Doctora is the story of a remarkable physician born and educated in Germany who fled Hitler's regime in 1940 and emigrated to Bolivia with her husband and two children. Although Ruth Tichauer originally intended to be a physician for "nice families and the diplomatic corps," "Doctora" came to recognize mutual "good feelings" with the Avmara Indians, who quickly became her major clientele.
Starting with scenes of La Paz, where Doctora has a consultorio, the evolution of her practice is discussed both bv the doctor herself and by the many clinic workers (her "team"), some of whlom started working as orderlies over 40 years ago, and all of whhomn extoll the virtues of Doctora today. The head nurse for the clinic has been working with Doctora for 25 years: as an Avmara she has tremendous rapport and conducts many interviews with the Indian patients, some of whom travel many miles to come to the clinic.
"Professor Gomez," who "kept letting the air out of the gringa' tires as a box 40 years before, noxw' serves as medical equipment technologist for the clinic. A lawyer is also part of the clinic team, because of the lack of birth certificates among the Indians and the need to settle land claims for the campesinos. A dentist is also part of the team, having joined the clinic after a two-year internship in the jungle.
Doctora's clinic is as overflowing with patients as are her patients with praise for the doctor. She is lauded for being direct and simple, with "no pride or expectation that people look up to her."
She is seen as having "respect" for the Indians: she wears Indian shoes, eats the same food as the peasants and cooks and shares food with evervone-behaviors not typical in Bolivia, where Indians are viewed as servants. Furthermore, the doctor speaks Aymara, in addition to Spanish.
But the clinic in La Paz is but one facet of Doctora's practice.
Against the superbly photographed backdrop of the Anides, with snow-capped peaks and tortuous roads, and a soundtrack of indigenous quena music, Xviewers accompany Doctora on her weekly "rounds" in the countryside where she holds clinics, literally by the roadside ''"where people don't have to be afraid-thev can see their neighbors stepping on the scale or getting shots or pills--which increases confidence." Medical anthropologists will find Doctora's clinical skills noteworth for their cultural sensitivity: by Western standards she is highly formal in her approach to patients, often examining them from across a small table and perfecting the art of physical examination wvithout the remoxal of clothes, techniques that "fit" Avmara cultural expectations perfectlyx. Doctora also advocates the explanatory model (EM) approach when questioning patients about symptoms (without so identifying it), an approach no doubt learned over the course of the many years of practice and the wealth of experience indicated by her medical records, which contain over 100,000 individual charts through three generations of patients.
Perhaps more questionable from an anthropological perspective is Doctora's practice of teaching Aymara children new crop cultivation techniques and admonishing them to "go teach their fathers and mothers."
Clearly, though, this compassionate woman is a dynamic and devoted healer whose approach to her Aymara patients would make medical anthropologists proud and whose story deserves to be told. Yet it is unclear who the audience should be. As a documentary film, Doctora succeeds in many ways: wonderful photography, haunting indigenous music, and solid editing overcome the few technological flaws (often illegible graphics and weak voiceover translations). Unfortunately, as rich as our appreciation is for the doctor and her work as a result of this film, Doctora reveals little about Avmara culture, specifically about traditional health beliefs and practices. Neither does Doctora illuminate the larger sociopolitical context of health care, such as local and international financial support for the clinic, how her practice fits into the plural health culture of Bolivia, or what will happen when she can no longer practice.
Because of these unexplored areas, Doctora is great biography but shallow ethnography. This limits the film's usefulness to more advanced anthropology courses taught by Andean specialists who can comment as much about what it does not show as about what it does, or for teaching health professions students interested in international health, who would benefit from exposure to such an undeniably remarkable role model.
Doctora. 1983. A film by Linda Post and Eugene Rosow. 52 minutes.
Inquire to: Cultural Research and Communication, Inc., Lion's Gate, 1861 S. Bundv Drive, Los Angeles, CA 90025 (213/207-0919).
Thomas l. Johnson, PhD
Anthropology, Southern Methodist University
Slv!ia S. Bolnton, PhD
Education, Texas Women's University
Wednesday, May 28, 2008
A publication from 1974
BOLIVIA' S SERVAS SECRETARY IS CARING FOR THE AYMARA INDIANS!
Dr Ruth Tichauer, born in Germany, moved to Bolivia at the start of World War II to take a post in social medicine.
One day, 27 years ago, a council of Indians came shyly to ask if she would settle among them to work.
They found her a place in the poor section of the city of La Paz, put in some plumbing, patched and plastered "and when they came and asked for money for curtains, I knew it was ready." She had no idea then, she said, that the clinic would become famous.
"Soon people were coming from the interior, and would travel two or three days on foot to be with us. Some of them had not seen a doctor in 17 years." Services -all of which are free -have now expanded to include more doctors, a dentist, lawyers, agricultural consultants, and such lay personnel as farmers and a bee-keeper who have been trained to help.
Apart from the original La Paz clinic, there is now another in the Andean jungle, and a mobile, roadside health service. The jungle establishment began *ith sessions under a papaya tree, and "when there were more than thirty people gathered around, we started to build." In that area, soil was so barren that "even coffee wouldn't grow." It has now been transformed into a veritable Garden of Eden, said Dr Tichauer, with the help of agricultural consultants. People who lived there in poverty, undernourished and sickly, now can grow food. This is real help, based on love and respect.
Dr Tichauer's clinics operate partially on her own funds, partially on donations, a large measure of support coming from a group of retired American women doctors. She prefers not to ask the Government for funds.
www.servas.org/siexco/
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