offends us. We won’t allow that because we are a sovereign people as it is stated in article 110 of the new constitution. They don’t give us the treatment we deserve . . . We don’t want these people [a list of names: two ORPIA representatives, the head of district, the Salesian mission coordinator in La Esmeralda, a Plan Casiquiare coordinator] who don’t know what we want and what we need. We want you to solve this problem for us.” Closing the protest, leaders requested that officials sign their statements and provide copies for the president. The episode lasted some twenty minutes. I now consider how this event relates to our ongoing discussions. The Yanomami had a claim on the ambulances, recognizing them as the result of their original petitions and having seen their communities’ names on them. The decision to change the beneficiaries of the ambulances without consultation was perceived as high-handed, an aggression requiring a response. The incident confirmed the deceitful nature of criollos, who were trying to deprive the Yanomami of something that was legitimately

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theirs. Leaders seized the opportunity to reclaim the ambulances, giving the event its performative character, a test of the ability to overpower criollo resistance to a Yanomami claim or desire. In its motivation, then, this event was a collective instance of a common form of Yanomami-criollo relations. But there is more of significance evident in these divergent contexts. Not mixing with the rest of the La Esmeralda residents and adopting a distinctive warrior appearance was a deliberate differentiation to increase the effectiveness of a Yanomami performance. Claims such as “We are suffering,” “We are dying,” “We are in need” is consistent with Yanomami ethics of not letting people suffer—hence the reiteration of “You must concern yourself ”—but it also resonates with criollo images of Indians as poor, needy, and helpless, stereotypes of which interface Yanomami are aware. The warrior attire and “speaking without fear” sought to instill fear (Y. kirimai). All these features stress Yanomami-ness at the expense of napë-ness, pressing criollos to respond by instilling a combination of fear—via a warrior appearance and “speaking without fear”—and compassion—via the content of their discourse. Notably, even when some Yanomami realized the inadequacy of the ambulances, it was still an offense to proceed in this way. For the Yanomami, the only acceptable redress was for them to get their ambulances anyway. This is not the only occasion in which criollo decisions are interpreted with what criollos consider misplaced intentionality but what Yanomami see as part of the ongoing dynamic of political alliance and harm. Expecting a “logical” exchange, criollos encountered intransigence and so complained that Yanomami “don’t understand the ambulances are no good.” The whole demonstration was a reverse assertion: “The napë do not understand that they cannot decide the future of our ambulances.” In the context of napëprou, this Yanomami performance is the inverse complement of civilized Yanomami napë performances seen in upriver medical visits that I discussed in chapter 6. The protest spokesmen mediated between a group of Yanomami who have intentionally obviated their napë bodies and a group of innate napë yai, criollo military officers. Internal differences between civilized and waikasi Yanomami, as well as political ones, are obviated to maximally differentiate from the napë. Spokesmen stress their Yanomami-ness in their discourse but need to retain criollo attributes (use of Spanish, written documents, and attire) to mediate as they translate the Yanomami perspective to criollo officials. Such a display also demonstrates for fellow Yanomami their ability to negotiate with criollos. Spokesmen establish a moral continuity with the Yanomami present through their discursive Yanomami performance but differentiate

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themselves from the crowd in displaying napë body/knowledge. This distribution echoes my discussion in chapters 6 and 7 of doctors needing to be morally Yanomami while retaining their napë knowledge, and Ocamo Yanomami in upriver communities similarly adopting napë attitudes and bodies but retaining a moral continuity with waikasi and mediating on their behalf with the doctors. Depending on circumstances, civilized Yanomami will perform napë for upriver waikasi and perform Yanomami for napë yai such as military officers and doctors. Each type of relation sustains one side of the dual Yanomami/napë being of “civilized” Yanomami. Criollos, like state officials, innately perform napë by either providing objects/solutions (potential affine as ally) or resisting to do so (potential affine as enemy). That the emphasis on concern figures as prominently in events like this protest as it does in everyday relations with doctors is symptomatic of the underlying general need to compel criollos into moral action. As modes of action, diverse activities—extracting objects from reluctant doctors, patient negotiations, Ocamo health meetings, and the La Esmeralda protest—vary only as a matter of scale; all these situations define opposed Yanomami and napë positions. These are also episodes that temporarily crystallize the Yanomami as a group, a people who have done away with their internal differences when faced with the very epitome of difference in the form of their napë interlocutors. Having outlined important similarities between the extraordinary and collective and the individual and quotidian in Ocamo and upriver, let us now look at criollos’ interpretations of these events.

Criollos’ Interpretations The La Esmeralda protest exhibited elements of a political arena that combines Yanomami and institutional politics less relevant, if at all, in interpersonal doctor-Yanomami relations. This political component emerged at the end of the episode with the Acción Democrática representative’s document that singled out all the local and regional rivals of the incumbent mayor (ORPIA, Salesians, the health system, and Plan Casiquiare). Here, we see a political party representative skillfully promoting two interests and disguising an institutional rivalry with the legitimacy of the Yanomami protest. Asked about what happened, the then-head of Plan Casiquiare explained that this was a stratagem of the Acción Democrática mayor, whose representatives were manipulating the Yanomami like children, emulating what Acción Democrática has traditionally done elsewhere in Venezuela. In this

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officer’s opinion, it was lamentable that some Yanomami leaders were part of this political “old guard.” In this highly politicized environment, local criollos projected the agenda of the Acción Democrática representative on all the Yanomami in the protest, homogenizing Yanomami motivations, even though this representative’s intervention seems to have been riding the wave others had created. Particularly for the National Guard officers, the presence of Acción Democrática representatives reduced the legitimacy of the claim as a ploy to create unrest on behalf of the mayor. The officer’s statement puts some Yanomami, certain political leaders, on a par with criollos in their mastery of the political game. The rest are infantilized and cast as victims of their own leaders. There is little space here for cultural difference: this is pure politics, just like anywhere else. In the eyes of those who either lived in, or knew, La Esmeralda well, the devices of Yanomami leaders were all but ineffectual. Mediators were viewed indignantly as manipulators, warriors as manipulated children. The whole performance took on a false character of theatricality. This was not, however, the interpretation of those unacquainted with the local scene—the Presidential Guard, higher-rank officers, and journalists—who were, in contrast, intimidated by the situation’s uncertainty and, hoping to avert any potential commotion with the president, conceded to the protestors’ demands. And since these senior officials ultimately called the shots, the performance was in that sense effective.

A Critique of Identity Politics The stage afforded by the La Esmeralda protest allows for some reflection on the nature of indigenous performances, particularly when put into conversation with other accounts in the field of identity politics. Let me pause in the first instance on what the commentary of criollos in La Esmeralda says about Yanomami political agency. Several authors have noted that Westerners are less accepting of Indian displays of astute manipulation of the political game for it goes against their purportedly natural purity of character (cf. Conklin, 1997:725; Graham, 2002:187). Yet beyond this observation, which this episode fully corroborates, I want to call attention to the trouble criollos experience when dealing with Yanomami hybridity. Criollos’ assessments of the protest transform the Yanomami obviation of elements of their dual being into false theatricality. And this is not the first time we have seen problems arise in criollo interpretation of indigenous actions and choices. In chapter 2 I discussed the image of the naturalized Indian whose change is construed as a degradation, a loss of culture rather

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than a progression-transformation closer to the Yanomami people’s own evaluation. In chapter 7 we saw criollo resistance to Yanomami believing in both shamanism and biomedicine. All these Yanomami dualities run counter to a criollo emphasis on essence: one either is or is not; to be both is inauthentic or irresponsible or simply bewildering. I want to suggest and will attempt to demonstrate that this emphasis is closely tied to a Euro-American cultural bias that places much importance on identity and continuity (cf. Taylor, 1994; Conklin, 1997). I now turn to focus more closely on the issue of political self-representation and its adaptation to Western ideas and notions about Indians that several authors have discussed (Turner, 1991; Conklin, 1997; Graham, 2002; Albert, 2000; Ramos, 1998; Jackson, 1991; 1995; Vilaça, 1999). I address two complementary articles. Conklin (1997) examines the incorporation of Western notions of Amerindians into visual self-representations of indigenous activists, particularly in the context of international environmentalism. She notes the historical change in the use of Western clothing and traditional adornments and paint. Previously, Indians used Western clothing to hide their ethnicity in view of the whites’ derision of naked bodies, paint, and feathers. Commenting on their new audience in, among others, the Western environmentalist movement and their new sense of indigenous pride, she observes: “It is equally clear that this shift responds not only to indigenous values and internal societal dynamics, but also to foreign ideas, aesthetics, and expectations about Indians. As some native South Americans have learned to speak the language of Western environmentalism . . . so some have also learned to use Western visual codes to position themselves politically” (1997:712). However, she cautions against the perils of such a strategy with the potential to morally and politically displace those seen to be inauthentic Indians. Graham (2002) discusses the verbal performances of indigenous leaders for Western or mixed (Western-Indian) audiences. She defines a typology of linguistic interactions available to indigenous spokespersons who must balance symbolic effectiveness—related to the Western appreciation for indigenous languages and themes (e.g., myth) as indexes of authenticity— with straightforward communication of content. As an example of maximum symbolic gain, she summarizes some of the performances that took place in the now famous 1989 Altamira demonstrations in Brazil. Threatened by the imminent construction of a number hydroelectric dams, the Kayapó with hundreds of other Indians orchestrated a protest encounter with government officials. A considerable number of journalists also attended the event that, as Turner (1991:307) describes, was very

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much planned with Western audiences and video self-representation in mind. The audience appreciated the use of native language even when the content of many speeches remained incomprehensible. “One of the most stunning displays . . . was staged by a Kayapó woman, Tuire, who approached the podium brandishing a machete. Gracefully and deliberately she symbolically swiped it against the cheeks of the director of the regional power company as she orated in Kayapó. Her gestures and speech were so symbolically powerful that no translation was necessary. None was offered and the audience roared with applause in support of her performance” (Graham, 2002:207–8). What do the Esmeralda protest and its similarities with everyday relations with criollos illuminate when compared with the Altamira demonstration and Conklin’s and Graham’s analyses? What I want to tease out is how an emphasis on self-representation and identity overlooks a number of issues that invite us to rethink indigenous performances, at least in the cases here described. My analysis thus far reveals that these performances occur in upriver contexts to a certain effect and downriver to another. Going beyond the white-Indian interface and analyzing a whole network, we realize these performances complement each other and jointly constitute the civilized condition of Orinoco Yanomami. Such a condition requires constant differentiation from “real Yanomami” and “real napë” for its definition and sustenance in conceptual and practical terms. Moreover, these performances are essentially about “putting people on their moral mettle” (in Wagner’s words), actualizing a relationship. With criollos, a napë potential affine relation is encouraged, but among Yanomami themselves, the same device is used in other contexts. Besides the choreographic effect, waving axes or machetes and speaking in native language are appropriate ways of addressing criollos as enemies, inciting fear to prompt a reaction. Was Tuire staging her performance or reacting as she would in the face of those considered enemies, assured that officials would not retaliate? Graham analyzes language choice in indigenous leaders’ performances in terms of the strategic balancing of symbolic capital and communication. In the course of this book, I have emphasized the place of language as a Yanomami index of humanity/morality. The Ocamo elder addresses the officials in Yanomami, not in search of criollo approval, but because he is angry and expressing himself in a human/moral/ Yanomami way, differentiating himself from criollos. Wagner observes: “As a matter of moral principle, the giving of gifts is not ‘economic,’ and the elicitation of kin relationships is not ‘kinship’” (1981:92, his emphasis). Similarly, a language choice is neither “linguistic” nor “strategic.” Offering an alternative

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to the more common interpretation of these performances, I want to suggest that the differentiation implicated in a Yanomami performance is less about self-representation than self-knowledge, a mode of action and a test intended to elicit a response: “We are real Yanomami. Are you real napë?” Differentiating has the effect of distancing parties in a relationship by saying, “We are enemies,” just as when I respond in Yanomami to a child calling me “Doctor,” I am (inadvertently) saying, “We are similar.” It is misleading to see differentiating devices as representations; they are “becomings” pivoting between the Yanomami conventional and the napë transformational contexts. The Esmeralda protest is a performance that must succeed for a mixed audience. This means that mediators are constrained by the perspectives of both criollos and Yanomami: translation and display of leadership qualities. We cannot, then, limit the analysis to Western aesthetics but must include indigenous views too. The interplay between moral collectivization (Yanomami) and body/knowledge differentiation (napë) is just as present here as in a number of contexts along the river network. Yet, with mixed Yanomami and criollo actors and audiences, these events are also prone to mutual misunderstandings and cross-cultural affinities of the type I have argued are characteristic of Indian-white engagements. Whereas Conklin calls attention to the incorporation of and conformity to Western body aesthetics in Amerindian’s political displays, Vilaça (1999) suggests that the body’s relevance in this identity politics stems partly from its role in the socio-politics of identity and alterity in a perspectivist ontology. In Amerindian socio-cosmologies, personhood is ascribed to humans and non-humans, and the body, understood as a habitus, encodes difference and relation between agented entities. To what extent body aesthetics are responding to indigenous or Western cosmologies and ideologies would be hard to discern, precisely because of the homonymic relation between Western and Amerindian notions of the body. It is this homonymy that allows the convergence between becoming napë as a body/habitus transformation, fully grounded in Yanomami sociality, and making criollos, the inculcation of criollo body practices, fully grounded in Western and Christian criteria of decency and society. Similarly, criollos’ notions of Indians as needy or helpless are undoubtedly incorporated into Yanomami performances, but would this be the case if they did not strike an affinity with the indigenous ethics of ameliorating suffering? Moreover, as the pairing of Conklin and Vilaça’s analyses on the body illustrates, homonymy can either encumber or facilitate not only Indians’ and whites’ interpretations of each other’s actions and projects but also their anthropological analysis.

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Let me consider another ethnographic scenario to illustrate this point. The Warao in La Tortuga Island in the Orinoco Delta—from whom Briggs gathered narratives of the 1992 cholera epidemic that decimated hundreds—contrast their way of life with that of the Warao of Mariusa, whom they consider less civilized, making reference to their geographical remoteness and their practice of continuing to eat from the forest and avoiding certain Western foodstuffs, significantly beef (2003:188–90). For Briggs’s interlocutors on Tortuga Island, Mariusans are true contemporary ancestors. When Tortugans speak of them, they emphasize spatial and temporal separation, not continuity, even though Tortugans frequently visit the Mariusan space on the coast to hunt, collect palms, harvest crabs, that is, to do just what the Mariusans do. Mariusans also stop by La Tortuga when they travel to the mainland. Similar to the Orinoco Yanomami and the Wari’ of Brazil (Vilaça, 2002), Tortugans focus on a change of habitus—what they eat and where they live—to indicate a state of civilization or of transformation into something closer to criollos than “pure” Indians. And, like the Piro in Peru (Gow, 1993), their participation in a regional economic network constitutes a part of what distinguishes them from their “less developed” compatriots. A napë transformational axis with spatio-temporal references like the one I have described could be in operation here. Tortugans’ contextual separation from other less civilized Warao could well be seen as the obviation of Indian-ness in favor of criollo-ness. Briggs notes that his interlocutor’s references to going to the coast “did not have any bearing on his identity.” Given what we know of other cases, it would not be surprising for Tortugans in different contexts to obviate their criollo-ness and emphasize their Indian roots and way of life, their Indian identity. Yet Briggs accounts for Tortugans’ perspective on Mariusans differently: The sense that Mariusa is remote and not part of the modern world was produced both by racialization, which painted it as the quintessence of the indígena world, and capitalization, which located Tortuga as part of the market economy and Mariusa as lying off that map . . . The creation of spatio-temporal distance through schemes of racialization and capitalization is the core of colonialism . . . As they imagined themselves in terms of this linear process that led from a pre-modern, indígena time-space to a modern, criollo one, the Tortugans internalized the very practices that racialize and subordinate them. And they helped racialize cholera as a disease that springs from the indígena heartland. (Briggs, 2003:190)

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My analysis of Yanomami dual and performative being, the dynamics of differentiation involved in becoming napë, and the dialectic between the conventional and napë transformational contexts would tip the explanatory balance toward indigenous sociality and its ontological basis. Again, a certain homonymy between the ways criollos and Indians speak of history and social geography allows us to explain similar events pointing to Indian or Western references. My reading suggests, in any case, that an alternative interpretation is plausible, one that does not assume that when criollos and Indians say similar things about, for example, being “civilized,” they mean the same things and for the same reasons, such as their having incorporated ideologies of race and capital. Given this homonymic situation, I would, nonetheless, concur with Briggs that Tortugans’ narratives in the ears of local criollos helps “racialize cholera as a disease that springs from the indígena heartland.” I would suggest, however, that Briggs’s interpretation of Tortugans as bearers of a discourse of race and capital may be based on a similar misrecognition of homonymy. I reprise this all-important point about homonymy and its misrecognition in the third section of this chapter. The second part of this chapter is devoted to the analysis of the Shakitha (a community of the Mavaca conglomerate) Yanomami conference held in 2001. I have chosen to describe it at length because its attendance, its duration, and its location in Yanomami territory made it a historical event for the Venezuelan Yanomami. The gradient of exchange with criollos and their institutions is evident in the experiences and problems expounded by different Yanomami spokespersons and in the terms in which specific demands were couched. The Mavaca Yanomami conference also portrayed a clear picture of what napëprou means for the Orinoco Yanomami, the way in which the health system is related to this historical trajectory, and the dynamics of opposition and alliance with napë potential affines.

The Mavaca Yanomami Conference, Shakitha 2001 Following the publication of Tierney’s (2000) Darkness in El Dorado, a special governmental commission was set up to investigate the allegations of biomedical, anthropological, and political wrongdoing toward the Yanomami. This commission grew concerned with not only the veracity of the account of past events but also the current “Yanomami situation.” It was decided during a visit of commission representatives to the Upper

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Orinoco that there would be a conference of historical dimensions in Shakitha, with the greatest Yanomami representation possible and criollo representatives from all institutions with a bearing on the Upper Orinoco’s future. The objective was to bring these parties together so Yanomami could explain their demands directly to officials with the authority to commit their institutions then and there. The meeting was held from November 19 to 22, 2001. During the first two days, the Yanomami discussed several themes of the conference that had been defined previously during preparatory workshops. The main areas of concern were education, health, environment, and political participation. The subject of the environment involved the more precise themes of land demarcation, research permit regulation, and economic self-management. Similarly, the topic of political participation subsumed discussions of indigenous organization (SUYAO), Yanomami municipality, and Parish Councils (Sp. Juntas Parroquiales), reflecting concerns with the role and interrelation of indigenous and party politics, and the possibilities of creating either a special Yanomami-only municipality or maintaining the existing multiethnic municipality. The second two days involved formal presentations from the criollo representatives who had arrived, summaries of the main conclusions reached on each theme to the now mixed Yanomami and criollo audience, breaking up into theme-specific discussion groups, and, finally, drafting and signing “commitment” documents. There were about 40 invited criollo representatives, while the Yanomami participating in the plenary of the conference and from one day to the next varied from 60 to more than 200. On the official list were 52 communities represented by 142 delegates, although some 500 people must have been at the event in Shakitha if we consider delegates’ companions and Shakitha residents. The location of the conference on Yanomami land, the preparation of the agenda, and the two “Yanomamionly” discussion days were all choices to tip the balance of power toward the Yanomami: criollos here would dance to a Yanomami tune. Taken as a whole, the conference allows for some internal distinctions. In contrast with upriver communities, Orinoco Yanomami have long-term experience of missionary education, the health system, and party politics. On health matters, these speakers referred to specific problems and people within the health system in ways that upriver Yanomami did not. In the plenary, speeches by upriver representatives were comparatively few in number and shorter in length. Their themes included references to their community’s location, the presence of shawara in their area, particular accounts of illness or suffering, and their interest in learning more about

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the whole gathering. Their requests involved general pleas for increased exchange with criollos and downriver Yanomami. Orinoco Yanomami could also comment on the general direction of engagement with criollos and related topics of conference discussion. Many of these propositions had a broader sense of the Yanomami in mind in contrast to upriver participants who generally spoke about specific problems on behalf of their communities. Due to their greater experience of criollos, Orinoco Yanomami also assumed the role of mediators and cultural translators, explaining to upriver participants criollos’ ways and their perceptions of the Yanomami. Finally, Orinoco Yanomami speeches reflected their involvement in institutional politics. Sustained mainly among Orinoco Yanomami, debate of this nature was comparatively irrelevant for upriver participants.

The Conference in the Context of Napëprou Several statements by influential Orinoco Yanomami indicated that the conference was a special opportunity to define more precisely the collective trajectory of an ongoing becoming napë. This historical moment was one in which Yanomami could directly negotiate their future with influential criollos based beyond the Upper Orinoco, powerful agents whom they knew could really have an impact on their lives. Let me cite two examples. The source of the first account was the Mavaca nurse, a man regionally known for his nursing and political activities (associated at the time with the AD Mayor). Early in the conference he expounded to the audience: “The problem is important you see. Why is it important? Because shawara is always attacking us. Why is it important? So we can use clothes, so our children can become napë, you see. You have to think about all of this . . . You must explain this to the elders. The people from Yaurawë theri don’t know. The people from Sheroana theri don’t know [communities he considers “far away” that interact infrequently with criollos] . . . Many people don’t know.” The Ocamo nurse is also known regionally for his politics (mostly associated at the time with SUYAO and ORPIA). He recommended focusing on what would really solve their health problems—training more Yanomami health personnel. He cast this as part of a process with its own inertia: “When we prepare/train ourselves this is ‘progress.’ Elders, ‘progress’ is a word in Spanish. We are already on the path/trail of the napë. If we are already on the napë’s path, why are we not becoming [nurses]? We have to be [nurses]!” He emphasized a historical process already in motion that served to place the conference on an existing course. That “progress” is explained

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as a trajectory along a trail is consonant with the notion of napëprou as historical transformation, since Yanomami sometimes talk of the past as movement in the forest, referring to the sites of previous residences, gardens, and events. Travel elicits the telling of history; history can take the form of a journey. It is fitting, then, that progress is expressed as a trajectory.

Images of the Napë: Deceit Images of criollos as deceitful and untrustworthy were deployed in different contexts. For instance, an Orinoco representative reflected on the Yanomami municipal government representatives (concejales) and their relation with criollos: “Those who were going to help us, concejales, they are liars. They don’t speak. They don’t enter/get in [with the napë government] . . . [In fact,] they enter [the government], but the napë deceive them. Once deceived they cannot work. This is how things are.” Initially criticizing the Yanomami concejales, he concludes criollo deceit is responsible for their inefficiency. A similar conspiracy is evoked by an Acción Democrática representative who is also a nurse and vocal critic of the health system, mixing shared Yanomami concerns with the mayor’s discourse: “‘The bosses don’t send medicine,’ say the doctors [in the Upper Orinoco]. Yes, they do send medicine. On behalf of the Yanomami [in our name], at national and international level, in the land of foreigners [other countries], our name travels all over. Because of this, some napë want to help us. They send medicine, but in Caracas, those who work there, they simply block it.”

Images of the Napë: A Need for Concern The issue of doctors’ concern for patients was also raised in a series of accounts of personal illness and suffering. Statements of personal suffering met with a lack of concern were particularly poignant and moving criticisms of the health system. One man angrily recalled an episode of poor response to an emergency situation, criticizing both doctors and Yanomami health personnel: “That one sitting down who lives in La Esmeralda [indicating the head of district in the audience], I called [the doctor] on the radio. My son was very ill, so I called, but in vain, he didn’t respond to my call . . . I called again and again in vain . . . I also called the Yanomami in vain. Nothing. How many have died along my river? [Mavaca], listen! Listen! . . . Thirty-nine of us have died . . . When my son’s breath had run out [he died], when I was mourning, only then did the doctors who lived

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there [in Mavaca] come with medicine.” Only after the child had died did doctors arrive, increasing the man’s anger and frustration. The mention of the number of deaths along the Upper Mavaca was a crude reminder of the limited coverage of the system.

Critiques and Demands Acción Democrática criticism of the state of the health system was particularly harsh, also deploying images of criollos unconcerned about Yanomami. Some opined that doctors came to the Upper Orinoco only to study the Yanomami, to write books and theses. Some said right out that “doctors don’t keep their clinic clean.” They do not bother because “it doesn’t matter. It’s for Yanomami.” “Because criollos only work for money, they don’t send us ‘real doctors,’ only students.” The issue of medical students drew widespread criticism from Orinoco participants. In chapter 7 we saw that medical students are recognized as trainees or sometimes as people “who don’t know,” likened to shapori apprentices or even to false shapori but always distinguished from “graduated” doctors. Demands for real doctors took several forms: “Don’t send people who don’t know, [adding that this is lamentably what happens now] . . . Those who know/recognize shawara well, these are the ones you must send!” “Let us request [doctors] from the regional health director . . . They [students] come to us. When they learn, they leave [to their homes]. They don’t take care of us [either because they do not know how or do not usually do it] . . . Let us request real doctors . . . They will live all over the place, in Mavaca, Platanal, Ocamo.” The first statement characterizes students as unable to recognize shawara. The second assertion links their not caring to their transience. The former example points to a lack of criollo knowledge, the latter to the Yanomami morality of permanent co-residence, reflecting the moral (Yanomami)/knowledge (criollo) combination that constitutes desirable and expected doctor performances. I have little doubt that Yanomami insistence on criticizing students derives not from their being, as a group, better or worse than doctors, or for that matter anthropologists or missionaries, but stems rather from their being the least permanent health personnel. They receive the bulk of the blame by inadvertently embodying the inverse of what the morality of being human demands for convivial relations; this despite the fact that many Yanomami youths engage thoroughly with students. My impression is that elder Yanomami do not consider students a serious alternative to tackle their health situation.

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Perhaps the most frequent demand, apart from the recurring request for “real” doctors, was for an increase in Yanomami health personnel—nurses and microscopists. Many speakers concluded their statements about the health system with this request and suggested different numbers for each Yanomami area. Upgrading clinics and doctors’ houses was also mentioned. Finally, there were, especially from upriver participants, emphatic requests for an expansion of health services deeper into the hinterland. The emphasis on training Yanomami personnel comes as both a realization of the criollo inability to solve Yanomami health problems and a Yanomami desire to manage the benefits of biomedicine on their own terms. On the one hand, given the relentless force of shawara, a dependence on criollo biomedicine is acknowledged. On the other, a recognition of that same dependence is offset by an aspiration for greater autonomy, a goal achievable through a broadening of self-management with nurses and microscopists. In short, this was a critique of the present as well as an indication of the future direction. In the bigger picture, this presentation of strong criticism while thoroughly embracing the health system epitomizes criollos’ potential affine status: necessary enemies. A final word on content: Several regionally known Yanomami were consistent in recognizing a change in the balance of the relationship between Yanomami and criollos, appealing to the audience to follow suit. The Ocamo nurse blamed the Yanomami themselves for “not preparing themselves” to better deal with epidemic diseases. Another SUYAO representative explained that they should not only “request, request” from the visiting officials but should also demonstrate that they could make their own contributions. Another Acción Democrática representative explained that in the past, Yanomami were unaware/oblivious/gullible (Y. mohoti), but today several Yanomami were learned/smart/alert (Y. moyawë). All these statements point in the direction of a more balanced and equal relation with criollos, a shift from passive acceptance of paternalistic policies to more active negotiation with criollos. As with the Esmeralda protest, the Mavaca conference exhibits an “us” position of solidarity, making “community” or making “the Yanomami.” These positions are in dialogic relation with that of criollos, whose innate qualities of deceit, lack of concern, and resistance to Yanomami desires are all rehearsed before reaching agreements on what to do about a doctor, the ambulances, or a “general way forward.” “The Yanomami” is by no means an easily created, supra-local sense of similarity; internal differences of a diverse nature are intentionally obviated. Differentiation and antagonism that divide Yanomami among themselves, such as regional,

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up/downriver, and party politics, are painstakingly expelled to collectivize Yanomami against criollos. The relative absence of key words like “culture,” “identity,” and “rights” in the events described is noteworthy. These terms only appeared in parts of the interventions by some of the most experienced Yanomami spokespersons. The overwhelming majority of health-related claims were cast in terms of the specific historical relation between Yanomami and criollos. The key points were the “morality of being human” and the consequences of “becoming napë.” Criollos, known to possess unlimited resources and powerful knowledge, must prevent Yanomami suffering by not being stingy. The criollo-originated spread of shawara gives napëprou a character of irreversibility: “We are dying out” (Sp. acabando), some claim. Others ask, “How can we multiply/grow in numbers?” (Y: parai). Yanomami bodies have become napë with shawara, a historical condition that frames demands for more nurses, microscopists, health promoters, radios, clinics, and doctors—the only way forward if becoming napë is to remain a worthwhile trajectory. Consistent with my discussion of the complementarity of biomedicine and shamanism in chapter 7, the demands made at the Mavaca conference indicate the correspondence between shawara and biomedicine. Yanomami are little concerned about the imposition of biomedicine or the need to strengthen traditional medical practices, a justified preoccupation of state officials and other institutions (e.g., Ministry of Health, Pan American Health Organization). Yanomami have a place for biomedicine and its practice. Their request, given the spread of shawara, is that the state appropriately fill that place. An important gradient of difference distinguishing Orinoco Yanomami who are becoming napë from their upriver counterparts means that redress is sought in various terms. Here we must recognize a few more experienced leaders among the Orinoco Yanomami, true cultural commentators with a broader view enabling them not only to locate themselves in a historical process with multiple Yanomami and criollo agents but also to recommend paths to follow. They are also aware that “the Yanomami” are the object of national and international attention and a subject of interest in different institutions for their health, culture, environment, and the like. All these aspects of Yanomami life become objectified topics of debate and consequently subject to negotiation with criollos. As has been observed in the context of indigenous identity politics (Jackson, 1991; 1995; HughJones, 1997; Turner, 1991; Ramos, 1998; Albert, 1993), these leaders, seeing themselves as agents of a negotiable relation with criollos made evident

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in a discourse of “awakening,” “collaboration,” “co-responsibility,” and “progress,” are speaking the language of political ethnicity rather than cosmological alterity (Albert, 2000). In the terms of our analysis, this amounts to a critical change in what is considered innate and what is open to human agency. The deliberate negotiation of a way forward, the general objectification of what being Yanomami is and what it should be, are attempts at “making convention.” However, like the artificial clinic conventions we discussed in chapter 6, in everyday circumstances involving Ocamo or upriver Yanomami, these artifacts are confronted with the innate conventional relation to criollos subsumed in the notion of potential affinity. Leaders are caught between guiding engagement with criollos through establishing convention, a move welcomed by criollos, while at the same time maintaining the potential affine status of criollos, closer to “ordinary” Yanomami expectations.

The Aftermath Emphasis on similarities between large public events and the everyday relations with criollos should not obscure important differences. One such difference is the decrease of Yanomami ability to manage criollos. In general, encounters with higher officials result in more commitments than criollos can usually actualize. No ambulances, for example, were given to the Yanomami—in fact, the original ones were never used, and finally, in a very deteriorated condition, they were removed from La Esmeralda one by one by large military aircraft in 2006. Not one of the health demands of the Mavaca Yanomami conference was implemented until the Yanomami Health Plan took off four years later, and this still constitutes a timid effort that falls short of legitimate Yanomami expectations. Two months after the conference, a compelling letter from a participant arrived in Puerto Ayacucho from Hokotopiwei theri, considered a distant community: [Opening greetings] . . . Look doctor [regional health director], remember that you committed yourself to provide a microscopist course. I am waiting [Sp. pendiente] for you here in Hokoto. When is my course going to begin? I am worried [Sp. preocupado] because there is no medicine. This is why I am giving you this information. But when are you coming for me? I am tired of waiting here in Hokoto. Look doctor, speak with Dr. [regional epidemiologist] on my behalf . . . so I can study to be a microscopist. I’m in a hurry. That’s it, nothing else. [Closing formalities].

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The letter is telling in its reiteration of key words that characterize the relationship with powerful state officials who arrive at meetings: “commitment,” “concern,” “wait.” In contrast with their local experience of effectively managing doctors and students, the structural inequity of Yanomami, and indigenous peoples in general, is evident in Yanomami people’s decreased capacity to influence those who have the power to make large-scale changes. “Commitment,” “concern,” and “wait” encapsulate a cycle of powerlessness that adds historical concreteness to the cosmological predisposition to see criollos as intrinsically deceitful and unconcerned. In the first part of this chapter, the La Esmeralda protest served to illustrate the performative quality of a Yanomami demonstration and its complementary relation with upriver performances. Instances of mutual misunderstanding between criollos and Yanomami also arose when we noted the affinity and homonymy between Western and Indian notions of the body. In the second part, the Mavaca conference provided concrete examples of the ways Yanomami speak of criollos in accordance with the notion of potential affinity. It also illustrated a characteristic feature of meetings with state officials whereby the enemy-ness of criollos is initially stressed—images of deceit, untrustworthiness, and lack of concern—only to then strike agreements, commitments, and a workable alliance capable of extracting resources and services from criollos that can outweigh the negative effects of napëprou and continue to make it a worthwhile avenue into the future. The third and final part of this chapter takes us to a more recent meeting held in La Esmeralda. This analysis concentrates on the issue of homonymic affinities and mutual misunderstandings, recasting them through Viveiros de Castro’s (2004a) notion of “equivocation.” This ethnographic example and use of the concept of equivocation has a twofold objective: on the one hand, to wrap up our running discussion on Indian-white misunderstandings, providing a framework for grasping the different aspects of this complex relation; on the other, to illustrate the relevance of notions such as becoming napë and equivocation for the design and implementation of a public health policy for Indians. I hope to demonstrate that, beyond theoretical debate, these are profitable ideas for furthering a more fruitful engagement between the state and the Yanomami. This discussion draws on the internal critique in anthropology about the interpretation of cultures—in particular those expounded in Wagner’s Invention of Culture—as the basis to question received notions of “culture” and “identity” and their usefulness in interpreting Indians’ projects and circumstances, a crucial step in the generation of appropriate policies. If I follow Wagner (1981) closely, it is for

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the simple reason that what holds true for the relationship between anthropology and its subjects (natives) in his discussion must also be intrinsic to the anthropology the state deploys in its attempts to instantiate a multicultural paradigm, an applied anthropology if there ever was one. I want to underline that I have chosen to focus on this event for its thought-provoking relevance and productivity in the examination of the Venezuelan state’s relationship with Indians. These meetings occurred at the beginning of a period in which important changes were taking place in the Ministry of Health, changes that I describe in the next chapter and that make the issues I criticize an exception in policy principles rather than the rule. The MoH has probably taken the lead in consistent and appropriate policymaking for indigenous people, yet the ministry itself remains an exception in the state apparatus as a whole in its understanding of the “indigenous issue.” Hence, the themes I will elucidate using these events as a starting point are apparent in other realms of the state’s engagement with Indians and thus pertinent in descriptive and analytical terms.

Encuentros de Saberes, La Esmeralda 2004 In November 2003 and February 2004, the MoH sponsored two large workshop-type meetings in La Esmeralda with ministry officials and indigenous representatives from different parts of Amazonas State. Led by the then-minister of health, Roger Capella, and organized by the newly created Indigenous Health Office (Coordinación Intercultural de Salud con Pueblos Indígenas, CISPI),2 these meetings were an effort to coordinate the implementation of two constitutional provisions: the principle of participatory democracy, whereby state and community representatives are encouraged to interact directly; and indigenous peoples’ rights to political participation and a culturally sensitive health service. These were hitherto unseen means of participatory development of public health policies for indigenous peoples. Acknowledging the felicitous nature of these events and echoing the language used in the commemoration of the five-hundredth anniversary of the arrival of Europeans in the Americas, the meetings were called Encuentros de Saberes, a choice of words that discursively levels the unequal relationship between criollos and Indians (an “encounter” or “coming together” versus a historical imposition) and between traditional medicine and biomedicine. Here both are considered domains of knowledge or wisdom, eschewing the more common pretense that elevates science over traditional practices.

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The balance of these encounters, however, heavily tilted toward traditional knowledge, and, in fact, the MoH made efforts to promote and incorporate traditional medicine into the health system. The four principal policy guidelines that emerged from the second meeting are evidence of this emphasis on the traditional side of the encounter. These policies entailed the creation of a shaman school, the incorporation of traditional therapists in the Ministry of Health’s payroll, the creation of a state indigenous health council—an advisory council of traditional therapists to regional health authorities—and the revival of the longstanding but recently interrupted Community Health Workers Programme (Programa de Medicina Simplificada), which had been training Indians as basic-level nurses for the last forty years. Let us consider the state of the health system and some health indicators in the Upper Orinoco. At the time it was estimated that 70 percent of the Yanomami population lay beyond the reach of the health system. Infrastructure and logistics where the system did exist had been allowed to deteriorate to the extent that the shortfalls were seriously impeding the work of the few doctors working in the area. At health posts, medical supplies and equipment were also in critically short supply. Based on a 2001 study, infant mortality rates, even in Yanomami communities with regular medical attention, was still some ten times higher than the Venezuelan national average (Kelly, 2003). The policies discussed were intended to tackle the health situation of all indigenous peoples in the country, not just that of the Yanomami, and one might validly question whether the general situation of indigenous peoples is well represented by the Yanomami case. A survey of the health problems among many other indigenous groups, however, reveals that the most common picture in Amazonas and the rest of the country is that of communities without access to basic health services or to some degree underserviced (Freire and Tillett, 2007a; 2007b). Alongside the Yanomami, other indigenous groups such as the Pumé in the Apure plains abutting Colombia and the Warao of the Orinoco Delta exhibit the worst health indicators in the country. Quite a different picture emerges if we examine the state distribution of traditional medical systems. Yanomami shamanism is vigorous. Most communities have several shamans at their disposal, and, to my knowledge, the unavailability of a trusted shaman’s services has never been an issue in particular cases of disease, unless a patient has been removed to a distant health post or to the hospital in Puerto Ayacucho. The presence of different therapeutic practices that include shamanism, phytotherapy, and

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collective rituals are also key aspects of contemporary Warao and Pumé life (Wilbert and Ayala, 2007; Barreto and Rivas, 2007). Among the Wayuu, most of whom live in urban settings with a history of biomedical doctors, you can also find numerous traditional therapists in urban as well as rural settings. In general, even though historical transformations have affected the configuration and vigor of traditional medical systems, and some indigenous communities are seeking to recover or reinvigorate different aspects of their cultures, the fact remains that ready access to traditional medical services is far more widespread than access to biomedical ones. In this context, we may ask why the “Encounters” placed what appears to be a disproportionate emphasis on traditional medical systems almost to the exclusion of any serious discussion about the improvement and expansion of the biomedical services available in the official health system. One must also ask to what degree the policies discussed met indigenous expectations for the health system. In short, lack of access to biomedical health services is by far the greatest health problem for most indigenous people. I will not deal here with the first of these questions but to observe the following: the circulation and sedimentation among different actors— academics, Indians, politicians, activists, and public servants—of ideas derived from the culture concept have, no doubt, been indispensable for the amelioration of the power inequity between state and indigenous peoples throughout Latin America. The stage afforded by Encuentros de Saberes, however, throws some of the pitfalls of the uncritical application of received wisdom into relief. Both indigenist identity politics and medical and anthropological discourses have favored the conceptual equivalence of indigenous and cultural issues (cf. Farmer, 1999; Briggs, 2003) and, often in matters of health, one step further, cultural and medical issues. This double slippage is accompanied by an analytical shift that reifies one culture as the site of a problem, at the expense of breaking down complex networks (such as the Ministry of Health, the state apparatus) and their constitutive relationships (Indian-criollo, for example). This discursive context can render unapparent the disparity between the Encounters’ traditionalist emphasis and the problems of indigenous health.3 I will now turn to the second question: Yanomami reaction to the traditionalist emphasis of the Encounters. The following are conversation extracts from one of several workshop roundtables on different proposals. This workshop found Yanomami representatives, young and old, in discussion with the regional health director and the then-head of CISPI (late 2003 to early 2004) on the proposal to create a state indigenous health council, traditional therapists acting as an advisory council to regional

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health authorities. I reproduce these conversations at length because they illuminate a sense of non-communication common in many state-Indian dialogues that will surely ring a familiar bell with those who have worked in different parts of Amazonia.

A Bizarre Conversation The head of CISPI begins: “I understand that you must be tired of so many promises because here everybody comes promising . . . But I am not promising anything . . . If we are here, it is to listen. We won’t promise anything. We are going to bring results as soon as we can and you will then reflect on whether all this was worthwhile.”4 Next, she explains that one of the duties of the proposed council would be to alert the regional health authorities to deficiencies in the health system. She then inquires about other responsibilities the Yanomami thought the council could take on, having to ask the same question three times in different ways. “What else should this Council do?” was a question intended to get her message across to the Yanomami elders who were clearly thinking about delivering their own message to the state. Yanomami representative: You only take our opinions with you and do nothing. All you do is read them. That’s all you do. You [napë] never tell us, “it will be as you say” . . . Sadly, they [napë] keep medicines away from us. What I really want is to have knowledgeable doctors living here with us. This is how I am thinking . . . Another Yanomami: You just make us tired of speaking . . . We the Yanomami, we don’t know medicine. We don’t know about it, neither do we practice any natural medicine . . . We only treat ourselves with a few plants and then only slowly do we recover. Only sometimes is it that we recover ourselves with plants, and this is why you should help the elders by giving medicine to our young ones [the bilingual representatives] . . . We the Yanomami, we know nothing of medicines . . . With potent hallucinogens, we can kill the spirits of epidemic diseases, but this shawara doesn’t die. Only sometimes do we recover. For this reason, the only good thing you can do is help us. You only profit from the use of the Yanomami name. Don’t eat the money you get on our behalf! Help us! . . . Yanomami are dying because we don’t know about medicines . . . You [napë] think we cure ourselves easily with the hekura spirits. It is only sometimes that the hekura cure us. They do kill the spirits of

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disease. Other times they can’t cure. The hekura follow the traces [of the aggressor spirits]. They follow the track. They don’t fail. They stay on the right track, then [ill people] recover well . . . I am really tired of all this here, so only if you help us will this have been good [worthwhile] . . . You only make us tired. Translator, speaking to the head of CISPI: Those who knew of traditional medicine were the ones who lived before. In those times, there wasn’t much disease. Now there is . . . Sometimes [shamans] cure, sometimes they don’t. Moreover, shamans don’t cure diarrhea or flu . . . They cure diseases caused by demons sent by other shamans . . . We have already had a meeting in Shakitha . . . and there we asked for nursing and microscopist courses . . . Instead we have pasantes [medical students]. They can’t work well because there is no medicine. The head of CISPI: What do you think these representatives [to the Indigenous Council] should do? . . . What responsibilities would you give them? Translator, speaking to the elders: About these two representatives we are electing, what do you think about them? How are you going to keep an eye on them?

At this point, an elder begins talking about something unrelated to the question. He is interrupted and quickly receives hints from younger Yanomami spokesmen who, with some impatience, notice that he is lost. The elder then repeats the suggestions he has received, and the translator passes on the message to CISPI: Translator, talking to the Head of CISPI: If our representatives are smart/alert, they have to complain so things get better, and you [napë] must be true to these two, so they can bring the information [presumably the outcome of the council meetings] . . . In this way, I think this can work well. Head of CISPI: What do you think this council should do? Besides complaining, should it do anything else? How is that committee going to help us, because things are not only on this side [a reference to co-responsibility on the part of Indians] . . . Ask the shaman to see what he thinks. Yanomami elder: I requested medicine a long time ago, the first time [Shakitha conference] . . . The only thing I want to see is you arriving among us with medicines. My son has translated this for you a long time ago [Shakitha conference] . . . We shamans, when we kill

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the spirits of disease, if at the same time you doctors help with medicines on your part, then we will work well together. This is what I have said a long time ago. Translator, speaking to CISPI: . . . We have already made our proposals in Shakitha . . . We have already a commitment to you, but you are not living up to your part of this commitment. You are not abiding by this agreement . . . This is why our people are getting worse all the time . . . You don’t keep your word, because we asked for medicines, for specialist doctors . . . so they can live in Mavaca . . . two or three years . . . So let’s see if we make another commitment, but if you don’t fulfill your part, what are we going to do? We are committing ourselves in vain . . .

At this point in the dialogue, another Yanomami took the initiative, posing questions on subjects of concern as opposed to answering questions on subjects that seemed either confusing or irrelevant. He asked what had happened to the Yanomami Health Plan of which they had heard so much but seen nothing. Even though this discussion was supposed to address a specific policy proposal that was never fully comprehended by the Yanomami elders, their message comes across loud and clear as a response to the general emphasis of the Encounters on traditional medicine.

Criollo and Yanomami Translations Whatever else can be said about the proposals that emerged at the second Encounter—the unavoidable social decontextualization caused by a shaman school; the disruption of inter- and intra-community political relations spurred by salary payments; the conundrum of establishing criteria for registering “legitimate” healers—they present us with a curious scenario whereby state representatives offer traditional medicine to Indians asking for biomedicine or—in the terms of each party to this encounter— criollos offering Indian medicine (the state’s Indian) to Indians asking for criollos’ medicine (the Yanomami’s criollo). Singular as it might appear, as I have shown in previous chapters, this type of cross-cultural misunderstanding is common in Yanomami-criollo relationships from the quotidian, individual exchanges to the less frequent collective, political ones. During events such as Encuentros de Saberes, Yanomami and state representatives match up their understandings of each other, an understanding born of the same exercise of extending their conventions to incorporate something external or novel—biomedical or indigenous health systems.

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This creative extension necessarily entails the reduction of others’ meanings into the terms of one’s own symbols. Let us explore the biases that inflect criollo and Yanomami reciprocal translations, whose essences are visible in the Encounters. State officials incorporate the figure of the shaman in that of the doctor by way of an analogy based on the role doctors and shamans share as healers. In this way, the known concept of “doctor” is extended to assimilate the less known figure of “shaman.” The same principle operates in the state’s wider interest in indigenous medical systems, an interest guided by the Western valuation of culture, understood as the assemblage of one’s or others’ techniques and achievements—of things produced (Wagner, 1981:21–3). A related concern with identity and history is implicated in the treatment of culture as a patrimony that needs to be restored and preserved, hence the urgency of reinvigorating ethnic identities. The issue of identity is particularly relevant here, for by acknowledging a history of assimilation—the dissolution of Amerindian distinctiveness in favor of an undifferentiated national identity—the state now promotes ethnic identities so Amerindians can continue to be so. The inevitable reduction and bias of these interpretative extensions becomes clear if, returning to the example of the shaman, we consider the number of other possible resymbolizations. In a religious context one could see a priest in the figure of the shaman (cf. Hugh-Jones, 1996). And, in a political setting, in the figure of the shaman one could also discern that of an ambassador, or even a military general, or spy, a double agent representing humans in the spirit world. And if we have not yet seen representatives of the Ministry of Defense recruiting shamans to marshal their military potential or intelligence, it is because multiculturalism has grown to favor certain translations—making some conventional and others unthinkable—for the operation that turns a shaman into a doctor, an ambassador, or a spy is identical. Before turning to a discussion of the Yanomami side of this exchange, I want to substantiate my claims on the relatedness of culture and identity in modern multiculturalism to then demonstrate how the MoH deployed these terms in its health program for indigenous peoples. Taylor (1994) points out that multiculturalism goes hand in hand with individual and collective identity, for the basic reason that people’s understandings of their “selves” are in dialogue with other’s understandings of who they are. He also reminds us that, for multiculturalism and identity politics to have emerged, a certain understanding of, and preoccupation with, personal identity and a sense of self had to become commonplace, allowing such

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claims to be received as sensible. His thesis asserts that this modern concern with identity could take place only once fixed social hierarchies had been dissolved or weakened and a universalist politics of human dignity superseded the exclusivist politics of honor sustaining elites and differently valued citizens. In addition, a sense of individualized identity had to develop, a notion that “arrives along with an ideal, that of being true to myself and my own particular way of being . . . I will speak of this as the ideal of ‘authenticity’ ” (Taylor, 1994:28). The ideal of authenticity “greatly increases the importance of self-contact by introducing the principle of originality: each of our voices has something unique to say. Not only should I not mould my life to the demands of external conformity; I can’t even find the model by which to live outside myself. I can only find it within” (30). Taylor traces the roots of these transformations to several philosophers, among them Rousseau, Hegel, and Herder. Relevant to our discussion is the argument that the modern concern with identity is historically contingent: everybody will have changing and contextual notions of personal and collective identity; it is wrong to assume that all humanity shares in character and in degree our modern preoccupation with identity. In its characterization of indigenous people and their health problems, the programmatic text that oriented MoH policy at the time placed little emphasis on the cultural and historical heterogeneity within and across Venezuela’s different indigenous peoples. A general picture of “societies in transition,” not inaccurate in itself, uncritically assumed the existence of problems of “cultural survival” and “alienation” among all these peoples. These documents also expounded a holistic and integrated biopsycho-social understanding of health in explicit opposition to the more commonplace notion of “absence of disease” and the individualized and organicist approach of standard biomedicine. The new conceptualization of health on which this program of action was based reads as follows: “Health is the capacity and right of each person to make life choices that will allow him/her to be increasingly more self-possessed and less alienated. Health as an epiphenomenon of life is an integral and harmonic process of self-possession, self-recognition, self-respect, and self-valuation, and leads to the recognition, respect, and valuation of the other in all his/ her biological and cultural diversity” (MSDS, 2004:24, my translation). Given its resemblance to the ideal of authenticity that undergirds our notion of identity, this text can be read as a medical inflection of the modern preoccupation with identity. In this conceptual framework, alienation is a threat to authenticity and becomes the greatest enemy to be warded off.

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As a result, due to both its underlying image of Indians and its theoretical inspiration, this approach professed considerable faith in culture—the reinvigoration of ethnic identity and the reassembling of shattered cultures— as the site of the solution to indigenous peoples’ health problems. The Encounters were testimony to this orientation. Let us now return to the Yanomami. For their part, Yanomami representatives and shamans request doctors, technology, industrialized medicine, and biomedical knowledge. Aside from the perceived positive impact of biomedicine, this interest in things medical is part of a more general interest in our “cargo” (manufactured products but also health and educational services) that extends Yanomami valuation of human relations at interpersonal and collective scales. As an example of this bias, one may think of how coveted manufactured objects often in high demand, rather than being accumulated, are passed on and put into circulation, strengthening or multiplying relationships to different political effect. As discussed in chapter 7, criollo doctors and other state representatives are quick to interpret Yanomami demands for goods in materialistic terms and claim they are only interested in criollos because of their goods. I once said to a Yanomami friend, “You don’t care for criollos. You are only interested in our things.” “No,” he replied. “Things are not like that. If we didn’t care for criollos, where would we get goods from?” This paraphrased response suggests the relevance of the relationship with criollos that is made visible in the act of procuring things from them. As we have seen, exchange of these goods among Yanomami themselves differentiates givers from receivers, the former assimilating meanings attached to criollos, and the latter, meanings attached to Yanomami in a novel context of relationships I have been calling the napë transformational axis. Two more orientations are allied with this one. One is a concern for personal and collective differentiation that, as expounded in chapter 5, seems to be an expression of a more generalized proclivity for “other becoming” as opposed to a “being a self ” among Amazonian peoples (Viveiros de Castro, 1992). The contrast with the ideals of self-possession identified in the MoH text cited earlier is evident. Amazonian cosmologies that predicate an essential commonality between humans and non-humans, extending the status of personhood to the latter, demand constant individual and collective differentiation against a background of similarity—a shared soul and culture (Viveiros de Castro, 1998). In myth, the incompatibility of identity with social life is reflected throughout the Americas in the impossibility of complete identity between the twin demiurges whose constant differentiation generates a “perpetual disequilibrium,” both descriptive

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and prescriptive of sociality (Lévi-Strauss, 1991). In the context of the Encounters, the relevant differentiation is that of becoming napë. The second conventional orientation focuses on production. Seen in terms of a political economy of people, this is about controlling the distribution of scarce producers (men) rather than resources (Rivière, 1984). As discussed in chapter 3, closely related to the need for differentiation, kinship must be constructed and requires an active and mutual production of kin, a process that emphasizes co-residence and commensality, often resting on the idiom of the body. I have been arguing throughout this book that the health system, unevenly distributed among Yanomami communities, with its health posts, medicines, criollo doctors, and trained Yanomami personnel, has historically contributed to both the differentiation and the production of people. The Yanomami at the Encounters are speaking from within this context and experience. There is, no doubt, a concern for health, both among those who feel the duty to provide this service for those who have been historically excluded from it and also among those who endure the painful experiences of high mortality rates. But however abysmal, to reduce Yanomami motivations for pursuing biomedical services to the extent of their social exclusion is as far from exhausting the meaningfulness of the health service’s potential for differentiation as it is from explaining the particular emphasis of the MoH on culture and identity. It would, moreover, completely overlook the equivocations that so characterize Yanomami-criollo relations.

Equivocations Viveiros de Castro’s (2004a) discussion of equivocation is particularly useful for the analysis of Yanomami and state representatives translating each other’s circumstances. The term arises in the comparison of Amerindian and anthropologists’ anthropologies, within a reflexive exercise about what anthropology has to learn from Amerindian perspectivism when it is considered as anthropological method. Within a perspectivist world, different species of being (humans, spirits, animals) share a common culture yet inhabit multiple natures. Hence, trans-species communication is always a translation that involves retaining awareness of dissimilar referents concealed under a common representation. Translation reminds people that the world of things and events is in fact a world of homonyms and actions. One must not lose sight of the fact that what humans see, for example, as blood, jaguars may see as manioc beer—to use one of Viveiros de Castro’s examples—and that an accident (a snakebite, for example) may

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well have an intentional agent behind it. Controlled equivocation is the name Viveiros de Castro gives to the Amerindian proclivity for awareness of the existence of different systems of reference to which every thing and every event can point. And in this positive sense, it can subvert the classical anthropological method premised on the existence of a common nature and multiple cultures. Yet Viveiros de Castro also uses equivocation to refer to the anthropologists’ lack of awareness of the equivocations that underlie cultural translation as much as they underlie trans-species communication for Amerindians. Although he does not do it himself, for the sake of symmetry, we may label this unawareness of homonymy an “uncontrolled” equivocation, which, in this more negative sense, refers to literalizing translations, the extension of one’s own symbols unaffected by the meanings of another’s culture. So in the first sense, we have either the native or the anthropologist aware of homonymy—multiple referents underlying a common representation—and in the second sense, we have either the native or the anthropologist unaware of homonymy and assuming univocality, that is, the existence of a single and shared system of reference to which all representations belong.5 Following Viveiros de Castro, I use the term “equivocation” in its “uncontrolled” sense, meaning not a “failure to understand” but rather “a failure to understand that [others’] understandings are necessarily not the same” (2004a:11). This approach more aptly describes the situation of the Encounters and all the other “mutual misunderstandings” and “working disagreements” I have discussed, for the idea of misunderstanding points to a confusion of shared meanings and not the misrecognition of alternative meaning with which these relations confront us. equivocation mistaken for misunderstanding. A common and genuine interest in health brought both parties, state and Yanomami, together for the Encounters. The state, nonetheless, inflected its health project with its biased concern for culture and identity, seeking to “make Indians” in the firm belief that this path would make healthy people. For the Yanomami, any discussion with criollos state representatives about health will tend to address biomedical services exclusively rather than traditional medicine. And as we saw at the Mavaca conference, identity and the availability of traditional therapists are of little concern to Yanomami, who see health as an intrinsic part of becoming napë. This situation bears a remarkable resemblance to another encounter of sorts, one that Lévi-Strauss (2006) recounts regarding Spanish and Amerindian investigations into each other’s humanity—an anecdote aptly recovered by Viveiros de Castro, both in the description of Amerindian perspectivism

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and cross-cultural equivocation (1998; 2004a). While the Spanish queried Amerindians’ possession of a soul, the possession of a body being selfevident, Indians experimented with their Spanish captives to see whether their body was subject to putrefaction, given that their possession of a soul was taken for granted. But the encounter on the issue of health of the divergent projects of making Indians and becoming napë is not simply a matter of misunderstanding, of different approaches to solving the same problem. It is one of equivocation, the misrecognition of alternative meaning, the reconfiguration of other’s symbols in the terms of our own conventions—in this case, the alternative meanings of “criollo” and “Indian” from criollo and Indian perspectives. Yanomami are not becoming the criollos we conceive of, nor are the Indians the state wants to reinstate the ones that Yanomami take themselves to be (cf. Viveiros de Castro, 2006a:48). In Lévi-Strauss’s anecdote, the alternative meanings of body and soul from European and Indian perspectives are in play. In both these cases, health and humanity act as homonyms where two distinct “systems of reference” may focus attention, but equivocation operates against the realization of the existence of another system of reference. Concealing its own existence, it makes homonymy oscillate between perceptions of understanding and misunderstanding always within the actor’s system of reference. This mirroring exercise, which Wagner has revealed to haunt anthropology, arises if we do not account for the mediative basis of concepts like culture and identity, that is, concepts that are metaphorizations of our relations with Indians with counterparts in Indians’ relations with us. As Wagner observes in his discussion of the relationship between anthropologists and Melanesians: “The fact that ‘cargo’ and ‘culture’ metaphorize the same inter-societal relation, while doing so in opposite directions, so to speak, makes them effectively metaphorizations of each other” (1981:32). Expanding on the case of the Encounters, just as “culture” and “cargo” are metaphors of each other, it may be useful to see the process of “becoming Indian” (Jackson, 1991) that the state induces—in fact, a process of “making Indians” that includes the development of ethnic identities, the popularization of an objectified notion of culture and the corresponding “identity politics,” and the juridical conceptualization of territories—as the metaphorical counterpart of “becoming napë.” The equivalence between these two processes is only visible if we maintain through its translation the disparate understandings of criollo and Indian held by these actors, and thus substitute the meanings we (and the state) attach to identity and the production of things that become culture for those Yanomami attach

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to differentiation and the production of people. Counterintuitive as it may seem, the state’s Indian making and the Yanomami napë becoming, like cargo and culture, “metaphorize the same inter-societal relation, while doing so in opposite directions.” Yet, once the common interest in health cannot disguise the divergent projects of making Indians and becoming napë, the homonymy breaks down and a certain tension creeps in as a mutual resistance to each party’s project: criollos tend to interpret Yanomami becoming napë as alienation and cultural loss; Yanomami, in turn, criticize criollos’ stinginess with their biomedical resources and their untrustworthiness. The condition of “people talking past each other” prevails. People sense they are not communicating, but the double equivocation remains concealed, mistaken for a misunderstanding that may be resolved by reiteration or further explanation. (e.g., And again, what do you think the attributes of the indigenous council should be?) If all else fails, criollos end up doubting the Indians’ mental capabilities—in Amazonas, criollos have historically been referred to as racionales in opposition to Indians. equivocation mistaken for understanding. Yet if this were the only type of relation possible, one would rightly wonder how any kind of constructive engagement involving the state and the Yanomami is possible. In The Domestication of the Savage Mind, Goody (1977:8) poses the same question to critique Lévi-Strauss’s characterization of two modes of thought between natives (bricoleurs) and Moderns (engineers) in La Penseé Sauvage. If, as Lévi-Strauss suggests, we approach the physical world from opposite ends, Goody inquires how is it that he has never experienced the “hiatus in communication” that one would then expect when engaging with other cultures. One could argue whether Goody exaggerates the difference posited by Lévi-Strauss, whether it is larger, smaller, or inexistent. This exercise, however, is futile. If, to follow Wagner (1981), we consider culture as the inventive creation of meaning through extending our conventional symbols, the situation of culture shock that objectifies culture explicitly for an anthropologist arriving in some field must necessarily hide as many differences between anthropologist and native as it reveals. So, to answer Goody’s query differently, this possibility of communication is at least in part aided by a situation of homonymy probably much more common, namely, one whereby the advancement of each party’s project mistakes equivocation not for misunderstanding but rather understanding. This is exactly the situation that we have been referring to regarding mutual misunderstandings and homonymic affinities. It begins with an affinity of interest in something that plays a part in each party’s project.

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There is a certain homonymy in the thing or process of common interest, and to the extent that projects are furthered, the homonymy persists, and the equivocations involved come across as understanding. Our first example was the common interest in civilization found in the historical relation between missionaries and other state agents and the Upper Orinoco Yanomami. Both missionaries and Yanomami were then interested in civilizing, the former’s making criollos homonymous with latter’s becoming napë, and to the degree that each project was seen to advance, this homonymy was seen as understanding. Civilizing via making society is less convergent with the Yanomami becoming napë project, and just as in the case of the Encounters, some sense of misunderstanding is recognized, and Yanomami and criollos appear to resist each other’s intentions. We have also seen that within the encompassing context where criollos’ “civilizing” articulates with Yanomami becoming napë, we can find numerous minor equivocations between criollo and Yanomami conventional focuses. We discussed in chapter 7 the equivocation that holds between the native category of shawara and biomedical categories such as parasites and bacteria (germs). This homonymy allows for an easy understanding of the biomedical procedures necessary without subscribing to the biomedical germ theory behind it. In many cases, this shawara-germ equivocation allows doctor’s and Yanomami’s projects to converge in patient treatment. We have also mentioned in previous chapters the equivocations surrounding criollo and Indian notions of the body, as well as the one between Yanomami ethics of ameliorating suffering and criollo perception of Indians as helpless and needy. All state agents—be they missionaries, representatives of the health and educational systems, politicians, or whoever else—promote some sort of civilizing project among the Yanomami. Relations between Yanomami and each category of criollos oscillate between homonymic understanding and the break down of homonymy into misunderstanding, depending on the perceived success of each other’s projects. In this context, criollos may accommodate their expectations to the recognizable limitations of their project, fuelled by faith, duty, or the enjoyment of not taking oneself too seriously. They may, of course, become frustrated and leave—an option always open to them. Upper Orinoco Yanomami, for their part, also measure the benefits of having missionaries and the health system, and accommodate their own expectations. It is worth inquiring whether the equivocations involved in these relations are ever recognized as such, whether the awareness of alternative meanings can escape from the oscillatory illusions between degrees of

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shared meanings. I suspect the terrain of ethno-politics is the most fertile location for the awareness of alternative meaning. Given that it is Indians who have for decades accumulated the experience of dealing with a plethora of state and other non-governmental representatives, indigenous anthropology of whites is likely to be much more profound than that of the average state representative, whose experience and knowledge of Indians is, for the most, incipient and generic. In fact, Albert’s (1993) analysis of Davi Kopenawa’s—the most renowned spokesperson for the Yanomami people—anthropology of whites is a clear example of the indigenous recognition of alternative meaning. We can now see that equivocations mistaken for understandings assume the form of working disagreements, this is the case of “civilization” and the shawara-germ equivocation. Its complement is an equivocation mistaken for misunderstanding, as in the case illustrated by the Encounters, where univocality, and not homonymy, is assumed to underlie Yanomami and criollo uses of the terms “criollo” and “Indian.” The misrecognition of alternative meaning can thus work in favor of or against the advancement of each party’s project. In general, I think equivocation defines privileged lines of articulation between Indians and whites in many parts of Amazonia. The dynamic of project advancement and frustration that results from the illusions of understanding and misunderstanding also seems to be a fruitful way to account for the often bizarre relations between states and Amerindians. I will now close with commentary on some of the implications of this discussion for multicultural public policymaking in the field of indigenous health. The analytical slippages of collapsing indigenous issues into cultural ones, then cultural issues into medical ones, could easily mislead anyone seeking an understanding of indigenous health and ways of improving it. Our analysis of the dialogues in the Encounters was an entry point for discussing equivocation as a key feature of cross-cultural relationships, a discussion where culture and identity were seen as particularly relevant in shaping Indian-state relationships. A way to overcome the limitations of these concepts could hardly invoke their replacement with more appropriate ones. Our discussion of equivocation suggests that the problem does not lie in the concepts themselves but rather the status we give them: what we take these concepts to be. As Wagner observes: “We must be able to experience our subject matter directly, as alternative meaning, rather than indirectly, through literalization or reduction to the terms of our ideologies. The issue can be phrased in practical, philosophical, or ethical language, but in any case it devolves upon the question of what we want to

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mean by the word ‘culture,’ and how we choose to resolve, and to invent, its ambiguities” (30–31, his emphasis). As long as the state chooses to implement multiculturalism dismissing the mediative basis of culture and identity, it will be forced literally to reduce a shaman to a doctor. There is then nothing to further check literalizations, for once a shaman is fully perceived as a doctor, his/her role must be institutionalized, turned into a profession, which then requires regulation (registration of legitimate healers), monetary rewards (salary), and the systematic production of professionals (an officially recognized school). So thorough is the literalization that, during the second Encounter, it was argued to an indigenous audience that a salaried healer could then dedicate all his time to curing, his service to the community unrivalled by the trivial business of ordinary life—hunting, gardening, and the like, in short, those things that make a human person a man or a woman. Echoing the angst of the urban lifestyle, this judgment is based on a division between work and domestic life central to the Moderns yet hardly evident in Yanomami conceptions of what s/he does for a living. Little further proof is needed to demonstrate the quality of the indirect speech of this state anthropology. As a matter of choice, we should be mindful of “culture” as a mediative term, that is, as the constant formulation of analogies that extend our conventions and particularize them in the process, be it within or across recognizable cultural boundaries. This conceptualization rids us of the moral conundrums of change, for this understanding of culture refers precisely to the way people change, the analogies and extensions that make their lives meaningful. In this light, becoming napë is not a loss of culture but rather a very indigenous way of changing; making Indians is not cultural gain but rather a very modern aspiration. An understanding of “culture” and “identity” as mediative terms amounts to transferring the seriousness with which we are used to treating “culture” and “identity” to Indians themselves and what they have to say. A multicultural program of action that takes people seriously acknowledges that culture is often a means of talking about other things that threaten people’s ideas of a life worth living, in the Amerindian historical relation with the state, a paramount concern for their territories, for example. Put another way, the recognition of the existence of alternative meaning should guide multicultural policymaking in the direction of ensuring the conditions of its production. And this takes us back to land, health, and, crucially, shifts the whole focus of attention toward finding the means to counter the power imbalance between the state and indigenous people.

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The critical discussion here is more about increasing dependency and less about culture loss (Sahlins, 1999b). I have so far analyzed the state and Yanomami translations of each other as versions of the same extension of conventions. However symmetrical this basic operation might be, when the state actively engages with Indians, it patently has the upper hand in defining the broadness or narrowness of the boundaries within which resignification takes place. Indians and state indigenize each other, so to speak, but the latter determines the limits of the former’s maneuvers. Indigenous peoples’ growing political participation notwithstanding, they still have little control over the projects that state policymakers have in store for them. The state’s indigenization of Indians tends to set out a program of action in our own image, which is precisely the opposite of the purported intentions of multiculturalism. And if, as Wagner suggests, literalizing anthropology makes for bad anthropology, it makes for bad policy as well, for policy, consciously or not, is applied anthropology. If the state approaches indigenous health without the burden of “culture” and “identity,” it will be better prepared to take Indians seriously and negotiate the most appropriate means for attending to their situation, considering their expectations and the public health rationale it can bring to the table. In this effort of making healthy people, if we can call it that, instead of making Indians, cultural difference will, certainly, merit substantial discussion, not as a goal in itself but rather as an aspect that needs to be considered to render better health possible.

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cha p te r n i n e

Changing Tides and Mixed Feelings

With the new constitution of 1999, Venezuela officially became a multicultural and pluri-ethnic nation. This final chapter is devoted to describing some of the changes that have since occurred in the Venezuelan state’s relations with indigenous peoples. I begin by describing the general shift in the treatment of the “indigenous issue,” revealing how the image of Indians has become a key symbol of the government-led nationrebuilding process known as the Bolivarian Revolution. I then examine how the Ministry of Health has chosen to implement multiculturalism through the work of the Indigenous Health Office (IHO) and one of its main programs, the Yanomami Health Plan (YHP). This chapter is less analytical than the previous ones, drawing more closely on my personal experience within the IHO and the YHP, on the one hand, and of working in Amazonas and with the Yanomami, on the other. Without generalizing aspirations, I hope to illustrate the jumbled scenario of progress and setbacks that results when an entrenched bureaucratic state culture attempts a paradigm shift of the kind that the Bolivarian project aspires to and of the kind required to improve indigenous peoples’ health.

The Indigenous Issue in Venezuela Until the drafting of the new constitution in 1999, Venezuela was one of the least progressive countries regarding indigenous legislation among the American nations. The relative invisibility of Indians in the national 200

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imagination and the official abandonment and delegation of the Indian issue were hallmarks of the nation’s attitude toward indigenous people.1 The task of assimilating Indians in the national cultural and economic milieu was either delegated to different missionary orders or left to the natural integration of peoples expected from the expansion of economic fronts, the population of apparently empty spaces, and the spread of development and modernity. Dominant Hispanist views of national history normally characterized Indian cultural and economic ways as obstacles to civilization (Carrera Damas, 2006:24) and as hindering progress in national development schemes. Since the 1970s the stubborn, yet ultimately fruitless attempts to transform indigenous shifting agriculture into modern farming to increase productivity are good examples of this view (Freire, 2007). Government agencies responsible for Indian affairs have been batted back and forth from ministry to ministry during the last fifty odd years. Their budgets and political clout have always been lacking. Even when the 1961 agrarian reform provided legal possibilities for indigenous land tenure, it did so at the expense of imposing on Indians peasant models of land use and socio-political organization. Furthermore, at least in Amazonas, no indigenous community ever received anything beyond provisional land titles under the agrarian reform (Colchester and Watson, 1995:15). People considered “indigenists” were few in number, and despite their great efforts, their success in raising consciousness in sectors of the population beyond the political left was limited. Nor should it be forgotten that criollos hunted Pumé Indians in the Apure lowlands until the 1960s (Monsonyi, 1972:46). For the Indians to be made invisible something else had to conceal them (cf. Arvelo-Jiménez, 1972). Venezuelan national identity has been predicated upon the notion of mestizaje, the mixing of Indian, black, and white blood. An indigenous component of national identity was celebrated not as a living aspect of today’s multicultural scenario but rather as a historical component of nation building; Indians were not ethnic minorities but historical forebears. Probably within the education system, this dominant discourse has been more effective. One only has to recall how history was taught in schools: the comparatively short space in books and time in classes devoted to pre-Columbian history indicated that history started with the arrival of Europeans. Indians were portrayed as lazy or feeble, which is why Spanish colonizers sought the muscle of African slaves. Generally speaking, given that the Indian was perceived as having little of good in himself, the process of colonization was cast more, to paraphrase Thomas (1994:124), as the operation of welfare than conquest, conversion to Christianity being very

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much the vehicle and symbol of improvement. The opening words of an influential historian, Guillermo Moron, on the subject of “the Aboriginals” in a high-school history textbook exemplify this view: Should indigenous communities be preserved? This cannot be desired by anybody. Communities are destined to slowly disappear although today’s comprehensive and well-established political action is speeding up this process. We must hope that in a near future—with the conquering of the forest and when all the lands are filled with towns and cities— there will remain not a single group speaking Carib or another aboriginal language . . . To hope for the contrary is to preach for a backtracking in the cultural process to stages already overcome by the country. The Indian is part of our history as a composing factor of mestizaje; in this way it accomplished a purpose that no one can deny him. But it is necessary to assimilate him altogether, integrate him to our way of understanding culture. Mestizaje is the historical means for this incorporation.” (1974:16, my translation)2

The force of the mestizaje ideology can be gauged by the reaction incited in 2002 when President Chávez announced his intention to change the name of Columbus Day (October 12) from Día de la Raza to Día de la Resistencia Indígena. The following piece is written by a well-known and respected politician among the Venezuelan middle class, who was also one of the most vehement opponents to the inclusion of indigenous rights in the 1999 constitution. However, the weight given to the twelfth of October by the great historical value with which it is universally acknowledged is not enough to overcome the barrier of the inferiority-complex-induced ignorance [Sp. acomplejada ignorancia] of Señora Noehli Pocaterra, who is a Guajiro Indian; of the Minister of Education, Aristobulo Isturiz, who descends from Black Africans; and President Hugo Chávez, who is a descendant of both races. I know they will accuse me of racism for saying this. But it is they who are saying it, and it is they who, abusing the power they have today, decree October 12 as what it is not, and propose to distort history, injecting the venom of their racial complexes. The truth is that the integration of the aboriginal peoples to the new mestizo societies that began in the sixteenth century was the first formative step of the Hispanic peoples of America. In contrast to what occurred in AngloAmerica, there was neither segregation nor annihilation of Indians, but

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rather they were incorporated to the culture and the fundamental values of the Western Christian civilization to which we belong, even if they [the above mentioned] decree its denial. These were the values that Bartolomé de las Casas and many others preached and wrote about, to defend the human rights of the Indians, rights that Indians neither knew nor recognized . . . What Chávez decrees to commemorate in an inverse and contrary way of what happened ignores or denies what the Franciscans, Dominicans, and Jesuits did to gain for Catholicism the Hispanic peoples of America . . . The indigenist-Marxist interpretation of history denies the evangelizing work of Spain . . . [that] planted the seed of Christ in the ductile souls of Mexicas, Mayas [long list of ethnic groups] vertebrating in the Christian ethics the mestizo societies that were hence formed (Olavarria, El Nacional, 12.10.02, my translation).

A proper analysis of this statement would require a thorough discussion of Venezuela’s recent political history. I want to highlight the way the ideology of mestizaje promotes an idea of a history that actually puts an end to itself once the mixture is total. What is declared is that there is no “Indian issue” as such. The official mestizaje discourse was not alone in diminishing the presence of Indians in the Venezuelan consciousness. The statements of the arriving Upper Orinoco doctors presented in chapter 2 offer another concrete illustration. A commitment to achieving modernity that has characterized the politics of the Venezuelan petro-state (Coronil, 1997) introduces another type of discontinuity between Indians and non-Indians. Indians embodied the very opposite of modernity and hence could hardly be seen as a potential source for it. They represent what the modernizing project should transform in the country’s efforts to escape underdevelopment. There is, then, an ideological affinity between a theory of mestizaje as a means for social improvement via the spread of European and Christian values and the petro-state’s aspiration to propel the nation into modernity: the continuation of “civilization” by other means.

Indians’ New Context and Some of Its Consequences The rise of the indigenous issue within the Bolivarian Revolution occurs alongside renewed official discourses of identity and culture, both in relation to Indians’ ethnicity as well as in the more general terms of a new Venezuelan identity and the promotion of Latin-American integration.

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President Chávez has publicly commented on his indigenous ancestry and occasionally recalls experiencing the dire reality of the Pumé and Cuiva Indians in the State of Apure, where he was posted as a young army officer. Government-sponsored media constantly celebrate traditional Venezuelan culture, and several national cultural institutions are currently dedicated to universal high culture and national folklore. The government has also stepped up its efforts to provide all citizens with national identification cards and ensure civil registration at birth. Other programs invest in different forms of cultural promotion. Bank notes of the new Venezuelan currency, the strong bolívar that began circulating in January 2008, include—in contrast with the previous notes—an array of historical figures and images representative of the country’s cultural and environmental diversity. The notes include images of Guaicaipuro and Negro Primero, the former, an Indian symbol of resistance to Spanish colonial powers, and the latter, an Afro-Venezuelan hero of the independence wars. Since the ratification of the 1999 constitution, legislation that guarantees rights to indigenous people in Venezuela has been growing. For the first time the national constitution included eight articles specifying indigenous rights, including those to land. In 2001 the International Labor Organization Convention 169 was ratified, and in 2003 a law was enacted to further land-demarcation processes. The Organic Law of Indigenous Peoples and Communities dealing with specificities for the implementation of constitutional rights followed in 2005. So, while many of the constitutional principles remain to be actualized for a great number of indigenous people, the legal grounds on which to fight for them has become increasingly solid. Another important change has been the rapid growth of indigenous political participation in mainstream politics. By law, indigenous peoples are accorded three representatives in the National Assembly (parliament). There has been an Indian governor in Amazonas for two terms. In the states of Amazonas, Bolívar, Delta Amacuro, and Zulia, Indians have been elected as mayors. A new ministry for indigenous people was created in early 2007, and Indians have been heading the indigenous peoples offices of the ministries of health and education for several years. The number of Indians incorporated into local and regional governments and ministries is also growing. A final significant change can be registered in the content and relevance of official discourse on Indians. Indigenous people have been officially portrayed in at least three ways during the Bolivarian Revolution, all of which associate Indians with the nation rebuilding process and thus

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make them key symbols of the new nation. Indians have become a state symbol of resistance in a rereading of history that provides a different origin myth of the nation-state. Thus, the traditional name for the twelfth of October, Dia de la Raza, suggesting a nation born from the mixing of races—generally considered a felicitous process of improvement—has been changed to Dia de la Resistencia Indígena, suggesting a nation born from the indigenous struggle against the Spanish empire. Indians alone were named heroic forbears of the nation alongside the heroes of the independence wars in the preamble of the 1999 constitution. This image of indigenous resistance is also attuned to the discourse of struggle for a more just society on which the current Bolivarian project is predicated, along with its rhetoric of rejection of American imperialism. The historical continuity between the two Bolivarian moments—independence and the Chávez period, two births of the nation against imperialism and social injustice— gives the new nation a politically motivating image, an anti-imperialist and fighting essence. Indians provide a connecting thread for this history, an ideological operation of making indigenous and national history coincide. On October 13, 2005, Carlos Escarrá, a well-known Chavista politician, closed an article published in a national newspaper under the title “Day of Indigenous Resistance” as follows: “What is important to remember in these moments is that our Indigenous Peoples must be considered as the precursors of the great social struggles that have taken place in our continent, constituting the courage and character of this brave People (Sp. bravo pueblo), and that today they have, more than ever, the support of the Government to repay the historical social debt owed to them by our state, as pioneers of the struggles for liberty and equality” (Escarrá, 2005, my translation). Later in the Bolivarian period the president and others have presented indigenous peoples as the original socialists. Reprising the thoughts of the early twentieth-century Peruvian socialist José Carlos Mariátegui, the government’s political ideology, known as the “twenty-first century’s socialism,” is often cast as having roots in an indigenous socialist ethos as opposed to other forms of socialism. Talk of Indo-American socialism became more prevalent after the president’s re-election in December 2006, a period depicted as the inauguration of the next phase of the revolution. In his traditionally pedagogic way, the president gave speeches on different aspects of his socialist project. In December 2006, he explained: We will relaunch the Indo-Venezuelan socialism, a socialism inspired by our own roots . . . Re-energized, updated, we must incorporate the

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indigenous or Indo-Venezuelan socialism. We have to respect and help strengthen the roots of our socialism. Those practices are like seeds that must expand, multiply themselves. Look, things are the opposite of what many people have suggested. Many people have said, “Lets go to the indigenous communities to help them.” Yet, on the contrary, we should say, “Let’s ask them for help so they can cooperate with us in the construction of the socialist project of the twenty-first century.” Governor Rangel Gomez of Bolívar [state] was telling me not long ago, over there in Bolívar [state], that he has realized how the communal councils, [community organizations the government promotes for the implementation of local development projects nationwide], for example, work a lot faster and more efficiently among indigenous communities. That’s logical because it is their millenarian culture. Ours, on the contrary, is poisoned by capitalism, individualism, selfishness. (President Chávez, 2007:44, my translation)

Drawing on images of indigenous communal life and values provides a political philosophy consistent with a spirit of resistance and thus adds a socialist essence to the anti-imperialist nature of the new nation. A third crucial way in which Indians appear in governmental political discourse is as historically excluded citizens and, along with peasants and the urban poor, prime objects of re-dignifying government policies. As hyper-excluded peoples, they simultaneously represent the dire results of the unhampered spread of dominant political and economic forms and values (capitalism, neoliberalism, individualism, materialism) and become prime candidates to demonstrate the benefits of the application of the opposite principles (socialism, cooperation, solidarity) promoted as the basis of government policies. We could question the veracity of these descriptions, whether Indians are or are not like this or that. Anthropological criticisms of essentialism and Romanticism are well known, but we cannot forget that these images are produced in a specific political environment. The rebuilding of the nation is precisely about inventing traditions, selective essentialization, making emblems, and differentiation from moral enemies. And while much has improved in terms of indigenous peoples’ positions facing the state, it is also true that Indian-ness is being used as political capital, most often not by Indians themselves and still without an appropriate “return” regarding the actualization of basic rights—more specifically and critically, those to land. One of the more notable consequences of this new period is the indigenous movement’s change in character, particularly in the case of

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Amazonas State. Indigenous organizations during the nineties were militant in character, speaking for their communities and fighting for their rights as explicitly non-governmental bodies. Given the growing number of indigenous people taking up posts within local and regional governments and in different ministries, Indians now find themselves in the positions of policymakers and resource managers. Many of the more seasoned indigenous representatives have been incorporated into government bodies in both the executive and legislative branches of power. Owing to its historical granting of indigenous rights and to the rise of the indigenous issue in the political agenda it has fostered, the ChĂĄvez government is generally seen as allied with the indigenous cause. Members of indigenous organizations are thus more cautious and hesitant about openly criticizing its failures to fulfill indigenous rights. The government also has its own indigenous personnel to dialogue and negotiate with indigenous representatives who raise demands and grievances. All this amounts to a co-opting of the political force of the indigenous movement, which, as mentioned in chapter 1, was already subject to the lure of the large resources available to municipalities and states, a temptation that militates against indigenous political action. If this is a downside of the diversification of the political action available to indigenous people, there is also an upside: the creation of an indigenous network within the government. I take my next example from my work in the Indigenous Health Office, headed from 2004 to 2010 by a young Wayuu medical doctor and epidemiologist. An Indian with a history in the indigenous movement, the IHO head is also part of an indigenous network that includes current representatives and politicians in local and regional governments or public servants in other ministries. In the painfully bureaucratized and frustratingly slow state apparatus, much work gets accomplished by activating these networks where Indian movement solidarity is either tacitly assumed or overtly invoked in dealings between Indian officials. The nature of the challenges confronted by local organizations and communities has also changed. Having been identified as excluded citizens, Indians are now invariably included in governmental social programs. These programs have highly diverse objectives, such as education (from basic literacy to higher education), food provision and security (from subsidized food outlets to special food packages for the elderly and sick), cultural promotion, reforestation, and micro-economic development. With this abundance of programs and resources, the challenge for indigenous communities and their allies is no longer counteracting invisibility but rather exercising the good judgment necessary to incorporate and adapt

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from the range of government initiatives those deemed beneficial without increasing dependency on the state. Many times, these programs are applied with little adaptation to local culture or history. Program managers are also pressed to produce results and demonstrate maximum social inclusion. In general, while the violation of basic rights persists, local development actors (Indian and criollo) must now divide their attention and efforts between upholding rights and managing variably pertinent social programs.

The Indigenous Health Office The first bureau in the MoH specifically dedicated to indigenous health was brought into being when new health authorities decided to provide a more solid platform for a small group of young anthropologists and a medical doctor, who had been working in an office in the department of epidemiology, under the name of the Indigenous Health and Social Development Workgroup. I visited this office in late 2003. Having just finished my doctorate, I was eager to see how it was constituted. I knew they had begun to deal with the Yanomami Health Plan and was keen to see how I could become involved. This tiny office—in which the four employees could not fit all at once and whose single computer was symptomatic of the actual importance the ministry was according indigenous health—did not do justice to the enthusiasm of the tightly knit—was there an option?—workgroup. This period was characterized by lack of political clout within the MoH or beyond. Following changes in the higher ranks of the ministry, a new person was assigned to head this small group, a daughter of one of President Chávez’s longer-lasting ministers. She added to the existing workgroup a number of young Indians and set up a new office, CISPI, Coordination of Intercultural Health with Indigenous Peoples.3 The newly created CISPI immediately profited from the influence its head commanded both in and beyond the Ministry of Health, achieving the political positioning that the original workgroup lacked. New office space, work force, and networking with other ministries raised the profile and influence of the office as a whole. In November 2004, there was another change of minister and another reshuffling in the higher ranks of the MoH. Noly Fernandez, a female doctor and Wayuu epidemiologist, became head of CISPI, an appointment that proved crucial for the growth and consolidation of the IHO (as it latter came to be known). In this period, the office grew in number (to over a hundred indigenous and non-indigenous employees of the medical and social sciences), in presence (with branch

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offices in all the eight states with indigenous populations), and in formal organizational ranking within the ministry. Its activities from Caracas to indigenous communities multiplied, and from 2004 through 2006, the office realized two vital achievements: regional presence and bureaucratic existence. The first provided local-level knowledge of problems; the second guaranteed permanence within the state apparatus. I now want to consider this performance with respect to my previous discussion of the renewed symbolic status of Indians, which I believe has much to do with its success. This account draws specifically on the experience of Noly Fernandez, who was my boss for two years and whom I accompanied on many meetings until my formal departure from the Yanomami Health Plan in late 2006. To what extent similar or contradictory examples can be found in other ministries or government departments, I cannot say. What I want to stress is the way the indigenous issue has permeated and established itself as part and parcel of the Ministry of Health’s concerns and activities. A high-level ministry official can be all that more influential today if s/he is Indian. Previously, other public servants, particularly those of higher ranks, would find themselves conversing with an “indian”; presently, they know they are speaking to an “Indian,” a key symbol of the new nation. Their new context enhances Indian status. Interlocutors at formal meetings consider the weight of their opinions, displaying focused attention, respect, and sometimes deference. In debates within and beyond the MoH, Noly Fernandez can step out of her public servant shoes and into her Indian ones, adopting a critical stance that non-Indians cannot. This can shame the state in ways beyond the capacity of non-Indian public servants such as myself at the time. Nowhere was this more evident than in the president’s speech on the twelfth of October 2005, when the expulsion of the New Tribes Missions was announced. From a Pumé community, an emotional Chávez expressed the shame he felt seeing the condition of the Pumé living next to NTM missionaries, the symbol of courageous historical resistance pulverized by a more contemporary image of malnourished children and destitute Indian families. Our children continue dying . . . Indians, children of hunger and misery, right in front of our faces! . . . I call upon national dignity—governors, mayors, generals, admirals, commanders, political leaders, military leaders, priests, Catholics, evangelicals . . . to confront this reality . . . que nos echemos a cuestas nuestras cruces de 500 años carajo! We must seriously commit to [this issue]. We must tear our chests apart in pain . . .

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If we don’t do this, then it would be a lie. If we are not capable of doing this, it’s all a lie. It would all be a terrible lie, and we would have to say at the end of these days, however many they might be, like the Father Liberator, “Carajo! I have been ploughing the sea.” (President Chávez, October 12, 2005, my translation)

For an office whose task is to spearhead the transformation of Indians’ drastic health standards, the new symbolic position of Indians was still not enough to move a ministerial machine of departments, units, procedures, norms, and lapses. State bureaucracy, the bulk of which comprises public servants going about their business as usual, finds new symbols far less compelling. Societal transformation, which revolutionary discourse, legal rearrangements, and new institutions hope to propel, begins to slow down as soon as one enters ground-level ministry doors, becomes slower when walking up the stairs, and almost grinds to a halt at the ministry’s core departments such as administration, purchasing, and human resources. In an effort to overcome this torpor, the IHO invested considerable energy in making the Indian issue visible within ministry walls, a project that included a strong communications campaign and consciousness-raising sessions. Another important factor that helped raise the profile of the indigenous issue in the MoH was the particular emphasis given the matter by the minister in office from November 2004 to January 2007, Francisco Armada, formerly a rural doctor in Amazonas and subsequently the regional health director. Several other members of his team had similar career trajectories and personal experience with Indians. From the start, the minister made indigenous health an MoH priority, a platform that, along with the sympathy of “the team” in other high-level positions, expanded the Indigenous Health Office’s influence throughout the ministry and added several allies the IHO could count on to get things done, speeding up bureaucracy or bypassing it altogether. Before leaving the subject of the IHO, I want to comment on some of its strategic decisions and difficulties. A key early decision was not to create an indigenous health subsystem with a separate budget, organizational structure, and functioning as in Brazil, for example. The IHO’s main function was “transversalization,” meaning the adaptation of existing laws, policies, programs, and plans to the socioeconomic, historical, and cultural characteristics of indigenous people. Transversalization is based on the belief that the state should provide Indians differential yet not preferential treatment. This choice was not divorced from another one: to either create agile bodies of direct intervention alongside the standard MoH structure

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in light of the drastic health situation of many indigenous communities or to press for the increased efficiency of existing MoH organs. Those of us closer to the operational level of the system favored the first option; there was no time to waste waiting for the massive structure of the MoH to gradually become more efficient. Higher up in the system, the second option was preferred; redesigning the MoH, making it more agile, universal, and equitable for all Venezuelans, was their responsibility. In practice, different aspects of the IHO’s work reflected elements of both approaches. Perhaps the main difficulty that the IHO encountered—apart from the constant struggle with bureaucratic inefficiency—was precisely the misinterpretation of its “transversal” essence. It was unclear to many whether health problems arising with Indian patients or indigenous communities was the responsibility of the IHO or the appropriate MoH outpost, such as a given hospital or the department of epidemiology. Where each body’s scope begins and ends and how they articulate was a key area that remained to be practically mapped out. The flipside of this coin was that the IHO was constantly asked to take part in other government bodies’ plans and projects with Indians, making it hard to engage properly with its own institutional agenda.

The Yanomami Health Plan The Yanomami Health Plan (YHP) is directly related to the Hashimu massacre, the killing of sixteen Yanomam Indians by illegal gold miners in 1993. Featured in both national and international media, Hashimu brought renewed attention to the Yanomami’s constant struggle for their land. After the massacre, the Puerto Ayacucho Vicariate Human Rights Office led a case against the Venezuelan state at the Inter-American Human Rights Commission for violating a number of human rights (Bello, 2005:412). In 1999 the Venezuelan state, seeking an amicable solution, agreed among other things to design and execute an integral health plan for the Yanomami people. Independently and around the same period, health authorities and other institutions with a bearing on health delivery to the Yanomami had been meeting in Puerto Ayacucho to address the improvement of health services. At the time it was estimated that 70 percent of Yanomami population was beyond the health system’s reach, and thus the issue of expansion was of particular concern. An initial plan was drawn up during these meetings. In 2001 another multi-institutional meeting was held, resulting in a document

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requesting funds from the government. To what extent the intense national political climate of 2001 through 2002, including an oil strike and coup d’état, affected the stagnation of the plan, I cannot say, yet it was only up to December 2003/January 2004 that President Chávez had assigned the plan a specific budget—1,500 million Venezuelan bolívars, at the time a little less than US$1 million. In 2004 CISPI was created and revived discussions of the plan. In November of that year, the minister of health was replaced. The IHO’s new boss and her small team—of which I became a part—sought to bring the plan to fruition, and the YHP became a flagship program for the ministry. Officially the plan took off in January 2005. As mentioned in chapter 2, the Upper Orinoco Health District had many chronic problems: a fluctuating presence of doctors, poor infrastructure, and logistical deficiencies. The YHP then had to distribute its efforts between recovering the existing network of services and expanding into the unattended areas. The YHP team also designed an education program specifically adapted to Yanomami language, culture, and epidemiology. Before commenting on the concrete results of the YHP, it is worth mentioning how the YHP incorporated some of the anthropological insights I have discussed. First, Yanomami opinions and demands presented at the Shakitha Yanomami conference (discussed in chapter 8) were taken into account, thus avoiding a new round of meetings in search of Yanomami perspectives on these matters. The conceptual and practical complementarity subscribed to by the Yanomami themselves (the subject matter of chapter 7) also informed decisions as to how the YHP should integrate biomedicine with traditional therapies—a problem for which the Yanomami had long ago a clear and sensible answer. The goal was to guarantee the complementarity between these therapeutic alternatives such that access to one did not preclude or otherwise limit access to the other. This generally translated into the necessity of expanding biomedical health services and educating Yanomami with the biomedical knowledge that they did not have themselves, our part of the health alternatives deal, so to speak. In recognition of the inadequacy of high rotation rates on the operational level, greater emphasis was placed on training Yanomami from all parts of their territory in nursing. An increased number of permanent Yanomami personnel would progressively relieve the dependency on criollo doctors. In terms of the health system itself, the YHP was thought of as a temporary adjunct to the existing health structure. In time, the health district headquarters would incorporate the extra features of the YHP, thereby achieving institutional rather than nominal presence and reaching technical and administrative autonomy. There is still a long road to travel in the

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accomplishment of these last two objectives. Finally, it must be noted that with a team of people knowledgeable about the Yanomami culture and epidemiology, discussion with the Yanomami took on a different character in comparison to the average state representative’s visit. Yanomami appreciate their interlocutors’ efforts to understand them, and thus the typical commoditized visits, the episodes of mutual incomprehension, the empty promises, and trickery gave way to a more serious search for long-term solutions. In its first three years (2005 through 2007), the YHP progressively improved the service network, providing all health posts with adequate communications, equipment, infrastructure, and transport. Fuel supplies that allow health teams to work were vastly increased, as did the regularity of delivery and quantity of medicines. Regarding expansion, two new health posts were opened—in Mavaquita, on the Mavaca River, financed by a Danish NGO, and in Koyowë, on the Orinoquito River, in the wake of the departure of NTM missionaries. These posts provide better assistance to some one thousand previously underserved Yanomami. In 2006, the first time since the 1993 Hashimu massacre, a YHP team reached the community of Hashimu (now called Hara u theri) in the Orinoco headwaters. Visits to this community to implement vaccination and disease control programs have slowly increased, and two adolescents have graduated as basic-level nurses. Health teams also visited other completely unattended areas in the Upper Ocamo, Siapa valley, and the Maiyo theri sector, albeit very irregularly. Information on the census and location of many hinterland communities concomitantly improved. This effort involved hundreds of Cessna and helicopter flying hours provided at no cost by the Air Force as part of the government’s Plan for the South (see chapter 1). Even when based on poor census information, the estimate of the total Yanomami population in Amazonas completely excluded from the system has dropped from approximately 70 percent to between 40 and 45 percent. Doctors working in the area also increased in number. While only one doctor was working in the Upper Orinoco in late 2004, between six and twelve were working between 2004 and 2007. In 2006 twenty-three youths began a nursing training program designed specifically for the Yanomami, the first time such a course was taught in an indigenous language in Venezuela. This course eliminated the requirements of having to read and write in Spanish and having a sixth-grade education, which had been the case for previous courses of Simplified Medicine, limiting Yanomami attendance to the mission educated. Although the course was affected by periods of discontinuity, most of the students graduated in August 2008. Epidemiological information necessary for measuring

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health outcomes only began to improve in 2007. The piecemeal information available for 2005 indicates that basic health indicators for the areas with regular attention have yet to register significant improvements. The brute infant mortality rate, for example, for the population of Ocamo, Mavaca, Mavaquita, and Platanal was 164.7 per 1000 live births, while the national average was 15.5. In 2007 the brute infant mortality rate of the same region was 138.8.4 Compared with the state of the health system in late 2004, these are important steps forward. However, seen from the perspective of the ultimate YHP goal of providing appropriate health services for all Yanomami, these efforts are incipient. Even the most basic health indicators for regularly attended areas are still painfully high, and several areas in Yanomami territory remain completely unattended. Also, areas where recent expansion has been achieved are still far from reaching decent levels of attention. The number of Yanomami communities requiring local health personnel is still vast, and the ability of the health system to adequately supervise the recently trained Yanomami—a key feature for any degree of success—is uncertain. The integration of epidemiological information and the coordination of health programs and interventions throughout the health districts in Amazonas with Yanomami population (and here I mean Yanomami, Sanema, and Yanomam) are all but nonexistent, not to speak of that between Amazonas and Bolívar states. Similar efforts between Venezuelan and Brazilian health authorities are still timid and never proceed beyond initial bi-national conversations. Opportunities for making a career out of indigenous health must also be developed for both criollo and Yanomami personnel. Last but not least, and in view of the intensified state interest in making itself present and attending to Yanomami in so many different ways, developing means to balance the power relations between Yanomami and the state seems as crucial as ever. Creating and providing local organizations with the tools and information necessary to make the best decisions seems indispensable. My final insight as to necessary changes for the general improvement of Yanomami health merits telling a story that follows the meanderings the state can graft onto the apparently straight line between a ministry and a bank. With some retrospective humor, we can see this as a treasure hunt.

The Treasure Hunt The 1,500 million Venezuelan bolívars allocated in December 2003/January 2004 for the YHP were deposited into a state bank account, BANDES,5 together with preexisting deposits earmarked for “Integral Development

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for Indigenous People” and for the Street Children Programme. Management of these funds was left to SENIFA,6 an autonomous institute attached to the MoH, dedicated to developing social programs for underprivileged infancy. The funds for the Yanomami remained untouched in BANDES a shameful twenty-seven months until March 2006. During this period, their value dropped given that domestic inflation was greater than accrued interest and that the bolívar lost a third of its value against the dollar.7 It took us from January 2005 to March 2006 to begin spending the YHP funds. The first problem was to define the bureaucratic entity that could legally be in charge of administering the funds. SENIFA initially imposed the need to create an NGO to manage the funds, with the caveat that no public servant could be part of it—hence, no one in the YHP or the IHO could manage the funds! The Regional Health Bureau of Amazonas was dismissed as an option because of its history of corruption and politicization, and the Indigenous Health Office did not yet properly exist in bureaucratic terms. Other alternatives were all found subject to one legal-administrative impediment or another. For the state to adequately address Indian issues Indians in faraway places seemed inherently impossible, displaying an inverse relationship between “going by the book” and efficiency. After months of bouncing back and forth, the guarantorship of funds was transferred to another autonomous institute with a reputation for efficiency. Their reputation was well-deserved: the YHP administration progressed smoothly once the INHRR8 began mediating with the bank a few months later. This was not all. State reorganization triggered another set of delays. The Ministry of Health had two vice-ministries, health and social development. In 2005 the social development side of the MoH was eliminated and its functions transferred to the new Ministry for the People’s Participation and Social Development. In the organizational reshuffling, SENIFA was removed from the MoH and reattached to the Ministry of Education, and one of the three funds in the BANDES account, that of the Street Children Programme, was then transferred to the new ministry because it was no longer part of the MoH’s domain. Consequently, three ministries had to coordinate for SENIFA to relinquish its guarantorship of all the funds and have them divided appropriately between the MoH and the new ministry. Negotiations with BANDES led us to the state’s National Budget Office (ONAPRE),9 which had to oversee these financial transfers. BANDES and ONAPRE each had their own rules, views, and suggestions, increasing complexity and contradictions as a growing number of partial views of the whole accrued. In September 2005 it was even suggested that President Chávez himself, who had allocated the funds by decree in late

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2003, would have to decree the new distribution of funds on the grounds that “what had been done by decree could only be modified by decree.” No such decree proved necessary, and in the first months of 2006, a new contract between BANDES and the MoH, with the INHRR as mediator, was signed. Finally, the funds began to “flow.” Needless to say, all these delays made substantial dents in our stamina and morale, and worst of all, our credibility with the Yanomami began to crumble. Fortunately, the tides changed pretty much just in time. This tale should suffice to illustrate one simple point. Adaptations that can make a service more culturally sensitive are more readily addressed than the state’s administrative culture, without which cultural adaptations, however innovative, reach nobody. An intervention in the state’s bureaucratic culture would no doubt constitute the most far-reaching adaptation with the potentially greatest impact on indigenous health. We frequently hear and read that Indians die of preventable and easily curable diseases, which gives persuasive force to arguments for health improvement. Yet to consider a “simple pill” in the jungle sufficient is to misread reality. Similarly, a shot in a city hospital is not just about medicine but rather a health system full of regulations, offices, signatures, employees, protests, medicines, and outboard motors. As Latour has observed, airlines fly, not airplanes. This brief account of the mixed fortunes of the IHO and the YHP during their initial years and their sense of uncertainty about the future reflects, I believe, the general character of the latest developments in the state’s relation to indigenous people in Venezuela: mixed feelings of radical progress accompanied by frustrating limitations; new opportunities exploited in favorable historical circumstances yet equally thwarted by enduring vices of state inefficiency; the new symbolic status of Indians offering certain advantages but also encouraging their use as political capital; recognition of hitherto inexistent rights alongside reticence to demarcate indigenous territories. It is impossible to predict what will be next, which public policies will be sustained and which abandoned, and how different indigenous communities will articulate with a state increasingly interested in them. The initial impetus of the YHP, for one, has waned with its increased absorption into the standard structure of the MoH, with new health authorities and changing priorities. The extent to which the progress made proves to be structural rather than contingent remains to be seen. Nonetheless, this passage from ideological invisibility and programmatic abandonment to center-stage focus of the Bolivarian Revolution will likely continue to be a highly transformative period for indigenous people.

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The scope and density of Upper Orinoco Yanomami integration into the Venezuelan state has not stopped growing since the initial permanent missionary contacts in the 1950s. The daunting complexity of Yanomamicriollo relations that leaves most criollos, be they missionaries, doctors or anthropologists, slightly bewildered and episodically perplexed has become increasingly evident. The health system has been a key factor in the creation and maintenance of novel relationships along a network of communities modified by the new meaningful contexts propagated from a growing Yanomami-criollo socius. It is also an institution that needs improvement and expansion to guarantee the physical continuity of the Yanomami people and their ability to reproduce the alternative meaningful world in which they live. It is my hope that this account of Yanomami-criollo relations, seen through the lens of the operation of the health system, comes as a timely contribution for anthropological and other audiences involved with Amerindians and public services, for the circumstances of the Yanomami in Venezuela are far from unique in Amazonia. This book has sought not so much to “explain” this relation but rather, inspired by Roy Wagner’s anthropological ideas, explore the Yanomami’s and criollos’ relative regard for each other. It has been an exercise in perspectivist anthropology, as Viveiros de Castro (2004a) observes, aimed at retaining awareness of the homonymy between Yanomami and criollo meanings in the hope of supplanting literalizing anthropology. I now want to suggest some of the broader implications of this study for Amazonian anthropology. 217

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Conventional and Napë Transformational Contexts Albert (1988) revealed how whites, manufactured objects, and epidemic diseases traversed in tandem the Yanomami conventional socio-political space. We have seen how such a trajectory necessarily implied the extension of the meanings of Yanomami and napë, and the emergence of a novel set of ideas and relationships that I have called the napë transformational context. This context revolves not around degrees of enmity or alliance, like the conventional one, but around the degree of a historical transformation into napë. The new context is an expansion rather than replacement of the conventional one, which is why current relations exhibit elements of both the conventional morality of being human and the innovated, and now conventionalized, napë transformational context. Hence, every relation between criollos and Yanomami, or between Yanomami themselves with distinct degrees of “civilization,” can be seen to contain a moral component defining a degree of identity (Yanomami) or alterity (napë), and a body/ knowledge component defining a napë or Yanomami position by a cumulative degree of criollo habitus and knowledge. The former refers to the Yanomami conventional, the latter to the napë transformational, context. Each occasion also separates/differentiates in one way and collectivizes/connects in another, depending on the actor and his/her intentions. So it is that a doctor’s successful performance in tending to a seriously ill patient may hinge on the simultaneous display of Yanomami morality and napë knowledge. So it is that interface Yanomami mediation in an upriver medical visit or in a downriver protest hinges on the same performative combination. So it is that exchange of manufactured goods differentiates in one way—making someone napë and someone else Yanomami in the napë transformational context—and collectivizes in another—binding two Yanomami who display an appropriately human morality in the Yanomami conventional context. Several anthropologists’ descriptions of the intermingling of Indian and white worlds, objects, and values suggest that this interplay between conventional and innovational contexts and its moral and body/knowledge components might be of use for analyzing other interethnic scenarios in Amazonia. Consider Hugh-Jones on the debt-bondage chain of relations in northwest Amazonia: “This chain does not suddenly stop at an ill-defined ethnic frontier. It stretches on to bind Indian to Indian, so that the morality of the market penetrates that of kinship and the morality of kinship may be extended to dealings with white people” (1992:51). In more research on economics, Gordon (2006:294), analyzing the Xikrin Kayapó (Brazil) use of goods and money, comments on the two-sided

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quality of money. In every act of incorporation of money, one finds a sign of a predatory relation with whites from which it comes from. But in its internal circulation among the Indians themselves, another facet is manifest, one in which money is a sign of relationships between kin and, as such, is governed by the same morality that underlies the sharing of food. “In other words, [money] is not just a sign of a relation between the Mebêngôkre with another type of agent (kube) [whites], but also a sign of relation among Mebêngôkre, in the process of fabrication of a same people in terms of ‘body-affect’ ” (Ibid., my translation). One could see the first sign as a differentiating body/knowledge component and the second sign as a collectivizing moral component of relations mediated by money. The first points to a white transformational context upon which Mebêngôkre leadership is now based, the second to a conventional context of kin-making. The Piro of the Bajo Urubamba are also part of an economic system that links consumption of manufactured products to degrees of civilization, yet the system of habilitacíon is articulated with the internal economy that produces kin who eat and share “real food” (Gow, 1991). Once again, differentiating and collectivizing contexts are articulated. All these examples pertain to the world of economics because the differentiating potential of the napë transformational context is centered on body/knowledge and because so much of the morality of being human hinges on appropriate exchange relations. I have, however, tried to demonstrate that other aspects of life, such as medical performances, meetings, and political demonstrations, also exhibit the same interplay of meaningful contexts.

Becoming Napë and Napë Potential Affinity The intensification of relations between whites and indigenous peoples in Amazonia has pressed Indians into developing a delicate politics with their respective states. If this demanded a “pacification” or “domestication” of whites (Albert and Ramos, 2000) because of the mutuality of kin-making and the “other becoming” propensity of Amazonian peoples (Viveiros de Castro, 1992), a becoming of sorts, often expressed as becoming white or civilized, was concomitant. It is important to note that the principles underlying this transformation, even though expressions such as “we are now civilized” would imply the contrary, are entrenched in indigenous sociality. Gow (1991) has examined what this means for the Piro: the aspiration to

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autonomous life in villages where you are surrounded by kin and provided with schools while eating “real food.” I have tried to elucidate how this idiom is related to Amerindian notions of kinship and personhood. Becoming napë and the construction of kinship are similar in that both involve the progressive obviation of something understood to be innate. They are inverse processes in that the former presents similarity (Indian) as the innate given condition, whereas the latter features difference (affinity) as the given (Viveiros de Castro, 2001). Because both are about obviating something innate, neither of these processes reaches completion. Several ethnographies of Amerindians reveal that while whites remain in the position that epitomizes otherness, Indians, despite their permanent transformation, also see themselves always as Indian. Similarly, the process of removing innate alterity in the production of kin and community, as Viveiros de Castro (2001) has argued, is never-ending: complete identity among members of a local group is never reached. As a historical transformation, becoming napë has created Indian/white composite persons (civilized Indians). This Indian/white duality may be a new “contact” construct, but in its character and dynamic, it is another guise of the Self/Other internal duality that has been described for the Amerindian person (Viveiros de Castro, 2001; Kelly, 2001). Its character is that of being white and Indian, just as people are relationally consanguine to some people and affine to others, or perspectivally “body” to some and “soul” to others (Viveiros de Castro, 1998). The given conventional (Indian) does not fuse indistinguishably with the made inventional (white). These components coexist but do not mix. Its dynamic is expressed in Yanomami and napë performative action that obviates and externalizes internal dualities in a way that resounds with Melanesian “dividuality” (Strathern, 1988). We are faced here not with mestizaje, which preaches the mixing of races to which social and moral qualities are attached producing a new biological and social blend of people—café con leche—to use the Venezuelan idiom on the subject (Wright, 1990). Instead, the character and dynamic of this compositeness, based on different concepts of the body and kinship immersed in a distinct sociality, is an anti-mestizaje. Instead of fusion and new identity, we see addition and new alterity—new possibilities for relational and dialectical alteration between distinct bundles of attributes—to retain the metaphor, café y leche. The comparison with mestizaje reveals another significant difference related to the notion of becoming. Mestizaje may be said to correspond to a process, an evolution,

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a progression of steps toward a final state: the mestizo person, social class, or nation. Mestizaje has no return. It produces a distinct kind of people and thus eliminates the relation between the original peoples who end up “consumed in the mix,” a mix possessing a common identity. “Becoming” in “becoming napë” refers more to the concatenation of virtual and actualized states: otherness is a virtual state of the Yanomami person. Yanomami and napë sustain a figure-ground relation, each creating a contrasting context of the other. The transformation in becoming napë is of a kind with those recounted in Yanomami myth. Ancient Yanomami becoming animals, for example, was the actualization of animal virtuality latent in the mythical characters, which may have been anticipated by their rather bizarre behavior, a scenario seen in Amerindian mythology in general. Once transformed to an animal, the human quality is not lost but retains a virtual presence as the immaterial aspect of the animal (Y. no uhutipi), permanently actualized in shamanism’s personification of animal spirits in anthropomorphic form (cf. Viveiros de Castro, 2006b:4). In becoming napë or civilizado, then, Yanomami are not becoming or seeking to become mestizo or to be assimilated with whites; on the contrary, the relation between Yanomami and napë must remain, for in the napë transformational context, people must be able to alternate from one meaningful position to the other. For several Amazonian peoples with distinct forms of social organization and historical relations with their respective states, such as the Kayapó (Gordon, 2006), the Piro (Gow, 2001), the Wari’ (Vilaça, 2006), and the Yanomami, whites remain at once as canonical others and sources of difference to be internalized to propel community life into the future. All these cases illustrate the value of the notion of potential affinity derived by Viveiros de Castro (1993b; 2002b) in the analysis of Amerindian kinship systems, a concept, that, like Amerindian mythology itself, seems to have a place reserved to be eventually occupied by whites. Indians may speak of being or becoming civilized while keeping whites as canonical others, and even those who see themselves as in some way “mixed” may not aspire to become mestizo or assimilated with whites. Such situations are of some political relevance in countries where appeals to a history of mestizaje (in the Venezuelan case) or the Westernization of Indians’ lifestyles (in the Brazilian case) sustain claims that there are no longer any “real Indians,” assertions intended to undermine the granting or upholding of indigenous rights. The same can be said of the phenomena of (re)-ethnification, generally received cynically by the political mainstream as strategic political ploys on the part of mestizo populations or else

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sympathetically by analysts who nonetheless reduce these phenomena wholly to the workings of the state (cf. Viveiros de Castro, 1999:189–211).

Equivocation and Homonymy Equivocation, when understood as the misrecognition of alternative meaning, is perhaps one of the most useful concepts to describe the articulation of Yanomami and criollos’ mutual regard. We have seen how the health system is immersed in a historical process bringing together two partially overlapping projects that motivate Yanomami and criollo interest in each other. In the broadest of terms, these projects are both about “civilizing.” Criollo civilizing projects, be they missionary evangelization or other incorporation of the Yanomami into the nation-state via health and education services or politics, can be divided into efforts to “make criollos,” that is, the modification of the body and its habitus according to dominant models of Christian or national lifestyles and biomedical criteria, and efforts to “make society,” that is, the establishment of conventional rules of engagement that can sustain the fruitful Yanomami-criollo socius demanded by public services or political citizenship. Yanomami civilizing or becoming napë, we have seen, is more about the acquisition of napë body/knowledge and the production of Yanomami/napë kin. Making criollos strikes an affinity with Yanomami becoming napë due to the common focus on the body, its habitus, and the differentiation that it affords. Making society, in contrast, is at odds with becoming napë for it pits criollos’ fabricated conventions against Yanomami innate conventions, collectivizing efforts against differentiating ones, institutional relationships against napë potential affinity. The sense of advancement of each party’s civilizing projects produces the illusion of understanding, of sharing meanings and goals; the sense of resistance to each other’s agenda produces the illusion of misunderstanding, the confusion of meanings within a shared system of references. The homonymic nature of civilization in this intercultural space is rarely recognized. For the most part, both Yanomami and criollos adjust their expectations of each other and make the most of the overlapping aspects of their projects. Within this overarching equivocation that in one way simplifies Yanomamicriollo relations and in another complexifies them, a series of homonymic conceptualizations delineate privileged avenues of engagement. Equivocation involving the notion of body sustains Yanomami-criollo relations;

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equivocation around the notion of shawara and germ theory sustains a good deal of the articulation of Yanomami and biomedical systems; equivocation about the Yanomami ethics of ameliorating suffering and criollos’ views of Indians as helpless and needy can sustain certain collective and political engagements between Yanomami and state officials. A crucial equivocation involving the meanings of Indian and criollo, as my analysis of the Encuentros de Saberes in chapter 8 illustrated, generates resistance when state officials wanting to make Indians meet with Yanomami wanting to become napë. The assumption that “Indian” and “criollo” or “civilized” mean the same thing for Indians and criollos is at the root of criollos’ interpretation of indigenous peoples’ change as inevitable culture loss, alienation, assimilation, and the like (cf. Gow, 1991). Even allowing for these kinds of evaluations to be found among Indians themselves, the automatic assumption of degenerated cultures leaves no room for asking about indigenous perspectives, Indians’ valuation of their historical processes, and the principles that may be underlying their meaningful world. I have used equivocation as not just an analytical construct to describe the dynamics of Indian-white relations but also a methodological principle by which I sought to elucidate Yanomami and criollos’ conventional biases involved in their mutual interpretations. Equivocation is understood in this case as an awareness of alternative meaning rather than its misrecognition, a “controlled equivocation” in Viveiros de Castro’s (2004a) words. This makes a non-literalizing translation, an establishment of cross-cultural analogies between Indian and Western anthropologies, possible. In this way, we saw that the state’s concentration on the production of things (culture) and identity, which impels them to “make Indians” when attempting to concretize multicultural policies, translates to Yanomami concentration on the production of people and differentiation, which impels them to “become napë.” Only by realizing the homonymy involved in terms like “Indian” and “criollo,” by being aware of the disparate system of references deployed by criollos and Indians, is the analogic-metaphoric relation between these two very distinct processes made evident. Also by virtue of this perspectivist anthropology, we can see how Yanomami and criollos enter each other’s world in the form of the innate. As instantiations of the innate, at the level of motivations, the Western concept of nature, which Yanomami embody in the absence of society, and Yanomami potential affinity, which criollos epitomize, are also metaphorical counterparts. Hence, they experience the mutual desire to work upon each other, the need to make society and to domesticate criollos.

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Conventions and the Reciprocal Evocation of Moral Relationships As do so many other Amerindians, the Yanomami inhabit a highly transformational world. Myths speak of transformation. The arrival of missionaries can be cast in similarly transformative terms. Shamanism and the spirits of the forest remind people of the unreliability of appearances. Becoming napë is an ongoing transformation. This is a “ ‘world as hypothesis’ that need never suffer the stringencies of final ‘proof ’ or legitimation” (Wagner, 1981:108), which in fact means that it demands “temporary” proofs, the constant ratification of one’s human, political, Yanomami, or napë standing in others’ regard. Thus morality is a matter of reciprocal evocation. My analysis of doctor-patient relations, specifically in chapter 6, suggests that a knowledge of Yanomami morality, language, and conventional relationships within and outside the medical realm on the part of doctors and criollos in general is beneficial in ways other than achieving communication or understanding cultural context. Beyond adapting interventions or explanations, displaying awareness of conventional knowledge compels the actualization of moral relationships. By performing Yanomami, a doctor helps a patient remain Yanomami too. Consciously or not, language and convention, as part of the innate form of humanity/morality, have the performative potential to make the difference between “collaboration” and “sabotage.” Notably, that doctors think differently from Yanomami in medical terms does not seem to bother them; rather, they are concerned that doctors not “let people suffer” and that they stick to conventional procedures. The issue of the reciprocal evocation of moral relationships in Yanomami sociality also affects the general character of the relation of the health system with the Yanomami. The inconstancy of the system, the rotation of operational personnel, changes in policies and authorities, unkept promises, the still erratic flow of logistical resources, bureaucratic delays—all this amounts to the antithesis of that which can reduce the innate alterity Yanomami confer on criollos. All the mechanisms available to obviate difference—co-residence, permanence, knowledge of the conventional— are almost absent. The relevance of this inconstancy in Yanomami eyes is evident in their demands: they focus their criticisms on the least permanent category of health personnel (students); they call for permanence and expansion of health services; imposing a corporate quality upon the system, they remind authorities of previous commitments that ever-changing state representatives—especially in times of “revolution”—wanting to

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distinguish themselves, hope Indians would forget. Yanomami relations with criollos within the health system can thus be partially read as a response to this amoral inconstancy that elicits confrontational relations. The health system’s historical inconstancy confirms napë cosmological alterity to which Yanomami respond accordingly with a napë performance in the conventional sense.

Articulating and Harmonizing the Health System with Yanomami Communities The articulation of state institutions with Yanomami communities stages an encounter of sorts. The circumstance is of a kind with those seen as mixing “gift” and “commodity” economies (Gregory, 1982) or as the coming together of “hot” and “cold” societies (Lévi-Strauss, 1962; Gow, 2001). Even if focused on a certain way of conceptualizing things and people or the relationship of history to society, the issue revolves around noticing distinct modes of being in the world and distinct ways of envisioning society and its reproduction (Wagner, 1981). Throughout this study, I have cast the encounter in terms of the articulation of innate (Yanomami) and fabricated (criollo) conventions, of partially overlapping projects of civilization, of Yanomami and criollos entering each other’s worlds as forms of the innate (potential affinity and nature, respectively). Equivocations facilitate the articulation along lines of homonymic affinity of concepts and interests in some ways and offer resistance to the advancement of each party’s project in others. I want to call attention now to the place of meetings in the sustenance of the Yanomami-criollo socius, for they are at once the state’s privileged form of engagement with communities and instances where the Yanomami-criollo society is itself periodically reproduced. Criollos and their world are “added” to the Yanomami lived world as an existing form of alterity. The morphology of criollo-Yanomami relations is an ecology of difference and similarity akin to Self/Other dualities in all their guises throughout Amazonia. In this regard, meetings are transformative substitutes of the rituals of social reproduction where difference typically plays out. Guests or opposed moieties present themselves as symbolic affines or enemies in the local setting, only to then obviate this, keeping real difference beyond the local. These rituals domesticate Others and ensure that the outside remains a source of fertile difference. This dialectic is portrayed, for example, in Fausto’s (2000) analysis of the Pakaranã

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opetymo ritual, McCallum’s (2001) description of the Cashinahua kachanahua ritual, Vilaça’s (2006) accounts of feasting among different Wari’ sub-groups, and Albert’s (1985) analysis of the Yanomam reahu. Through this dialectic many Amerindians reproduce or invent their societies as self/ other complements, contradictory yet mutually implicated and generative. A meeting such as the Mavaca conference or the La Esmeralda Encuentro de Saberes clearly differentiates Yanomami from criollos, presenting the latter as enemies at some points, and obviating difference at others, presenting criollos as allies, and “civilized” Yanomami, as Yanomami/napë complements, are invented in the process. As moments of social reproduction, meetings rehearse the dialect involved in the essential Yanomaminapë relation, articulating the Yanomami conventional and napë transformational contexts. They crystallize the pure and contradictory meaningful poles of Yanomami and napë and then enact the necessity of obviating these oppositions for propelling napë becoming. This dialectical and episodic reproduction of Yanomami society with its added criollo half, nonetheless, poses challenges for those guiding the destiny of this hybrid socius—Yanomami leaders and state representatives and authorities—for the simple reason that criollos and the state neither envision society as contradictory yet generative halves nor view its reproduction in a dialectical manner. Whether in terms of previous policies for “making criollos,” which promoted the dissolving of indigenous cultural difference in favor of a national model of social, economic, and political being, or in the current terms of “making Indians,” exemplified by some instantiations of multicultural policies, for the state, the Yanomami are a minority whose needs and demands must be resolved in a fashion that will always be subordinate to the larger project of the nation-state defined in linear, historical, and progressive, rather than dialectical and cyclical, terms (cf. Wagner, 1981:chapter 5). Yet, even in the eyes of the ordinary doctor or the health district head going about his/her business of providing the best possible service without larger projects in mind, the dialectal reproduction of the society of which they are a temporary part produces a sense of stagnation and a constant need for negotiation. Being part of, and backed by, an ever-changing health system while working alongside often contradictory state policies exacerbates this condition. With respect to individuals, this situation demands a high capacity for dialogue, establishment of long-term relationships, adjustment of expectations with the pace of transformative solutions, and passionate involvement tempered by a degree of serenity. With respect to the health system, it demands the elimination of inconstant personnel

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rotation, greater logistical capacity and engagement with communities, and more emphasis on the training of Yanomami health personnel at all levels. With respect to Yanomami leaders and representatives, it calls for the ability to negotiate and manage the resistance that results from the non–congruent aspects of Yanomami and criollo projects. The mediation of effective alliances with doctors and health authorities and the establishment of supra-local forms of organization that can exert social control are decisive factors when confronting the relentless force of epidemic diseases. In the bigger picture, such abilities in an intercultural political scenario are as necessary as they are complex, particularly in this period of heightened state attention to indigenous people. The harmonization of Yanomami and state projects in terms of the health system is, indeed, possible, and the Yanomami Health Plan has taken important steps in this direction in its consideration of the Yanomami conceptual and practical articulation of the biomedicine and shamanism, in its concentration on training Yanomami health workers, and in its efforts to stabilize the system’s logistics. This challenge involves articulating Yanomami and criollo potential in a complementary way that maximizes the capacities and minimizes the limitations of each party. Only trained Yanomami health personnel have knowledge of their language, cultural conventions, and history, and they can live and travel comfortably in the forest. Their status as fully moral human beings within kinship is a key asset that no doctor, in the conventional position of napë, can attain. Criollo health personnel, for the time being, have knowledge of biomedicine and epidemiology both to provide a service and to train Yanomami. Moreover, their institutional and generalized relationship—their status as napë potential affines—imposes on them none of the Yanomami kinship and intercommunity political exigencies. Each party’s limitation can thus be offset by the other’s potential. The establishment of long-term relations within consistent and constant policies fosters the interchange of capacities: criollos are domesticated, morally indigenized, and Yanomami are trained, napë-fied knowledge-wise. The delicate art of articulating the health system with Yanomami communities consists of fostering the flow of medical cultures—the exchange of objects, practices, and knowledge between biomedicine and shamanism—while minimizing the friction that stems from distinct forms of conceiving of and reproducing a society. Biomedicine is part of a state ministry of health, a conventionalizing system envisioned as a linear progression toward an end—better health. Shamanism operates within a differentiating society that conceives its reproduction in dialectical terms.

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The Limits of Becoming Napë and State Indigenization I have attempted to reveal the profoundly indigenous character of becoming napë, finding similar examples of collective transformations in other parts of Amazonia, and thus displacing the literalizing interpretation that can render this change only as culture loss or alienation. Its indigeneity, however, does not necessarily mean it is an innocuous process, in principle because it is in permanent articulation with what with the state or national society presents Indians, something Indians will make their own, yet in circumstances they do not control (cf. Gow, 2001; Gordon, 2006). During the last decade or so, Upper Orinoco Yanomami have embraced party politics thoroughly. The bounty of goods and salaries made available to the Yanomami through municipal and regional governments and, more recently, through numerous governmental programs has accelerated differentiation and diversified its sources. Given the flourishing of new opportunities and the greater community involvement in this political dynamic, becoming napë, inflected as it is by the clientelistic and competitive character of party politics, has an important element of experimentation combining both the excitement and the caution of a challenge. Relations with the state confront Indians with the constant need to assess their historical decisions and reexamine their alternatives. Becoming napë and domesticating criollos are mutually implicated processes whose extent, intensity, and character are continually being negotiated within indigenous communities and with state agents. Viveiros de Castro (2000:51) is surely correct in asserting that whites are supra-cultural yet infra-social beings in Indian eyes: possessors of fabulous knowledge and objects who, nonetheless, do not know how to behave as real humans. This underpins the profound ambiguity of the Yanomami to all things criollo, including party politics. Although Yanomami are eager participants for all the practical, symbolic, and political reasons that becoming napë subsumes, they also attribute to political engagement certain anti-sociable effects. In the several meetings held in late 2007 in Ocamo, Mavaca, and Platanal, Orinoco Yanomami spoke of the spread of politics as a kind of shawara, an epidemic disease that has exacerbated internal divisions among them. Except for the most successful politicians, many described their frustration with the decline of SUYAO—the sole Yanomami indigenous organization in the Upper Orinoco—and others claimed renewed attempts at creating an organization that united Orinoco communities was doomed to fail because Yanomami resolve would succumb to the luring and divisive force of politics.

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The analogy of politics and shawara strikes me as both incisive and profound if we recall the manner in which shawara is rendered in different Yanomami contexts: an ontologically criollo form of disease, cannibal demons that slash infants to pieces (see Kopenawa in Albert, 2000), a forest infestation that cannot be eliminated, a product of the historical encounter with criollos. Politics spearheads a still uncertain and somewhat experimental journey in controlling criollos, a journey that also demands Yanomami control themselves in the process. And it is perhaps this realm of life that confronts Yanomami with the crucial issue as to the means and limits of becoming napë, a question that different indigenous peoples resolve in a range of ways and that Viveiros de Castro grasps as follows: But if the problem of the origin of whites is, in a way, resolved since before the beginning of the world, the inverse and symmetric problem of the destiny of Indians remains, I think, crucially open for them. For the challenge and enigma with which Indians are faced consists of knowing whether it is really possible to use the technological potency of whites, that is, their mode of objectification (their culture), without letting yourself be poisoned by their absurd violence, their grotesque fetishisation of commodities, their unbearable arrogance, that is, by their mode of subjectification—their society. (Viveiros de Castro, 2000:51, my translation)

Upper Orinoco Yanomami have engaged politics because it has been the option most forcefully presented to them by the state. The alternative of creating special indigenous politico-administrative divisions in Amazonas has lost all its initial force. The strength of indigenous organizations as political options has also withered in the face of influence exerted by municipalities and other instances of local and regional government. The Upper Orinoco-Casiquiare Biosphere Reserve never gained any relevance as a framework for territorial management. The alternative of demarcating indigenous territories reaches the Yanomami at a time when the municipality is thoroughly entrenched in their experience as the main alternative for dealing with criollos and projecting themselves into the future. As noted in chapter 2, political parties profess a modernizing ideology that casts indigenous tradition and culture as hindrances to be overcome in the march toward social equality with criollos and inclusion in the nation-state. This ideology has certainly struck a chord with the process of napë becoming, adding, for those who still live beyond the centers of “civilization,” an element of humiliation to the propensity for differentiation. The state initially

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delegated the civilizing of Indians to missionaries. Today, with Amazonas’ statehood and its municipalities’ financial clout, the state has, in effect, shifted this responsibility to political parties that have received the modernizing baton from missionaries. With regard to the Yanomami, the state has, then, hardly abandoned its project of making criollos out of Indians by promoting the life of Moderns, and of making society among Indians by promoting its forms of social organization as the sole means of integration into the nation-state. With the new symbolic and political prominence of Indians in the Bolivarian Revolution, culture and identity have become important values. Added to the solid legal support available for claiming and defending indigenous rights, this new context has the potential to check the force of these dominant models. As we learned with the example of the Encuentros de Saberes, however, the consideration of cultural difference in the design of multicultural polices may represent a huge step forward in comparison with the modernizing-assimilating ideology of the past, but it also runs the risk of making Indians modeled on the state’s conception of culture and identity. In the bigger picture, the symbolic and political rise of Indians seems overly determined by the agenda of the Revolution: they are called upon insofar as they can portray resistant socialists ready to exemplify the benefits of government initiatives (cf. Mansutti-Rodriguez and Alès, 2007). Although becoming napë can be seen as an Amerindian form of indigenizing modernity (Sahlins, 1997), we cannot lose sight of the fact that it occurs in contexts where “state indigenization” already restricts indigenous creativity. Be it in the form of explicit modernizing-assimilating projects or through multicultural policies, the state’s tendency is to set out a program in its own self-image, a literalizing project motivated by the conventionalizing urge to rationalize and integrate. Here “differentiation and contradiction are rationalized and ‘worked into the system’ as ‘means’ to a single, monolithic ‘end’—a better life, a more democratic administration, a sounder species, and so forth” (Wagner, 1981:126, his emphasis).1 The most striking illustration of this subordinated integration continues to be the issue of territorial rights. Its unresolved status rests largely on the illusion—particularly infectious in the military mind and with no supporting evidence—that indigenous land rights constitute a threat to the paramount values of national sovereignty and territorial integrity. We see, then, that while the state is prepared to consider or respect indigenous culture, it refrains from such generosity and openness when it comes to tolerating indigenous society. Indigenous people seek greater control and autonomy in order to indigenize modernity, to capture elements of

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globalized culture for the reproduction of their society as they see fit. It is at this juncture the Venezuelan state has stopped for the time being, albeit compensating for this reticence with a variety of social inclusion and development measures. These programs vary in appropriateness and pertinence, but the point remains that the state is bargaining with what it should not. Many indigenous communities seem to be experimenting with whether they can really continue to incorporate white culture without ultimately being consumed by white society. The outcomes at this crossroads will forever be implicated in the symmetrical problem previously neglected by the assimilating state and now faced by the multicultural one: whether it can really offer its culture without imposing the society in which it is produced. In other words, what is the symmetrical inversion of indigenizing modernity that can inform ethical state action? State indigenization, while limiting indigenous creativity and margins for maneuvering, is as intrinsic to meaning making for whites and the state as indigenizing modernity is for Indians. As we saw in chapter 8, the Yanomami become napë in one way, while the multicultural state ends up at times making Indians and more generally becoming Indian itself in a symmetrical yet necessarily very different way. A call for the state not to indigenize, which would ostensibly widen the margins of indigenous resymbolizing maneuvers, rests on the same illusion held by the anthropologist who “becomes native” and, as such, is pure fantasy. If instead, following Wagner and Viveiros de Castro, an awareness of ontological, above and beyond, epistemological diversity; an awareness of the existence of alternative meaning and modes of being in the world; and an awareness of others’ modes of creativity are taken as sound principles for anthropology, then it is also sound to consider these principles in the admittedly complex and ever-changing field of state-Indian relations. More than a “sound” choice, this is a political-theoretical option, for the least that anthropologists can aspire to do, regardless of whether they consider their approach pure or engaged, is to grant the “native” a creative endowment equal to their own.

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Introduction 1. Centro Amazónico de Investigación y Control de Enfermedades Tropicales. 2. This approach is close to the spirit of Latour’s (1991) symmetrical anthropology. 3. See the volumes edited by Buchillet (1991); Santos and Coimbra Jr. (1994); Chiappino and Alès (1997); Langdon and Garnello (2004); Freire and Tillett (2007a; 2007b). 4. Names in parentheses correspond to different ethnonyms and spellings used in the recent anthropological literature on each subgroup. Additionally, different subgroups have been referred to as Guaharibos, Guaharibos blancos, Waika, Guaica, Kirishana, Chori and Chirichano among other designations in the accounts of early travelers and ethnographers, as well as in historical and contemporary parlance in Amazonas and Bolívar states in Venezuela.

Chapter 1. The Upper Orinoco Yanomami and Their Context 1. Data from www.socioambiental.org.br, based on FUNASA (Brazilian Ministry of Health) 2005 census. 2. Different classifications for the Yanomami language have been suggested by numerous authors, who have seen it as isolated, independent, carib, macro-chibcha, chibcha, and proto-pano (Albert, 1985:43). More recently, Ramírez (1994:27–30) has examined the proximity of the Yanomami language to several other linguistic groups. He concludes, nonetheless, that Yanomami language “does not appear to have structural affinity with the diverse arawak, tupi and carib languages” (29–30, my translation). 3. Cocco (1972) and Ferguson (1995) focus on Yanomami history from first contacts to the establishment of permanent missions. Caballero-Arias (2003) and Alès (2007) concentrate on more recent developments, in particular Yanomami engagement in

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indigenous and national party politics. In a different line of analysis, Lizot (1984) reconstructs the migratory history of the Upper Orinoco Yanomami and the sequence of successive community fissions. 4. All Yanomami communities are given a name followed by the term theri, which can be translated in this use simply as “people.” 5. Shaponos Unidos Yanomami del Alto Orinoco 6. Comité de Organización Política Electoral Independiente. 7. For an account of the controversial figure of Jaime Turón and the politics of the Upper Orinoco municipality, yet with a focus on the Yekuana Indians, see Lauer (2006). An in-depth exploration of Yanomami involvement in politics can be found in Caballero-Arias (2003). 8. Data taken from www.cne.gob.ve accessed in November 2008. 9. Organización Regional de los Pueblos Indígenas de Amazonas 10. Pueblo Unido Multiétnico de Amazonas 11. Comisión para el Desarrollo del Sur 12. For accounts of this history, see, among others, Taylor (1979), Ramos (1979), and Albert (2000). 13. For this history, see Colchester and Fuentes (1983), Colchester (1995), and Caballero-Arias (2003). 14. The discussion of indigenous rights during the drafting of the 1999 national constitution stirred heated debate. In particular, the terms “territory” and “people” were troubling, for they could presumably be invoked by indigenous peoples to plea for secession from the nation. A negotiated final wording of the constitution substitutes “land and habitat” for “territory.” The term “people” remains but with a specific clarification as to the non-applicability of the term in its international legal sense. 15. Plan Nacional para la Defensa, Desarrollo y Consolidación del Sur.

Chapter 2. Particularizing the Upper Orinoco Health System 1. This was the situation for several years until approximately 2006. The microscopist stopped working for the health system, and José, the nurse, retired. David underwent formal training in 2006. 2. As of 2003, there were new actors on the medical scene in the Upper Orinoco. First, the capital, La Esmeralda, began to include in its staff one to three Cuban doctors. As of late 2005, several Venezuelan and Latin American graduate doctors trained in Cuba began to share the work in rural clinics tending Yanomami communities together with the Venezuelan graduates. New graduate and postgraduate courses, ostensibly designed to more adequately respond to Venezuela’s impoverished and rural population, have also been put in place by the MoH (see PAHO, 2006:82–87). 3. This is part of a long-lived program called Proyecto Amazonas, established by the Amazonas regional government and the Central University of Venezuela. Among other things, it brings students from primarily the medical sciences to Amazonas as part of their training. The program worked until about 2003–4 when policy changes reduced the flow of students to Amazonas. For some time, another agreement between the National Guard and the Central University brought medical students to the Amazonas. In early 2006 Proyecto Amazonas was revitalized, and the flow of students gradually increased again.

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4. For a more comprehensive political economic analysis of the Venezuelan health sector, see PAHO (2006), Muntaner et al. (2006), and Feo and Curcio (2004).

Chapter 3. Epidemic Diseases, Criollos, and the Morality of Being Human 1. The reader interested in more in-depth analyses of Yanomami etiology can consult Albert (1985) and Lizot (2007). 2. Communities within each of these socio-political categories vary depending on the historical evolution of political, economic, and marital exchanges as well as geographical movements and processes of internal fission. 3. Following Strathern, I use “sociable” to distinguish it from “social,” the former carrying the normal positive connotations of “being social” (1999:18–19). Social encompasses sociable in that it refers to all relations with beings with agency regardless of whether they are positive or negative or whether they attempt to connect or separate persons. 4. The Yanomami cosmos has five spheres or tiers, which the Yanomami refer to as disks. The Yanomami live on the third (from top to bottom) layer. Above this is the sky where dead souls go (hetu misi), and above this is another extremely hot level (tuku misi or oshetiwë misi) inhabited by the sun-spirit and other beings. Below (on the fourth tier from top to bottom) is the plane of the amahiri (hetu misi waro pata), immortal beings onto whom the shawara demons are cast by shaman when expelled from patients’ bodies. The lowest plane is one of rottenness, inhabited by grotesque, giant worms (Lizot, 2007:271–76). 5. My colleague Javier Carrera brought this myth and its reflection of relations with criollos to my attention. 6. Notably, in terms of a person’s constitution, criollos, I was told, are made up of these same components; that is, they are as equally equipped as the Yanomami for human/moral action. “Humanity” differs from “personhood” in the same way that “sociable” does from “social.” Personhood implies agency and, to follow Viveiros de Castro (1998), a point of view on the world. Persons are both human and non-human. A hekura spirit of the forest or shapori’s helper spirit is a non-human person. Humanity is epitomized by close kin who live together in a manner antithetical to that exemplified by Pore, the stranger and ghost. In this way, humanity/morality is a matter of degree that varies on a continuum defined by personhood, including yai demons, shawara, pores, enemies, criollos, close kin, etc. 7. Shapori helper spirits refer to him as father, and shapori call them sons.

Chapter 4. Becoming Napë and the Napë Transformational Axis 1. This interview was part of a short documentary (Wallace, 2001) devoted to the preparation for the Yanomami Mavaca conference in November 2001. 2. “Those” might refer to the mythical origins of shawara involving demiurges transformed into yai demons that spread shawara (see chapter 3). 3. This indigenous analysis is echoed by the Kayapó, who claim that eating Brazilian food, drinking alcohol, or having sex with criollos makes you weak (Turner,

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1991:304). Elder Huaorani contend that the bodies of young Huaorani are bland and soft due to their new diet of manioc, rice, oats, and sugar (Rival, 2002:162). 4. See Gow (1991), Gallois (2000), Turner (1991), Hugh-Jones (1997), and Rival (2002) for similar analyses that discuss indigenous interest (Piro, Waiãpi, Kayapó, Barasana, Huaorani respectively) in controlling resources needed from the world of whites. 5. This term in particular is likely derived from how training courses are commonly described in Spanish as cursos de capacitación, or “capacitating courses.” 6. The myth in question deals with the differentiation of human groups. As cannibal waters rise threatening to kill the ancients, some Yanomami climb up Mount Mãiyõ to save themselves. Water rushes by them carrying many Yanomami. After the sacrifice of an old woman who is thrown into the water, the flood recedes, and the Yanomami who had been swept away become criollos, other Indians, and other Yanomami groups (Lizot, 1975:35). Many in Ocamo and upriver told me this story describing the origin of criollos.

Chapter 6. Being and Performing Napë and Yanomami 1. The expression molestando las mujeres, “bothering the women,” normally refers to clandestine relations of huya with married or otherwise unavailable women. 2. This is a literal translation from the Spanish vamos a vivir bien, “let us live well,” or vamos a vivir bien con los médicos, “let us live well with the doctors.” Such an emphasis resonates with what other researchers find elsewhere in Amazonia, a striving to uphold a convivial ambience at the community level (see Overing and Passes, 2000:2). 3. No sentirse persona: In Yanomami the expression is the negation of a compound verb, puhi yanomami. Albert (Ibid.:175) reports very similar expressions for “becoming ghost.” 4. Again, I thank Javier Carrera for bringing this point to my attention. 5. Vamos a ver si cumple mi palabra: I strongly suspect the expression in Yanomami is “lets see if s/he listens.” When people do not do as they are told, it is simply said that “they don’t listen.” 6. The term doctors use for the accompanying relative is acompañante, which translates directly as “one who accompanies.” People in Ocamo use the term nohi thaporewë. This translates to “one who takes care of” or “one who surveys,” which much better connotes the role assigned to the acompañante. 7. This man, approximately forty years of age, was flown to the hospital from Ocamo. He came from upriver, was severely anemic, had tested positive to malaria, and had strong symptoms of hepatitis. The liquid my friend mentioned could have been either blood (transfusion) or an intravenous anti-malarial medicine.

Chapter 7. Doctors and Shamans 1. For discussions of this articulation in Amazonia, see Kroeger and Barbira-Freedman (1992), contributions to the volume edited by Buchillet (1991), contributions to

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Santos and Coimbra Jr. (1994), contributions to Chiappino and Alès (1997), contributions to Langdon and Garnello (2004), and the two edited volumes by Freire and Tillet (2007a, 2007b). On the Yanomami, see Alès and Chiappino (1985), Chiappino (1997), Lizot (1998), Semba (1985), and Albert and Goodwin-Gomez (1997). 2. Medical pluralism, including shamanism, biomedicine, and other forms of healing, is well-documented among Venezuelan Amerindians (Chiappino and Alès, 1997; Briggs, 2003), in Colombia (Langdon, 1991), in Brazil (Buchillet, 1991c; Gallois, 1991; Pollock, 1994; Conklin, 1994), and in Ecuador and Peruvian Amazon (Kroeger and Barbira-Freedman, 1992). 3. These analogies have been reported elsewhere. Consider the statement of a Baniwa from São Gabriel da Cachoeira with reference to the rezador healer: “Those healers who really know how to pray [incantations] are just like X-rays, they say exactly what the illness is” (de Souza Santos and Mendoça Lima, 1991:240, my translation). Conklin observes, “There are even shamans that consider their powers superior to those of Western doctors, because they need instruments to ‘see’ the illness” (1994:168). 4. Albert (2000:363, ff. 39) speaks of the napënapëripë, “vital images,” of whites among the Brazilian Yanomam.

Chapter 8. Two Meetings and a Protest 1. The expression “We the Yanomami are feeling sad!,” which would be an unusual statement for a criollo spokesperson in a similar context, is a direct translation of the Yanomami term “hushuo” meaning “to be angry” but also “to be grieving a death” and hence sad. The Yanomami representative misstepped by choosing tristes, which in Spanish translates only to “sad,” rather than bravos or molestos, which the context called for. 2. This office is now called the Indigenous Health Bureau (Dirección de Salud Indigena). 3. I have elsewhere (Kelly, in press) provided a detailed analysis of the historical circumstances and ideological biases within the indigenous movement and some medical and anthropological writing that work together to favor these slippages. 4. I was not present for this conversation, which was recorded by a Yanomami friend. I later transcribed it with the aid of another Yanomami who was also present at the meeting. 5. Viveiros de Castro does not himself make this distinction, but it seems useful to me as a way to distinguish equivocal or perspectival anthropology where authors are aware of homonymy—which, as I understand it, is what Viveiros de Castro is calling for—from the anthropological extension of one’s own symbols where univocality is assumed—which is what he is criticizing.

Chapter 9. Changing Tides and Mixed Feelings 1. For more detailed accounts of Venezuela’s indigenist policies, see among others Arvelo-Jiménez (1972; 1992), Monsoyi (1972), Colchester and Watson (1995), Oldham (1995), Heinen and Seijas (1998).

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2. Contrary to these popular views and as a corroboration of their dominant status, Carrera Damas (2006:24) writes: “A hispanist view of the history of Venezuela, and of the history of America, has led us to think that indigenous societies only participated in the colonial process as an obstacle, or relative aid for the realization of an ‘act of civilization’ that should overcome or supplant ‘indigenous barbarism.’ Another perspective of the history of America, which I adopt, provides a quite different view from this usual one . . . The contribution of the indigenous base [societies] to the constitution of our societies was not only fundamental in those first stages [colonization], but continues to be so today, in such a way that in our view there cannot be a valid theory of Latin America if it considers the indigenous base as a substrate, a complement, a hindrance” (my translation, Damas’s emphasis). 3. Coordinación de Salud Intercultural con Pueblos Indígenas. 4. The rate reported for the Yanomami population in 2005 is based on information collected only until September 20 of that year as opposed to the whole year. All the base data for calculating these rates comes from the Upper Orinoco Health District’s epidemiological database. 5. Banco de Desarrollo Económico y Social de Venezuela. 6. Servicio Nacional Autónomo de Antención Integral a la Infancia. 7. The exchange rate dropped from 1600 Venezuelan bolívars ! 1 US dollar to 2150 Venezuelan bolívars ! 1 US dollar. 8. Instituto Nacional de Higiene Rafael Rangel. 9. Oficina Nacional de Presupuesto.

Conclusion 1. Wagner is talking here specifically of competition in American culture. It is with some license that I incorporate this quote into this argument.

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About the Author

After graduating in electronic engineering at the Universidad Simón Bolívar (USB) in Venezuela, José Antonio Kelly did his MPhil and PhD training in social anthropology at the University of Cambridge. He has worked for the Ministry of Health in Venezuela, first as a consultant to the Onchocerciasis Control Programme among the Yanomami, then as head of the Yanomami Health Plan. He also contributes to a small ethnoeducation program working with a group of Yanomami communities in Venezuela. As of 2010, he teaches anthropology at the Universidade Federal de Santa Catarina (UFSC) in Brazil. He has published work on Amerindian theories of personhood and on the political anthropology of health among the Venezuelan Yanomami. Now his research is devoted to the more general issue of political anthropology of indigenous Amazonia.

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