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BAR Book Forum: Amy Cooper’s “State of Health”
Roberto Sirvent, BAR Book Forum Editor
10 Mar 2021
BAR Book Forum: Amy Cooper’s “State of Health”
BAR Book Forum: Amy Cooper’s “State of Health”

Unlike the US and other corporate-ruled countries, activists inside and outside of government collaborated to bring about radical social change in Venezuela.

“People viewed the state as a source of immense wealth that rightly belonged to them.”

In this series, we ask acclaimed authors to answer five questions about their book. This week’s featured author is Amy Cooper. Cooper is Assistant Professor of Anthropology at Saint Louis University. Her book is State of Health: Pleasure and Politics in Venezuelan Health Care under Chávez.

Roberto Sirvent: How can your book help BAR readers understand the current political and social climate?

Amy Cooper: As long as we organize human populations into state societies, we must grapple with the historical fact that states often fail to promote dignity and wellbeing for the people they govern. Yet if they cannot do this, what is their purpose for people? Debates about alternative ways to organize our systems of government are becoming more mainstream in the U.S., apparent in national discussions over the possibility of enacting Medicaid for all and defunding police forces, for example. Latin American histories of participatory democracy, such as Venezuelan society under Chávez, help clarify the possibilities and challenges of a politics aimed at radically restructuring state-society relationships. My book describes Venezuelans’ experiences of living in a political moment when officials promised to bring about revolutionary social change inspired by anti-capitalist, anti-imperialist, and anti-racist principles. The book provides an in-depth account of how poor people collaborated alongside a pro-poor government apparatus to try to transform the national distribution of health care. 

What do you hope activists and community organizers will take away from reading your book?

The book describes activists collaborating with state agents for radical social change. The assumption that leftist activists work outside of and in opposition to state institutions made little sense in Chávez’s Venezuela. Many organizers struggling to build a better world predated and inspired Chávez’s administration, but many people became activists because of the leftist government’s inspiring rhetoric and substantive programs to uplift marginalized communities. The government built participatory democracy into its infrastructure, laws, and messaging, and people viewed the state as a source of immense wealth that rightly belonged to them. In this setting, activists and government representatives collaborating with each other was commonsensical, even such collaborations were fraught. Many community organizers viewed the state as a collection of resources to help achieve their goals, or even as an entity they could remake and embody themselves, rather than as an adversary to overcome. In the realm of health care provision, it was often impossible to draw a line between community activism and government-provided health services. Although the ideology of poder popular  (popular power; people-led government) did not take up permanent residence in Venezuelan state institutions, practices and theories of communal governance continue to shape local activism across the country. Thus, the history and future of 21st century Venezuela provides ideas for harnessing and inhabiting power to build new models of radically democratic governance.

We know readers will learn a lot from your book, but what do you hope readers will un-learn? In other words, is there a particular ideology you’re hoping to dismantle?

I hope to help dismantle the idea that biomedicine is an unproblematic pathway to health. Many of us believe that biomedicine is superior to other healing traditions and that improving access to biomedical care will inevitably improve health. But improving health may also require improving people’s experience of social relationships, the natural environment, their sense of control over their world, foodways, education, labor, and housing. Health gains made during Chávez’s presidency have as much to do with social programs in nutrition, education, land tenure, political participation, retirement benefits, etc. as they had to do with the government’s investment in its public health system. My book also demonstrates that improving access to biomedical care can change people’s sense of health and their sense of political belonging and community – but only if people experience medical care in positive terms. Much of the anthropological research documenting marginalized people’s encounters with biomedicine demonstrates its potential to dehumanize and disempower even while it claims to bring about health benefits. I found that accessing biomedical care can empower as much as it can disempower, primarily via people’s face-to-face encounters with medical providers. Further, I hope the book shows readers that biomedicine is just one of many valued healing traditions in Venezuela. Improving marginalized people’s access to biomedical care did not lead people to abandon spiritual healing, plant-based medicine, or home remedies. In fact, these forms of healing thrived during the period when I did my research, even while access to biomedical care improved by huge margins. The Chávez government explicitly celebrated medical pluralism, which empowered people to govern their own health seeking and maintained the dignity of non-biomedical healing traditions and the communities associated with those healing traditions.

Who are the intellectual heroes that inspire your work?

My high school history teacher, Wendall Zartman, was a living embodiment of intellectual curiosity who engaged crowded rooms of Houston public school students with warmth and love. His course World Area Studies introduced us to legacies of imperialism and other topics that are often ignored in US educational agendas. One of my advisors in graduate school, Judith Farquhar, reshaped my thinking about the anthropology of health in crucial ways, while anthropologist Fernando Coronil was instrumental in my understanding of Venezuelan politics. Many people who participated in my research in Caracas inspired me to think more expansively about the potential for radical social change and I think I have been changed as a result of my associations with them. Lately, I have been thinking about ways to engage wider audiences about the themes I research and have been looking to fiction writers and public scholars for inspiration in making a stronger commitment to public engagement. Of these, I have found the work of speculative fiction authors such as Octavia Butler, Ursula K. LeGuin, and Kim Stanley Robinson inspiring. Anthropologists who have published books aimed at a general audience, including Agustín Fuentes and Tanya Luhrmann, inspire me to try to popularize medical anthropology insights through writing. 

In what way does your book help us imagine new worlds?

The book offers a corrective to mainstream media reports that systematically ignore and distort positive changes to society enabled by leftist politics in Venezuela. Today, it seems unthinkable that the Chávez era produced improvements in marginalized people’s lives. Yet the political landscape in Caracas during the years I conducted fieldwork (2006-2009) was a lively and creative laboratory where city residents enacted radical improvements in their social, political, and material worlds. Many problems persisted, but there was a sense of potential for improving nearly every aspect of life. Many people felt empowered for the first time in their lives to get their hands dirty working to change their local communities. The book documents a rapid transformation of major aspects of Venezuelan society in a very short period of time – something that helps us see the possibilities for radically changing social institutions in our lifetime. Many of the changes I documented occurred at the community level and did not require changes in infrastructure, financial resources, or state involvement, such as groups of elderly neighbors forming “Grandparents Clubs” whose members exercised and socialized in public spaces, improving their health while changing the significance of those city spaces.  I hope that the book helps readers see that equitable systems of care are more possible to achieve than we may think. 

Roberto Sirvent is editor of the Black Agenda Report  Book Forum. 

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