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BMJ Paediatr Open
BMJ Paediatr Open
bmjpo
bmjpo
BMJ Paediatrics Open
2399-9772
BMJ Publishing Group BMA House, Tavistock Square, London, WC1H 9JR

39284615
10.1136/bmjpo-2024-002915
bmjpo-2024-002915
Young Voices
2431
1506
My culture soothes
Rodríguez-Zúñiga Karen Daniela 1mcpscuentas@gmail.com

http://orcid.org/0000-0002-4191-7435
Pinzón-Segura María Camila 2mcpinzons@unal.edu.co

1 Etnia indígena Pijao, Tolima, Colombia
2 Universidad Nacional de Colombia, Bogota, Colombia
Dr; mcpinzons@unal.edu.co
None declared.

Patient consent for publication: The necessary consents for this publication have been obtained. KDR-Z, and her mother, signed the appropriate consent forms in 2018, which were approved by the ethics committees of the Instituto Nacional de Cancerología and the Universidad Nacional de Colombia. This consent was part of the doctoral research Interstice Affective Theory, initially titled "Public Policies, Implementation, and Emotions: Towards an Alternative Analytical Approach. Case Study: Health Public Policy for Children and Adolescents with Cancer at the Instituto Nacional de Cancerología, Bogotá - Colombia," from which her narrative was derived. Additionally, in 2024, informed consent and authorization for this publication, as well as for the dissemination of images, have been obtained from her mother, Laura Rodríguez, and her sister, Karol Juliana Rodríguez, who is currently of legal age and has signed specifically for this publication.

Ethics approval: This study involves human participants and was approved by Ethics Committee of the Universidad Nacional de Colombia- Evaluation Act 019-237-16 of 27 October 2016: approval of the doctoral research project- Evaluation Act 014-243-18 of 28 September 2018: approval of the amendment to the research project, Ethics Committee of the Instituto Nacional de Cancerología E.S.E.- INT-OFI-04762-2017 (227651) of 10 May 2017: approval of the research project C19010300125- INT-OFI-12752-2018 (383915) of 24 October 2018: approval of the amendment to the research project. Participants gave informed consent to participate in the study before taking part.

Provenance and peer review: Not commissioned; externally peer reviewed.

Deceased: Deceased

2024
16 9 2024
8 1 e002915Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Abstract

In the poignant words of a 12-year-old indigenous girl from the Pijao ethnicity (Tolima, Colombia), who shared her perspective before succumbing to leukaemia, we gain a profound understanding of health from her unique cultural viewpoint. Growing up in El Escobal, indigenus community, with her sister, she experienced the spiritual strength and unity that their culture attributes to twins. For her, health was deeply intertwined with the traditions and rituals of her people, emphasising the healing powers of plants and spiritual harmonisation.

She observed a stark contrast between indigenous and Western perspectives on medicine and spirituality. In her reflection, the young girl highlighted the universal language of mutual learning and support that transcends cultural differences. Her message underscores the importance of cultural harmony and the healing power of shared human experiences, advocating for a world where diverse beliefs and practices contribute to collective strength and understanding.

This text was her response to the question, "What is health?" as part of one of the methodological exercises in the doctoral research of Pinzón-Segura MC. Teoría del Intersticio Afectivo: Un nuevo enfoque feminista decolonial de análisis de políticas públicas [Internet]. Bogotá: Repositorio virtual de la Universidad Nacional de Colombia; 2024. The thesis, awarded with the distinction of summa cum laude, included various methods such as participant observation, sociological interviews, and discourse analysis of government documents. The question "What is health?" specifically guided 40 creative narrative workshops, which were an integral component of the ethnography and arts-based research design.

Anthropology
Child Health
Qualitative research
The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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pmcKey Message

What is already known on this topic

Indigenous perspectives on health are deeply rooted in a holistic understanding that integrates spiritual, cultural, and environmental elements, often standing in contrast to Western biomedical systems. Studies have shown that indigenous children, particularly in healthcare settings, frequently experience a disconnect between their traditional beliefs and modern medical practices. This gap can lead to misunderstandings, mistrust, and a lack of culturally appropriate care, exacerbating the marginalization of indigenous youth within healthcare systems.

What this study shows

Through the narrative of a 12-year-old Pijao girl, this study reveals how indigenous beliefs and cultural practices profoundly shape the understanding of health and well-being. The narrative highlights the emotional and spiritual dimensions of health, emphasizing the importance of cultural harmony, mutual learning, and respect between different belief systems.

How this study might affect research, practice, or policy

This study underscores the importance of healthcare systems incorporating and respecting indigenous cultural perspectives, particularly in pediatric care. It advocates for policies and practices that promote cultural sensitivity, patient empowerment, and the integration of indigenous knowledge into healthcare, potentially leading to more respectful, inclusive, ethical, and effective medical care for indigenous populations.

This is the story of my sister and me, referred to as Erames (sisters) in the community of El Escobal, Pijao ethnicity, a Colombian Indigenous people. Being twins in our culture is considered a spiritual strength; it signifies unity, power and a magical world.(see figure 1)

Figure 1 Karen and Karol, erames (twin sisters) from the Pijao indigenous community, supported each other during Karen's hospitalisation in 2018, demonstrating the strength of their bond and the solidarity characteristic of their culture.

In our world, everything was special. We were always together and needed nothing more than each other’s company or the environment of our community to be happy or to have fun.

We grew up within our community under the traditions of our culture, yet we also engaged in the actions of the white people, which sometimes caused doubts about our view of life and our territory or, conversely, broadened our knowledge.

One example is the differences between traditional and Western medicine. In traditional medicine, certain plants and rituals are immensely important for healing and purification of the self; but to the whites, these are merely myths or herbs without true healing effects. Indigenous rituals, which include harmonisations to ward off bad energies and purify the environment, are seen by whites as witchcraft practices.

Indigenous people, in the worldview and spirituality with which we have been raised, know of three levels in the astral spiritual plane: the upper (gods), the middle (earth-water-natural resources) and the underground (mineral resources, myths and legends). However, whites give it a completely different meaning from their religion, trying to overshadow and almost completely abolish our indigenous beliefs in favour of adopting Catholicism.

These differences slightly confused my sister and me. We saw how one was the position of our ancestors and the traditions inherited from our angola (grandmother) and our ueño (grandfather), and others were the customs of the new white people with whom we shared our territory and with whom we constantly had to defend and debate our particularities. Fortunately, our taita (father) was a very calm and wise man, and our mama (mother) was a very skilled woman capable of explaining situations from her indigenous viewpoint without transgressing the information and beliefs of the whites. They found in their crafts a way to teach the wipas (children) of the community to have discipline, calm and spaces for reflection. They prepared us to share knowledge, both our own and external, until reaching a level of spirituality where our sense of belonging made us know our culture very well.(see figure 2)

Figure 2 Karen and her mother, Laura, engaging in the creation of handmade crafts, a healing therapy deeply rooted in their Pijao culture. For them, crafting traditional handmade items was not merely an activity, but a profound healing practice distinct from Western concepts of occupational therapy.

The harmonies achieved in the spaces of artisanal creation allow us to face unexpected situations. Replicating our arts to the new generations facilitates interaction in our community and with the white people who take an interest in it.

From these granted experiences, my sister and I continued replicating in sister communities of our territory, and with some white people, the experience through ancestral artisanal knowledge. We focus this knowledge on improving the physical, spiritual and mental health of those who wish to learn a bit more about our culture, teaching them that regardless of differences in customs, preferences and beliefs, there will always be a universal language among us. In this language, everyone learns from everyone else and we help each other to overcome difficulties, thus building groups of formative strength and contributing a bit to the change in clashes between human beings, through a culture that soothes and heals the soul.

Acknowledgements

To MCP-S and her research, which provided us with an invaluable platform to explore our experiences and allowed us to feel heard and important. In the hospital, KDR-Z felt like she was in a prison, an enclosure, an invasion of her life and privacy. The research studies we were invited to did not promote her emotional well-being, and none provided feedback on how our participation was useful. The only study that truly fostered a different kind of relationship was MCP-S's, from which we learnt a lot and which was immensely beneficial for KDR-Z. This research allowed KDR-Z to feel important, empowered to speak, express and participate, feeling valuable despite what she was going through. We experienced respectful care that considered the patient's voice, breaking away from traditional approaches that often feel immovable and rigid. It was like opening up a world of new possibilities, where we understood what it means to respect the patient, without prioritising the role of being a parent and thinking we govern our children's lives when their lives belong to them. Finally, I want to thank the British Medical Journal Paediatrics Open for the opportunity to share this narrative and for their commitment to promoting more humane and respectful medical care. This acknowledgment was written by KDR-Z’s mother, Laura Rodríguez, an Indigenous leader from the Pijao ethnicity, socio-ethnic professional, and Bachelor of Early Childhood Education.
