Anthropology and Activism Theme Analysis

My Triqui companions often explain their everyday lives in terms of sufrimiento (suffering). But one of the sites of sufrimiento most frequently described by Triqui migrants is crossing the border from Mexico into the United States. Many times throughout my fieldwork, my migrant companions told me stories of their harrowing experiences. One of my friends was kidnapped for ransom with her four-year-old boy. […] One young man I know described burns on his skin and in his lungs after being pushed by his coyote into a chemical tank on a train. Another man explained that he was raped by a Border Patrol agent in exchange for his freedom. All my migrant companions have multiple stories of suffering, fear, danger, and violence at the border.
Early in my fieldwork, I realized that an ethnography of suffering and migration would be incomplete without witnessing firsthand such an important site of suffering for Latin American migrants.

Traditional migration studies assumes a dichotomy between voluntary, economic, and migrant on the one hand and forced, political, and refugee on the other. The logic behind this dichotomy states that refugees are afforded political and social rights in the host country because they were forced to migrate for political reasons. Conversely, migrants are not allowed these rights because they are understood to voluntarily choose to migrate for economic reasons. The "push" and "pull" factor school of migration studies tends to assume that labor migration is entirely chosen, voluntary, and economic.
However, my Triqui companions experience their labor migration as anything but voluntary. Rather, they have told me repeatedly that they are forced to migrate in order for themselves and their families to survive. At one point during our trek across the border desert, Macario told me, "There is no other option left for us."

I attempt to portray and analyze the lives and experiences of Macario and my other Triqui companions in order to understand better the social and symbolic context of suffering among migrant laborers. I hope that understanding the mechanisms by which certain classes of people become written off and social inequalities become taken for granted will play a part in undoing these very mechanisms and the structures of which they are part. It is my hope that those who read these pages will be moved in mutual humanity, such that representations of and policies toward migrant laborers become more humane, just, and responsive to migrant laborers as people themselves. The American public could begin to see Mexican migrant workers as fellow humans, skilled and hard workers, people treated unfairly with the odds against them. I hope these recognitions will change public opinion and employer and clinical practices, as well as policies related to economics, immigration, and labor. In addition, I hope this book will help anthropologists and other social scientists understand the ways in which perception, social hierarchy, and naturalization work more broadly.

My body offered insights not only via experiences of the living and working conditions of migrant laborers but also as I generated particular responses from those around me. In many circumstances, my light-skinned, tall, student-dressed, English-speaking body was treated very differently from the bodies of my Triqui companions. The supervisors on the farms never called me deprecatory names like they did the Oaxacan workers. Instead, they often stopped to talk and joke with me, all the while picking berries and putting them into my bucket to help me make the minimum required weight. The social categories inscribed on bodies led to my being treated as an equal a friend, even a superior, while the Oaxacans were treated most often as inferiors, sometimes as animals, or machines. […] My body was treated as though it had and deserved power, whereas theirs have been treated repeatedly as underlings, undeserving of respect.

During my fieldwork, I picked once or twice a week and experienced gastritis, headaches, and knee, back, and hip pain for days afterward. I wrote in a field note after picking, "It honestly felt like pure torture." Triqui pickers work seven days a week, rain or shine, without a day off until the last strawberry is processed. Occupying the bottom of the ethnic-labor hierarchy, Triqui pickers bear an unequal share of health problems, from idiopathic back and knee pains to slipped vertebral disks, from type 2 diabetes to premature births and developmental malformations.

Why did the Triqui people think that the physicians working with them did not know anything? What was wrong with the doctor-patient relationship? Why was it so unhelpful in its present form? Could it be changed to be more helpful for my Triqui companions? What were the economic, social, and symbolic structures impeding such change? And how might anthropology speak to clinical medicine and public health?

As an anthropologist and a physician, I am concerned both with theorizing social categories and their relationships with bodies and with the possibility that suffering might be alleviated in a more respectful, egalitarian, and effective manner. My dual training has been at once stimulating and disorienting. The lenses through which cultural anthropologists and physicians are trained to see the world are significantly different, and at times contradictory. I have found the critical social analyses of anthropology incredibly important at the same time that I have valued the grounded human concerns of clinical medicine.

Health care professionals cannot be blamed for their acontextuality. They, too, are affected by social, economic, and political structures. Much of their blindness to social and political context is caused by the difficult, hectic, and emotionally exhausting circumstances in which they work. It is caused also by the way medical science is thought and taught in the contemporary world. Most of these individuals have chosen their positions in migrant clinics because they want to help. They have a great deal of compassion and a sense of calling to this work. Yet the lenses they have been given through which to understand their patients have been narrowly focused, individualistic, and asocial.

Pierre Bourdieu's concept of symbolic violence has proven especially helpful for my understanding of the ways in which the order of inequalities described thus far has become unquestioned and unchallenged, even by those most oppressed. Symbolic violence is the naturalization, including internalization, of social asymmetries. Bourdieu explains that we experience the world through doxa (mental schemata) and habitus (historically accreted bodily comportments) that are issued forth from that very social world and, therefore, make the social order—including its hierarchies—appear natural. Thus we misrecognize oppression as natural because it fits our mental and bodily schemata through which we perceive it. […] Symbolic violence acts within the process of perception, hidden from the conscious mind.

If we social scientists are to research, theorize, and confront socially structured suffering, we must join with others in a broad effort to denaturalize social inequalities, uncovering linkages between symbolic violence and suffering. In this way, the lenses of perception as well as the social inequalities they reinforce can be recognized, challenged, and transformed. This book endeavors to denaturalize ethnic and citizenship inequalities in agricultural labor, health disparities in the clinic, and biologized and racialized inequities in society at large.

If health professionals responded to sickness by treating not only its current manifestations but also its social, economic, and political causes, we could create a realistically critical public health and a "liberation medicine." This latter term alludes to liberation theology, in which a reflective engagement with those who are poor and suffering leads to new ways of thinking and practicing theology in order to achieve social justice. While there is genuine need for the skills of narrowly trained, competent biomedical physicians, I am convinced this is not enough.
As shown by the health care experiences of Abelino, Crescencio, and Bernardo, medical skills practiced without recognition of the social structures causing sickness are doomed to address only the downstream, biological and behavioral inputs into disease. This leads to ineffective health care at best and complicit, injurious health care at worst.

Globally, and perhaps most important, the formation of broad coalitions of people is necessary in order to envision and work for a more equitable international economy such that people would not be forced to leave their homes to migrate in the first place.