Artigos

Introduction:
When speaking of forced displacement and migration dynamics, the literature demonstrates that indigenous peoples constitute one of the most disadvantaged groups in this regard. In this sense, it stands out that indigenous women are the population group that has the deepest disadvantage, the majority of them residing in the poorest, most marginalized municipalities with an increased presence of armed actors2. For this reason, many women have found it necessary to migrate to the city as a means of escaping violence and conflict3. In addition to this, other reasons that drive women to migrate to the city are the need to obtain resources to support their families and themselves; the search for better opportunities in health, education and employment; and, ultimately, achieving a better quality of life4.
With respect to this, various studies show that migration is a risk factor that affects mental health, in aspects such as mental disorders, making meaning of one’s life, the possibility of autonomy, development, and the capacity of one’s agency5. However, although these effects on mental health have been widely documented, it is evident that, in the case of indigenous communities, that marginalization due to culture, language and ethnicity still prevails. Likewise, cultural differences in language, communication, values, beliefs and ways of life have not been taken into account in health care6.
However, as has been documented by many distinct researchers, women who face these difficulties caused by conflict and migration still manage to develop resilience strategies by taking advantage of the social and emotional resources at their disposal7,8. Accordingly, this project is not concerned with documenting how these women have been victimized given their situation, but rather how they have constructed and practiced strategies of resilience that preserve their buen vivir, or good living, and conserve their cultural identities.
Among the recent advances presented by studies on resilience, women and migration, it is found that, currently, it has been shown that the role of indigenous women transits between the changes of globalization, together with the intergenerational changes implied by intercultural and border contexts9, 10.
It is also highlighted that this type of studies mark the beginning of a new line of work that recognizes indigenous women as wise women who maintain and defend their culture in the face of contemporary challenges, establishing resilient practices in the face of territorial social conflicts that have stripped them of their traditional lands and customs9, 10.
The evidence of this reality has implied challenges such as the need to invest from institutionality, ancestry and narratives of origin, in the revitalization of women's territorial identity leadership. The inclusion of their voices and perspectives in the production of academic and social knowledge promotes greater equity and respect for cultural diversity, thus allowing the design of more effective and culturally sensitive interventions in the face of current exclusion and discrimination9, 10.
Likewise, among the challenges, the loss of traditions and the change of customs between generations, the threat to food sovereignty, gender issues, as well as migration stand out. It is also important to continue to invest in education as a fundamental area of defense of good living, through research on the narratives that promote it in indigenous communities, from the visions and proposals of these peoples, as well as from the perspective of interculturality11, 12.

For the reasons stated above, within the framework of the Martin A. Dale '53 scholarship, with the principal investigator and intern Cierra Moore, it was considered important to develop this project, which aimed to understand the meanings and practices of resilience constructed by indigenous women who live and study in the urban context of Medellín13. Based on its development, proposals were built, from the perspective of the participants, to respond in a more adequate and timely manner to their mental health needs, contributing to their empowerment and to the reduction of inequalities that further hinder their status as migrants.

Methods:
This project was developed with qualitative research utilizing participatory research tools, as well as analytical tools from Grounded Theory14, 15, 16. The data collection method used was photovoice, which is a process developed by Caroline Wang and Mary Ann Burris, through which people can identify, represent and improve their community through photography17.
The authors of this article understand that resilience is not a concept that can be considered in abstraction, but rather must be examined through the intersection of several different lenses that were relevant to this project: through an individual versus community lens, through the lens of Medellín and its history of transformation, through an indigenous lens, and finally, through a feminist lens.
Regarding the individual lens, resilience is a process that begins when certain protective factors interact with risk factors in a way that generates a positive self-image, reduces the effects of risk factors, and breaks negative cycles, which opens up new opportunities. Some examples of individual factors are positive temperament, self-esteem, set of enduring values, etc.18.
Community/cultural resilience, on the other hand, is understood as the capacity of a distinct community or cultural system to absorb disturbances and reorganize itself while experiencing change, to retain key elements of structure and identity that preserve its distinctiveness18.
Likewise, the existence of indigenous communities, despite persistent risks and vulnerabilities, speaks to their capacity for community and cultural resilience, aided by certain cultural protective factors, such as spirituality, traditional activities, languages, and healing18.
On the other hand, Medellín's brand as a resilient city is derived from the fact that, despite decades of violence and corruption due to armed conflict and drug trafficking, since the 2000s there has been a radical change towards "social urbanism", that is, investment in the "urban fabric" of the city (mobility, culture, and education), which has made Medellín, thanks to the ability to overcome obstacles, currently considered an innovative, inclusive, and forward-looking city19.
Finally, for this project, a feminist approach was adopted from which women's experiences are addressed, not from a place of victimization, but from a place of strength and resistance, in which community strengths and resistance mechanisms are emphasized, as opposed to vulnerabilities and historical trauma7.
On the other hand, to facilitate the selection and contact with participants, a convenience sample was carried out, which consists of the selection of participants in an arbitrary manner, using communication networks of indigenous cultural groups within the University of Antioquia and word of mouth. People who knew indigenous women were contacted, to establish communication bridges with them and assess their possibility of participation. Also, cultural groups at the University were assisted to present the project and propose that indigenous women participate in it, as well as, through word of mouth, a strategy was generated so that the previously contacted people could recommend others among their acquaintances and friends. In this way, indigenous women who were linked at that time with the University of Antioquia were contacted, as students, employees, contractors, professors or graduates. Ten indigenous women participated. Also, this research was carried out between 2022 and 2023 at the University of Antioquia.
In its execution, this project largely followed the progression used in photovoice projects proposed by Wang and Burris.
1) Introduction and Training: The principal investigator met with the participants to present the project; to bolster their understanding and execution of the photovoice technique; to make acquaintance with them and have them sign the consent form; and to give them their cameras17, 20, 21.

2) Taking Photos: Participants were given two to three weeks to take 27 photographs pertaining to the themes and guidelines of the project.


3) Developing the Film: Once the photos were taken, the principal investigator met with each participant to talk about her experience and allow her the opportunity to select three to five of her favorite photos. After collecting the cameras, the film was taken to a photography store to be developed and printed.

4) Facilitated Group Discussions and Community Exhibition: The research team held group discussions, the purpose of which was to allow participants the opportunity to review and reflect on their photos17, as well as share their photos among a group of indigenous women. During these discussions, each participant was afforded time to share their photos with other members of the group. With the guidance of the facilitators, participants were encouraged to discuss recurring issues, themes, and theories that emerged from the photo exchange20.


5) Contextualization and Codification: The tools of Grounded Theory were used to construct categories. This project completed the first phase of this research methodology, which consists of the generation of descriptive categories. To carry out this phase, the research team began with open coding based on individual discussions with the participants regarding their photos. Next came the generation of descriptive categories through classifying codes by their shared characteristics16. The categories that emerged from the research were:
- The cultural and traditional practices of indigenous women.
- Indigenous women’s experiences of migration to the city, their buen vivir and their connection with their original territories.
- The meanings of resilience and mental wellbeing from the perspective of indigenous women.
- The meaning that these experiences take on in the urban context in which these women find themselves.
- The practices of resilience, buen vivir, and connection with their original territories that these indigenous women develop.

Next, the content of the generated categories was shared with the participants through a virtual socialization and validation meeting in order to incorporate their modifications and confirm the analysis. Once consolidated, the categories were combined with the most relevant photographs.


Results:
Participant Demographics:
The following table categorizes the sociodemographic variables of the indigenous women who participated in this project.
The average age of the 10 participants was 29.8 years. Also, regarding places of origin, the Misak people originate from the department of Cauca, in southern Colombia; the Kamëntšá people are located in the Sibundoy Valley, Putumayo; the Cabildo Renacer de los Pastos originates from the municipality of Colón, Putumayo; the Embera Chamí people are concentrated in the department of Risaralda; the Inga people come from the Sibundoy Valley and Mocoa, Putumayo; the Embera Eyabida are located in the departments of Chocó, Córdoba and Putumayo; the Zenú people are located in the reservations of San Andrés de Sotavento, Córdoba, El Volao, Antioquían Urabá, as well as in Córdoba, Sucre, Antioquia and Chocó; and finally, the Uitoto people are native to the Amazon22.
Regarding places of residence, it is important to note that Bello is a municipality of the Metropolitan Area of Medellín. In turn, the Metropolitan Area is defined as an administrative entity under public law which constitutes 10 municipalities, including Medellín. The Prado Centro, Campo Valdés and Centro neighborhoods are part of Medellín23.

Illustrative Material 1. Participant Sociodemographic Variables

Source: proprietary development.

The following chapter describes the means by which the participants ’experiences of migration to the city has spurred changes, some positive and others negative, in their daily lives. The findings elucidate, for example, that migration to the city has been an essential lived experience for the achievements that these women have attained, on a personal, academic and work level. However, this migration has also impelled moving away from their communities and traditional practices, which help them maintain their wellbeing and mental health. Additionally, findings also indicate that the context in which these women find themselves in the city is characterized by a bustling pace of life, full of pollution, insecurity, urbanization and a scarcity of nature. All of these factors have driven the majority of these women to proactively participate in activities that save and protect their indigenous identities and original customs.

The migration experience as an ambivalence that oscillates between opportunities and risks.
The migration of indigenous peoples in urban areas is considered a current challenge for the fields of social science and public health. Currently, 48% of the indigenous population in Latin America resides in urban areas. Among the causes of this migration are factors such as displacement as a result of the armed conflict, natural disasters, and the desire for new opportunities in the areas of access to education, health services and job development24,25. In this sense, the women participating in this research consider migration from their territory to the city to be an essential lived experience for the successes and experiences that they have achieved, thus constituting a positive change in the personal, academic and work spheres. The above is supported by the following testimony:
“The objective of coming to the city was also to be able to prepare myself academically to be able to work or have job options in the city (…) coming to the University has been very beneficial for my life, for acquiring Western experiences and also having a workplace in the city” Indigenous female graduate, belonging to the Inga people.
For this reason, in most cases, indigenous people who migrate to the city find greater opportunities for personal, educational, work and economic development. However, this migration also implies moving away from their traditional lands and customs, forcing them to face innumerable challenges, among those that one may encounter in an urban context characterized by a busy, dangerous pace of life, accompanied by visual and auditory pollution, urbanization and scarcity of nature.
“The chaos of the city, there are many cars, everything is at the speed of day-to-day life, so it is not that calm, because of the traffic light, the noise from the whistles of the motorcycles, the cars, and everything is surrounded by construction, there is little nature that one can see” Indigenous female student, belonging to the Kamëntšá people.
In this sense, urban migration does not always yield improvements in the quality of life of indigenous populations, especially when considering that those who migrate to cities face nuanced, additional problems, such as unemployment, limited access to services and adequate housing, in addition to frequent experiences with discrimination and difficulties maintaining their language, identity and culture25. The above is supported by the testimony of a participant, who has witnessed different jobs that indigenous communities are forced to dedicate themselves to in order to sustain themselves in the city.
“That's in Junín, a very famous street here in Medellín, there those little indigenous groups go to dance, it seems to me that there is cultural exploitation when they do that, because they start dancing to get money, the indigenous population should not be like this, they should be in their territory doing what they do ancestrally, crafts, sowing the land, not like this” Graduate indigenous woman, belonging to the Zenú people.
Accordingly, apart from the basic factors associated with poverty, such as age, education and employment situation, being of indigenous origin significantly increases an individual's chances of being poor. Often the translation of their customs and lifestyles to urban spaces only increases their gap in equality with the rest of the population25.

The chapter presented below addresses the practices of resilience and buen vivir developed by women with the purpose of staying connected with their identities and territories, and thus, maintaining their well-being and mental health. Among these practices, weaving stands out, among others: craft-making; body painting; burning incense; and participating as their full indigenous identities within urban spaces.

Meanings and practices of resilience and buen vivir: an integrative vision of the alternative and the traditional.
When investigating the meanings of resilience for indigenous women, most of them mentioned that resilience is related to feelings of tranquility, peace, well-being, and the possibility of moving forward. Moreover, when asking about the concept of good living, these women emphasize that it is not a defined term, yet it constitutes activities and attitudes that make them well; each community has developed buen vivir in their own way; It is related to well-being, health, practicing traditions, and their relationship with their territory. It has even been indicated that this concept is so broad that it can be adapted to each woman, and that it can vary or be similar between communities.
“Buen vivir is a term that is very broad, so when we talk about buen vivir in indigenous communities, it is more retrospective to our worldview, habits and those types of things.” Indigenous female student, belonging to the Misak people.
These women consider their territory to be one of the most important dimensions in terms of buen vivir and mental health. In this sense, certain aspects of the territory require analysis, such as whether it is habitable, since staying within or leaving the territory carries influence, and also, when family is well in their territory, the indigenous woman is also well. Additionally, these women highlight that visualizing their nucleus being planted in a certain part of the earth makes them feel as though they belong to their communities.
“When one inhabits the territory, that living allows for their full development, it is easier to have a good life this way, than when it is a territory that cannot be inhabited, that one’s families cannot inhabit, or that one cannot visit” Graduate indigenous woman, belonging to the Inga people.
Their capacity for resilience also has to do with conserving and maintaining customs that promote their roots, bringing their territory through memory and tradition, or when one resides elsewhere, taking note of how this connection is needed and how to find it. Women have found this connection in places such as the city's tutelary hills, the Botanical Garden, other reservations and nearby trails. This is why women look for places in Medellín that are similar to their territories of origin, where they can have constant contact with nature.
“For us, the indigenous population, the land is very important, taking care of the land, taking care of what the land produces and that is what I see in the Botanical Garden, trees and animals are taken care of, so it is like nature in the city” Graduate indigenous woman, belonging to the Inga people.
It is worth highlighting that the differences between the practices for maintaining and recovering health in their territory and community, compared to the practices developed in the city, initially made it difficult for indigenous women to adapt to their urban context and its dynamics.
“For me it was a very strong shock, because when I came here to the University, I had to adapt my life to that other way, where you get sick and take this pill, everything was Western medicine, while at home you get sick, your head hurts, take this aromatic herb, we will burn it” Indigenous female student, belonging to the Kamëntšá people.
Hence, indigenous women who reside and study in the city preserve their familial and cultural values and their life experiences as psychosocial tools, for example, by bringing medicines from their territories for cleansing, healing, health care and to stay connected with the knowledge of their lineage.
"These remedies are made in my land, in Putumayo, I brought it more than 10 years ago, it is a bottle with many plants, but not just anyone makes it, it is a taita, these plants are useful for when one's head hurts, for eliminating negative energies, for watering [plants] in the house, so for me, for example, having the little bottle is also one of the things that brings me closer to remembering my mother, she is in Putumayo, my mother also does this, It is a way of remembering her and being connected to her knowledge” Indigenous female student, belonging to the Kamëntšá people.
In contrast to the previous perspective, some indigenous women who come to reside in the city, detach themselves to a certain extent from their culture as a form of identification with a dominant culture; certain practices are adopted in order to adapt or there is a social mimicry in which they take on the psychosocial forms of the dominant culture, sometimes incorporating their indigenous worldview25.
“I feel that I have lost many of the practices that I did there, there they are practiced without one feeling bad, one does them there because that is how it is, because one believes, not necessarily because one is feeling bad” Indigenous female student, belonging to the Cabildo Renacer de los Pastos.
Continuing with the conception of buen vivir held by indigenous women, they also emphasize practicing their native language as a way to stay connected to their roots and preserve their traditional practices.
“I love reviewing and reading everything that has to do with indigenous communities, and especially my own. That is a little book, which is written in the Camsá language, it has many little things that help me continue to remember the language, lots of ancestral knowledge of my community” Indigenous female student, belonging to the Kamëntšá people.
Furthermore, within indigenous communities, weaving has to do with a relationship between the environment and people’s physical, emotional and spiritual needs. In their weavings, the women express their worldview, cosmogony and cosmology26, and also seek feelings of well-being, tranquility, calm and freedom from burdens.
“In this photo I am weaving these “eyes of God”, I love weaving, it is something that gives, that makes you feel good, you feel relieved when doing this craft, and the result is very beautiful, they are great, so you weave and you construct something, stress destroys you, as you build, you destroy what stresses you, that makes me feel very good about myself” Indigenous female student, belonging to the Cabildo Renacer de los Pastos.
In addition to the above, another resilience practice that women develop is painting their bodies, since this custom allows them to receive warnings through dreams, spiritually protect themselves from negative events that may happen in the city and attract good luck. Also, painting allows them to connect with their indigenous culture and heal together with other women.
“Painting has a spiritual meaning, painting makes us dream, we use it to protect ourselves from evil spirits. Here I learned much about valuing painting, bringing it out with a process for therapeutic purposes, because I also work in a women's circle with painting as healing, because a prayer is also made to painting” Indigenous female student, belonging to the Embera Chamí people.

The following photo shows a female participant carrying out the ancestral practice of painting her body:

Illustrative material 2. Photo of a painted woman.

Source: proprietary development of female project participants.

On the other hand, for indigenous peoples, fire symbolizes affection, protection and both material and spiritual nutrition27. For the women participating in this research, fire is an element that allows for reflection, mental clarity and regaining hope.
“When you see the fire, you concentrate a lot, the fire also makes you reflect, it gives you hope, the fire helps you see things more clearly, a little light at the end of the tunnel” Indigenous female student, belonging to the Cabildo Renacer de los Pastos.

In the photo below we can see a candle as a symbol of fire for these women:

Illustrative Material 3. Photo of a candle.

Source: proprietary development of female project participants.

Food sovereignty is the collective right to decide on the production, distribution and consumption of food. Indigenous communities understand food sovereignty to be the conservation of native seeds and their own foods, viewed as an opportunity for health care28. For this reason, another traditional practice that some women develop is planting food and taking care of community gardens, which allows them to have a certain autonomy in nutrition, exchange seeds, connect with ancestral knowledge and promote the decolonization of thought for people from the city.
“Resisting, planting food is like being self-sufficient, being very autonomous in food, and also giving seeds the opportunity to flourish in an urban context. Having these corn seeds in such an academic and urban context is very important for us to continue strengthening the seeds and planting. Exchange of seeds, exchange of knowledge, and it is also decolonizing thought, that one can only plant tomatoes, bell pepper, garlic, onions, but rather we can also plant corn in the city. Furthermore, it is a lesson for those who are from the city, it is teaching them that we have impairments in being able to reach the time, read the moon, and to say on this moon we can plant” Indigenous female student, belonging to the Kamëntšá people.

The following photo has two significances: one, as a symbol of planting, and the other, the importance of nature for these women.




Illustrative Material 4. Photo of a woman hugging a tree.

Source: proprietary development of female project participants.

Furthermore, the photo below represents the abundance of Mother Earth through sowing the land.


Illustrative Material 5. Photo of a doll and food.

On the other hand, sahumar is defined as an ancestral practice in which elements such as incense and plants are burned, with the intention of purification, healing, cleaning, among others. Burning incense accompanies therapeutic processes; its medicinal properties are related to treatments linked to care, prevention, well-being and human health29.
“Burning incense comes from my community, there the incense is used a lot to chase away negative energies, there they believe in spirits, so when you feel bored, those in the house are fighting a lot, you feel tired, you feel a heavy atmosphere in the house, burning incense helps balance that energy, we use copal and rosewood. They also use incense in my community when someone dies, or when you feel a bad headache, dizziness, so this helps so that the environment can be calmer” Indigenous female student, belonging to the Kamëntšá people.
Also, among the practices of resilience and buen vivir developed by the participants, there are group practices, such as meetings, dances, women's gatherings, which contribute to their mental healthcare, staying active, and connecting with other members of the indigenous population:
“There it is with other indigenous companions who have the same situation as me, who come from far away to study in the city, so on that day there was an encounter, a meeting, there we are like doing play activities, there was a minga, we made food , and it was a good time, a pleasant time that we spent with many companions” Indigenous female student, belonging to the Misak people.

Discussion
Identity is a relational process that is built from the relationship that actors hold with themselves and with others, through the interactions and circumstances in which they operate30. In the present study, we exhibit how migrant indigenous women, upon finding themselves in Medellín, have experienced a dynamic process, in which, on the one hand, they have had the possibility of interacting with different people and in different environments, and on the other hand, they have played an active role, recognizing themselves as agents who have come to contribute to a synergy between traditional practices and modern practices that are developed in this environment, utilizing their worldview, customs and ideologies.
In this sense, although it is recognized that interactions with others can alter the thinking, personality, behavior and cultural values that constitute the identity of the subject, indigenous women highlight that, to adapt to the urban environment, they have made a kind of mimicry, in which they have adopted practices that they have considered beneficial and useful for their lives in the city, integrating them into the traditional customs that are typical of their communities of origin. This has made it possible for them to maintain mental health and well-being in a context that is not theirs. This proposal echoes the literature, which states that, despite migrating from their communities of origin, people continue to identify with many social and symbolic aspects of their culture. The feeling of ethnic belonging surpasses the borders of territoriality, since, despite the fact that the subject migrates, the consciousness of cultural identification is maintained and interacts with new values, experiences and situations faced when arriving in a new environment31.
In addition to the above, upon reviewing the literature, it is evident that indigenous women constitute the majority of the population in the poorest and most marginalized municipalities, which largely have been affected by the phenomena of armed conflict, violence and forced displacement2. In this sense, the literature demonstrates that migration constitutes a risk factor for suffering effects in the area of mental health, due to the high degree of vulnerability, the profound changes experienced in their identity, the experience of grief, and the hostility of the environment to which they arrive32. This is why women highlight the possibility of remaining connected with their territory of origin and continuing to develop their traditional practices as fundamental elements to maintaining their well-being and buen vivir.
Furthermore, women emphasize the importance of designing and executing community strategies that address mental health with a comprehensive view, taking into account the interculturality that characterizes communities and the country; knowing that this interculturality is often undervalued and even made invisible by academia and by certain institutions. This proposal is in line with that expressed by the International Organization for Migration, which highlights the importance of encouraging society and institutions to reshape their methods of approaching indigenous peoples towards more inclusive systems through intercultural dialogue, and thus avoiding the imposition of service methods without taking into account the particularities and unique characteristics of each people3. In accordance with the aforementioned, it is necessary to make more robust the generation of knowledge about mental health situations from an indigenous worldview with an intersectional and gender approach, which recognizes the different nuances that permeate their conceptions, precepts and daily practices.

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13. Consequently, due to their interest and expertise in this topic, both the line of research in Sexual and Reproductive Health and the line of research in Community and Intercultural Mental Health at the National School of Public Health of the University of Antioquia proposed support for development of this research. This article, of an unpublished nature, is derived from the project “The Resiliency Reports: Capturing Practices of Resilience and Mental Wellbeing among Indigenous Women in Medellín.” Start date: June 15, 2022. End date: December 15, 2022. Funding entity: Martin A. Dale '53 Fellowship.
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