Journal of Ethnic and Migration Studies

Vol. 36, No. 3, March 2010, pp. 407
423

Transnational Lives, Travelling

Emotions and Idioms of Distress
Among Bolivian Migrants in Spain
Xavier Escandell and Maria Tapias

This article examines the emotional and health impacts that immigration to Spain has
on Bolivian families. We explore transnational preventive and healing activities deployed
in Spain and Bolivia to allay emergent anxieties, frustrations and illnesses. Although
undocumented migrants have access to a universal public health system, they adopt
pluralistic approaches to healing, combining traditional and biomedical treatments. An
understanding of these healing strategies requires attention to how emotions and their
embodiment are experienced in the context of immigration. We propose a theoretical
framework which draws upon a constructivist approach to emotions and expand its
potential by linking it to influences of transnational lifestyles and bifocality. Preoccupa-
tion and sorrow are considered key etiological agents for many illnesses in the Andes and
therefore migrants are particularly mindful about how their own suffering abroad affects
vulnerable relatives in Bolivia. Communication between migrants and relatives is
permeated by white lies, non-disclosure or blatant suppression of information about
illnesses or personal difficulties. Migrants rely on particular relatives to access
transnational healing methods, while simultaneously concealing information about
their health from others. A migrant’s health experiences are thus constrained not only by
difficulties with the public health system but also by emotional considerations that span
informal transnational networks.

Keywords: Emotions; Transnational Lifestyles; Bifocality; Secrecy; Healing; Bolivian

Migrants; Spain

Xavier Escandell is an Assistant Professor of Sociology at the University of Northern Iowa. Correspondence to:
Dr X. Escandell, Department of Sociology, Anthropology and Criminology, 363 Baker Hall, University of
Northern Iowa, Cedar Falls, Iowa 50614-0513, USA. E-mail: xavier.escandell@uni.edu. Maria Tapias is an
Associate Professor of Anthropology at Grinnell College. Correspondence to: Prof. M. Tapias, Dept of
Anthropology, 203 Goodnow Hall, Grinnell College, 1118 Park Street, Grinnell, IA 50112-1670, USA.
E-mail: tapias@grinnell.edu

ISSN 1369-183X print/ISSN 1469-9451 online/10/030407-17 # 2010 Taylor & Francis

DOI: 10.1080/13691830903266093
408 X. Escandell & M. Tapias

She’s suffering . . . she misses our children. It’s been . . . almost two years. She tells
me ‘Sometimes I get sick, but I don’t want to tell you, because I know you will also
start to worry and get sick yourself ’. I also don’t want to tell her anything that is
going on here*if we get sick, the kids or I*because you can start to feel very bad
there as well. I just about conceal everything so that she doesn’t worry, so that she
doesn’t suffer, so that she doesn’t feel so afflicted (Joaquı́n, shopkeeper in Bolivia,
recounting the story of his wife’s migration to Spain).

I’ve lost 10 kilos since I’ve arrived in Spain. I don’t sleep and have no appetite. Life
here is very hard . . . . But I can’t tell my husband [back home]. If he saw me like
this, he’d tell me to return immediately . . . . You don’t want your family to know
you are suffering, and they also don’t want you to know what is going on back
home to spare you more sorrow. I know, for example, that my father is ill but they
won’t tell me anything so as to not worry me. I live counting the days to when I can
return home to my husband, my family, and my girls (Teresa, domestic worker,
describing her turbulent start in Spain).

In this article, we examine how Bolivian migrants in Spain and their relatives in
Bolivia adapt to and negotiate the fragmentation of their families through the lens of
health and emotions (Bäärnhielm and Ekblad 2000; Streit et al. 1998). We examine
how emotional management and secrecy figure within narratives of illness and
prevention and how both migrants and relatives back home deploy monitoring and
transnational healing practices to cope with anxieties and frustrations. Although
migrants have access to the universal health care system in Spain, they often configure
pluralistic treatment plans that rely upon both biomedical and traditional forms of
care (Castellón 1997; Crandon Malamud 1991; Menjı́var 2002). Drawing attention to
the bifocal nature of illness and treatment constructions, we find that many migrants
who fall ill seek to conceal (or at least not reveal) their maladies to relatives in an
effort to prevent worry and consequent ill health among their loved ones. We argue
that an understanding of the healing strategies and preventive measures utilised by
these migrants requires attention to how emotions and their embodiment are
experienced in the context of immigration.
While extensive scholarship exists examining the experience of immigration, fewer
studies have analysed how emotions are linked with transnational lifestyles and
migration (Ewing 2005; Velayutham and Wise 2005). Wise and Chapman (2005) note
the lack of attention to how affect articulates with new experiences migrants have as
they encounter cultural difference. If this gap is to be filled, however, scholars must
attune themselves not only to the particular population’s constructions of emotions
but also, we argue, to the bodily experience of emotion. In the case of Bolivian
migrants, special attention must be paid to ‘traditional’ healthcare practices in
Bolivia, in which emotions have a direct effect on bodily well-being, and bodily
injuries, in turn, can cause emotional distress. These practices, as well as ‘traditional’
constructions of illness, we suggest, are employed transnationally, in ways that
specifically speak to Bolivians’ health and emotional concerns.
 Journal of Ethnic and Migration Studies 409

Previous studies in the Andes have demonstrated how emotions such as rage,
pining, sorrow, jealousy, envy and fright are considered important etiological factors
for numerous illnesses among Quechua- and Spanish-speaking individuals (Crandon
1983; Hammer 1997; Hawkins and Price 2001; Tapias 2006a, 2006b). Such insights
have bearing on the examination of how emotions ‘travel’ as part of the migratory
experience since these emotions are a regular part of migrants’ lives and individuals
may find themselves experiencing health problems not recognised as such by
biomedical practitioners in Spain. Here we focus on the preventive measures and
transnational healing strategies used to avoid or respond to emotion-related illnesses.
We analyse practices of secrecy, non-disclosure and obfuscation to examine how
migrants and relatives manage and control potentially adverse effects of emotional or
bodily sickness within the transnational sphere. These communication strategies
amount to a form of preventive medicine which keeps loved ones from getting sick by
protecting them from hardship stories. Furthermore, the very practice of secrecy and
non-disclosure demonstrates the extent to which ‘traditional’ health beliefs about
illness and affect remain alive; indeed, the ways people cope with illnesses either
through discursive or embodied practices represent vibrant sites to examine social
and cultural change.

Emotions Abroad and at Home

Social scientists have addressed the culturally constructed nature of emotions and
affect (Abu-Lughod and Lutz 1990; Desjarlais 1992; Lutz 1988; Rosaldo 1980). They
argue that emotions are not ‘precultural’ or ‘natural phenomena’ but rather should be
understood as shaped by the cultural context in which they emerge. We argue that the
‘cultural’ context relevant to Bolivia
Spain migrants is an inherently transnational
one. As such, emotions in this context not only have ‘local’ meanings, manifestations
and effects specific to each country, but also a recombined ‘local’ meaning which
makes sense only when embedded within the transnational cultural trajectory of the
migrant life.
Several studies critique the limitations of a constructivist approach. A first critique
concerns the potentially monolithic, collective generalisations that might emerge
from constructivism, and that have the potential to obscure the vibrant heterogeneity
of individuals in a cultural setting (Reddy 1999). This critique has been addressed by
examination of how power relations intersect with emotional expression. Influenced
by the work of Foucault, several authors highlight the discursive elements of
emotions and pay close attention to how power structures influence their expression
(Abu-Lughod and Lutz 1990; Appadurai 1990). Our work also illustrates the ways in
which idioms of distress are articulated through the migrants’ relative powerlessness
with respect to new power structures within which they are embedded.
Other scholars, influenced by non-essentialist feminist theory, have further refined
constructivism by examining how individuals negotiate and orchestrate their
emotional expression (which at times means not expressing emotions at all) in
410 X. Escandell & M. Tapias

power relations (Rebhun 1993, 1999; Tapias 2006b). For example, a worker may quell
his anger around his boss, the person who dictates the terms of his employment, but
may actively complain to co-workers who share his emotions, showing peers that he
is not a silent ‘tool’. An undocumented migrant employee may choose not to express
her concerns at all, however, in order to avoid drawing attention to herself, though
she may voice her opinions to other migrants and even join in passive resistance
tactics by covering for another worker during unauthorised breaks. Thus, even within
a single locality there is heterogeneity in where, when and by whom emotions are
expressed; and of course, gender, class, age, ethnicity, sexual and political identities
may further intersect with the expression of emotions. Similarly, Bolivian migrants
and their families at home exercise some control over how their emotions and
feelings of exploitation are expressed to each other.
Another critique levied at constructivism concerns the emphasis it places on the
cultural ‘matrix’ in which emotions manifest themselves, which makes it difficult to
describe the experience of people who straddle multiple cultures (Ewing 2005: 226).
Certainly, the contexts that define emotions and the power dynamics inherent in
social relations that shape their expression change with the migratory experience;
however, migrants (regardless of their legal status) do not immediately embrace or
reject the discursive elements that shape expression in the host country, nor do they
‘forget’ or privilege the local discourses from their own home countries. The socio-
cultural matrices that shape emotions are wider and more complexly woven. Roger
Rouse, discussing the circuits migrants create as they negotiate their movement
between places, stresses that they do not sever themselves from one national space
and embrace another but rather construct a new ‘community dispersed in a variety of
places’ (Rouse 1988: 1
2). The same occurs with migrants’ emotional lives and
expression. Migrants are adept at concurrently drawing from and negotiating
different emotional geographies.
These critiques to constructivism rest upon the very ‘bounded’ and static views of
culture that constructivism has tried to avoid. Even within the confines of a particular
‘place’, people participate, contest and negotiate hierarchical power relations and the
multiple constructs of emotions that emerge in these settings. It is no different in the
case of migration. Thus, we posit that constructivism remains a viable approach to
examine how emotions articulate to the migratory experience but that it is greatly
enriched by articulating it to notions of embodiment*the way people relate to and
experience their bodies and bodily processes (Desjarlais 1992; Turner 1994)*and to
influences of transnational lifestyles (Vertovec 2004a, 2004b).
A transnational framework clarifies how constructs of emotions articulate with
migration by acknowledging that people draw from a ‘plurality of cultural codes and
symbols that go beyond the nation-state and also multiple locations of ‘‘home’’ that
may exist not only geographically but ideologically and emotionally as well’ (Wolf
2002: 257). This consideration of emotions abroad and at home has warranted taking
what Vertovec calls a ‘bifocal’ approach, a term used to describe how migrants’
identities and emotional ties are simultaneously ‘here’ and ‘there’, resulting from time
 Journal of Ethnic and Migration Studies 411

and space compression made possible by practices of transnational communication

(Vertovec 2004b; see also Portes 2003).
The regularity and speed with which migrants and their relatives share information
unravels new self-monitoring practices regarding their emotional lives. This self-
monitoring is a direct reflection of ‘traditional’ beliefs that physical pains unleash
emotional harms and, vice versa, that emotional harms can manifest themselves as
physical pains. Contact made possible by cheap phone calls and the Internet
stimulates increased censorship in the (sometimes daily) conversations migrants have
with family members. Thus, they tell one another about their lives and distress but
also mutually consider how their own suffering affects the emotional states of those
from whom they are separated. The monitoring practices, as illustrated in the two
opening narratives, occur on both ends of the migratory chain. Furthermore, when
ill, Bolivian migrants make bifocal decisions about healthcare; they may consult with
doctors, pharmacists and healers in Spain but also rely on transnational networks of
health aid through couriers, and advice via the phone, email and letters. Although
our focus is on the articulation of emotions and illness (rather than healing practices
per se), the transnationalisation of healing practices figures in the story.

Field Sites and Methods

The data for this article are drawn from participant observation and in-depth
interviews conducted in 2006 and 2007 in Bolivia and Spain and from prior research
in Bolivia during 1996
98 and in 2003. We relied on contacts from the extended
research in Bolivia to put us in touch with members of migrant households. Many
women interviewed during the 1990s now have relatives residing in Spain. In Bolivia,
we first interviewed bilingual Quechua- and Spanish-speakers with relatives abroad
on what motivated family members to migrate, the impact of migration on
households, how migrants fared in Spain and on any health crises at home or
abroad since migration. During the second phase of our research, we travelled to
Spain to interview the family members of those interviewed in Bolivia. The selected
transnational families resided in the region of the Valle Alto and the city of
Cochabamba and in Barcelona, Madrid and Bilbao.
We interviewed 28 transnational families, comprising a total of 58 individuals (31
in Bolivia and 27 in Spain). A transnational family is formed by at least two
generations, originally from Bolivia and which has one or more members residing in
a foreign country and who engaged in at least weekly communication over the phone
or Internet (see also Horst 2006; Parreñas 2005; Velayutham and Wise 2005; Vertovec
2004a). Of those interviewed in Bolivia, 21 were female and ten were male. In Spain,
we interviewed 16 females and 11 males. Nearly all of those interviewed in Spain were
between 21 and 40 years old; those residing in Bolivia tended to be older, more or less
equally divided between those aged 21
40 and those aged 41.
Interviewees in Spain had working-class backgrounds. Only two of the families
were considered ‘prosperous’ by local Bolivian standards: the first owned a
412 X. Escandell & M. Tapias

construction company and hardware store, and the second was headed by a chola1
matriarch who was a market woman. Class and ethnicity, however, intersect in
interesting ways in Bolivia: most urban middle-class mestizos would view even these
prosperous Quechua families as campesinos, peasants, and as such classify them as
rural and poor. Most of our interviewees in Spain had some university education or
technical schooling but were unable to access middle-class jobs in Bolivia, faced
rampant ethnic and class prejudice and lacked important social networks in cities
where the more desirable jobs were located. In Spain, migrants performed unskilled
construction and domestic jobs.

Bolivian Migration to Spain

Since the 1990s, Spain has become an alternative popular destination to the US and
Argentina*to where Bolivians have traditionally migrated. Immigration to the US
has decreased since 11 September 2001, and Argentina, suffering its own economic
crisis, is less attractive than it was. The Spanish national statistical office (INE 2007)
reported that, in 2006, there were 140,740 Bolivians residing in Spain. Fifty-six per
cent of them are female. The Spanish embassy in Bolivia, however, estimates closer to
300,000 Bolivians residing in Spain, only 20 per cent of them with legal residency and
work permits (Bárbulo 2007).
A combination of factors including demands for cheap labour and economic
growth in Spain, and the lack of good jobs and salaries in Bolivia, has accentuated this
inter-continental migratory flow (Izquierdo 1996; Solé and Parella 2003). The
common language further facilitated incorporation into the informal economy,
generally in the agricultural and construction sectors for men, and in domestic and
care work for women. Women are often better paid and have more job security than
men. Scholars in the field of migration and gender focusing on Southern Europe have
explained these gendered economic opportunities as resulting from the feminisation
of the Spanish labour market (Solé and Parella 2003). Since the 1970s, women have
increasingly integrated the labour market and their presence has triggered a whole set
of gender role transformations within Spanish households, creating an increased need
for domestic help and caretakers.
Many migrants found it difficult to establish themselves, and often the reality of
their experiences did not match the ideal vision of economic prosperity and
opportunity portrayed by their friends and relatives. Some found work immediately,
while others spent months in search of employment. Even those who secured work
were frustrated by the small remittances they could send home, one of the only
tangible ways to forge a sense of still providing ‘good parenting’ (Hondagneu-Sotelo
and Avila 1997). Migrants spent several months (sometimes years) repaying debts
accrued in order to migrate, as well as other family debts (such as those accumulated
to buy land, build houses or pay for their children’s education).
With respect to health concerns, migrants belong to a healthier part of the
population due to the young age at which they migrate (Cots et al. 2007). Still, when
 Journal of Ethnic and Migration Studies 413

sick, they face challenges that necessitate relying on friends in Spain and/or their
family back home. Unlike in the US, where the uninsured (which often includes
undocumented migrants) have limited access to adequate health care, Spain provides
universal coverage. This accessibility, however, is not without constraints. In order to
schedule a doctor’s appointment, a migrant must have an identification card (tarjeta
sanitaria), issued by the government. Many migrants may be unaware of their right to
access or may hesitate to apply for the card out of fear of deportation.
Previous studies show that minorities are more likely to use the emergency room
for their health needs compared to other health services (Cornelius 1993); this is also
the case in Spain. One incentive for this practice is that a patient may seek emergency
room care at any time of the day, while scheduling an appointment with a doctor
requires flexibility often unavailable to a migrant. However, this is only a partial
picture of the treatment plans deployed. Practices among migrants are fundamentally
pluralistic, much as they are in Bolivia, and comprise traditional, preventive and
biomedical healing strategies.
The emotional toll of migration to Spain has been especially pronounced. Unlike
previous waves of Bolivian immigration to other countries, one special feature of
migration to Spain is that young married and unmarried women commonly travel
first, often leaving children for several years under the care of husbands, boyfriends or
grandparents. In other instances, boyfriends and husbands who migrate first are
joined by their wives and girlfriends, and children are left behind with grandparents
or older siblings. These migrants, because of their undocumented status, have little
hope of being reunited with their loved ones. Thus, ongoing emotional suffering,
long-distance parenting, and uncertainty about the well-being of their relatives back
home are permanent features of their experiences abroad.

‘Don’t Tell My Mother’: Secrecy as Preventive Practice

When migrants communicated with their loved ones back home, they selectively
disclosed information to key people in the household and seldom discussed the stress
of unemployment, dwindling savings, discrimination or health problems with others.
In fact, our conversations in Spain were repeatedly interrupted by requests such as:
‘Don’t tell my mother’, ‘Don’t say anything to my sister’, ‘Don’t tell my family’. Such
remarks did not imply a lack of trust in relatives but rather a careful selection of those
with whom they would share details of their adversities. A bifocal constructivist
approach to emotions*that is, a consideration of the ramifications of expression
‘here and there’*coupled with awareness of how emotions are embodied, help us
understand these requests for non-disclosure. Migrants were mindful of the ill effects
that sorrow, preoccupation and pining could have on family members (often elderly
parents and grandparents or people debilitated by illnesses) and were likely to censor
what they told certain family members about their own health and suffering.
Many migrants talked about the stresses surrounding their arrivals. They often
lacked social networks, experienced legal difficulties, faced discrimination and sexual
414 X. Escandell & M. Tapias

harassment, and felt disappointment as relatives and friends took advantage of their
vulnerable status. Often the very same relatives and friends who encouraged
migration let them down. Migrants discussed the sheer disillusionment felt when
their own blood relatives or comadres failed them. Meanwhile, family members in
Bolivia had peace of mind knowing that their children or spouses were migrating to a
country where relatives and others would look out for them. The realities of
migration, however, often stressed these relations to the point of dissolving them
(Menjı́var 1995; Napolitano Quayson 2005).
Marta, a 38-year-old hired to care for an elderly woman, tearfully recalled how her
cousin failed to meet her at the airport:

She promised she would meet me and never did. I had no idea where to go or what
to do. I didn’t know anyone here. I didn’t know the currency, I didn’t know how to
get around . . . I was terrified*you have no idea how much I suffered.

Mariela (22) had returned to Bolivia; she said, ‘I had a lot of conflicts with my
brother while in Spain. He would not help me, he wanted me to wash and cook for
him so he could go to work. That’s not what I went for’. Dora, a 28-year-old janitor,
complained about her sisters-in-law’s envy of her ability to find work in Spain
immediately. ‘They made my life impossible; they told my husband that I was
sleeping around and not coming home at night’. Dora eventually moved out of their
apartment because she realised they overcharged her rent.
These examples illustrate how migration altered the power relations and trust
between family members. In Bolivia, these relations may have been on a more equal
footing but, in Spain, newly arrived migrants were very dependent on and often
disappointed by their relatives abroad.
Exploitation by Spaniards was also a problem, as we heard from Lucı́a, a 26-
year-old who studied business administration in Bolivia. Her father, a construction
company owner, was upset over her decision to migrate and concerned that other
community members would perceive him as unable to support his daughter. Not
college-educated himself, his ability to send his children to university was a source of
pride to him. However, he knew that Lucı́a would probably have to work as a
domestic servant, nanny, or caretaker for the elderly*occupations ‘beneath’ those
who have the privilege of attending college. Lucı́a saw it differently; she wanted
financial independence and, in light of the poor prospects for employment in Bolivia,
decided to leave. For some time, Lucı́a and her father were not on speaking terms. He
was angry that she had left, and she did not want him or the rest of her family to
know how she struggled. Her sisters and parents in Bolivia complained: ‘She doesn’t
tell us anything. In Spain there is no fraternity among Bolivians, but she doesn’t let us
know’.
Lucı́a feared that if they knew the truth they would pressure her to return home.
She recounted instances of hardship, sexual harassment and discrimination as an
undocumented worker. In her re-telling of these conflicts she asked us not to recount
her stories to her family, ‘. . . so they don’t worry’. Upon arrival, it took Lucı́a over a
 Journal of Ethnic and Migration Studies 415

month to find employment, though she met other Bolivian women who were even
more desperate:

Sometimes desperation leads you to do things that you wouldn’t think yourself
capable of . . . . There was a group of Bolivian women who used to go together each
day to the employment agencies to find work. So one day two of them and I were
seated waiting and a Spanish guy shows up and asks ‘Are you looking for work? I
can give you work’. I was very scared; what if he was a policeman or something? The
other two women, however, talked to him. A few minutes later they came back and
told me he offered them a job as prostitutes, that they would make really good
money . . . . The two girls told me ‘If tomorrow we don’t get work [from the
agencies] we are going to go with him, because we no longer have anything to eat’.
Even if I had been without work for more time, I don’t think I would have ended up
doing that. I would have swallowed my pride and I would have preferred to ask my
father for money than take that route.

Eventually, Lucı́a found domestic work with a family she disliked, although she had
the tranquility of a steady income and a place to live. She also worked weekends at a
reception hall, but quit within a short time.

They paid us well but . . . the owner was a jerk . . . He told me ‘I will give you a
house to live in and will sign the forms for you to get papers but only if you start
going out with me’. He kept pestering me. He called me to his office to pay me my
salary one day and he was giving me more than I earned. I told him ‘No, I am
supposed to make 90 euros per Saturday’ and he was giving me an additional 200
euros. He pushed the money back at me and said ‘This is for you*Why don’t you
think about my offer this week? Anyone else would surely accept this’. I never went
back.

Lucı́a did not speak of these conflicts with her family. Her concern was that her
parents might fall ill from sorrow and preoccupation. While she was close with her
sisters she also refrained from telling them about her hardships. One sister in Bolivia
sensed the difficulties Lucı́a was facing and told us ‘Tell her to come home. The
sacrifices she is making are not worth it; the emotional costs of migrating are too
great to compensate for the little bit of money you can make’.
Requests for secrecy and non-disclosure, catalysed by the desire not to preoccupy
family members, were interwoven into many narratives collected both in Spain and
Bolivia. Most migrants did not have large networks of friends or acquaintances on
which they could depend and lacked the social capital that could ease their stay
abroad. Nonetheless, they hesitated to share their suffering with relatives openly. The
same patterns of non-disclosure and secrecy were also prominent in Bolivia. While
most people suspected their loved ones in Spain withheld information, they engaged
in similar practices. The distress of numerous interviewees in Bolivia was readily
apparent as they talked about relatives and actively sought themselves to conceal
problems or health issues, including their anguish at missing relatives abroad.
Rosa (49), for example, lamented her daughter Soraya’s lack of job opportunities in
Bolivia and cried as she contemplated ways to lure her daughter home. Rosa had been
416 X. Escandell & M. Tapias

hospitalised twice since Soraya’s departure and attributed her ailments (diagnosed as
high blood pressure) to the sorrow she experienced as a result of her daughter’s
departure. When asked how Spaniards treated Soraya, Rosa replied:

Ay! Except that she never says anything. It’s just that she doesn’t want to tell me*
because we suffer crying. Since she has left I have already been hospitalised. From
suffering, from affliction. For a long time I suffered from high blood pressure. The
doctors gave me pills to take everyday so my pressure would not go up*for when I
thought of her. When she calls me to ask how I am, she tells me ‘Mami, you should
continue to go to the hospital, you should get yourself checked out’. But I don’t tell
her anything, so that she doesn’t worry.

Rosa knew that Soraya concealed her own suffering and sorrow and while this
frustrated Rosa, she engaged in the same practice. At the time of our interview with
Rosa, Soraya concealed other important information from her mother. Upon leaving
Rosa’s house, our field assistant, (Soraya’s close friend) told us Soraya was four
months pregnant but had not yet mustered the courage to tell her mother.

Relative Disclosures and Transnational Healing Strategies

While secrecy permeated interactions with loved ones, at times undocumented
migrants also had to rely on their families back home. In cases of illness, migrants
often benefited by keeping strong ties with people in Bolivia since they provided
resources, such as rituals and advice, that were unavailable abroad.
The narratives of two migrants*one with back problems and another with
chronic headaches*illustrate how families negotiate health crises which include not
only biomedical forms of healing (available through the public health system and
basic aid provided by non-profit organisations in Spain and Bolivia) but also forms of
healing that take place in Bolivia and are destined to have a transnational impact.
Alejandro, 23 and unemployed, had been in Spain with his wife Miriam for three
years. Alejandro left Bolivia one semester before graduating with an engineering
degree*a decision which haunted his mother, as she saw that her sacrificess to send
to send him to college were in vain. As the dark-skinned son of a Quechua chola,
without extensive city networks, he felt his options for employment in Bolivia were
limited. He was lured to Spain by the prospect of making as much as 700 euros a
month (over ten times the local salaries in Bolivia).
After searching for months for steady employment, Alejandro landed a full-time
job pouring concrete. One day at work he injured his back. The pain progressed,
gradually impeding him from walking long distances or exerting himself during daily
activities. Alejandro did what most people do who come from settings where there are
multiple healthcare options: he made use of hospital services in Barcelona, while
simultaneously deploying assistance transatlantically from a brother-in-law who is a
physician, his sister and a Bolivian healer (Castellón 1997; Crandon-Malamud 1991;
Menjı́var 2002).
 Journal of Ethnic and Migration Studies 417

During phone conversations with his mother, Alejandro never disclosed his illness
or inability to work. Despite these efforts, she seemed to realise something was
troubling him. When we interviewed her, she cried openly as she told us, ‘He says he
is well, but I know he is not. My children don’t want to tell me but a mother knows’.
Alejandro was diagnosed with a herniated disk. He was dissatisfied with the
impersonal and rushed care he received: ‘The doctor gave me a couple of pills and
didn’t do anything. Here they see you in a hurry; in Bolivia doctors spend time with
you’. Alejandro was put on a waiting list for non-emergency back surgery. He was
desperate, as he and his wife were barely making ends meet and unable to send
remittances home. He searched for jobs that would not stress his back*attending a
parking lot; working in a telephone centre or as a porter in a building. Fourteen
months post-diagnosis, he had yet to find a suitable job or have the surgery. Miriam,
however, found a job as a nanny within days of her arrival. For the next few months
her 700-euro salary was the household’s only income, spent on living expenses,
medicine and repaying loans procured in Bolivia for her travel to Spain.
While awaiting surgery, Alejandro obtained palliative care from Luı́s, his brother-
in-law. Alejandro faxed copies of his MRI scans, x-rays and lab reports to Bolivia. Luı́s
confirmed the diagnosis and urged him to return to Bolivia to have surgery. But
Alejandro worried about his re-entry to Spain, since he remained undocumented,
and besides, the operation in Spain would be done free of charge. He decided to
remain on the list, so Luı́s prescribed some stronger painkillers which Alejandro was
able to obtain in Spain on the black market.
Alejandro’s sister, Teresa, who also urged us not to tell her mother what she was
about to disclose, had another perspective on her brother’s illness. Although she
believed her husband’s re-confirmation of the diagnosis, she was concerned that there
were other sources to Alejandro’s distress. She procured the services of a healer in
Cochabamba, who undertook a traditional diagnostic ritual and told Teresa that
Alejandro was afflicted with a folk illness known as Pachamama*an ailment in which
the earth mother seizes a person’s animo (soul, life essence) when dissatisfied with the
way she is treated. For example, when people construct houses or dig the earth for
planting, a series of rituals are conducted for permission and to satiate the earth. This
also happens when people feel rage or an intense emotion in certain areas of the
landscape. Because Alejandro worked restoring old homes, his sister feared he did not
carry out the appropriate rituals in Spain or perhaps he had felt angry in a dangerous
place, which rendered him sick. The healer conducted a ritual to purify him
transatlantically.
Alejandro mailed home an article of clothing on which the healer conducted the
ritual and the family waits to see whether his health improves. As Teresa’s hopes
suggest, rituals expected to have a transnational effect are flourishing around Bolivia:

It doesn’t matter that Alejandro is all the way in Spain. It can still be effective. My
husband does not think it is Pachamama, given the symptoms, but I say it could be
both [Pachamama and a herniated disk]. That’s why I want him to try all the
418 X. Escandell & M. Tapias

healing methods available. I tell him to be patient and that, if one thing doesn’t
work, another will.

This case illustrates not only how immigrants draw upon resources available to them
in Spain but also how, in the process, they selectively disclose their health issues.
Lucı́a, likewise, was careful not to disclose the discrimination and harassment she
experienced to certain members of her family, though she complained of persistent
and unrelenting headaches to her sisters:

There were moments that the pain was unbearable. I did not feel well. I could not
concentrate at work. At work my employer would yell at me and I would say to
myself ‘Why is this happening? I wasn’t like this before’.

These complaints were a red flag of distress to her family, who reacted by finding
traditional treatment methods for an ailment known as susto (an illness caused by
fright).

My parents took some items of [my] clothing to the healer and did not say
anything else about me. The healer did a diagnostic ritual in which she was able to
detect what was ailing me. She said ‘It’s a boat, it’s a big boat. Your daughter has
been frightened’.

Lucı́a had, in fact, just taken a boat trip with her new employer; it was her first time
ever in a boat and she was overwhelmed by the ocean’s immensity.

My mother never told the healer that I was in Spain but the healer said ‘Your
daughter is very far and needs to be healed’. My mother called me on the phone and
told me not to go out that evening. They did another ritual to cure me of my susto.

After that evening, Lucı́a’s headaches ended. She attributes her improvement to the
ritual conducted in Bolivia. In response to migrants’ lack of trust in the health system,
other creative options enable patients to benefit from healing practices from afar.
There has been a veritable transnationalisation of traditional healing practices in/and
from Bolivia. In some instances secrecy and concerns about how their suffering
affects loved ones back home determine the types of support migrants can rely upon,
but in other instances transnational networks are providing additional options in the
quest for well-being.

Reconfiguring Affect
As migrants encounter new opportunities or hardship, or negotiate new power
relations, they are exposed to new emotional vocabularies and ways of ‘feeling’. The
longer they stay abroad, the more acquainted they become with ‘new’ ways of
expressing emotions and the more they have to reconcile these views with the
emotional knowledge they carry. That is, they become adept at navigating within the
cross-currents of ‘appropriate’ emotional expression in Spain and Bolivia. At times
 Journal of Ethnic and Migration Studies 419

this reconciliation entails adopting new modes of expression and may cause more
distress as migrants ‘second guess’ their original beliefs about emotions; at others,
they may remain steadfast in their original beliefs.
Celeste, a domestic worker, insightfully told us: ‘Before coming to Spain, I didn’t’
know the word ‘‘estrés (stress)’’. This emotional state did not figure in her emotional
vocabulary in Bolivia, but she had since learnt its meaning and adopted it as a new
viable interpretation of her experiences. While this term may have been new to her,
she continued to engage in practices particular to emotional expression in Bolivia.
That is, she continued to protect her loved ones by not disclosing the details of her
suffering out of fear that it might harm them.
Julia, a carer for a patient with Alzheimer’s, also continued in her practices of non-
disclosure, although she became increasingly skeptical of these beliefs. Julia lived in
Spain for nearly nine years and encountered many difficulties during her stay there.
At her first job as a domestic cook a pressure cooker exploded, causing third-degree
burns on her back and arms. Despite her (at the time) undocumented status, Julia
received care through the public health system. She spent several weeks in hospital
and tearfully recounted how lonely and scared she felt at the time. After the accident
she met another migrant with whom she eventually had a daughter. About a year after
the birth, her partner became physically abusive, and Julia had concerns about
whether he might harm their daughter. She took the child to Bolivia under the
pretence of introducing her to her family. Julia returned to Spain a month later,
leaving the child in her mother’s care. At the time of our interview she had not seen
her daughter in five years. Julia recounted instances of bad luck and suffering and
lamented the isolation and mistreatment she received in her personal and work
relationships. Since many of our interviewees spoke of envy and jealousy as a possible
source of misfortune through sorcery, we asked whether she suspected that this might
be the source of her problems. She paused and said ‘I no longer believe in those
things. I know in Bolivia people really believe in that, but not me, not anymore. Here
(in Spain) people would laugh at me if I suggested this’.
Lucı́a, the woman with susto, echoed a similar experience of ridicule when she told
a Spanish friend about her ailment and the rituals her parents conducted for her.
He teased her about having such ‘superstitions’.

I’ve learned not to say anything to anyone. I know people don’t view these beliefs
very highly. I also told my boss what was happening and she said ‘How could you
possibly believe that?!’ and started to laugh at me.

Throughout conversations with Lucı́a the general attitude that prevailed about
Spaniards was not very positive but, unlike Julia, having her beliefs challenged
reinforced them. She felt there was a great deal of discrimination against Latin
Americans and that the ridicule of her experiences was a larger reflection of this. As
these examples illustrate, there are multiple ways of negotiating the competing views
of emotions which people experience when they migrate. It remains to be seen how,
over time, emotional expression continues to be influenced by the contexts in which
420 X. Escandell & M. Tapias

migrants find themselves as well as the degree to which children of migrants continue
with these practices.

Conclusions
We have argued for a theoretical framework which draws upon a bifocal
constructivist approach to emotions, expanding the traditional approach to greater
awareness to how transnational lifestyles reconfigure affect. Traditional approaches
were critiqued for being ‘bound’ to a particular place/location*a fact which is
challenged by migration. Our approach considers that migrants become adept at
navigating multiple cultural fields and draw from multiple codes which inform
emotional expression and experience. Thus, while their stays abroad may broaden
their emotional experiences, their connections to their homelands may still very
much inform them as well. Attention to the multiple contexts ‘here’ and ‘there’, which
influence emotional experience, is vital when examining the lives of migrants.
We contend that scholarship on migration has not paid sufficient attention to
emotionality and embodiment among migrants. Scholarship on emotions has
demonstrated that emotional experiences and their consequences vary across
cultures. Thus social scientists must be mindful of the way particular migrants
conceptualise emotions, their consequences and the ways in which new subjectivities
are constructed under harsh conditions. The case of Bolivians in Spain provides an
excellent example of the value of a transnational constructivist approach, an
examination of actual cultural practices of bifocality and attention to embodiment.
Among Bolivian families the stresses and hardship produced by migration are
believed to be the triggers of illnesses among migrants themselves and/or their
relatives back home. The belief that emotions such as preoccupation, rage, pining,
sorrow, jealousy, envy and fright are important etiological factors for numerous
illnesses influences how migrants treat their illnesses in Spain and how they
administer and share personal difficulties with relatives. We examined practices of
non-disclosure and secrecy because they so tangibly demonstrate the relationship
between bodily and emotional health, and because they are a concrete and ongoing
linkage between people at opposite ends of the migratory chain. Controlling
emotional expression is a way of managing the ill-effects that emotions can cause
for their loved ones back home. Our conversations with family members in Bolivia
showed they engaged in similar ‘protective’ practices. As we have sought to
demonstrate, Bolivian migrants utilise understandings of the relationship between
bodily and emotional sickness in their lives and, most tangibly, in their efforts to
conceal and reveal facts about their emotional and physical lives with loved ones. Not
only are their narratives embedded within the trajectory of immigration but, as they
interpret their experiences through the mind
body lens of Bolivian healing methods,
they reinvent these ideas within a transnational bifocal context.
There are strong economic incentives for migrants to utilise the public
healthcare system. Nevertheless, their deployment of informal ties*locally and
 Journal of Ethnic and Migration Studies 421

transnationally*enables them to access both biomedical care and traditional healing

practices. Despite the tendency to conceal details of their suffering, migrants still
exchange information with family members transnationally when it comes to treating
an illness. Migrants rely on the internet, faxes, webcams and the telephone to
communicate with friends and relatives in order to share their symptoms,
information and potential biomedical and traditional treatments. Exchanging
information in this manner is sometimes the only option available since a return
trip home is not only financially draining but fears about re-entry to Spain abound.
As a result, migrants increasingly engage in transnational forms of healing and rituals
conducted in Bolivia which are expected to have a healing effect abroad. The long
queues to visit healers in the towns of the Cochabamba Valley attest to the demand
for these new transnational rituals. In combining traditional and biomedical forms of
care, migrants are able to cover all the bases, maximising their chances of being healed
and relieving their distress.

Acknowledgements
The authors would like to thank Takeyuki Tsuda, Suzanne Simon and the JEMS
anonymous reviewers for the extensive and thoughtful feedback on earlier versions of
this article.

Note
[1] Chola/o is an ethnic term used for a person who is considered ‘part’ Indian (Quechua or
Aymara) and ‘part’ mestizo (de la Cadena 1995; Weismantel 2001).

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