Forty percent of Texas Latinos lack health coverage. Where do they turn?
Two years after being diagnosed with a kidney infection, Maria de los Angeles Martinez is rolling on the streets of a dusty, northern Mexican town 400 miles from her home in Edinburg, Texas. Her white pants and shirt are brown with dirt. For almost an hour, she’s been dragging herself along Espinazo’s Avenida de Dolor, the Avenue of Pain. Weakened by her illness, the 56-year-old is finding the pain difficult to bear. When she grimaces, a guide clad in a white robe and red cape sprays holy water from a plastic bottle into her mouth and onto her head. “Andale mija,” she tells de los Angeles Martinez. “Let’s go.”
De los Angeles Martinez is in the middle of a procession that has taken over Espinazo’s narrow streets, winding slowly through market stalls and makeshift taquerias. She’s one of more than 20,000 pilgrims who have come to be healed by El NiÃ±o Fidencio, a folk saint whose body is buried in the center of town, on the 70th anniversary of his October death.
When Fidencio’s tomb, the procession’s destination, finally comes into view, de los Angeles Martinez’s eyes well with tears. “NiÃ±ito Santo,” she sings, “can you hear me suffering?” Her voice is swallowed by the clamor of the procession, a Hieronymus Bosch painting come to life-writhing bodies, high-pitched incantations, and frenetic displays of faith. Like de los Angeles Martinez, the sickest and most dedicated of Fidencio’s followers scrape flesh against asphalt over the entire quarter-mile journey, making penance in exchange for healing.
When she arrives, de los Angeles Martinez drapes herself over Fidencio’s tomb, which is covered in flowers and devotional candles. “I’ve come because I need you more than ever,” she says. Lacking health insurance, she couldn’t afford treatment in Texas. In Espinazo, she believes there is hope. She saved for months to pull together $500 for the trip through the Sierra Madre Oriental Mountains.
In the 1920s, it’s said that Fidencio healed lepers in a muddy Espinazo pool, performed surgery with shards of glass, and danced with patients, shaking diseases from their bodies. Now his spirit is called upon by thousands of Texans, many gravely ill, some of whom make pilgrimages to the town every March (his saint day) and October (to mark his birth and death). Many have been spurned by the American health care system-they’re among the 40 percent of Latinos in Texas, nearly 3.4 million, without health insurance. Like de los Angeles Martinez, they have turned to curanderos, or folk healers-none more popular than the materias who claim to channel Fidencio’s spirit.
For three nights in Espinazo, de los Angeles Martinez will sleep on the floor of a stranger’s home instead of a hospital bed. In place of conventional Western medical treatment, she will receive herbs and ointments made of cactus and aloe. With Fidencio long deceased, those cures now come from the white-robed materias, who lead people like de los Angeles Martinez along Avenida de Dolor to Fidencio’s tomb. Their followers pay for the healings only if they so desire. They cling to the faith’s fundamental axiom, words from Fidencio: “The poor are not poor. The wealthy are not wealthy. The only poor are those who suffer from pain.”
“It’s a faith of desperation,” says Antonio Zavaleta, an anthropologist at the University of Texas at Brownsville who has studied Fidencismo for 25 years. “It provides hope for the hopeless. And that hopelessness is closely tied to insufficient access to medical care.”
Before Jose Fidencio Sintora Constantino-nicknamed El NiÃ±o for his boyish physique and high-pitched voice-moved from Guanajuato to Espinazo in the early 1920s, the town was little more than a few homes surrounded by farmland, unknown outside the immediate area. The Sierra Madre Oriental kept the sprawl of northern Mexico’s biggest cities well out of sight.
When the rail-thin, 28-year-old cooking apprentice announced that he could heal ailing villagers, a local landowner gave him a chance. Within months, residents were lining up to be prescribed medicinal plants and herbal cures from El NiÃ±o, who also claimed he could channel Jesus and was the son of Mexico’s patron saint, the Virgin of Guadalupe. “They called him a thaumaturge,” Zavaleta says. “A miracle worker.”
Fidencio’s boasts and the histrionics of his healing sessions attracted thousands to Espinazo over the next decade, an influx captured in surviving photos of Fidencio reaching toward masses of clamoring followers. Word spread widely that he cured the mentally ill by placing them in a rope swing attached to a tree, and cured physical ailments with raw eggs and native plants. In 1928, The New York Times wrote that interest in both a nascent Mexican rebel movement and a presidential campaign had “waned recently, as the public has devoted itself to extraordinary reports from Espinazo.”
That same year, Mexican President Elias Calles visited Espinazo to meet Fidencio, possibly intending to arrest him for practicing medicine without a license. But the president left Espinazo a believer, claiming Fidencio had healed him. The story, reported throughout Mexico, solidified Fidencio’s reputation as one of his country’s most important curanderos.
Fidencistas believe that El NiÃ±o predicted his own death, telling his followers he would live on through materias. There are more than a thousand of them now-men and women who say the folk saint uses them as vehicles to converse with those in need. “I lose consciousness,” says Lidia Velasquez, a 70-year-old materia from Edinburg. “I’m just flesh. It’s Fidencio’s spirit.” During healing sessions, the materias close their eyes, sometimes convulsing as they call on Fidencio. For hours at a time, they speak in the squeaky falsetto said to resemble the saint’s voice, doling out traditional remedies and advising prayer.
Fidencio isn’t the only spirit channeled by Mexican or Mexican-American healers. Nor is Fidencismo the only brand of curanderismo, or folk healing, still used on both sides of the border. There are kueseros, or traditional bonesetters; yerberos, or herbalists; and sobadores, or traditional masseuses. Fidencio is believed to be the leading santo popular or folk saint, attracting a following of more than 100,000, according to anthropologists. The faithful call themselves a Catholic sect, and often invoke Jesus and El NiÃ±o in the same hymns. In Espinazo, key chains and candles emblazoned with his image are sold next to paintings of Catholic saints. The Roman Catholic Church has refused to accept Fidencismo, calling Espinazo’s pilgrims heretical and misguided.
The church’s derision hasn’t stopped Fidencismo from spreading north of the Rio Grande, where missions and weekly healing sessions can be found in all of Texas’ major cities. Thanks to northward migration and word of mouth, tens of thousands of Fidencistas call Texas home. Throughout the three-day festival, their conversation often returns to the shortcomings of the American health care system and the triumph of faith over science.
“When I could afford it, I went to a doctor,” de los Angeles Martinez says. “It was always the same. More and more pills. More and more money.”
When the income from her small bridal store no longer covered hospital visits, she decided to look for alternative treatments. De los Angeles Martinez went to a local healer known for channeling Fidencio. The healer first prescribed the juice of an aloe plant and a bottle of water with pieces of chaparral to treat her kidney infection. “It was incredible,” she says. “I felt healed not only physically, but emotionally.”
Now, like many pilgrims in Espinazo, de los Angeles Martinez turns first to a healer. If the healer-or the spirit being channeled-tells her to seek medical help from a doctor, she tries to do so. At times like now, when she can’t pay medical bills, she says Fidencismo is her only option. “With El NiÃ±o,” she says, “it’s not a question of money. It’s a question of faith.”
Fidencismo continues to spread in Texas as health care among Latinos lags far behind that of other minorities, largely because of an uninsured rate more than two times the national average and more than 10 percent higher than among African Americans. And health care for Latinos appears to be deteriorating rather than improving. In 2006, the National Healthcare Disparities Report from the U.S. Department of Health and Human Services found that quality of care was rising for all racial and ethnic groups-except Latinos. Experts say the numbers are closely tied to immigration; Americans born outside of the country are about 2.5 times more likely to be uninsured than those born in the United States.
In Espinazo, those statistics are supported anecdotally. Jessie, a 30-year-old from Houston who asked that his last name be omitted to protect a relative’s job in a hospital, remembers when his mother, uninsured at the time, was diagnosed with gall bladder problems. “We live in an age now where either you have health insurance, or you don’t go to a doctor, and you tough it out,” he says.
Or you find an alternative. Jessie and his ailing mother came to Espinazo in the late 1980s after the family learned of Fidencismo through an acquaintance. When Jessie’s mother’s health improved-thanks, they believe, to an herbal remedy and a materia’s spiritual intervention-he made a commitment to Fidencismo. He has returned to Espinazo nearly every year since. Like many pilgrims, he comes not out of concern for specific ailments, but to give thanks to Fidencio.
“You could say, ‘Why would you come here and be without running water and be without light?'” Garcia says. “But this is a place where you feel better than where you’re at. Medicine is business; it’s about money. This isn’t. This is real help.”
Fidencismo dictates prescriptions with authority. In Espinazo, those prescriptions are broadcast continually by a man’s voice on a loudspeaker along la Avenida. He names more than 40 remedies. Volcanic oil for back pain. Ointments for irregular menstruation. A special tonic for children with growth problems. “There are so many cures available here,” the man says with a salesman’s enthusiasm. “Take advantage of the cures of Espinazo.”
Jessie and many others say that it’s not just the difficulty in obtaining medical care that leads them to curanderos, but the quality and nature of the services. Researchers along the U.S.-Mexico border say that thousands of Mexican Americans, many with insurance, are dissuaded from seeing physicians every year because of a cultural disconnect. American medical practitioners haven’t considered the traditions and expectations of many Mexican Americans, who are used to the close physical contact and spiritualism of folk healers.
“Health care providers along the border are trying to fit a square peg in a round hole,” says Iran Barrera, professor of social work at the University of Texas-Pan American in Edinburg. “We call these alternative healings, but for many people it’s not an alternative. Going to a physician is the alternative.” Barrera says that “cultural incompetency” is especially common in mental health care, where Mexican-American patients often feel their needs aren’t met. “The distance and the lack of physical connection between doctor and patient feels alien to them,” he says. “They’ll go once, decide it’s not for them, and return to the curandero.”
The Texas Department of Health has long been aware of the problem. In the late 1950s, the department funded a study into the prevalence of curanderismo along the state’s border with Mexico-an attempt to research the needs of its growing Mexican-American population. “It is useless for M.D.s to assail this quackery,” Time magazine asserted after the report was published in 1961. “To the Mexican-American, the gringo doctor is the quack.”
Fifty years later, the relationship between the country’s medical establishment and believers in curanderismo remains tense. Jose Pagan, a professor of health economics at the University of Texas-Pan American, understands why people turn to faith healers. “Along the Texas border and in other areas with high uninsurance, people are going to look for other ways to take care of themselves,” he says. “We’ve seen a clear growth in the use of alternative medicine as the price of insurance has risen.” Pagan worries that if patients rely on curanderos without consulting their physicians, they risk misdiagnoses. And when the believers do seek conventional care, their doctors often struggle to uncover patient histories with folk healers and identify the remedies they have taken.
“We see it all the time: Patients take it upon themselves to treat themselves before they come in,” says Paula Gomez, executive director of the Brownsville Community Health Center. “We have to ask what they’ve been taking, how long they’ve been seeing curanderos before coming to us.” Many such patients, she says, have resorted to conventional medicine after unsuccessful healings. Others have been urged by a curandero to visit a physician. The healers’ prescriptions are rarely inherently dangerous, Gomez says. But without knowing the extent of a patient’s reliance on curanderismo, it’s often difficult to discern how long the illness has persisted and decide how to treat it.
“El NiÃ±o isn’t scared of doctors,” says Alberto Salinas, an Edinburg-based materia and former sheriff’s deputy. “He knows how important they are. He knows they’re often necessary.” But as long as so many Latinos lack health insurance and feel uncomfortable with the American medical system, physicians will inevitably take a backseat to materias for thousands of needy Texans. Every March and October, pickups bearing Texas plates will continue to line Espinazo’s streets.
As the crowds thin and normality returns to drowsy Espinazo, portraits and statuettes of NiÃ±o Fidencio are placed carefully in northbound vehicles-soon-to-be additions to Texas living rooms and homemade altars.
After three days in Espinazo, de los Angeles Martinez says she feels like a different person, as if a tremendous weight has been lifted from her body. She has promised El NiÃ±o she’ll return to thank him for the healing, though she’s not yet sure how she’ll afford the trip. “For El NiÃ±o, I know I’ll have to make sacrifices,” she says. “That’s a part of the faith-giving of myself.”
Leaving Espinazo does not mean leaving Fidencio. Back in Edinburg, she’ll have several materias to choose from-men and women who host daylong healing sessions, usually in their living rooms. Salinas has transformed a cotton farm into an elaborate shrine to Fidencio that includes models of Espinazo’s holiest sites: the pool where Fidencio healed the sick, the swing where he treated the mentally ill, a small room filled with rosary beads and statuettes where Salinas performs exorcisms.
A week after returning to Edinburg, de los Angeles Martinez comes to Salinas’ shrine to think about Espinazo, about the effort it took to arrive at Fidencio’s tomb. She sits on a small, wooden bench in the shadow of a giant crucifix, identical to the ones that pepper the mountains around Espinazo. “I was so cold and wet, covered in pieces of trash,” she says. “But if that’s what it takes to feel the way I do now-relieved, healthy-I’ll do it over and over again.”
Kevin Sieff is a reporter for the Brownsville Herald.
Investigative reporting for this article was supported, in part, by a
grant from the Open Society Institute.< em>