a revolution that makes possible the Revolution The impact of Zapatismo on indigenous women’s access to reproductive health services in Chiapas, Mexico. Caitlin Williams Submitted in partial fulfillment for Honors in Global Studies. Department of Global Studies March 23, 2012 Approved: ___________________________________________ Altha Cravey ___________________________________________ Benjamin Mason Meier ___________________________________________ Miguel La Serna 1 | P a g e Table of Contents Acknowledgements.................................................................................................................... 3 Abbreviations ............................................................................................................................. 5 Chapter 1: Introduction ............................................................................................................. 6 Background ............................................................................................................................ 7 Methodology .......................................................................................................................... 8 Chapter 2: Literature Review ................................................................................................... 10 From the depths of poverty ................................................................................................. 10 The legacy of popular health ............................................................................................... 17 The deliberate egalitarianism of Zapatismo ........................................................................ 22 Zapatista Feminisms ............................................................................................................ 24 Why Women’s Health .......................................................................................................... 29 Chapter 3: Methodology .......................................................................................................... 31 Quantitative Data ................................................................................................................. 32 Access ............................................................................................................................... 32 Maternal Mortality .......................................................................................................... 32 Qualitative Data ................................................................................................................... 33 Interviews......................................................................................................................... 34 Field Observations ........................................................................................................... 35 Limitations ........................................................................................................................... 35 Chapter 4: Case Study .............................................................................................................. 38 Perceptions of the Government Health System .................................................................. 38 Access ............................................................................................................................... 39 Militarization of space and community outreach ............................................................ 47 Contraceptive supplies and sterilization .......................................................................... 52 Language and culture ....................................................................................................... 60 Maternal Mortality .......................................................................................................... 63 Perceptions of the Zapatista’s Autonomous Health System ............................................... 68 Access ............................................................................................................................... 69 Militarization of space and community outreach ............................................................ 77 Contraceptive supplies and sterilization .......................................................................... 80 Language and culture ....................................................................................................... 83 Maternal mortality ........................................................................................................... 85 Chapter 5: Conclusion .............................................................................................................. 88 Appendix A: The Women’s Revolutionary Law ........................................................................ 94 Sources ..................................................................................................................................... 95 2 | P a g e Acknowledgements This document is the culmination of roughly a year and a half of fieldwork; poring through government, opposition and third-party documents; banging my head against a wall; number crunching; more banging my head against a wall; writing; rewriting; etc. It is only through the tremendous love and support of a number of incredible individuals that this piece was finished at all. I owe a particular debt to Altha Cravey for keeping me calm and focused throughout this journey, to Benjamin Mason Meier for motivating me throughout the process and to Miguel La Serna for reminding me why this topic is so important to me. Erica Johnson’s unending support, from the initial conception of this project to its completion, was essential. Thank you for answering a million and one questions and for your many thought-provoking comments and suggestions. I could not have finished this project without you. However, I could never have started this project without Linda Quiquivix. Without her I may never have learned of the Zapatistas and I would certainly be a much lesser human being. Thank you for all of your kind words and for re-motivating me when I was starting to flag. I would also like to extend a special thank you to Yousuf Al-Bulushi, Mariah Darlington, Mara Kaufman and Alvaro Reyes for taking time out of their extremely busy lives to talk to me about Chiapas before and after my trip there. Without their encouragement, most of what I experienced in Chiapas would not have made much sense. The trip itself would not have been possible without the unending support of Vicki Stocking, Jay Green and the rest of the Robertson Scholars Program staff. Without their tireless dedication to this project, it never would have gotten off the ground. I am extremely grateful to Julian Robertson and the Robertson Foundation for financing this undertaking, both during the summer and the academic years that framed it. Finally, I must thank my family and friends who put up with me throughout this process. Thank you to David Mulcahy for taking all of the half-cooked meals, dirty dishes and 3 | P a g e stress in stride and for giving me pep talks and ice cream when the going got tough. Likewise to Jess Adams, Anne Bertelsen, Arima Claypool, Spencer Kuzmier, Catherine Sum, Caleb Williams, Ellie Williams and John Williams. You all pushed me through this when I thought the end would never come. Thank you. And last, but certainly not least, a huge thank you goes to Ramiro Diz. Thank you for being there through the good times and the bad times, for pushing me farther than I ever thought it possible to go and for teaching me to follow my passion, wherever it may lead. I would not be half the person I am today without your faith in me and your insistence that I give everything my all. TQM. Dedicated to Inés… 4 | P a g e Abbreviations EZLN Ejército Zapatista de Liberación Nacional; Zapatista Army of National Liberation. The military wing of the Zapatista Movement. IMSS Instituto Mexicano de Seguro Social; Mexican Social Security Institute. This is one component of the Mexican public health system (The SSA is the other). The IMSS was formed in 1973 to provide social security for Mexican workers and became actively involved in Chiapan reproductive politics in the 1990s. NAFTA The North Atlantic Free Trade Agreement is a free trade agreement between Canada, the United States and Mexico. The armed Zapatista uprising of January 1, 1994 was timed to coincide with the day that NAFTA went into effect, signaling the Zapatistas’ disapproval of the treaty. OMIECH Organización de Médicos Indígenas del Estado de Chiapas; Indigenous Doctors’ Organization of the State of Chiapas. This was one of the first non- government indigenous institutions to organize around indigenous health issues. The OMIECH was founded in the 1980s. Oportunidades IMSS program started in 1997 (then named IMSS-Solidaridad) to coordinate interdisciplinary approaches to improving education, health and nutrition. SINAIS Sistema Nacional de Información en Salud; National Health Information System. This is one of the federal institutes that records health statistics, including maternal mortality, from across Mexico. SSA Secretaría de Salud; Mexican federal Department of Health. This is one component of the Mexican public health system (The IMSS is the other) SSAZ Sistema de Salud Autónoma Zapatista; Autonomous Zapatista Health System. This is the name the Zapatistas have given to their alternative health system, composed of hospitals, clinics,