K has been working for the last two years as a trainer of health promoters in the autonomous health service in the Zapatista controlled areas of Chiapas, Mexico. He recently spoke at public meetings in Glasgow and Edinburgh.
How are the health promoters organised?
Each of the 5 Caracoles or Zones, run by 5 Juntas of Good Govenment orgainise differently and there are several different municipalities in each Caracol. Health promoters are chosen from those who show an interest. Health promoters can understand Spanish. Most of the training is in Spanish with translation into the local languages. It is difficult to learn indigenous languages. It is difficult for the health promoters to learn and work in a second language. 60% of the training course doesn’t get through. Health promoters have to leave their family and job. They don’t get paid and have to support themselves. Health promoters are not doing it for the money, but for the community Trainers or Multipliers of others from the communities have more responsibility, but are also chosen by the people and are elected, recallable and rotated. They stay as health promoters as long as needed. Multipliers are used to cut down on outsiders. In some places Multipliers need 10 years experience, but in other places no experience is required. The level and pace of the course depends on the experience of the health promoters whose age can range from 10 – 70 years old. Some health promoters have been there for years. Some health promoters have greater knowledge than outside trainers.
What is the role of NGOs?
There are a mixture of volunteers and NGO employees. In one case an NGO gave money directly to the Zapatistas to run health services themselves. Some of the well known NGOs in the past, tried to tell Zapatistas what to do, so they weren’t allowed to work in Zapatista areas.
What about the problem of dependency on outside experts and the move from dependency to autonomy?
At present they don’t have enough tools to become fully autonomous . It is very important not to create dependency. There is a need to deal with all health problems, but it will take time. They want to end dependency. The idea behind the training courses is exactly that, to enable people in the communities to take care of themselves so no outside input will be needed.
Is there a plan or timescale for this?
This is a western concept of time. The revolution is not happening tomorrow. The revolution was not 1994. The revolution is now, what they are building. War never changed anything. It is destruction not creation. Now there is a chance to create.
I have read that there have been problems with food shortages for health promoters?
Food supply is weather dependent and their are many other factors. The earth varies. It is not always pleasant. 30 years ago there was a volcano that was outwith people’s control. There are a few swollen big bellys, but there is not starvation like in Africa. There are different levels of poverty. There are always shortages in houses, malnutrution, sometimes caused by worms. Families don’t starve, a little, but not much. With health promoters there can be too many people around for training courses at the one time and families have to share their food. Health promoters have to support themselves.
How is the health service organised at the the municipal and Junta of Good Government level?
All health, education, justice matters, everything goes through the Junta. Decisions are ratified. The Junta will talk to each municipality, then each village. Issues can also be raised first at the village level, then taken to the municipality and the Junta. Members of the Junta have to step down after 3 years. Everyone has to be in government at some point until everyone is rotated. There are 10 year olds in Juntas. There can be problem with the 2 week rotation of Junta members from different municipalities like having to ask the new Junta the same questions every 2 weeks. Internationals can get annoyed with Juntas, but they have to prioritise and may have been discussing problems for hours.
The Zapatistas have announced that there is self-sufficiency in their health service and some small surgery takes place in their clinics.
There are differences in Caracoles. In Oventik there is an operating theatre, endoscopes, dentists, vets, midwives, natural medicines, trained indigenous people. There is a need for major surgery, because of cancer.
The average wage for a peasant family is £3.50 a day per day. Medicine costs are equal to 2 days work. Cancer operations cost 60,000 pesos/£3000 in a Mexican government hospital and more in a private hospital. There are not enough vehicles available to take people to government hospitals. In 2006 national insurance for children, born after 2006, was introduced, but the health service is still not free. There is a signed contract and small payments like a mortgage. Social security like the Seguro Popular are linked to government programmes and are given out in return for votes for the political party in power.
How many auntonomous health clinics are there?
Again there are differences in the Carocoles. For example there are 13 micro-clinics in the one zone plus 1 clinic. There is one hospital in another. In one Caracol they created a big clinic then created smaller places – micro clinics and then smaller health houses. In another they created working health houses first until they get enough money for a clinic.
There are lots of government health clinics but without health promoters, medicine or doctors. Doctors from other parts of Mexico can’t make enough money. Government resources don’t get to the people
What about traditional medicine?
Midwives practice it. Little children and their parents know about plants. Some healers (curanderos) can fix bones immediately without a caste. Pain in the small of my back I have had for 10 years stopped after one session with a healer.
How are the other autonomous services run, education, agriculture/coffee, justice?
Health, education and agriculture are very similar. For example as agricultural peasants they know how to use the land better. At the start they used chemicals, but the organisation (EZLN) decided not to use chemicals. They know the quality is better. The training is done by education promoters, which came out of volunteers, in the same way as the health promoters. Companies such as Monsanto promoted chemicals. This was sponsored by the Mexican government and was linked to schemes like ‘pro campo’ where peasants had to use chemicals. Chemical use is linked to cancers years later. Most people with cancer in communities just accept they are going to die as they don’t have the money for the treatment. There are not schools in all places. Families educate children, mostly not a formal education. In one Caracol education is based at schools. Schools are sometimes in the house of an educator. In another Caracol classes are more vocational, more practical with some theory, more based on food production, on corn and GM crops for example, because the weather is better. There are some primary and secondary schools, only 1 secondary in one Caracol and only 2 in another.
Little girls are learning to read and write in Spanish and indigenous languages are a priority. There are lots of government schools, but they are empty. Every community has a different way of doing things. It can be complicated, experience is different, but not understood elsewhere, but it is working well.
With justice there are chosen decision makers that includes the Junta. When a problem arises with non-Zapatistas over water/electricity/land both parties are invited to take part. The disputes are usually over land and the Mexican governemnt wants fights over land. The Juntas are seen as impartial as they do not always take the Zapatista side.
What about full Autonomy, Libertarian Communism, from each according to their ability, to each according to their need? Does this ever get discussed?
This is a western concept. No one has read Marx, Kropotkin… well this is not really true, some of the compas do read some political stuff but most of them have not. This is to say that it is difficult to classify them as…
But someone could wake up anywhere and think why don’t we get rid of money, introduce barter or our owns coupons or get rid of any from of exchange whatsoever? What about the ejidos?
There is no economic plan openly discussed. In a ejido the land belongs to everyone, but it is not worked collectively. It is mostly small family land. Once a week or once a month they work collectively to cut grass for example. There is some communality, but out of necessity. Production is for subsistence, so there is no excess.
What is the power realtionship like between the health promoters and the Juntas? Even if both the health promoters and the Juntas are run in a direct democratic way the communities are still employing a group of workers and this is still the case if some of the health promoters come directly from the the communities?
The health promoters work autonomously and organise their work as they believe is better. Anyway they have to notify the Junta about their decisions or proposals, as mentioned above the Junta will pass the information to the rest of the people in the communities and if something has to be discussed they will do.
The health promoters are not workers as such. Health promoters are people that have a better knowledge on health but they receive no money for their knowledge so the term employment does not have room there. Of course they work, they are peasants, and that is a hard work. Once they finish their work is when they are called in the case they are needed.
About the outsiders that are employed… this is not always the case. At present some of us working in some areas do receive some money for what we do but most of the time we are volunteers so the employment word looses its meaning again as there is no economic transaction involved.