Episode 54: Mi abuela la curandera (My Grandmother the Healer)

As a child, Dr. Linda Valencia was fascinated by her grandmother, a traditional healer in Guatemala. But after choosing a different path and becoming a medical doctor, Linda realized that she could integrate the best parts of her grandmother's practices into modern medicine, in order to transform healthcare across Guatemala.

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Transcript

Martina: Hey listeners! When this episode was made, we had to record at home to protect everyone's safety, so you might notice a slight difference in sound quality. Thanks, and we hope you enjoy today's episode.

A quick note to any parents listening with children. This episode touches on topics related to reproductive health and contraception.

Martina: In 2004, Dr. Linda Valencia came across something she had never seen before in her line of work. She had been working for the Ministry of Public Health in Guatemala for almost two years—when she first visited a hospital with a room for parteras, or traditional midwives. It was in Sololá, in the west of the country.

Linda: A diferencia de una maternidad común, en ese hospital había una sala grande con unos sillones. Ahí las parteras podían ayudar a las mujeres antes, durante y después del parto, con la supervisión de un médico.

Martina: Linda's job was to evaluate the quality of public hospitals in all of Guatemala. She was pleasantly surprised that in this one there was a space reserved for traditional midwives, but her initial excitement didn't last long.

Linda: Yo vi que la mayoría de los trabajadores en el hospital trataba mal a las parteras, incluso los doctores y las enfermeras. No las dejaban ayudar durante el parto. Yo sentí que todo era una farsa.

Martina: Some of the parteras were asked to sweep the floors, pick up the garbage, even to mop up the rooms after a delivery. They were treated more like janitors than healthcare professionals.

Linda: En ese momento, yo me di cuenta de que solo las tenían ahí para que llegaran más pacientes. Esto es porque, en Guatemala, especialmente en las áreas rurales, las personas prefieren la medicina tradicional a la medicina moderna.

Martina: The experience was a turning point for Linda. As the granddaughter of a traditional Guatemalan healer, she had long been searching for a way to unite the best parts of traditional and modern medicine.

Linda: Esa experiencia me dio una idea que cambió la dirección de mi carrera profesional para siempre. Y también cambió la calidad de la salud materna en mi país.

Martina: Bienvenidos and welcome to the Duolingo Spanish Podcast—I'm Martina Castro. Every episode, we bring you fascinating true stories, to help you improve your Spanish listening and gain new perspectives on the world.

The storyteller will be using intermediate Spanish and I'll be chiming in for context in English. If you miss something, you can always skip back and listen again. We also offer full transcripts at podcast.duolingo.com.

Martina: Growing up, Linda was fascinated with her grandmother, Herlinda. Herlinda was a healer, or curandera, someone who administers remedies for mental, emotional, physical or spiritual illnesses. In Guatemala, this is a practice passed down orally through generations in the same family.

Linda: Las personas iban a visitar a mi abuela cuando no se sentían bien. Ella les daba medicina para sus enfermedades, les limpiaba el estómago, o les curaba el "mal de ojo".

Martina: "Mal de ojo", or the "evil eye", is considered an illness by many Guatemalans who believe humans have the power to transfer bad energy to others. Neighbors would bring their babies to Linda's grandmother when they suspected an energy imbalance.

Linda: Si un bebé lloraba demasiado, su madre lo llevaba a nuestra casa para curarlo. Nosotras vivíamos en Escuintla, un pueblito en el centro sur del país. Mi abuela masajeaba el cuerpo del bebé con un huevo y con hierbas. La gente pensaba que así la mala energía pasaba del cuerpo del bebé al huevo.

Martina: Then Linda's grandmother would break the egg and leave it in a glass half full of water under the bed where the baby was lying.

Linda: Luego, mi abuela analizaba la forma que el huevo tomaba en la taza. Eso le indicaba lo que tenía el bebé y la ayudaba a saber cómo curarlo. Cuando el bebé dejaba de llorar, mi abuela decía: "Su bebé ya está curado".

Martina: Linda's family is mestizo, meaning they have a mix of indigenous and European roots. Herlinda became a healer because her mother and her grandmother had been healers, too. Herlinda had never questioned her path in life—she simply followed her family's tradition.

Linda: Mi abuela era una mujer pequeña, delgada y de piel clara. Su pelo siempre fue blanco, casi platinado. Yo recuerdo que ella muy pocas veces tomaba medicamentos. Ella siempre preparaba toda su medicina, incluso los laxantes.

Martina: But Linda's mother, Margarita, had no interest in following her family's footsteps. She was skeptical of traditional medicine. So she forged her own path in life, becoming the first in the family to attend college.

Linda: Mi mamá estudió leyes y era quien ganaba el dinero para mantenernos a nosotras. Ella tenía que trabajar mucho. Por eso, mi abuela fue quien realmente me crió y quien dejó un impacto muy fuerte en mí.

Martina: Linda grew up in a time when modern medicine was transforming Guatemala's health care system. Up to that moment, medicine in Guatemala had been largely traditional—a legacy from Mayan culture. It was mainly plant-based and included religious elements and rituals.

Linda: Una parte de la medicina tradicional se relaciona con las energías y el equilibrio del cuerpo. Ahí está la magia de la medicina tradicional. La otra parte tiene que ver con el uso de las plantas naturales y la preparación de infusiones, porque con eso se tratan las diferentes enfermedades.

Martina: In countries like Guatemala, where mestizo and indigenous people are still rooted in ancestral practices, the use of modern medicine is a complicated social issue. During the 70s and 80s, Guatemala started a widespread campaign to promote modern medical practices, with the intention of improving the health of people living in poverty and in remote areas.

Linda: Cuando la medicina moderna se extendió por Guatemala, se creó una relación jerárquica entre los doctores y los pacientes.

Martina: Guatemala has a very hierarchical social structure that dates back to the Spanish colonization of the Americas. This means indigenous and mestizo communities often suffer racism and discrimination. As the country's health care system modernized, communities like Linda's felt left out of the transition.

Linda: Por eso, esta nueva relación con la medicina a veces causaba desconfianza. Además, no olvidemos el costo económico de la salud, porque ese era un problema para las personas pobres que vivían en las zonas rurales.

Martina: But distrust had never been an issue for healers like Linda's grandmother. Linda remembers her grandmother establishing strong relationships with her patients.

Linda: La curandería no está simplemente relacionada con las enfermedades físicas de una persona, sino también con el aspecto emocional y espiritual. Pero eso no era parte del sistema público de salud.

Martina: Linda's grandmother never pressured her to become a curandera. In fact, she always encouraged her to study, read, and learn as much as possible while she was in school.

Linda: Ella siempre estuvo segura de que yo iba a ir a la universidad. Entonces, cuando llegó mi adolescencia, pensé: "Yo quiero seguir los pasos de mi abuela, pero yo voy a ser doctora".

Martina: Herlinda fully supported Linda's decision to become a doctor of modern medicine. She respected that Linda didn't want to become a curandera, and understood that Linda's feelings about traditional medicine were somewhat conflicted, given her own mother's attitude.

Linda: Por eso, decidí ser doctora y especializarme en ginecología. Me pareció la opción perfecta, viniendo de una familia llena de mujeres. ¡A mi abuela le encantó esa idea!

Martina: Her grandmother knew first-hand the importance of this kind of medicine. Linda also had long been interested in a specific group of patients who visited her grandmother: young women who didn't have access to family planning methods.

Linda: En general, eran mujeres muy jóvenes, de origen indígena, que siempre parecían tener miedo. Ellas iban a la casa porque querían medicinas caseras para evitar el embarazo. Este era un tema tabú en la comunidad y, por esta razón, esas mujeres lo hacían en secreto.

Martina: When Linda was a child, traditional remedies were the only kind of help a young woman could access in Guatemala if she didn't want to have children. There was no access to contraception or sex education, especially for women in poor and rural areas.

Linda: Muchas mujeres no tenían acceso a esa información y no conocían sus derechos. Ellas no podían comprar anticonceptivos sin la autorización de sus padres o de un representante legal. Además de eso, estaba la falta de educación en las escuelas y el machismo.

Martina: According to the United Nations, Guatemala has one of the highest teen birth rates in Latin America. Abortion is legal only in cases where the mother's life is in danger, which often leads to unsafe abortion practices. The rate of maternal mortality is also high.

Linda: En mi adolescencia, vi a muchas mujeres en mi casa hablando sobre este tipo de cosas con mi abuela, y comprendí que la salud materna es el corazón de la justicia social. En Guatemala, las mujeres de áreas rurales son muy vulnerables. Yo entendí que podía ayudar a mejorar esa situación.

Martina: Linda was so motivated to improve maternal health that in 1992 she left home to study medicine at the San Carlos University of Guatemala in Guatemala City. She won a full scholarship.

Linda: Mi abuela estaba muy orgullosa de mí. Su nieta iba a ser una profesional. Además, yo estaba siguiendo sus pasos porque quería ser sanadora, pero a través de la medicina moderna.

Martina: Linda promised her grandmother that one day, she would take her to the capital to live with her.

Linda: En los años de la universidad, no pude hacerlo porque no tenía suficiente dinero, pero ella me visitaba a menudo. Sin embargo, en 1999, pude llevarla a vivir conmigo. Durante ese mismo año, comencé mi residencia en el Hospital General San Juan de Dios.

Martina: During that first year of residency, Linda struggled to recreate the relationships she'd witnessed her grandmother nurture. She sometimes felt that instead of being a service based on trust, her work was a transaction based on speed and efficiency.

Linda: Durante mi residencia, yo pensaba en cómo mi trabajo verdaderamente podía mejorar la vida de las mujeres. Yo sabía que tenía que volver a la esencia de la medicina tradicional, de una u otra manera. Pero no sabía cómo. Por suerte, yo tenía a mi abuela como guía.

Martina: Linda was ultimately successful during her first years as a doctor. She became the second female Head of Residency for Gynecology in the history of the San Juan de Dios general Hospital. Then, she went on to work for the Ministry of Public Health.

Linda: Gracias a ese trabajo, yo conocí Guatemala de punta a punta, porque viajaba para supervisar la calidad de la atención materna en diferentes hospitales.

Martina: Linda visited 37 hospitals during her first year, and only two passed the minimum standard of quality established by the ministry. And in Linda's opinion, they all lacked the one thing she had always admired in her grandmother's healing practices: a caring relationship between patient and caregiver.

Linda: El servicio no era bueno, era sin cuidado, sin recursos y muy poco personalizado. Por eso, las mujeres en las áreas rurales no querían ir a los hospitales. Ellas, en cambio, sentían que la medicina tradicional era mejor y más humana.

Martina: It was around this time that Linda visited the hospital in Sololá. The one where doctors and nurses mistreated the parteras.

Linda: Ese fue uno de los tantos hospitales que no pasó la evaluación. Aunque la idea, en teoría, era buena: invitar al mundo de la medicina tradicional a los hospitales públicos. Algo de eso me dejó pensando.

Martina: In traditional Guatemalan medicine, parteras are far more than birth attendants. In addition to accompanying mothers during their pregnancy, they’re also highly respected community leaders and health promoters, especially in more rural or low-income communities.

Linda: Yo empecé a pasar tiempo con las parteras cada vez que visitaba un área rural. Hablaba con ellas para poder entender su visión. Y así me di cuenta de algo… además de conocer sobre el desarrollo de los bebés, las parteras actuaban como hermanas o amigas de las mujeres embarazadas. Realmente estaban con ellas, a su lado, durante todo el proceso.

Martina: As she visited rural areas and talked with the parteras, Linda started to feel happy. She was back inside that traditional community work she'd experienced with her grandmother Herlinda.

Linda: Yo entendí que las parteras podían ser un puente entre la medicina tradicional y la moderna. ¿Por qué? Simplemente porque mucha gente creía en ellas. Aunque primero, ellas tenían que ser aceptadas por la medicina moderna.

Martina: When Linda had a chance to attend the Maternal Mortality Conference held by the World Health Organization, she jumped at the opportunity. When she got to the conference, she met different organizations, including a group of parteras that caught her eye.

Linda: Era un grupo de mujeres de Puerto Rico. Ellas me explicaron que allá, al igual que en Guatemala y otras partes de América Latina, las parteras no estaban consideradas dentro del sistema de salud. Ellas querían cambiar eso y hubo intensos debates con ginecólogos de distintas instituciones.

Martina: As Linda participated in those debates, she felt like she was getting involved in something more important than just representing Guatemala's medical system at the conference. This feeling was confirmed a year later, when she received a document detailing the final resolution of the conference.

Linda: El documento decía que, desde ese momento, según la Organización Mundial de la Salud, las parteras iban a ser oficialmente consideradas como proveedoras de atención médica en toda América Latina. ¡Yo me sentí feliz y satisfecha! Fue un primer gran paso.

Martina: To put this new policy into practice in her home country, Linda joined forces with the nonprofit Planned Parenthood. Linda started to design a better system of care for Guatemalan women. Her goal was to expand access to sexual and reproductive healthcare—and she intended to make accessibility a national policy.

Linda: Nosotras trabajamos con un concepto llamado "desmedicalizar". Es un proceso que incluye tanto a las parteras como a las curanderas. Ellas aprenden a usar equipos para la presión arterial, y aprenden a prescribir antibióticos, entre otras cosas, pero nunca dejan de lado la medicina tradicional, ni su relación con la comunidad.

Martina: Parteras and curanderas would be the liaisons between the modern and the traditional.

Linda: Nosotras escribimos todo esto en un documento que luego fue enviado al Congreso.

Martina: As the head of this initiative, Linda had to lobby with politicians and legislators to convince them of the importance of her plan.

Linda: Mi objetivo era ayudarlos a entender por qué este cambio era necesario en nuestro sistema de salud. Yo les hablaba de cifras de mortalidad y de la importancia de cuidar la salud de las mujeres.

Martina: Linda's lobbying paid off. In 2010, twelve years after she became a physician, the Safe Motherhood Law was approved by Guatemala's legislature. This new law would transform maternal health care in Guatemala, making it more accessible, and appealing, to women in rural and low-income communities.

Linda: Yo de verdad creo que es la victoria más grande de toda mi carrera. Nada de esto habría sido posible sin la influencia de mi abuela. Ella me apoyaba incondicionalmente y estaba muy orgullosa de mí.

Martina: But Linda's efforts didn't stop there. Under the new law, Planned Parenthood and other health organizations were able to create the first school of professional parteras in Guatemala.

Linda: Es una carrera de tres años y, al final, las estudiantes reciben un diploma de técnicas de partería con especialización intercultural.

Martina: The first of many schools of partería in Guatemala opened in 2016, and Linda decided to become one of the teachers.

Linda: Había dieciséis alumnas, la mayoría venía de comunidades rurales, tal como yo en el pasado. Ahora ellas estaban en la capital estudiando.

Martina: Linda's grandmother, Herlinda, had stopped healing people from the community after she left to live with Linda in Guatemala City. But in a way, she always remained the curandera of her family. She passed away in 2011, very proud of Linda's professional path.

Linda: Mi abuela era mi aliada. Ella sembró en mí la idea de estudiar medicina y me mostró la importancia del mundo tradicional en Guatemala. Todavía queda mucho por hacer en mi país en materia de salud. Pero yo creo que, poco a poco, si combinamos lo mejor de la medicina tradicional con la medicina moderna, seguiremos avanzando.

Martina: In 2018, Dr. Linda Valencia received the Maternal Health Visionary Award given by Harvard University. She is the Senior Program Officer for Planned Parenthood Global, and she created, along with Hannah Freiwald, the Centro Integral de Parto Natural Ixchel, a medical center that provides personalized and professional care to women during their whole life cycle. She lives in Guatemala City.

This story was produced by Antonio Díaz Oliva, a Chilean writer based in East Nashville.

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The Duolingo Spanish podcast is produced by Duolingo and Adonde Media. I'm the executive producer, Martina Castro. ¡Gracias por escuchar!

Credits

This episode was produced by Duolingo and Adonde Media.