Decolonizing Medicine : Indigenous Politics and the Practice of Care in Bolivia

Decolonizing Medicine examines Bolivian state-led efforts to decolonize health services during the administration of Evo Morales, Bolivia's first Indigenous president. Governing from 2006 to 2019, the Morales administration undertook sweeping reforms, vowing to reverse intertwined colonial and capitalist systems of oppression and restore Indigenous good living. Predating more recent calls from global health practitioners to "decolonize global health," Bolivian state projects included a range of initiatives, such as integrating Indigenous traditional medical practitioners into clinical care and encouraging cultural sensitivity among healthcare providers. And yet, despite layered institutional investments, many Indigenous patients continued to describe their local hospital as a place "donde no hay atención" ("where there is no care"). Through fine-grained ethnography of health policymaking and implementation, Gabriela Elisa Morales tracks how Bolivian biomedical and public health institutions fell short of the far-reaching transformations proposed by decolonial activists and theorists. At the same time, she foregrounds how Indigenous patients and healers challenged the terms of caregiving and demanded that state and medical institutions fulfill their obligations to Indigenous flourishing. In tracing these dynamics, Morales articulates the multiplicity of ways that care practice becomes a locus of political foreclosure as well as radical transformation, with crucial insights for broader projects of decolonization and Indigenous rights.