Conflict, collective health and psychosocial harm in women.
The article analyzes the health situation and psychosocial damage of women, children and girls of the Tsuntsuim community, affected by the San Carlos Panantza metal mega-mining project, considered one of the five priorities of the national Government of Ecuador, a country whose Constitution recognizes nature as a subject of rights.
The conceptual and methodological approaches start from collective health, political ecology and ecofeminism to study the differential impacts by gender with a complex vision that incorporates three dimensions: territorial historical contexts, community ways of life and the health situation.
Through processes of psychosocial accompaniment (testimonies, ethnography and drawings), we understand how the occupation, dispossession and militarization of the territory mutate material and social reproduction, forms of consumption, community organization and relationships with nature. until all of this became psychosocial damage and psychic trauma.
During the last decades, the social and ecological conflict around the exploitation, appropriation and control of nature has been exacerbated in Latin America, and in this context large-scale metal mining is one of the most destructive and violent activities . The impacts of mega-mining are devastating, affecting the material and symbolic dimensions of the territory and alter social metabolisms in its five processes: appropriation, transformation, distribution, consumption and excretion.
Likewise, the occupation and militarization of indigenous and peasant territories by extractive multinationals operates as a kind of State terrorism. The persecution, criminalization and murder of indigenous leaders, environmentalists and peasants is a shared denominator in the geopolitical south (Martínez, 2013).
Even in countries like Ecuador,  whose Constitution recognizes the rights of nature, eleven percent of the national territory was given in concessions for mega-mining with the reopening of the mining cadastre in May 2016. These concessions were also developed illegally and unconstitutionally, neglecting the important processes of social mobilization and resistance to extractivism and the occupation of territories.
Extractivism and psychosocial harm
By subduing, dominating, militarizing and controlling local territories, mega-mining extractivism mutates the five dimensions of community ways of life (Breilh, 2004):
1) The productive models: The members of the communities live a transition from primary forms of relationship with nature (hunter-gatherers) or small-scale productive economies (family agriculture) towards processes of proletarianization, generally as workers with minimum wages and without labor rights, a condition that we have called labor chaining (Soliz et al., 2012). Extractive projects, while destroying the economic sovereignty, health and well-being of communities, are also the central source of livelihood both through wage payments and through compensation measures and royalties that often supersede social rights.
2) Social reproduction: Women assume a social, emotional and economic overload; they become the sole caregivers of the family, and live the economic pressure of dependence on their partner's salary or of the occupation of the territory that limits their productive autonomy. It is also women who, increasingly, lead community organization and resistance. An additional element of social reproduction that is usually controlled by extractive companies is the school. Its closure has been decisive in the control of territories and the displacement of populations (Soliz et al., 2012).
3) Consumption: By supplanting the State in the territory, extractive companies control consumption in its quantitative and qualitative dimensions: they determine access to infrastructure, social services, food, health and recreation, as well like the quality of all of them. Families tend to transition between self-consumption of the product from home gardens and buying processed foods. The alarming increase in alcohol consumption and the use of pesticides in agriculture is particularly striking.
4) Forms of social and community organization: Community relations become tense; The positions between the defense and the rejection of extractive companies are polarized. Those who have a job or enjoy some privilege support them, while those who experience contamination, loss of health, the impossibility of cultivating and continuing their artisanal mining practices demand their departure.
5) The relationship with nature: The relationships of the communities with nature are mediated by the State and the mining companies, which are the ones who establish prohibitions and possibilities: you cannot fish, hunt, use firewood, raise animals or wash handcrafted gold. In the name of an “eco-efficient” discourse, which endorses mega-mining as a clean and responsible alternative, the historic community metabolisms are upset.
Thus, the health situation in communities displaced by mining extractivism is a reflection of the balances of occupation and overlapping territorialities (ways of being, doing and living) in spaces historically inhabited by indigenous or colonist populations. It is in turn the result of the mutation of community lifestyles, the deterioration of their ecosystems, water pollution, the loss of biodiversity and the permanent presence of heavy machinery, toxins and explosions.
In the same way, psychosocial damage, understood as affecting the social, cultural, psycho-affective (feelings), psychosomatic (physical manifestations of damage) and cognitive (in communication and coping mechanisms) dimensions, is a process endowed with historicity and territoriality, framed in structural social conflict and expressed at the level of individuals, their families and their communities. As it is often not very visible, this article tries to reveal the magnitude of the psychosocial effects as a result of the imposition of mega-mining projects.
The San Carlos Panantza mega-mining project
The San Carlos Panantza copper mega-mining project, in the Morona Santiago province (Ecuador), covers an area of 41,760 hectares. Its concession benefits the Chinese company Explorcobres S. A. (EXSA) and will have an approximate validity of twenty-five years. It is considered the second largest copper mine in the world (Environmental Justice Atlas, 2017). At least fifteen Shuar communities suffer direct impacts from this mining project and four of them (Tsuntsuim, San Pedro, Kutukus and Nankints) have been affected by forced displacement.
Through a violent military operation, on August 11, 2016, the Nankints community was evicted and the La Esperanza mining camp was installed in its place. On December 14 of the same year, with a strong military presence on the ground and in the air, there was a serious confrontation that left two young Shuares among the wounded, one by high caliber bullet and the other with serious burns as a result of explosives planted by the army in the Tsuntsuim community. In addition, a police officer died (Acción Ecológica et al., 2017).
That same day, the state of exception decreed in the province of Morona Santiago allowed a military incursion never before seen in Ecuador: war tanks, helicopters, armored trucks and hundreds of soldiers and policemen raided several communities in search of the Shuar defenders with legal cases open. They were publicly exhibited as murderers,  omitting the human right of presumption of innocence (Acción Ecológica et al., 2017).
Tsuntsuim was one of the communities that experienced displacement. For weeks the military invaded, occupied and looted the houses; they took food and animals; they burned four houses; they broke the electrical connections, and buried the crops. Displaced families from Nankints and Tsuntsuim took refuge in the Tiink community until the beginning of March 2017, when they returned. Since then, a team of social organizations, academics and activists began a process of monitoring and recovering the health of women and their families, and we have documented it with testimonies and stories, as well as with drawings of children and women. girls
Psychosocial harm and impacts on women and children
During the accompaniment process, we found that this community, inhabited mainly by women with their children, had lost their ajas (farms), their animals and their work tools. It was a community that faced a war legitimized and consented to by the State, a war that came from the hand of hunger and fear. The food alternatives were reduced to some green and cassava, cooked in non-potable water. Families experienced hunger; they slept hungry and woke hungry for weeks. In this context, we identify four determining psychosocial conditions in the exercise of control and intimidation of the population (Beristain, 2009):
1) The sowing of fear: The investigation process of the seventy Shuar indigenous people determined that the men of the community should remain clandestine in the jungle to avoid their capture. This situation is recurrent in Ecuador and is known as the criminalization of social protest. At the same time, without food, without machetes to clear the forest and with sick children, women had to take care of everything. They were overwhelmed and sad, they spoke low, they stopped singing and they were afraid. Fear of the drones and helicopters that flew over, of the military, of new displacements, of the situation of his men, sick and isolated. Despite all the harshness, it was the women who returned to their community, brought him back to life and intensified the resistance.
2) The privileges: The Ministry of the Interior offered a reward of fifty thousand dollars for denouncing those who were on the list; promised compensation and employment in order to divide, break social ties and community union.
3) Social and political stigmas: A media onslaught was generated that presented the communities in resistance as a group of savage, primitive, terrorist, violent and armed cells. The construction of these stigmas blocks solidarity and isolates the victims, who are pointed out as responsible. At the same time, it strengthens and legitimizes the criminalization of protest.
4) Impunity: Forced displacement, looting, destruction and burning of houses and crops, mental trauma, injuries and death of a Shuar girl (Dallana, eleven months old) who amid the conditions of Displacement fell ill with the flu  and died, everything has remained in impunity, which has generated a loss of confidence in the State as guarantor of the rights of its peoples.
In the following months, Tsuntsuim experienced a food emergency situation. In August 2017, half of the children still had some level of malnutrition. Two out of every three children suffered from moderate or mild respiratory infections, as well as manifestations of scabies and pediculosis. Half of the women older than ten years showed signs and symptoms of psycho-affective affectation.
According to Soliz and Valverde (2012), the analysis of the drawing must start from the understanding of the use made of space. To do this, the page is divided into four quadrants: the upper ones symbolize fantasy; the lower ones, the reality. The left quadrants, the past, and the right, the future. Based on this interpretive lens, the drawings made by the children during our evaluation (see images 1, 2 and 3) are characterized by poor detail, sad faces, absence of limbs and small size of the family members, who generally take up little space on paper. The drawings have no soil and are located on the left side of the sheet, in the past. They reflect nostalgia for the family unit, fear, pain due to the absence of family members, rejection of the outside environment, isolation and uncertainty. Most drew their community without people and animals, like a ghost town where life did not exist. The drawings that incorporate people do so on the left side of the sheet. The law, the space that represents the future, is empty. The houses were drawn without doors or windows or with them closed. The weak line shows the perception of hostility in the external environment and fear of the world.
Health conditions and psychosocial damage in women and their children appeared as adaptive mechanisms to face a deeply violent reality. Changes in belief system and communication; feelings of sadness, hopelessness, anguish, and guilt; exaggerated alertness; irrational fears; the physical expressions of damage, and the impossibility of thinking and building the future were some of the psychosocial processes derived from the loss of territory, occupation and war.
Women especially suffered the impacts of the social, material and cultural appropriation of the territory; they lived and still live the social, affective and economic overload that determines the serious psycho-emotional conditions expressed, even, in psychosomatic manifestations. Despite all this, it was they who, with admirable strength, returned to their communities to rebuild them and rediscover ways of subsistence and resistance (Acción Ecológica et al., 2017). They have been the ones who, with their denunciation stories, have woven these stories, have recovered their ajas, have embraced their sons and daughters and have defended their territories. Thanks to them, life in Tsuntsuim has continued to be reborn. On the day of the displacement, a beautiful girl, Paula, was born and in these nine months three more have been born.
By María Fernanda Soliz
- Beristain, C., 2009. Dialogues on repair. Quito, IIHR.
- Borde, E., 2017. The territory in public health. Bogotá, National University of Colombia (unpublished essay).
- Breilh, J., 2004. Critical epidemiology. Buenos Aires, Place.
- Environmental Justice Atlas. Panantza - San Carlos, Ecuador, 2017. Available here, accessed June 3, 2017.
- Leff, E., 2000. The environmental complexity. Mexico D. F., XXI century.
- Martínez, J., 2013. “Ecologists with a belly full of lead”. La Jornada en Línea, Mexico City, UNAM. Available here, accessed September 15, 2017.
- Soliz, M. F. (coord.), 2017. Collective health and psychosocial damage in the families of the Tsuntsuim community. Quito, Ecological Action, Alames Ecuador, Conaie-Confeniae, Movement for the Health of Peoples, Crescent Moon.
- Soliz, M. F, A. Maldonado, C. Valladarez and D. Murcia, 2012. Golden childhood in the Cordillera del Condor. Quito, Environmental Clinic.
- Soliz M. F., and S. Valverde, 2012. Guide No. 2 for rapid diagnosis (6-11 years). Quito, Environmental Clinic.
-  Ecuador was a pioneer in recognizing nature as a subject of rights in its constitutional charter of 2008, a historic conquest that sought to mark a turning point with the anthropocentric logics that determine the primacy of the blind laws of the market over those of nature. and the senses of culture (Leff, 2000).
-  Seventy indigenous Shuares face investigation processes for murder and for attack or resistance in the protests that took place after the disappearance of the Nankints community, in which a police officer died (Acción Ecológica et al., 2017).
-  Flu was the term in Spanish that the family used to describe the cause of Dallana's death. We are alarmed that still in 2017 a baby may die of the flu. This is one more death than are known as displacement deaths.
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