Title: The Politics of Affliction
Description: This dissertation examines the nature of personal suffering and the impact of a local crisis on a group of small Quechua speaking communities in rural Bolivia. I consider the ongoing processes of both sudden social ruptures and "permanent" crisis, inherent in the unique evolution of a (post)colonial state as it coexists in association with "traditional" Andean society. Of most significant interest to me is the manner in which relatively rare, extreme, "deviant" events may illuminate, as a kind of analytical lens, larger issues of social, political and cultural forces at work. Within this context, key determining natures are those of individual affliction and a wider structural violence, both of which are identified here as integral and pervasive components within society as a whole. I explore these as reflecting the transformations of social agency and cultural identity among indigenous groups in contemporary Bolivia, which pertain to their dramatically expanding role in overall civil society and state practices--yet which, nevertheless, remain in dramatic juxtaposition to deeply entrenched systems of power and state control over both the social and the personal body.

Within a theoretical context of political economy and critical medical anthropology, I look at these dual subjects--the state and the indigenous citizen--in counterpoint with competing notions of birth, death, affliction, and the role of civil society, as perceived within a climate of unexpected crisis and renewal. As its central ethnographic case study I focus on chronically elevated rates of maternal mortality in Bolivia, and in particular the local instance of an unexpected and dramatic surge in deaths. The multiple complexities of personal priorities and discourses circulating around these events had at its center a crisis at once glaringly public and intensely personal--which was used to the actual advantage of some, while to the obvious disadvantage of others: what I refer to as the "quality of its imagining." This personal tragedy of "death in birth" offers a unique perspective on the political uses and abuses of indigeneity and traditional culture, within a nation-state struggling amidst the often conflictive process of achieving the officially proposed objectives of "interculturality" and "decolonization." Concurrent cultural manifestations may resist, or, conversely, adopt, assimilate, and accommodate the official tenets and trappings of modernity, while attempting to find viable solutions to seemingly intractable societal problems.

Local reactions and understandings of this ultimate failure in the "reproduction" of society result in crisis as a social phenomenon of significant proportions: the ultimate issue concerns what is at stake for those involved at differing levels, ranging from the (extended) family unit, to the greater community, and ultimately to the political power structures at work.