Pachamama Snatched Her: Getting Involved

Chagas’ disease became a major concern for Ruth Sensano in 1989. She is director of Proyecto Britanico Cardenal Maurer (PBCM),[44]which sponsors Chagas’ control projects in the Department of Chuquisaca. PBCM improved 452 houses between 1987 and 1991, another 400 in 1992, and by 1997 it had improved 2,600 houses.[45]PBCM improved the first 452 houses with a budget of U.S. $83,256, out of which the community contributed almost half, or $37,642. By the year 2005, Sensano predicts, she will have improved another 2,500 houses, counting on assistance from tax revenues given to the municipalities for regional improvement, as discussed in the previous chapter.

A native of Sucre and a mestiza, Ruth Sensano learned to be a project director. She controls the accounting process carefully so that there isn’t any graft. Bolivians have a phrase in Aymara that translates roughly, “Sucking from above and sucking from below”; it refers to the mid‑level Bolivian project personnel who steal from those above (foreign bosses) and from those below (peasants). Because of the great amount of graft in Bolivia, project directors need to scrutinize expenditures at every level.

Sensano is as shrewd as any native chola market woman and as accurate as an accountant: both skills enable her to deal with the bureaucratic economic systems of project supporters and the informal, dynamic economic systems of peasants. She was lured from a profitable accounting job in 1976 by Cardinal Maurer, a German immigrant and Bolivia’s first Roman Catholic cardinal, to extend health care to peasants within the Department of Chuquisaca. Since then, Sensano has established a medical program that serves 54,500 people in 168 communities in three zones of Yotala, Yamparaez, and Tarabuco. She accomplished in fifteen years what the Bolivian Secretary of Health with triple the personnel and budget was unable to do in thirty years.

When I met Sensano one June morning in 1991 in Sucre, Bolivia, she told me why she became involved: “About twenty months ago, we started the Chagas’ disease program. We found that campesinos came in with bulbulos, hardened and impacted intestines, and they couldn’t go to the bathroom. They say that they eat cold food, their intestines fill, harden, and they can’t defecate. This was caused by Chagas’ disease.” She also showed me a picture of a peasant with bulbulos who hadn’t defecated for months (see Figure 9).

^{Figure 21.}

^{Ruth Sensano is director of Chagas control in the Department of Chuquisaca, Bolivia. She has been a leader in the eradication of this disease, and her program is a model for other projects throughout Bolivia. (Photograph by Joseph W. Bastien)}

“We realized,” Sensano continued, “that in many communities people were sick with Chagas’ disease. The people are accustomed to vinchucasin their beds, thirty to forty in their beds. They are used to the bites. They say, ’All night we are taking off their heads and destroying them. We have to sleep outside the huts to escape them. Sometimes we don’t sleep all night because we have to kill vinchucas.’ When vinchucas bite, they scratch it.

“Campesinos see a person working and then fall asleep and die with two or three drops of blood coming out of the nostril. They say she died ’asustado’ (frightened), or ’La Pachamama ha agarrado’ (Mother Earth snatched her!). In reality, la vinchuca got her, just as they got me!” (Sensano interview 6/17/91)

I noticed that her left eye had the carbuncular sore beneath the eyelid characteristic of acute Chagas’ disease, Romañia’s sign, so I asked her if she had Chagas’ disease.

“I would be surprised if I wasn’t infected,” she replied, “seeing that I have slept in peasant huts many times. But that’s my job! More than likely, all my workers have Chagas’ disease. We are all in this together.”

Before I parted, an old Quechua lady came in with a face twisted from Bell’s Palsy. She was crying. Sensano hugged her, as a mother. Firmly, she advised the lady to take a taxi, providing her with the fare, to the Bolivian Supreme Court in Sucre.

^{Figure 22.}

^{Ruth Sensano assisting an Indian woman who had suffered Bell’s Palsy and had been released as a maid because of her facial deformity. Sensano served as arbitrator in the Bolivian courts over this matter. (Photograph by Joseph W. Bastien)}

“I’m also a social worker,” she explained to me. “This lady was fired as a maid after working thirty years for a wealthy family. They threw her out of the house because her disfigured face embarrassed them. They gave her no severance pay. Now, she is without a home and money.” Sensano is contesting this in court, and she hired a lawyer to defend the woman. The case was prolonged for six months. Ruth Sensano sighed, “So much suffering and so little justice in Bolivia.”