For The Wild - Dr. RUPA MARYA on Decentralizing the Power of Healing ⧸153

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00:00:26.200 hey for the wild listeners ayana here before we begin the show i'd like to thank the city of

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00:01:34.100 Welcome to For the Wild podcast.

00:01:36.920 I'm Ayanna Young.

00:01:38.520 Today on the show, I'll be speaking with Dr. Rupa Maria, an associate professor of

00:01:43.620 medicine at UC San Francisco and faculty director of the Do No Harm Coalition, a

00:01:49.800 collective of over 450 health workers committed to addressing structural issues that make health

00:01:56.000 impossible for communities. When someone says, well, how do I get involved in climate justice?

00:02:01.280 You go, show up the next time a Black person is shot by the police. Show up and shut down that 0.99

00:02:06.240 city hall. Because that violence towards that Black person is the same violence that removed 1.00

00:02:10.760 the Indigenous people from this land. And those people who were on this land knew how to run this 1.00

00:02:15.220 land knew how to be on this land dr maria has been working to make visible the health issues

00:02:23.300 at the nexus of racism and state violence through her medical work the justice study

00:02:28.640 national research investigating the health effects of police violence on black brown and

00:02:33.220 indigenous communities helping set up a free community clinic for the practice of decolonized

00:02:38.500 medicine under lakota leadership at standing rock the mini wachoni health clinic and farm

00:02:43.580 and international outreach with her band rupa and the april fishes she is currently working

00:02:49.940 on a book with author raj patel looking at the health impacts of colonization and capitalism

00:02:55.140 through her compositions and her band rupa and the april fishes they create a sound that pulsates

00:03:01.660 with the pluralism of bay area culture celebrating life and the art of resistance through a wide

00:03:08.000 musical palette that pulls from over a decade of playing street parties, festivals, and symphonic

00:03:13.760 concerts through 29 countries with songs in five languages. Under the direction of composer,

00:03:20.540 frontwoman, activist, and physician Rupa, the band creates a live experience which is a manifestation

00:03:27.340 of a world beyond nations where the heart of humanity beats louder than anything that divides us.

00:03:33.640 well welcome rufa thank you so much for joining us and i have to say you have been on my guest

00:03:42.560 wish list for years so today feels like a gift to be able to be spending this time with you

00:03:48.340 thank you so much i'd like to begin our conversation in recognition of quote the body

00:03:54.560 as a map of society's illness which is a quote of yours i came across in preparation for this

00:04:00.380 interview. And the notion of our bodies as a guidepost for social change is really so powerful.

00:04:08.020 And I'm hoping we can begin with you sharing a bit more about our collective health and what

00:04:14.280 that says about the current state of our society. Why is it necessary to think about and address

00:04:20.400 health in acknowledgement of social illness? Well, I think that the same sicknesses that are

00:04:28.120 impacting our planet. And by that, I mean, sort of the root causes of our illnesses are the same

00:04:33.160 ones that are driving a lot of the diseases that we see as hallmarks of industrialized societies.

00:04:39.220 So these diseases that have at their origin, an element of inflammation, often chronic

00:04:45.620 inflammation. And so when we look at how we abuse our soil, our water, our air, these things are

00:04:54.860 also manifested in how our guts, our heart, our waterways, and our own body, and our lungs,

00:05:02.100 how all of these things are impacted. And so I really think that the structures that we're seeing

00:05:07.420 with colonization, and I really say it as the misunderstanding of the commons, that these

00:05:16.360 things that are necessary for everyone to live, that belong into themselves and not to anybody

00:05:22.560 in particular, are things that need to be protected and honored and cared for, because

00:05:29.320 ultimately, when they are not, our bodies suffer. And the structure of society, as has been advanced

00:05:36.620 through the Extractive Capitalist Project and the Colonial Imperialist Project around the world,

00:05:43.660 those structures actually target exactly those things, the commons, the soil, the dirt, the land,

00:05:50.460 the water, the air, and our energy. Thank you, Rupa, for that introduction.

00:05:57.120 Medically speaking, what is chronic stress, anxiety, fatigue, and trauma doing to our bodies?

00:06:05.040 Why must we recognize this as a slow violence? So the chronic wear and tear of chronic stress,

00:06:14.600 trauma like you can put anxiety in there as well all of these phenomena drive low patterns of

00:06:23.340 inflammation in our bodies and deplete our bodies of the entities that actually defend our physical

00:06:32.260 systems from the impacts of chronic inflammation so for example anxiety we know now actually alters

00:06:39.480 which microbes can survive in your gut. And the gut microbiome is actually our first and last

00:06:46.880 defense against inflammation. These microbes that live in our gut, which we have more cells

00:06:52.780 on and in our body that are not us than are us. So we are more another than we are ourselves,

00:07:00.000 which I find poetic and powerful and interesting. And so these organisms in our gut actually

00:07:06.200 modulate our immune system they modulate our emotions they modulate our neurologic development

00:07:13.780 and our immune system development and so you know when there is anxiety and stress and trauma these

00:07:21.880 things it affects us down to our very cellular level and when those microbes are depleted in

00:07:28.320 our gut or altered in certain ways that we don't end up having the ones that can protect us from

00:07:33.760 inflammation. The inflammation kind of continues and smolders, which leaves us vulnerable to all

00:07:39.420 sorts of diseases. One of the most interesting things I've found is the relationship of diabetes

00:07:44.340 to inflammatory processes that are related to things like self-determinism. So, you know,

00:07:50.900 indigenous groups that have greater sense of autonomy and self-determinism are protected from

00:07:57.100 development of type 2 diabetes, which I find totally fascinating. So what is the

00:08:01.760 connection between that decolonizing reality of being able to advance one's own agenda for one's

00:08:11.360 people that isn't dependent on imperialist structures or imperialist permission. And so

00:08:18.220 that to me suggests that there's something deeply going on with how our social systems and our

00:08:24.460 binds and our cosmologies are translated down into the molecular level of our bodies.

00:08:30.820 and interpreted through the cellular communication between those organisms that are absolutely

00:08:36.580 necessary for our life in our microbiome and around our skin inside of us, and then our own

00:08:42.680 cells. And I think that as the science becomes clearer, we'll come to see that these things are

00:08:47.740 in very deep communication, not just within our bodies, but between our bodies and our surroundings.

00:08:53.080 So that if we're living in a sterilized soil, eating food that has been sterilized by the use

00:09:00.000 of fossil fuel inputs in our food system. So all the synthetic pesticides, herbicides, and fertilizers

00:09:05.620 that we use in our food system widely in conventional agriculture, completely destroy

00:09:11.160 the life of the soil, the vibrancy, the fertility, and the microbiology of the soil. So these systems

00:09:19.560 are all operating at the same time, and they're interrelated. And I think this is what climate

00:09:25.160 change is showing us. This is what it's bringing to the forefront is that you actually can't talk

00:09:30.660 about diabetes without talking about what's happening to the soil, without talking about

00:09:34.680 the built environment, without talking about the toxic exposures, without talking about the 1.00

00:09:39.980 violence towards black, brown, poor, and indigenous people that is a part of the engine of this 1.00

00:09:45.660 society. And so to remove any of these pieces from each other, you miss actually seeing the whole 1.00

00:09:52.040 thing. And so that's why this systems level thinking is crucial for actually obtaining

00:09:58.020 the correct diagnosis. Without the correct diagnosis, we will simply be offering insulin

00:10:03.940 to the disease, to the patient whose pancreatic cells are not producing enough insulin, rather

00:10:11.300 than seeking the question, like, why are so many people's pancreatic cells pooping out on them?

00:10:17.520 What is driving this? And so that is what I'm interested in, is what is driving this and how can we create solutions that will decentralize the power of healing, which is truly to decolonize, is to empower people's healings through multiple and local modalities where they are involved in structural change that makes these diseases rampant.

00:10:43.740 And so that's really what I'm interested in is the social structural analysis to help move the needle on these diseases.

00:10:52.600 Rupa, as you've been speaking, it's clear that much of your work revolves around decolonizing medicine.

00:10:59.240 And this word carries so much and is often used in many different contexts.

00:11:04.740 So I'm wondering if you could share with us what this means not as a metaphor, but in practice as it pertains to medicine.

00:11:11.980 as well as how this makes medicine accessible to all and forces us to explore the ways in which

00:11:18.300 we have gone about legitimizing Western medicine and basically delegitimizing everything else.

00:11:25.460 Right. So I think that part of that decolonization is removing the imperial

00:11:30.600 structure of medicine. So a physician trained in Western medicine is really good at certain things

00:11:36.820 And we're really bad at other things. Like we have very limited understanding of how the mind and body interact. We have very little understanding of how social structures impact illness. We have very little understanding of how cosmologies, like people's understanding of who they are and why they're sick and what medicine means and how they get well.

00:12:01.580 that these are things that have profound and subtle effects on the body, we have very little

00:12:07.640 understanding of how plant medicines work to support health and how traditional medicines

00:12:14.100 work to support health, traditional medicines from around the world. And so that being said,

00:12:19.760 I think if you think of colonialism as a system where power is centralized for the purpose of

00:12:25.760 exploiting resources to concentrate the profits of those resources in the hands of very few people,

00:12:32.860 often pulling wealth away from the communities, like extracting that wealth off to like some

00:12:38.980 remote location. The power in that system is not within the hands of obviously those who are

00:12:45.680 colonized, the vast majority. If you look at the wealth inequality that has been really driven

00:12:52.080 through neoliberal policy around the world,

00:12:55.080 but especially you see it here in the United States,

00:12:58.200 very profoundly here in the Bay Area,

00:13:00.600 that it's the same structure.

00:13:02.500 Colonialism isn't simply just brown and black people

00:13:04.940 being oppressed by white people around the world.

00:13:06.720 It's happening within societies.

00:13:09.180 It's happening all over us, all around us.

00:13:13.500 And so decolonizing is really, to me,

00:13:16.160 I see it as a system of decentralizing that power,

00:13:19.000 of localizing that power,

00:13:20.300 and reconnecting those things that have been divided and conquered.

00:13:25.960 And for me, that really is reconnecting ourselves to the earth,

00:13:29.700 ourselves to each other, and ourselves inside our bodies,

00:13:32.640 like understanding who we are and what medicines work for us

00:13:35.960 and what medicines don't.

00:13:37.440 And I think that science and Western medicine have given us a lot

00:13:40.960 and should be used.

00:13:42.020 I'm not at all someone who's willing or interested in throwing away

00:13:46.060 those powerful tools that can be available to us.

00:13:49.220 I also believe that there are other modalities that are equally powerful in different contexts, and sometimes in the same context, and that those things should be integrated and really brought to bear on how people are able to heal.

00:14:05.540 Thank you for that, Rupa. Now, I know that many of us are familiar with the horrors of our current healthcare model, given that over half of all Americans struggle with healthcare costs.

00:14:18.660 So I'd like to transition into a conversation on medical debt and the for-profit sector of medicine.

00:14:26.640 Perhaps you can begin by sharing the pervasiveness of the for-profit sector of medicine, or why you think there is such an aversion to enacting mass health care reform, despite the reality that our medical system is devoted to profit above anything else.

00:14:42.560 we have been divided we have been divided and conquered in our minds and then in in the space

00:14:50.820 of our imagination so when I was in medical school at Georgetown University and I was in an ethics

00:14:57.860 class and I raised my hand and I said does anyone else here see an ethical problem with being

00:15:04.480 involved in a medical system that is for profit and everyone turned and looked at me like who is

00:15:11.260 this person from California, right? And I realized like, no, that is actually a central core belief

00:15:17.760 for me is that if you are making a profit off of people's suffering, you are involved in very

00:15:24.080 tricky and savory business. And so the very issue of, you know, providing people with such a basic

00:15:32.500 need, which is to be able to see a doctor or a nurse, a healthcare provider when people need it,

00:15:39.340 And to be able to see someone to help them maintain their wellness and their lives, this to me should not be a for-profit industry.

00:15:47.420 This should be a service, a public service.

00:15:51.120 And so I have seen many families across all walks of life and from all sides of the political spectrum run into medical bankruptcy when someone got really sick.

00:16:04.860 and they're in the hospital for six months

00:16:07.020 or they're in a nursing home for three years

00:16:10.100 and they just, their family goes bankrupt.

00:16:13.660 It is the number one cause of bankruptcy,

00:16:15.900 personal bankruptcy in the United States,

00:16:17.680 which to me is criminal that we have a society

00:16:21.600 that is so wealthy and cannot manage to find a way

00:16:27.040 to take care of its own people.

00:16:29.760 And so I am a big fan of Medicare for all.

00:16:33.040 I'm very excited that I just got appointed by Governor Newsom to sit as a commissioner on this Healthy California for All Commission, which is to find a way to bring universal health care to all of California.

00:16:47.220 And so I have a very deep belief that we can do this.

00:16:50.720 We have to restructure our priorities.

00:16:53.380 But I think that it is something that all people deserve.

00:16:58.360 All people deserve it.

00:16:59.340 rupa i absolutely agree that all people deserve health care it's ridiculous that when our people

00:17:07.800 are trying to heal from an injury or illness they also have to deal with the stress of debt

00:17:12.420 i mean how are people supposed to heal well with the stress and the inflammation and all that it

00:17:18.000 brings it's insanity it's just a really insane system and well anyways before i go down that

00:17:27.380 rabbit hole. I want to go back to this presentation that I revisited that you gave

00:17:35.680 at Bioneers in 2017, where you discussed the free community clinic where you helped support

00:17:41.900 at Standing Rock. And you shared how the space for the clinic was radically different than

00:17:46.420 what we're used to. The exam rooms were big enough to fit a whole family. There was to be

00:17:51.560 a ceremonial space, a children's space, an elder's space, and classrooms all within the

00:17:57.420 clinic. And this got me thinking about what it would look like if we centered health in our

00:18:03.020 national dialogue. So I'm curious to ask, what do you think society would look like if the pursuit

00:18:09.380 of health was the foundation of our organizing? Well, I think we would not be spending as much

00:18:15.660 money on the military, and that would actually free up a lot of budget to do some very exciting

00:18:20.300 things. I think if we centered health and wellness, we would not allow the toxic pollution we do allow

00:18:28.540 right now. Basically, right now, industry runs our public health in this country. Industry dictates

00:18:33.920 what the public is exposed to, what the legal limits are of exposures. Lawmakers are in the

00:18:40.840 pockets of these industries, which I've seen here in our own Oakland. People who are apparently

00:18:46.180 progressive candidates are being supported by the same polluters. You know, the second largest air

00:18:52.040 polluter in the Bay Area is the AB&I Foundry. And so these corporations are buying off our

00:18:59.180 politicians. That should be illegal. The health of the people and the wellness of all people should

00:19:04.900 be our guiding light and principles. And the health of the earth and the health of the soils

00:19:10.880 and the health of the water.

00:19:13.100 And so these things are things that I would say

00:19:16.420 that indigenous peoples around the world know

00:19:18.980 and our California tribal people know.

00:19:21.880 And so I would love to see a way

00:19:24.900 where we would prioritize that as our guiding light

00:19:28.740 and really shape everything around that.

00:19:32.060 Because then our cities would become more livable.

00:19:34.700 Public transportation would be free

00:19:36.340 because why should it not be?

00:19:38.280 I mean, it's ridiculous that we have more billionaires per square foot in California than anywhere on planet Earth.

00:19:44.940 And we can't even get enough, you know, funding to get public transportation covered so people don't have to drive their cars.

00:19:52.320 Imagine what that would do for fossil fuel use.

00:19:55.000 But we don't do that because we allow those industries.

00:19:57.640 So we allow the Google buses to run through San Francisco and completely change, you know, fuel the housing crisis, essentially.

00:20:04.080 We allow these, you know, corporate buses and corporations to dictate how public life will be.

00:20:10.320 It would be amazing to have health be that guiding light instead.

00:20:15.680 I'm thinking about some of the incredibly harmful and abusive parts of Western medicine, especially its history of involuntary testing and forced sterilization.

00:20:26.000 In some ways, it seems like the medical field hasn't been forced to reckon with these injustices, because it is such a vital field that we are almost all dependent on.

00:20:37.880 So I'm wondering if you could discuss what you think proper reparations from the medical community should look like.

00:20:44.100 yes so medicine has been used it used as a tool of empire you know since the beginning of the

00:20:52.480 colonial project in africa in asia and here in the americas to the indigenous peoples

00:21:00.360 absolutely there needs to be reparations and accountability because that violence is

00:21:07.060 a part of our our history and when you look at the current

00:21:14.100 dynamics within the medical institutions and you see how medical racism still exists whether it's

00:21:22.560 conscious or unconscious it's criminal and I don't think that if we do not contend with our past

00:21:29.240 there's no way we can heal our present or go into the future with any different outcomes

00:21:34.620 so absolutely medicine has been weaponized against oppressed peoples and we need to

00:21:43.800 repair that and be accountable to that and change it because those systems are still in place you

00:21:50.760 know it might not be happening the same way the forced sterilization of indigenous women

00:21:54.920 performed by doctors of the IHS in the United States up until the 1970s that is not happening

00:22:02.800 today. But that system was never held to account for the violence, the eugenics and the violence

00:22:09.880 that was practiced by licensed physicians. So absolutely, we need to be accountable and we need

00:22:16.300 to repair. And that's where Western medicine, as a practitioner of Western medicine with a

00:22:23.460 eye for decolonizing, for me, it's always, I hold my training with a great deal of respect and also

00:22:31.600 degree of skepticism to try to understand the best way and the best thing I can do for a particular

00:22:38.360 patient. And as we're talking about reparations, I'm curious what these reparations would actually

00:22:45.000 look like. What would tangible forms of reparations be? Oh God, how do you repair testing on someone

00:22:54.440 without their knowledge. I mean, that's like, that's like Nuremberg trials, you know, that's

00:23:00.680 the stuff of Nazi Germany. How do you make repairs for that? I don't have a sense of what that looks 0.83

00:23:09.060 like. I think for California natives, I would love to see rematriation of land and sacred sites.

00:23:15.980 I would love to see indigenous people in charge of any industry and development in California. 0.86

00:23:22.780 I'm having the capacity to veto anything that we do and the capacity to lead so I think that you

00:23:30.040 know reparations would take its form with every different group that has been harmed would need

00:23:36.800 to take a different form with every group but I think that it I think the first part to that is

00:23:41.300 acknowledgement that this has happened and that is something that I would love to see happen and

00:23:47.000 now that there are more women of color in positions of power in institutions of medicine these

00:23:52.740 dialogues are coming up, which is exciting. I really agree with you that acknowledgement is

00:23:58.660 a good place to begin and that there will never be a one-size-fits-all approach or solution.

00:24:05.980 Yeah. Now, I'd like to turn towards your work with the Do No Harm Coalition and your commitment

00:24:13.240 towards chronicling what the absence of justice does to community health. As I understand it,

00:24:19.420 the coalition was formed in response to ongoing police violence in San Francisco and the 17-day

00:24:25.560 hunger strike by the Frisco Five. There are so many threads to pick up here, but perhaps we can

00:24:31.920 start at the beginning. What are the long-term physical and mental health outcomes of police

00:24:37.260 violence? And why is it necessary to discuss police violence in context to public health?

00:24:43.960 Well, the sixth leading cause of deaths for African-American males now between the age of

00:24:48.160 20 and 35 is police violence. So it's up there in the top 10 of things that kill young Black men

00:24:55.180 in the United States. So I feel like anything that is up in the top 10 deserves special attention. 1.00

00:25:01.680 Not only that, it is a top killer of young Black men in this country, but the process by which 1.00

00:25:10.360 justice is either attained or not attained for families after that person is killed 0.98

00:25:14.920 really exposes, kind of widens the wound.

00:25:18.840 So if the wound is the killing and there's no justice,

00:25:22.300 that wound is not healed, it's actually widened.

00:25:25.100 And there becomes an erosion of the very fabric

00:25:29.040 of civic trust, which is needed for good governance

00:25:32.040 and an operational society.

00:25:34.800 And so the wound to the social body

00:25:37.700 when there is a police killing,

00:25:39.340 when someone who's entrusted with public safety

00:25:41.400 is actually terrorizing the public

00:25:43.920 and that it's happening in such an overtly racist fashion, discriminatory fashion,

00:25:49.560 then that institution that is doing that harming, it needs to be brought into proper alignment with the goals and the vision of our society.

00:26:00.480 And so with police killings, I've seen firsthand how people are traumatized

00:26:06.700 and how the process of trying to seek justice in a system that was never created for the justice of black and brown people

00:26:13.340 how that frustrates their healing and compounds the trauma it re-traumatizes them

00:26:19.140 and so it feels like a very important issue for the healing of our society

00:26:24.920 oh my baby

00:26:30.420 i've grown tired

00:26:35.420 watching waiting

00:26:40.440 As you're decapitating all the flowers I've grown

00:26:48.840 Hours turn to colors changing

00:26:56.860 Don't you know I like to sit and watch things bloom

00:27:02.440 There's more than enough room for you here

00:27:07.620 In relationship to state-sponsored violence and the long-term trauma it creates,

00:27:20.040 I'm thinking about the ongoing crisis at the border and the daily terror inflicted by ICE and

00:27:25.920 Border Patrol. In this sense, it feels crucial to situate family as medicine. Can you speak to

00:27:33.300 the importance of family reunification, and how ICE and our current immigration policy

00:27:38.500 is a clear example of why we must abolish these systems altogether, not merely reform them.

00:27:45.780 Absolutely. So the criminalization of immigration is a recent phenomenon. So we didn't always just

00:27:52.320 pick up people and lock them up or separate them from their children. And really, this grew in

00:27:59.220 the Obama era. And that's important to point out because it's not like, oh, we have this evil man,

00:28:03.940 Trump. He, of course, is furthering a white nationalist agenda that has been brought forth 0.88

00:28:10.480 and really exposed in his henchman, Stephen Miller. But this policy of criminalizing

00:28:16.640 immigration is really something that came out under Obama, who was known as the deporter-in-chief,

00:28:21.380 who deported far more people than Bush I or Bush Part II. And so I think that it's really

00:28:28.420 important to recognize that this system of violence is something that has been going on

00:28:33.140 for a while. It's now just pushed to a head because of the white nationalism that is underpinning a

00:28:40.860 lot of these moves and then the expansion of these programs. I absolutely agree that immigration 0.97

00:28:45.860 should be decriminalized. I think these camps should be shut down. I think they're an abhorrency 1.00

00:28:50.100 to our nation's history and to our progress as people. And I also think that these migrations 1.00

00:28:57.560 are going to get more intense as climate change becomes more impactful. And those groups that

00:29:03.980 will be hit the hardest are the poorest. And those people are going to move. They're going to move

00:29:09.560 to become secure in their ability to find food, water, and shelter. And so it is a good time to

00:29:16.100 prepare ourselves for this movement that is coming. And it's already coming. So I definitely

00:29:22.480 support the decriminalization of migration. It's a natural phenomenon that's been happening for 1.00

00:29:27.840 thousands, hundreds of thousands of years. And to find a way to absorb and really work with people

00:29:35.820 and work with other countries that are struggling. So instead of being involved in meddling with

00:29:41.540 Central American countries' power structures, to really let those countries thrive. Most people

00:29:47.300 I know from Mexico who are here prefer to be in Mexico. But when our government is involved in

00:29:53.540 drugs and arms trafficking, it doesn't help that society be stable. And that is something I've

00:30:01.240 noticed as an agenda item of the United States in foreign policy is that it really does not want to 1.00

00:30:06.240 see brown and black countries thrive. And all of the countries that we are bombing currently, 0.71

00:30:11.640 and for the last 20 years, have been brown and black countries. So that this legacy of racism 0.95

00:30:17.180 of imperialist, racist agenda of the United States

00:30:20.440 is something that's being perpetuated right now.

00:30:24.100 It's not something that was just there

00:30:25.340 in the founding of this country

00:30:26.380 where indigenous children were stripped

00:30:28.540 from their parents up until the 1970s

00:30:31.000 and taken away so that they could be grown up

00:30:33.820 in white assimilated situations.

00:30:36.340 This phenomenon is happening today.

00:30:38.700 It's not something that just happened 30 years ago

00:30:41.320 or 200 years ago.

00:30:42.660 This is an ongoing project.

00:30:44.540 And that's why it's important to recognize

00:30:46.060 that, you know, if we can't dismantle these things as people, they will continue to recreate

00:30:53.200 trauma and inflammation. Rupa, I want to read a quote of yours. Quote,

00:30:59.660 one of the central challenges of health disparities research is using the language

00:31:04.140 and methodology of the oppressor to document the experience of the oppressed. Do we need data to

00:31:10.160 tell us just how traumatized POC are by police violence? How does the act of doing that study

00:31:16.460 reinforce the very structure of white supremacy that drives this violence and trauma for POC?

00:31:23.040 Can we develop new methodologies to liberate ourselves from the limitations of western

00:31:28.020 pedagogical structures as we work for the collective liberation of all beings from

00:31:32.760 systems of oppression? This question invites the radical imagination into the spaces of healing,

00:31:38.380 for I believe it is through the realm of the imaginary we will find the paths to healing

00:31:43.540 which has been deeply divided. Rupa that is such a beautiful quote and I really resonate with how

00:31:51.520 you're weaving the imaginary realm into the healing path so thank you for speaking so clearly

00:31:59.480 to this and I know that much of your work is in direct acknowledgement of the ways in which

00:32:06.800 white supremacy and colonialism are ever present in the medical field. So I'd like to talk about

00:32:12.920 the challenges of addressing health disparities, particularly in terms of colonial methodologies.

00:32:19.020 How are you imagining a framework that mitigates retraumatization, both in terms of research and

00:32:25.920 care? Yes, I think that that's, that's like the, that's like my life work. I feel like,

00:32:33.880 Right now, we're imagining a project in partnership with poverty scholars, so homeless folks who are developing their own paths of homefulness, with indigenous women here in the urban environment who are rematering land, with formerly incarcerated people who are learning organic farming techniques as a livelihood, and with undocumented folks who are learning farming as well.

00:33:00.340 and one of the questions we have that we're thinking about together is you know if you can

00:33:07.540 give access to food training how to make your own food and land what impact does that have on health

00:33:13.680 and so in that question which could have really powerful data that could be used to drive policy

00:33:21.240 that question is something that has to be driven and inquired and and developed by these people

00:33:32.740 who are asking the question and so instead of being a research that i do that like hey i want

00:33:40.980 to study your bodies for these things that i want to know it's more of a sitting together in in a

00:33:47.860 space of inquiry to say, what can we know here and how can we know it? And what are the ways of

00:33:53.840 knowing that are important to us in our different capacities and in our different ways of coming

00:34:01.140 here together? And so what's created is a real deep space of solidarity and inquiry into how to

00:34:09.380 use different tools that might be available to us, how to rip apart tools that feel violent and

00:34:14.660 intrusive and reframe them or reshape them into something that has a more liberatory energy to it.

00:34:23.540 And so this is a space of really active, creative engagement. There's a wonderful book called

00:34:29.160 Decolonizing Methodologies, which is about research in indigenous communities led by

00:34:35.940 indigenous investigators. And that's a very inspiring book. And then there's the work of

00:34:41.580 Tiny Garcia Poverty Scholarship. So she wrote this book, Poor People-Led Theory, Art,

00:34:47.240 Words and Tears Across Mama Earth. And that book is also very inspiring for seeing,

00:34:52.600 you know, what are ways we can really partner and be in service and accompany groups who are

00:35:00.780 historically struggling to uplift, help uplift them in their struggles, help participate

00:35:06.700 in moving the needle on the things that they need, that they identify. And so I have trouble

00:35:14.460 in the health disparity space because it feels that it becomes a morbid fascination in how our

00:35:20.760 bodies are being violated by the structures that are crushing them. And I'm not interested in that

00:35:28.560 morbid voyeurism. I'm interested in radically redistributing power and resources. And so

00:35:36.620 any way I can use my positionality to do that, I will. Thank you for your reflection, Rupa.

00:35:45.180 We've been talking about these darker areas, and I'd like to bring in some light specifically to

00:35:52.160 the importance of building community-based medicine as an antidote to structural violence.

00:35:57.780 How do you define community medicine, and what does it look like in terms of practices and

00:36:03.300 relationship? I think it depends on the community, but it's definitely medicine that is coming up

00:36:10.140 organically in a community, requested by a community, developed by a community, put together

00:36:16.760 with resources by reaching across to people who might be adjacent to that community.

00:36:21.780 But I think it's medicine that is derived through those relationships rather than something

00:36:27.480 like a doctor or a nurse comes and administers. And it's the medicine of relating and relating

00:36:34.220 in a different way. And so I think that relationships, those webs of relationships that

00:36:41.100 we can reestablish and reattach have a much more profound healing impact than any imposed structure

00:36:50.280 that a health system brings to your town. So I think that doctors and nurses and health workers

00:36:56.100 can be extremely effective and helpful,

00:36:58.380 but they should really be in service of the agenda

00:37:00.420 that a community is setting

00:37:01.600 and not showing up with their own agenda.

00:37:04.480 And so that really is like a, you know,

00:37:06.040 it's a bottom-up philosophy of driving health change.

00:37:12.320 And I think that different communities know what they need.

00:37:15.720 They really know what they need.

00:37:17.420 And so our job is to show up and be present and listen

00:37:22.140 and then work together in that space of the imagination.

00:37:26.100 to create what needs to happen, to create new models, to create new alliances and partnerships,

00:37:34.980 and to bring voices to the table that haven't been a part of the dialogue around health that

00:37:38.680 really should be. And so, you know, to be as wide in our net of what wellness and health really

00:37:43.860 means. I love hearing that. I just had an interview with Dr. Kyle White yesterday, and

00:37:50.360 we were speaking about the necessity of trust building and relationship building and consent

00:37:56.760 building and transparency and just many times when outsiders come in even with good intentions

00:38:05.160 it can really disrupt a community and the relationship building takes a lot longer and

00:38:10.500 I think that's why people opt out of wanting to do that when they think they have a good idea or

00:38:15.600 they think they know what to do, because they just want to implement their idea rather than

00:38:20.080 taking the time to actually build trust, to find out what will be best for the people on the ground.

00:38:26.520 Right. I mean, it's a very like Christian colonial missionary posture is to show up and try to save

00:38:33.640 people. And that's what's happening right now in the climate space, which I find kind of like

00:38:38.840 bittersweet and sad and scary is that you know we're here at the precipice of human existence

00:38:46.160 being threatened by climate catastrophe as the end expression of the colonial project so if you

00:38:55.320 go around the world and conquer everybody who knows how to live on their lands in a balanced

00:39:01.380 ecological sustainable way and then impose structures different religion different

00:39:07.500 structures different industries on those lands that can then extract the resources from those

00:39:14.760 lands you can't live in balance it's not balanced it's a highly imbalanced system and so we are here

00:39:21.800 precisely because of european colonization this is the end expression of the colonial project is

00:39:27.880 climate collapse the end expression of imperialism is climate change and so the people who are

00:39:35.140 positing the solutions right now as they're gathered in Europe, in Madrid, they're European.

00:39:41.700 They're largely the global north. And it's, you know, it's striking to me to think that a system

00:39:47.780 of thought that would lead us here would never be the one to actually solve the problem because

00:39:51.840 the problem is a system of thought. And so how do we empower those people who knew how to be on this

00:40:00.140 in their places to really seize the agenda of how we are together here on this earth

00:40:06.580 because clearly this way hasn't worked it doesn't work it drives illness on every part of our on the

00:40:15.120 planet and our bodies in between us and so we need to be hearing from those voices that are

00:40:21.800 already speaking they've been speaking for 600 years about how to do this differently and so

00:40:26.920 I really follow those voices and I'm excited to see them rising.

00:40:56.920 We are invisible and we grow like weaves

00:41:20.720 We are invisible and we blow like seas

00:41:23.520 We are invisible and we work like beasts

00:41:26.320 I recently came across a really beautiful interview with you that focused on your band

00:41:56.020 Rupa and the April Fishes. And in this interview, you're quoted as saying, quote, I realized that

00:42:03.380 what music is, it's the original medicine, end quote. And as someone who is both a doctor and

00:42:10.120 a musician, I can see how the common narrative might be to juxtapose these against one another.

00:42:16.120 But this proclamation of music as medicine is so good. So I'd love if you could share with us

00:42:22.380 more about the foundation of your music and medicine and the importance of the revolution

00:42:27.720 being one that sings and dances for ourselves and each other. Yeah. Well, I think that anything,

00:42:35.660 any big lasting social change has to come out of joy. I don't think that lasting social change

00:42:42.880 comes out of violence or comes out of imperialism. I think that that's all temporary, but the things

00:42:50.760 that last are things where there's a balance and a dance and joy. And music for me is joy. And it's

00:43:01.100 a way that I can express some of the heavy and hard things I see when I'm sitting in the hospital

00:43:08.360 with patients witnessing the things that I witness and turn it into something hopeful and heartful

00:43:16.040 and healing. And so music has this powerful alchemy that way to shift our nervous system's

00:43:24.700 vibration to resonate in our bodies, to move our bodies, to elevate our perspectives and to make us

00:43:32.540 feel joy. And so I think ultimately, you know, even though we're talking about these really

00:43:38.460 heavy things, because they are heavy, underneath the challenges and kind of pushing the agendas

00:43:47.000 is joy, is a desire to see people thrive, a recognition of what that looks like when people

00:43:53.900 are in harmony, when people are harmonizing with their environment and other beings in their

00:43:59.240 environment, what that looks and feels like and tastes like, that beauty, that joy, that power.

00:44:04.820 so that to me is really you know inspiring and I married a farmer for that reason an amazing man

00:44:13.020 who's a beautiful farmer and the way he dances with the earth and the plants it's just beautiful

00:44:19.020 it's so beautiful and I can see his joy in how he tends the earth and so that really is

00:44:26.440 the way that music heals me thank you Rupa for sharing some of those personal pieces and

00:44:34.560 yeah i think that the revolution needs the healing of joy what's happening right now and

00:44:42.520 what has been happening is heavy and devastating and i was with a dear mentor joanna macy and she

00:44:50.600 was at cougar mountain for summer solstice and we were sitting around the campfire and she was

00:44:55.980 speaking a poem and oh i don't want to botch this but i i probably will so don't quote me on this

00:45:02.820 one, but it was something like, will there be singing in the end times? Yes, there will be

00:45:10.300 singing about the end times or something like that. Or will there be singing when the dark

00:45:16.540 times come? You know, that kind of, um, yeah, that type of message. And I thought that was so

00:45:22.580 beautiful. And I really do feel that finding joy and community is necessary for our survival.

00:45:29.080 so yeah but um speaking of survival i i do want to bring up a topic that i know you're familiar

00:45:36.740 with that is of climate health justice and surprisingly this is something that for the

00:45:42.400 wild has yet to explicitly discuss so i wonder if you could share more about the urgency of this

00:45:48.640 realm and what it means to work in the pursuit of climate health justice what does this mean

00:45:54.400 in terms of protecting and repairing our water, air, and soil?

00:45:59.360 Right, our comments.

00:46:01.120 So the people who have been hit first, worst,

00:46:06.220 and hardest by climate change already

00:46:09.120 are the same people who have been oppressed through colonization.

00:46:15.260 So the black, brown, poor, indigenous around the world, 1.00

00:46:20.800 and it's already happening. 1.00

00:46:22.980 And if you think of climate change, for native Californians here, the climate has been changing since, you know, the 1700s, since the Spanish arrival.

00:46:34.560 When native people were taken off their lands and the soil was degraded through grazing, the grasses changed from perennial grasses to annual grasses.

00:46:44.640 Tule elk were slaughtered.

00:46:46.220 The grizzly bears were slaughtered.

00:46:47.960 The antelope were slaughtered.

00:46:49.640 The waterways were rerouted for this new agriculture. Spain became Mexico, became California, the gold rush, the bounty days, the wholesale genocide of California Native people. There's been climate change for a couple hundred years, and now it has accelerated. 0.98

00:47:07.980 And why I call that also climate change is because, you know, they set up a net basically at the mouth of the Sacramento Delta and just captured all the salmon and canned it.

00:47:19.180 And within like five years, the salmon population was decimated in the early 1900s.

00:47:26.240 With the loss of the salmon, the bear didn't have that phosphorus to eat and then to send out into our forests.

00:47:32.920 And so you lost this natural phosphorus pump that brought all these nutrients in from the ocean up into our deltas, out into our forests.

00:47:41.700 And then the grizzly bears died and then the, or were killed.

00:47:45.060 And then the berries, the highway of berries that was running through California were gone, the tule elk gone.

00:47:52.900 So we lost all this very complex interplay of food systems and then microbial systems and soil microbial systems that drove an incredibly stable system here in California for over 30,000 years.

00:48:10.480 And so within 200 years, you can't drink the water.

00:48:13.660 The air is toxic.

00:48:15.540 The soil has been poisoned.

00:48:17.060 And people are dying of cancer.

00:48:20.220 And, you know, young people have their colons cut out at incredible rates with inflammatory bowel disease.

00:48:27.220 People are developing diabetes, they're depressed, they're suicidal.

00:48:30.420 And all of these things are connected.

00:48:33.680 And so you can really look, you know, sometimes people have a hard time conceptualizing climate justice.

00:48:38.720 You can just look at environmental justice and racial justice and justice for indigenous people.

00:48:45.260 so when someone says well how do i get involved in climate justice you go show up the next time

00:48:51.060 a black person is shot by the police show up and shut down that city hall because that violence 0.95

00:48:56.540 towards that black person is the same violence that removed the indigenous people from this land 0.87

00:49:00.500 and those people who were on this land knew how to run this land knew how to be on this land and so 0.63

00:49:06.440 if we're not connecting those those things we're missing the whole point and it's shocking to me

00:49:12.940 that you'll see throngs of white people show up for the environmental movement. None of them show

00:49:17.880 up when someone's shot by the police. None of them showed up for Jamaica, who was just shot by SFPD

00:49:23.880 like two weekends ago in San Francisco, who's sitting in the ICU on his last breath, 24-year-old.

00:49:31.060 And so that to me shows that the people are not making the necessary connections they need to

00:49:36.340 make. They're not understanding actually how we got here. So once white folks are able to understand

00:49:42.760 that the violent systems of white supremacy which are actually recreated in the environmental

00:49:47.520 movement which are recreated in our movements for justice need to be seriously held to task

00:49:53.800 and and shifted so that that power structure so that people understand you put your power behind

00:49:58.580 anything that is damaging and degrading the people the voiceless whether that's the water

00:50:06.560 that's the young black man shot by the police the indigenous people that are being pushed off their

00:50:11.660 lands, the people who can't speak up when there's like a toxic pollutant, you know, 0.96

00:50:16.760 in Richmond or, you know, the refineries or, you know, here in East Oakland, but people

00:50:22.240 don't make those connections.

00:50:23.440 They're out there now to save the world without saving their own neighborhoods, which is,

00:50:26.880 you know, short-sighted and kind of fits with that whole savior complex that brought us

00:50:31.600 here in the first place. 0.59

00:50:33.200 And so how do we awaken our great white sleeping friends who are committed to justice?

00:50:41.660 without actually showing up.

00:50:44.100 So I would love to see them shut down City Hall

00:50:46.980 the next time someone gets shot.

00:50:48.440 And then I would say,

00:50:49.340 now we're ready for the climate justice movement.

00:50:52.220 Yes, I love those direct, tangible asks.

00:50:55.780 Thank you for planting those seeds in our imagination.

00:50:59.320 Yeah, so I emailed the woman

00:51:00.900 who organizes the San Francisco Women's March.

00:51:04.020 And she said, Rupak,

00:51:04.880 will you please bring your organization

00:51:06.400 to the march this January?

00:51:09.180 Or I can't remember if it was March, whenever it was. 0.99

00:51:11.660 And I said, you know, I have yet to see, you know, women in their pussy hats showing up to City Hall when someone's shot by police. 0.93

00:51:20.860 When I see that, I'm sure I can mobilize all our people to show up for the Women's March. 0.97

00:51:25.620 But I don't see that.

00:51:27.180 And I haven't seen that.

00:51:28.400 And I still haven't seen that.

00:51:30.560 And so what can be alienating is when there's this call that we all need to get behind.

00:51:38.000 We do all need to get behind the climate movement.

00:51:40.760 But to fail to understand that that movement is the same movement as fighting police terror, that's sort of the piece that needs to be connected.

00:51:50.040 I'd be remiss if we didn't speak about gentrification and the health crisis, which is something that I think is not talked about nearly enough.

00:51:59.180 But I know that this is an issue that Do No Harm Coalition is tackling, is this gentrification as a public health crisis.

00:52:07.260 So as someone who has experienced the gentrification of the bay firsthand, how is displacement linked to community health outside the obvious impacts of houselessness, et cetera?

00:52:18.260 Oh, so many ways.

00:52:19.900 So when an area is gentrified, let's say like the Mission District of San Francisco, there are whole economic ecosystems that have developed stably over 50 years that become degraded.

00:52:36.140 So, for example, young Latino kids going through the mission might not get a loan for going to college, a traditional loan or financial aid from a school or from a bank or from a federal institution.

00:52:49.040 They might get loans through their community.

00:52:50.960 So the community pushes forward its youth through long-term loving engagement and connections.

00:53:01.140 Now that that community is far flung, you don't have that epicenter of engagement anymore. So it erodes the kind of civic life that has developed. And that was a safety net, whether it's for healthcare, like someone goes through a healthcare issue, an illness, and a community is around to stabilize and help get that person back on their feet.

00:53:25.100 through gentrification and the moving in of wealthier white and Asian groups to the mission,

00:53:31.720 you don't have that same kind of system anymore. It's less resilient. And that impacts all sorts

00:53:38.500 of people's health, their mental health, their capacity to stay in their homes longer if they're

00:53:44.940 elderly, to stay in their homes in a safe way, and their ability to live and work in their communities.

00:53:50.700 So it has far reaching effects. It's also, you know, there's many, many areas where gentrification has been shown to be bad for health outcomes. So I think it is a very important, important problem.

00:54:01.740 thank you for speaking to gentrification so clearly as i'm sure many of our listeners are

00:54:08.300 feeling the pressures of this in their communities and i just really love how much your work if not

00:54:15.320 all of it reiterates the importance of root cause analysis which is something that feels so close to

00:54:21.600 us at for the wild you know sitting with the ultimate truth that nothing will change unless

00:54:26.680 we address the root of the problem not the symptoms yes so in closing rupa i'd love to

00:54:35.340 open the conversation to anything you'd like to share or what you see as realistic a more media

00:54:41.700 system change or perhaps you could share what you've learned from medicine and music when it

00:54:47.180 comes to shedding our identities as consumers and participating in the world in a meaningful

00:54:52.320 way or more meaningful ways, or even if you'd be willing, you could share a little bit about

00:54:57.420 your forthcoming book with Raj Patel. Basically, I'd just like to leave the space open to however

00:55:02.820 you'd like to close this conversation. Oh, thank you. And thank you for inviting me to talk with

00:55:09.500 you. I would just like to say that this is an extremely exciting moment in human history.

00:55:15.880 We have an opportunity right now to imagine other ways and imagine them into being and to create new partnerships that maybe we didn't think of before and to invite healing that is long overdue and to invite social paradigms into our imagination that have been off in the periphery or thought, oh, that's impossible.

00:55:44.440 we can't do that it's it's a time to bring those things to the table and to bring new relationships

00:55:51.400 to the table and to learn new tools of humility being on stolen native territory and to learn

00:55:59.100 new ways of relating to each other or maybe reawaken old ways of relating to each other

00:56:05.380 and so I am excited for the future and I'm excited for what the young generation is bringing out

00:56:12.860 right now and i'm excited for the awakening together to really seize power back into the

00:56:19.980 hands of the people for the improvement of our health and for imagining kinder more awakened

00:56:26.560 more inspiring society oh goodness rupa thank you so much for this profound conversation you are

00:56:35.160 such a warrioress for our times and i really appreciate the way you show up in the world and

00:56:41.780 all you do for our collective survival thank you thank you so much

00:56:46.640 thank you for listening to another episode of for the wild podcast i'm ayana young the music

00:57:01.260 you heard today was from rupa and the april fishes i'd like to take a moment and thank

00:57:07.680 our spectacular podcast production team aiden mccray andrew stores carter lou mcelroy erica

00:57:16.220 ekram aaron wise francesca glassbell hannah wilton and melanie younger before we say goodbye i'd like

00:57:25.080 to make a few shout outs one if you want to support this podcast production team in bringing

00:57:32.380 you this content week in and week out please make a donation at patreon.com backslash for the wild

00:57:39.960 also if you haven't rated us on itunes please do so as it really helps build our community

00:57:45.580 and lastly sign up for our newsletter on our website at for the wild.world all right folks

00:57:52.760 until next week

For The Wild - January 08, 2020

Dr. RUPA MARYA on Decentralizing the Power of Healing ⧸153

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