M I C H A E L C.

ENNIS-MCMILLAN
Department of Sociology, Anthropology, and Social Work
Skidmore College

Suffering from Water: Social Origins of Bodily

Distress in a Mexican Community

This article is an ethnographic analysis of what it means to "suffer from

water." Using a critical medical anthropology approach, the study exam-
ines how residents living in a foothill community of the Valley of Mexico
experience bodily distress associated with water scarcity. Data for the
study come from participant-observation of domestic water use and com-
munity drinking water management as well as interviews with local civil
and religious officials who monitor the water distribution system. While
the community discourse on suffering from water does not correspond to
biomedical categories of illness, it does speak to the physical and emo-
tional hardships and the social conditions that limit residents' access to
an adequate supply of domestic water. By taking a broad view of water-
related suffering, the study reveals some of the efforts made by people to
address what they consider to be the social origins of their bodily distress.
[critical medical anthropology, drinking water, social suffering, gender
and health, Latin America]

W e are suffering from water" (estamos sufriendo del agua) is a phrase I

often heard during my research in La Purificaci6n, a foothill community
in the Valley of Mexico. Community residents, los Purifiquenos, live in
a semiarid and densely populated setting where water for domestic consumption is
a scarce, costly, and contested resource. As a result, los Purifiquenos engage in a
variety of individual and collective struggles to obtain water for drinking and other
basic necessities. A great deal of scholarship in medical anthropology has explored
the varied forms of suffering related to unhealthy water quality. In this article, how-
ever, I examine forms of suffering that people link to water scarcity. While the dis-
course on water-related suffering in La Purificaci6n does not correspond to
biomedical categories of illness, it does, nevertheless, reveal the physical and emo-
tional hardship and the social context within which residents experience inadequate
domestic water supplies. In this article I provide an ethnographic analysis of how
los Purifiquenos use a local discourse on "suffering from water" in their efforts to
deal with the social dimensions of water scarcity.

Medical Anthropology Quarterty 15(3):368-390. Copyright © 2001, American Anthropological Association.

368
SUFFERING FROM WATER 369

Anthropology and Water-Related Suffering

To examine the local discourse on suffering, I use a critical medical anthro-
pology approach and draw from recent scholarship calling for closer attention to
the ways people recognize and address the social conditions that lead to ill health.1
My conceptual approach focuses on ways that suffering is shaped by access to and
control over sufficient water for the necessities of daily life. I am particularly inter-
ested in linking the political-economic dimensions of water scarcity with the local
meanings of "suffering from water" in this Mexican community.
Conventional analyses of water-related health issues in developing countries
have largely focused on technical, administrative, and some cultural aspects of in-
stalling piped drinking water systems. To"address the suffering associated with
diarrheal diseases, cholera, and polluted water supplies, many international health
and development programs have focused on installing water and sanitation sys-
tems and promoting specific public health measures such as washing hands, boil-
ing water, and isolating the disposal of human waste from drinking water sources
(Pan American Health Organization [PAHO] 1987; Whyte 1987). Anthropologi-
cal studies in Mexico and elsewhere have reported on cultural reasons people do
not adhere to such public health recommendations (Aguirre Beltr£n 1986; Elmen-
dorf 1981;Nichter 1988; Paul 1977; Wellin 1955; see also McElroy and Townsend
1985:385). The conventional analysis of water-quality issues has been guided by
the fact that waterborne diseases account for a significant amount of morbidity and
mortality, particularly for the poorest populations (Juan et al. 1995; Lane and Ru-
binstein 1996; Lee 1995; World Health Organization [WHO] 1981). This issue has
received heightened attention as a global problem, especially after the 1978 WHO
Alma Ata Declaration of the "Health for All by 2000" campaign and the sub-
sequent 1980-1990 International Drinking Water Supply and Sanitation Decade
(Whyte 1987; WHO 1981).
Medical anthropologists who take a critical perspective, however, have noted
that the conventional analysis puts less emphasis on social and political factors and
regularly implies that local culture constitutes a major barrier to the acceptance of
technical solutions to health problems (Morgan 1993:64; Morsy 1996; see also
Navarro 1984). In contrast, a critical medical anthropology perspective defines
health broadly as "access to and control over the basic material and nonmaterial re-
sources that sustain and promote life at a high level of satisfaction" (Baer et al.
1997:5). The emphasis on political economy includes analysis of "the social and
historical roots of disease and health care, with particular attention to the existence
of stratified social relations within a world economic system" (Morgan 1993:2).
With this theoretical approach in mind, recent studies have called for greater atten-
tion to the social dimensions of people's suffering associated with unequal access
to and control over natural resources, including access to drinking water (Ar-
melagos et al. 1992; Bennett 1995; Cox and Annis 1988; Lane and Rubinstein
1996; Leatherman et al. 1993; Morgan 1993; Stebbins 1986; Stephen 1992; White-
ford 1997; see also Doyal 1979). Such studies indicate that water-related health is-
sues may have less to do with traditional conceptions of disease and hygiene and
more to do with social factors limiting domestic water supplies to poor and less
powerful groups.
370 MEDICAL ANTHROPOLOGY QUARTERLY

Provision of water for drinking and other daily necessities, however, is more
than simply an unequally distributed health service. From a critical-interpretive
perspective of suffering (Lock and Scheper-Hughes 1996), I am interested in the
bodily experience of water-related suffering. Water is intrinsic to daily life and is
connected to bodily experience and practice through a wide range of activities such
as drinking, cooking, eating, cleaning, bathing, and healing. Indeed, in this study, I
employ the terms drinking water and domestic water interchangeably to refer to
the daily water supplies used for basic necessities. Many people—from residents in
La Purification to officials in international health programs—use the term drink-
ing water (agua potable in Spanish) to refer to water needed for a variety of do-
mestic purposes in addition to drinking.
In this article, I explore how inadequate supplies and distribution of domestic
water can lead to various forms of bodily distress. I use the concept of bodily dis-
tress to refer to a nexus of people's negative physical, emotional, psychological,
and social experiences. Medical anthropologists find this concept useful for ana-
lyzing forms of suffering, broadly conceived, that do not necessarily correspond to
disease and illness categories (Lock and Scheper-Hughes 1996). Forms of bodily
distress in many cultures motivate people to examine and alleviate disruptions in
the social order (Comaroff 1982). Medical anthropology studies in Mexico and
elsewhere in Latin America show how, in many groups, people link individual suf-
fering to social tensions (Aguirre Beltran 1986; Foster 1987; on this process, see
Lindenbaum and Lock 1993; Lock and Scheper-Hughes 1996). Scheper-Hughes
(1992:65-97) provides a poignant study of poor shantytown residents in Brazil
who express their thirst and "struggle" (luta) for water in relation to powerlessness
and social inequality. Studies have also shown that various locally defmed forms
of bodily disruptions—nervousness, hunger, and spirit possession—signal prob-
lems in the social order, especially as local groups contend with increasing social
stratification (Farmer 1992; Ong 1987; Scheper-Hughes 1992). In this regard,
medical anthropologists are increasingly using the term social suffering to examine
how people experience and articulate their bodily distress in relation to unequal so-
cial relations (Kleinman et al. 1996).

Water Scarcity in the Valley of Mexico

Water is a vital part of human survival, and scarcity of domestic water supplies
compromises health and generates suffering. Recentreportshave cited gloomy sta-
tistics about the unequal access to clean water in the world (Doyle 1997). Over half
of the world's freshwater supplies are located in a few nations, and higher-income
urban dwellers consume most of those supplies (Johnston and Donahue 1998). As
a result, over one billion of the world's people lack access to sufficient domestic
water (Lee 1995), their consumption often far less than the WHO recommendation
of 25 to 50 liters of clean water each day (cited in Flores 1995; Garcfa Lascurain
1995). For many rural people in Mexico and other developing countries, the issues
go beyond simple water quality. For them it is a struggle simply to gain access to
enough water for daily needs,regardlessof the water's potability.
Attempts to address water distribution problems in Mexico and other devel-
oping countries have met with limited long-term success. Elmendorf (1981) notes
that up to 50 percent of rural drinking water and sanitation systems become inoperable
SUFFERING FROM WATER 371

within five years. While drinking water development in Mexico, in theory, has
been part of national development programs (Bennett 1995; Leyes y Codigos de
Mexico 1994a), many Mexicans live with inadequate quantities and unequal distri-
bution of domestic water supplies. Overall, 27 percent of Mexico's population re-
port inadequate access to drinking water, and 10 percent of the urban population
and 45 percent of the rural population report having inadequate access (PAHO
1987; Restrcpo 1995).
In the Valley of Mexico, programs have restricted the development of piped
drinking water systems in poor communities in favor of providing water to wealth-
ier urban neighborhoods, the industrial sector, and irrigation projects (Bennett
1995; Flores 1995; Garcia Lascura'in 1995}. The valley floor is heavily urbanized
and dominated by the Mexico City metropolitan area, which comprises the Federal
District and 27 municipalities of the state of Mexico. The 1990 census reported that
the Mexico City metropolitan area had over 15 million inhabitants, which is over
18 percent of the national population (Merrill and Miro 1997:91,108). Within the
Mexico City metropolitan area, households in the upper socioeconomic strata re-
ceive up to 650 liters of water per person per day, but households in lower strata
regularly receive 20 to 40 liters per person per day (Flores 1995; Garcia Lascurain
1995). Furthermore, municipal governments often subsidize water for wealthier
neighborhoods, especially those that receive piped municipal supplies rather than
water from trucks, the more common form of distribution in poor neighborhoods
(Flores 1995). In 1991, people living in wealthier neighborhoods in the Mexico
City metropolitan area paid about MEX$40 per household for 1,000 liters of water
piped directly to their homes, even though it cost the water authority about
MEX$240 for each 1,000 liters of water delivered (Flores 1995). At the same time,
in poor settlements on the outskirts of the Mexico City metropolitan area (less than
15 kilometers from La Purificaci6n), people were paying M E X $ 5 0 0 - $ 1 , 1 0 0 to fill a
metal drum with 200 liters of water that had to last a household several days (Gar-
cia Lascura'in 1995). Flores concludes that "those who have fewer economic re-
sources and who consume less water pay for a liter of water at the highest price"
(1995:403, my translation). Restrepo (1995) argues that the situation in the Valley
of Mexico is becoming a human rights issue because water shortages, water ration-
ing, water pollution, and other problems disproportionately affect poor popula-
tions who have little ability to challenge the power relations that structure the un-
equal distribution of water.
Chronic water scarcity puts many people in the Valley of Mexico at increased
risk of suffering. Water scarcity can burden poor rural people, particularly women,
who often spend considerable time and money ensuring that their households have
adequate domestic water supplies (Elmendorf 1981). Garcia Lascura'in observes
that 'lack of hygiene, thirst, health problems, and constant nervous tension are the
principal consequences of the lack of water" for families living in poor urban set-
tings of the Valley of Mexico (1995:161, my translation). Furthermore, limited
water means that people cannot follow preventative hygiene measures, a situation
that puts them at risk for cholera, skin and eye infections, and other health prob-
lems (Juan et al. 1995).
372 MEDICAL ANTHROPOLOGY QUARTERLY

Water Management in La Purification

Water scarcity is also an issue for La Purificaci6n and other foothill and sierra
communities on the margins of the Valley of Mexico. La Purificacidn (2,375 meters
above sea level [m.a.s.l.]) is a mestizo community located in the northeastern foot-
hills of the Valley of Mexico in an area anthropologists refer to as the northern
Acolhuacan region (Palerm Viqueira 1995; Viqueira Landa 1992; Wolf and
Palerm 1955). With its semiarid climate, the region annually averages 641 milli-
meters of precipitation (ranging from 600 to 1,200 millimeters) and the tempera-
ture averages 14.8 degrees centigrade (Aldana Martinez 1994; Institute) National
de Estadistica, Geografica e Informaci6n [ENEGI] 1995). The rainy season runs
from June through September, and during the rest of the year the dry season is
marked by little or no precipitation.
The community is in the municipio of Texcoco in the state of Mexico, about
30 kilometers northeast of the center of Mexico City. La Purificaci6n's nucleus
was settled in the 17th century, and in the 1920s the community received a federal
grant of 260 hectares of rain-fed cooperative agricultural land (an ejido) at a lower
elevation (INEGI1995). In the 1970s, the population of about 1,000 people lived
in a semidispersed agricultural community. By the 1990s about 3,500 people
(about 865 households) were living in a compact and urbanizing space that in-
cluded the following: piped drinking water, electricity, telephone service, a paved
main road, regular bus service to and from Texcoco, a medical clinic staffed by a
medical student and a nurse, schools, and new restaurants, stores, and other small
businesses. In the absence of a public sewage system, most houses have septic
tanks and also drain gray wastewater (from washing clothes) onto their properties
or into the streets.
There is no local source of surface water, and geological studies of the foothill
zone have indicated that the settled nucleus of La Purificacidn lacks an easily ob-
tainable ground water source (Secretarfa de Recursos Hidr£ulicos 1950). For centu-
ries, people in this and nearby foothill communities have channeled water from
distant springs in the region's sierra zone (2,650-4,000 m.a.s.l.) to lower eleva-
tions (Lane Rodriguez 1994), something that residents in La Purificacidn continue
to do to supply irrigation water to some 200 households. The community rests on a
large, solid bed of volcanic rock, the reason for numerous failed attempts to drill
deep wells in the immediate vicinity. In the late 1970s, as the surface water began
to dwindle and become more polluted by upstream communities, La Purificacidn
drilled a deep well in the ejido and pumped groundwater up to the settlement
Paralleling regional trends, La Purificacidn's population increase is due
mainly to decreasing out-migration of established residents (those living in the
community for several generations) and steady in-migration of new residents. Be-
fore the 1970s, most households engaged in a mixture of wage labor and agricul-
ture for subsistence and profit. In the 1970s, however, the economic activities of
the population changed, and by the 1990s fewer than half of the families of estab-
lished residents had ejido lands or irrigation water. Some residents have taken up
commercial greenhouse production of ornamental flowers and make a living in the
community, but the majority travel on new paved roads and highways to work for
wages in nearby communities and Mexico City. Also in the 1970s, new residents
began moving to the community from Texcoco, Mexico City, and other urban
SUFFERING FROM WATER 373

areas and they also work outside the community. A large group of wage laborers
bought smaller residential (nonagricultural) properties (of 500 square meters or
less) and work in urban centers. A small but noticeable professional class of pro-
fessors, researchers, and administrators (some from other countries) have built
large, fenced-in, two-story houses and work in nearby graduate education institu-
tions.
In the local political organization, established male residents of middle and
lower socioeconomic strata hold power over drinking water management, and they
obligate other citizens to participate in civil and religious community customs in
order to gain access to water. A body of civil authorities called the delegation di-
rectly handles community drinking water distribution and is the main local institu-
tion that addresses collective aspects of suffering associated with water scarcity.
The delegaci6n is headed by three delegados and includes three administrative
committees: a Citizen Participation Committee, a Drinking Water Committee, and
an Irrigation Committee. The delegation also supervises a civil patrol and works
with representatives of the ejido. Most civil posts require three years of service.
Each year, 40 families are also chosen to fulfill obligatory service in the mayor-
domias, bodies that organize and sponsor annual festivals for the local Roman
Catholic Church. In principle, all of these civil and religious elected, unpaid posts
are rotated among all households in the community, and every citizen is obligated
to fulfill service when called on.2 In practice, however, new residents and women
hold the less important civil and religious posts. Established male residents hold
most civil posts, and males with both irrigation water and ejido land hold the top
posts in each civil committee.
The piped drinking water system includes a well, an electric water pump, and
a series of large pipes running from the well up to three stone holding tanks. Water
from the tanks runs by gravity through a network of metal pipes and rubber hoses
to individual households, where people store it in plastic buckets, metal tubs, ce-
ment cisterns, and fiberglass and cement holding tanks. Members of the Drinking
Water Committee turn on the water pump each morning for about six hours, which
is enough time to fill the holding tanks and ensure that each section of the commu-
nity receives at least two hours of water daily. The committee also collects a
MEX$25 monthly water payment (primarily to pay the electric bill to run the water
pump) and other user fees, and it supervises unpaid obligatory labor (locally called
faena) for water projects.3 The committee closely coordinates its work with the
other civil authorities in the delegaci6n and the ejido and sometimes with religious
authorities in the mayordomias.

Ethnographic Research in La Purification

I carried out ethnographic research during 21 months (1993-1996) of residence

in La Purificaci6n. I used participant-observation to gather the bulk of the data that
I analyze in this article. During the fieldwork, I particularly explored the meaning
of drinking water in daily life and how the local discourse on suffering was associ-
ated with disruptions in water consumption. I observed and participated in a wide
range of activities related to the use of drinking water in daily life (drinking, cook-
ing, cleaning, bathing, and doing laundry). By living in the community for an ex-
tended period of time, I was able to witness and collect firsthand information
374 MEDICAL ANTHROPOLOGY QUARTERLY

related to chronic water scarcity as well as periodic acute water shortages, which
were key moments when people readily commented on their water-related bodily
distress. I routinely listened to and elicited residents' comments during conversa-
tions, took brief notes about their comments and activities, and used the brief notes
as the basis for more detailed and expanded field notes. I then analyzed the field
notes for general patterns and themes regarding the idiom of "suffering from
water."
I collected extensive data on the community's civil and religious officehold-
ers, who coordinate activities and make decisions that directly and indirectly influ-
ence drinking water management. By working with over 100 civil and religious of-
ficeholders, I developed extensive social networks in La Purificaci6n and was
present during a range of events such as Drinking Water Committee meetings, pol-
icy discussions, water shutoffs, and faenas related to drinking water projects. I also
observed general activities of the community's civil delegaci6n (community meet-
ings, council assemblies, civil celebrations), irrigation management, faenas, may-
ordomias, and, to a limited extent, ejido activities. During acute water shortages, I
attended special community assemblies and accompanied local officials of a newly
organized water commission who went house-to-house collecting money from
debtors, noting anomalies (e.g., water theft), and listening to people's complaints. I
also visited many officeholders in their homes, which allowed me to make direct
observations of household water use in an unobtrusive manner.
Complimenting the participant-observation data, I conducted and taped a se-
ries of semistructured interviews with 41 local civil and religious authorities. In
each interview, I included questions about the meaning of the phrase "suffering
from water" and participants' views on community management of drinking water.
Those interviewed included 26 men and 15 women, who ranged in age from their
twenties to their nineties. Based on economic activities, landholdings, housing
type, and education, I grouped participants into three socioeconomic strata: upper
stratum (6), middle stratum (25), and lower stratum (10). I included 29 people who
identified themselves as established residents (born in La Purificaci6n) and 12 oth-
ers who were newer residents (most born in Mexico City or in other states in Mex-
ico). Every interview participant had some elementary education and was literate,
and a few were educated beyond secondary school.

The Meaning of "Suffering from Water" in La Purification

In the local idiom, "suffering from water" is a common theme of community

life in La Purification, one that I heard repeatedly expressed over the course of my
research during encounters in households, in the streets, and at public events and
activities. For residents I encountered and those I interviewed, phrases such as "to
suffer from water" (sufrir del agua) and "suffering from water" (sufriendo del
agua) referred to an aspect of community life that was so routine and prevalent it
required little explanation. In fact, when I began explicitly eliciting comments on
the meaning of the phrase "suffering from water," people were surprised by my
questions. For example, when I visited Carmen, a research participant, and snared
the midday meal with her family, she laughingly described to those gathered
around the table some of the interview questions I had asked her a few days earlier.
She told them that I had asked her the meaning of the phrase "to suffer from water."
SUFFERING FROM WATER 375

Carmen asked her family, in a tone that was part mocking and part disbelief, "Can
you believe that he doesn't know what that means?" Similarly, when I asked Iris,
another research participant, about the phrase "suffering from water," she shook
her head, laughed, and said that if I had to ask it was probably because I had never
suffered from water. Most striking, perhaps, was that los Purifiqueflos used the ex-
pression "we are suffering from water" to express a collective bodily distress due to
persistent water scarcity.
During an interview, when I asked Carmen about the meaning of the phrase
"suffering from water," she responded,
We suffer from having to struggle and having to run around paying for water from
water trucks, or when we don't have sufficient water for our necessities . . . like
for bathing, for washing clothes This is suffering because [during the last
water shortage], just like before [the community had a piped water system], we
have to carry clothes over to theriverby Molino de Flores, our clothes. I have a lit-
tle car, and I take [laundry] in the car, and we wash over there [at the river]. All of
this we call suffering from water, because we don't have our water in the house,
no water to fill buckets, not enough water even to bathe each week, so for me this
is a terrible suffering... carrying our water in pots and buckets. And when I want
to bathe, really it is draining, how one suffers.

During my observations in the civil offices, I heard community residents dis-

cuss their suffering before water authorities. In an interview, I asked Carlos, one of
the local water officials, what people meant when they said they were "suffering
from water," and he explained,
I can suffer in the sense that I don't have the service for the most indispensable
things... such as for preparing the food and for, well, for drinking. For bathing, if
you have irrigation water, well, you can use that. And one suffers about their allot-
ted supply not arriving, that amount requested of, let's say, 50 liters per person,
and it doesn't arrive. We have seen families with five people who are supplied
with a metal drum of 200 liters every other day. Now, with the amount, it would be
about 40 liters per person [every other day], no? But, it would be half, 20 liters
daily, while other people have double or triple or more. This would be suffering,
to not have water AND being obligated to pay for it, you know, hoping that the
water will arrive . . . [Then] this would be suffering, more than anything, moral
[suffering], to see that [my neighbor] has it and I don't have it.

Other residents of La Purificaci6n explained that they and their families also
suffered when they had inadequate water supplies for daily needs. The comments
of Carmen and Carlos are similar to those I heard from all of the interview partici-
pants who were established residents holding local offices and occupying the
lower and middle socioeconomic strata of the community. During my interviews
and in observations of public encounters, I commonly heard people note that they
had little water, sometimes less than 50 liters per person per day. People talked
about suffering/rom water and suffering about water when they had to wait for the
arrival of water, ration the use of water in the household, carry and store water, pay
for water, and contribute limited time, money, and physical labor to community
water projects. People also described a bodily discomfort they and their family
members felt when they could not bathe for days and could not wash dirty clothes,
dishes, and toilets. They spoke of their suffering when forced to carry laundry to a
376 MEDICAL ANTHROPOLOGY QUARTERLY

nearby river or some other place to wash it and when they had to bother neighbors,
friends, and kin with requests for water.
Households expected to receive piped water for two to four hours at least
every other morning, and they coordinated daily routines around the water sched-
ule and often waited for the water to reach the house before doing laundry and
other activities. When they did not receive adequate water supplies, residents com-
plained to the local water authorities (who were often neighbors, friends, or kin)
that they were "suffering from water." They would demand to know whether a
temporary technical problem or, in fact, a social injustice had prevented them from
receiving their fair share of drinking water. The mountainous terrain and the aging
equipment have produced technical problems: the water pump breaks down, the
electricity goes out, water pipes and hoses break and become plugged, and gravity
pulls water to households at lower elevations so that households at higher eleva-
tions receive less. People knew, however, that there were also social origins to
water problems: for example, residents intentionally tampering with water valves
and pipes; households at lower elevations leaving water faucets open to fill large
tanks; wealthier households pumping water to use for ornamental and commercial
gardening; and civil authorities changing the water schedule to favor particular ar-
eas of the community. People especially assessed whether water was being fairly
distributed to households regardless of socioeconomic level.
Los Purifiquenos with inadequate water said they were suffering when they
saw others with more water and others using drinking water to wash cars, water
lawns, clean sidewalks, and other inappropriate activities. Community residents
who saw others with more water described their bodily distress using terms such
as: frustration (frustration), anguish (angustia), bother (molestia), worry (preocu-
pacion), and anger (coraje). In their minds, it was unjust to receive inadequate
amounts of water while paying the same monthly water fees and fulfilling the same
annual labor obligations as other community members who enjoyed greater
amounts of water. I heard both men and women express this sort of suffering, but
my notes indicate that more women voiced such views. During community meet-
ings, for example, the majority of the people who got up to speak were women. In
fact, it was at the urging of several women during an emergency community as-
sembly that the civil officials organized a water commission of men and women to
go door-to-door and request contributions for the water system. Women also ex-
pressed their concern in the offices of the civil authorities as well as in their homes
and on the streets during informal gatherings with other residents. Women ex-
plained that, ultimately, they were responsible for water reaching their house-
holds, and when it did not, they took action by voicing the suffering of their fami-
lies to local authorities.
Residents, in general, did not associate this form of suffering with compro-
mised water quality. Residents seemed to base their views of drinking water qual-
ity on their health, which they perceived as good, and on the physical qualities of
the water, such as its color, smell, and taste. Community residents suggested, for
example, that the community's drinking water supply was relatively clean (Um-
pia), pure (pura), and healthy (sana), especially when compared with polluted sur-
face water from irrigation ditches and treated water from water trucks. People said
the water looked pure and lacked visible signs of pollution. In interviews, nobody
reported that they or a family member had gotten sick from the drinking water. As
SUFFERING FROM WATER 377

one woman told me, "We have never had an epidemic." None of me authorities I
interviewed reported that they purified their drinking water before consuming it,
and only 2 of the 41 people I interviewed reported that they boiled or filtered water
before drinking it In conversations, people commonly pointed out that they were
probably supposed to purify their drinking water in accordance with national
health education messages they had heard on television and radio. At meals, people
often joked with me about foreigners like myself wanting purified water (aguapu-
rificada), which, they pointed out, was readily available since the community was
called La Purification.
The local discourse on the physical and moral aspects of suffering motivated
people to identify and confront the injustice of that suffering. People of lower so-
cioeconomic strata seemed especially vocal about pointing out to me that they did
not have the means of storing large quantities of water and could not afford to pay
for trucks to deliver water to their houses. When the disruption in water supply was
due to technical problems, I heard residents pressure authorities to address the is-
sue, although they were somewhat understanding that such problems were bound
to occur in the ongoing process of developing a drinking water system. Nonethe-
less, any water disruption prompted people to ask whether the problem had a social
origin within the community and thus violated the principle that residents who ful-
filled obligations could expect to receive a fair share of drinking water. When a so-
cial origin was identified, people were less understanding and took individual and
collective action to address the problem.

Suffering and Social Inequality

Community members I encountered were aware of and concerned about

water scarcity in their community, and many articulated suffering as a collective
experience. As Carmen said, *Ve suffer from water." Nonetheless, whether or not
an individual referred to a collective suffering from water was dependent on the
speaker's socioeconomic position. For instance, most residents of the upper socio-
economic stratum live in large houses with large cisterns that allow them to
weather temporary disruptions in the water supply. I rarely heard such residents
use the idiom "suffering from water." Of the six members of the upper stratum I in-
terviewed, one said he had not heard of the phrase and another dismissed it as sim-
ply improper grammar.4 The situation was different among most of those occupy-
ing the middle and lower strata and holding local religious and civil offices. I heard
people from these strata use the idiom as they led community meetings, met in civil
offices, and went door-to-door to deal with water debts. In interviews, the 25 peo-
ple from the middle stratum and the ten people from the lower stratum said they
had heard the phrase and were able to explain its meaning to me. In addition, I
regularly heard people mention in civil offices and community meetings that they
were suffering from water because, they said, they did not have large reservoirs
and depended on receiving daily supplies of water.
A person's residency status also influenced experiences of suffering. I ob-
served ongoing conflicts and negotiations between established residents and new
residents over drinking water. In public encounters, established residents often
stated that the community as a whole was suffering from water and that they
needed to unite as a community to solve the problem. In these discussions, the
378 MEDICAL ANTHROPOLOGY QUARTERLY

established residents reminded listeners (especially new residents) that, before the
1970s, they were a poor peasant (campesino) community. Established residents
pointed out that new residents in the higher socioeconomic strata abused their com-
munity privileges by not contributing money or labor to community water projects.
At the same time, people noted that the settlement of new residents placed more de-
mands on the water system, especially when newer, wealthier residents built large
houses and ornamental flower gardens. Established males pointed out that in the
1970s they had provided unpaid labor to drilling projects in a search for a cleaner
and more reliable local groundwater source. New residents, on the other hand,
pointed to the supposedly backward and authoritarian manner in which the estab-
lished community residents ran the drinking water system. Newcomers com-
plained that they paid money for a service that was inefficiently run and not de-
signed to deliver water to the neighborhoods where new residents settled. New
residents suggested in community meetings that it would be better to pay an out-
side entity (a governmental or private organization) to run the water system.
Established residents generally opposed suggestions to change the commu-
nity management of the water system and sought to keep control of local water dis-
tribution as well as the higher civil and religious posts. They upheld customary
water management practices such as defining water for domestic use as a commu-
nal resource and expecting the water to be fairly distributed to all members of the
community. A resident gains a use right (derecho) to the water (as with any com-
munity resource) by fulfilling customary community obligations (costumbres)
such as paying water fees, providing labor for local public works projects, holding
civil and religious posts, and sponsoring religious festivals. Failure to fulfill these
and other obligations results in the imposition of sanctions, including the withhold-
ing of drinking water. Since established residents have, by definition, a longer his-
tory of such community service, they receive a use right to water at a lower fee than
those who have recently settled in the community. Since established residents con-
trol the civil and religious posts, they pass policies that new residents consider con-
troversial. For instance, during my research, civil authorities used the support of
community assemblies to require new residents, especially those constructing
larger houses, to pay substantially higher fees to be hooked up to the community's
water system.5

Responding to an Acute Water Shortage

In this section, I examine a specific water shortage, an instance of acute water

scarcity and socialized bodily distress that occurred during my fieldwork in La Pu-
rificacion. Much of the information related to this episode comes from direct ob-
servations in the offices of the civil authorities during a two-week period in July
1995 when residents, especially women from the lower and middle socioeconomic
strata, told officials repeatedly, "We are suffering from water." Community resi-
dents complained that they had no water for cooking, for getting children bathed
and ready for school, or for washing clothes. "We don't even have a drop of water
to drink," was a common expression I heard. Below, I examine how los Puri-
fiquenos were suffering from water and how they asked their elected water authori-
ties what they planned to do about it. I found that people responded to the situation
by engaging in various sorts of individual and collective actions.
SUFFERING FROM WATER 379

During the period in question, the community had no drinking water because
the electric company had suspended service to the community's water pump. Offi-
cials showed me five unpaid electric bills totaling over MEX$35,OOO (about
US$5,000). For several years, authorities had been troubled by the prospect of hav-
ing to pay higher electric rates to run the water pump. In 1993, the community dis-
covered that the federal government's privatization measures and the reform of na-
tional water laws had ended subsidies for electricity to operate water pumps in
rural areas. The reforms in water management were part of Mexico's plans to im-
plement the North American Free Trade Agreement (NAFTA) and other economic
liberalization measures (Leyes y Codigos de Mexico 1994b; Melville 1996;
White ford and Bernal 1996). These measur.es resulted in massive cutbacks in pub-
lic expenditures for health services, including delivery of drinking water (Laurell
1991). Furthermore, Mexico had entered an economic crisis in the final months of
1994 (months after the implementation of NAFTA) with the devaluation of the
peso and subsequent rapid inflation, wage freezes, and unemployment. In 1995,
the electric company increased its rates and the government raised the sales tax
(IVA) from 10 percent to 15 percent, almost tripling the cost of the electricity
needed to operate the community's water pump. The decrease in consumers' abili-
ties to pay water fees and the increasing operational costs created a financial crisis
for the management of the community's drinking water system.
Consequently, many households in La Purificacion had water debts. Using in-
formation from the account books of the Drinking Water Committee, I estimated
that up to 75 percent of the 844 households with registered connections to the
drinking water system had not paid their water fees for 1994 and 1995. Many debt-
ors said they understood the need to pay the fees but questioned why authorities
pressured them if other households owed water fees dating back to the 1970s. In-
formation from the drinking-water account books, however, indicated that about
90 percent of the households owed back fees of a few months to no more than two
years and that fewer than 4 percent of the households had water debts dating back
six years or more. If the community hoped to pay the delinquent electric bills,
authorities needed to collect money at least from the group that owed for the
months since 1994. During the shortage, authorities showed people the electric
bills as well as the account books for 1994 and 1995, demonstrating that most
households had not paid their drinking water fees and that the current crisis was not
simply caused by the few households with long-standing debts.

First Day of the Water Shortage

At the desk of the Drinking Water Committee, I listened and took notes as
Carlos and Pablo (the committee president and the treasurer, respectively) dealt
with people who came to express the suffering they endured because of the water
shortage. One of the first cases I heard was that of a woman, about 70 years old,
who approached the desk, sat down, and said she wanted to pay her drinking water
account. The woman said, "There's no water." Carlos explained that two days ear-
lier, the electric company had cut the electric power to the drinking water pumps,
and as a result, there would not be any water in the community. He said it was a big
problem and asked, "How are they going to give us water if we don't pay here?"
Other people approached the desk to listen to the interaction. The woman said that
380 MEDICAL ANTHROPOLOGY QUARTERLY

many people could not pay their water fees because they worked during the week
and arrived home late at night. She suggested that authorities should have been go-
ing directly to debtors' houses on Sundays to collect water fees. Carlos responded
that they had gone to people's houses, but people never seemed to be home. The
woman said she wanted to be up-to-date in paying her water fees but that she could
not pay the full amount that day. She remarked that she had lived in the community
for 20 years and had always paid her fees. As he did with many other people during
the water shortage, Carlos showed the woman the overdue bills from the electric
company. Pablo told the woman that she owed for 12 months for 1994 and 6
months in 1995, a total of MEX$450. The woman said she could pay only MEX$100,
or 4 months' charges, that day and that she would stop by another day to pay the
balance.
Later, another woman, in her sixties, came to pay her water fees. She asked,
"If I pay, will there be water or not?" Carlos explained the problem to her and said
there was no water in the entire community. The woman asked, in a joking tone, "If
I haven't bathed or washed clothes, why am I going to pay?" Carlos responded,
"Right now, all of us are suffering." He showed her the bills from the electric com-
pany to impress upon her the need for everyone to pay their water fees. Pablo ex-
amined her account and told her the amount of her 15-month water debt
Next, a woman in her seventies approached the desk to ask about water. She
remained standing, arms crossed, and confronted Carlos and Pedro while several
others looked on and listened. She had come to pay MEX$50 on her balance, and she
said that the authorities had to solve the problem. Carlos repeatedly told the woman
that everyone was equally affected and that everyone—community authorities and
residents—had a responsibility to help resolve the problem. He said, "It is unfortu-
nate that we are now accustomed to the water service, because it is difficult when
we don't have it." The woman said it was not fair that everyone whose payments
were up-to-date should now be left without water. She went on to say that the
authorities should withhold water from the worst offenders. In response, Carlos
complained that neighbors offered little help in locating debtors and that the repre-
sentatives needed the support of other community members in order to shut off a
debtor's drinking water. Because the Mexican constitution considers water to be
national property and guarantees it to all citizens, it is a federal offense for munici-
pal authorities to completely cut off a household's drinking water. In recent years,
some communities in the region have organized assemblies and formed larger
groups of officials and citizens to cut off water to debtors. As some residents told
me, this sort of collective strategy would force federal officials to arrest an entire
community, something outside authorities have not done and likely would not do.
The same woman who stated that water should be shut off to delinquent
households also pointed out that some people have wells and therefore would not
have to pay the fees but that she intended to pay even if her household did not have
water. In return, she expected water to be delivered to her household. In response,
Carlos pointed out that few residents have wells and that "we are all equals" (esta-
mos parejos) in suffering from water. The woman simply said she wanted water
and handed Carlos MEX$50. Carlos asked her, "What am I going to do with the
MEX$50 you pay me?" implying that he needed more people to pay their fees in or-
der to pay off the large electric bills. When the woman said that authorities should
have warned the community that the water would be shut off, Carlos explained that
SUFFERING FROM WATER 381

the electric company had not notified the community that it was cutting off the
electricity to the water pump. She asked, "What are we going to do? Have a month
without water?**
The morning continued with dozens of similar encounters at the desk of the
Drinking Water Committee. Many cases involved people who owed debts of less
than two years and who were outraged that they should be suffering because of the
negligence of those with larger water debts. In these encounters, people came to the
delegaci6n to inquire about the source of their suffering and pressure repre-
sentatives to do something to alleviate that suffering. Authorities often responded
that those now angrily complaining would have a chance to deal with these com-
plex issues when their turn came to occugy the offices responsible for managing
the drinking water system. Carlos and Pedro assured people that the current offi-
cers had not intentionally shut off the water to pressure people to pay their debts.
They also tried to persuade people that responsibility for the problem lay with
everyone, as most people had water debts. In this sense, the encounters were mo-
ments in which people were confronted by the social nature of the problem before
them.

Second Day of the Water Shortage

On the second day of the shortage, I observed dozens of people confronting

the water authorities. One encounter between Carlos and a single woman in her
thirties illustrates the general pattern of the discourse. The woman, a health care
worker, stood at the drinking water desk talking to authorities for over half an hour.
She said that since moving to the community a few years earlier, she had always
paid her entire water fee a year in advance and yet she had no water. Carlos ex-
plained that nobody in La Purificaci6n had drinking water. She asked, "Isn't there
another way to pressure people who have not paid?" Carlos replied that repre-
sentatives could not do anything when the electric company decided to cut the
power. He said community authorities were planning to call an assembly to enlist
support for pressuring debtors. The woman responded that the people who owed
would not go to an assembly.
Carlos continued by explaining to the woman that the local authorities needed
support from community members. He noted that, in the past, when the authorities
had threatened to shut off debtors' water, neighbors had not supported the Drink-
ing Water Committee. Also, when authorities had shut off water, people had taken
them to court for disobeying federal laws prohibiting such actions. Carlos stated
that while he was willing to shut off a debtor's drinking water, he did not want to be
the only person running the risk of being arrested by municipio or federal officials.
Carlos said many outsiders (gente de afuera) with different ways of thinking had
moved into the community, and some were opposed to shutting off the drinking
water of debtors or of residents who failed to fulfill customary community obliga-
tions. Carlos and other officers often reminded residents that municipio officials
had jailed previous community officers for shutting off the water to individual
households. This threat prompted Carlos to underscore the need for residents to
join with civil officials in a collective effort to address water problems.
Carlos continued that people had come to La Purificaci6n from the Mexico
City metropolitan area, where they were used to paying much less for their drinking
382 MEDICAL ANTHROPOLOGY QUARTERLY

water, and they did not want to pay the water fees established in the community.6
Carlos said he was under the impression that residents of Mexico City had become
accustomed to not paying for drinking water and that officials there generally did
not shut off the water of debtors. The health worker countered that municipal
authorities in Mexico City did regularly shut off debtors' drinking water. Carlos
explained that he and other drinking water officials were summoning debtors to the
delegaci6n, but, he said, "unfortunately, here there are different customs" and a
community assembly had to give authority to the delegaci6n to shut off a house-
hold's water. He hoped to have enough community support to mobilize a collective
effort to shut off debtors' drinking water. During this and other encounters, Carlos
reminded people of the power of collective action to address the social roots of
their suffering.
The woman continued by saying, "I'm not from here, I'm from the district
[Federal District]." She said that when she bought property in the community, *the
delegados told me, 'You have to fulfill your obligations with the obligatory com-
munity labor [faenas] and the church.' I accepted, but now I don't have water and I
paid for the water." The woman insisted that the authorities should have been shut-
ting off the water of those who had not paid their bills. Carlos explained that some
people wanted him to shut off the water of those who owed for two, three, or six
months, but others said people should have more time to pay their debts. For that
reason, he needed support from people like her in order to pass a resolution at the
community assembly authorizing him to shut off residents' water.
The woman suggested that the authorities needed to explore alternative ways
of managing the drinking water system. She said it should be like telephone serv-
ice, in that one paid for the installation and a monthly fee, and if one did not pay,
the company cut off the service. Community authorities should be stricter, the
woman insisted. Carlos responded that they had to be careful not to create other
problems, for example, by agreeing to "let the government give us state water."
The woman said that would be "treated water" (agua tratada), which would be
worse because "we want potable water not treated water" (queremos agua potable,
no agua tratada). They were referring to government programs designed to supply
rural communities with treated and untreated urban wastewater (the latter for irri-
gation) in exchange for the right to channel surface water from mountain springs
and groundwater from irrigation wells to urban areas in the Valley of Mexico.
These programs are a direct result of the shortage of groundwater in the Valley of
Mexico and the prohibition against drilling more deep wells for drinking water
(see Cirelli 1996; Lane Rodriguez 1994; Pefta 1996). Carlos concluded that at least
"here, our water, thank God, is very pure, more pure than water they sell in bot-
tles."

Resolving the Crisis

Initially, the office of the Drinking Water Committee was the principal setting
in which individuals expressed their suffering to community authorities. After the
first few days, however, people mobilized the community's political organization
(comprising civil and religious officials) and organized collective efforts to deal
with the social aspects of the problem. Encounters focusing on the problem ex-
tended beyond the context of the Drinking Water Committee and involved other
SUFFERING FROM WATER 383

civil and religious officials and residents. These encounters took place at commu-
nity assemblies, in the streets, and during large gatherings for life-cycle celebra-
tions at people's homes. Eventually, authorities put up posters asking residents to
pay for their consumption of drinking water so that the community, in turn, could
pay the electric bill and restore power to the water pump. They intensified their ef-
forts to serve notice to debtors, which involved physically carrying summonses to
people's houses. Individuals also talked about the problem in settings where they
gathered to obtain water. For example, people began hauling laundry to a small
spring at the southern edge of the community. Others hauled buckets of water from
the spring to their houses. Still others ordered water trucks from Texcoco and paid
to fill their household cisterns. All the whije, people complained about the suffer-
ing generated by hauling water, looking for water, rationing water, collecting rain-
water, and using irrigation water.
The community authorities held emergency assemblies (asembleas urgentes)
and coordinated a series of collective actions to deal with the situation. During the
first assembly, residents accepted a resolution (drafted by the Drinking Water
Committee) stating, among other things, that civil authorities could shut off the
water of anyone who owed for more than two months' usage. Residents, however,
urged the authorities to use direct means to pressure people who owed payments on
their drinking water accounts. During the assembly, women argued that they
needed water immediately to care for family members and said they were not inter-
ested in waiting for other residents to come pay their water bills. At the urging of
community residents, the authorities agreed to form a commission to oversee a
house-to-house campaign to collect money from debtors. Immediately after the as-
sembly, the first commission sent groups to each of the five barrios in the commu-
nity. Each group was composed of male civil representatives and male and female
volunteers from each barrio. Subsequently, the local male and female religious of-
ficials joined the commission and helped pressure people to pay water bills and ful-
fill community service in order to keep their water service.
Two weeks after the electricity was shut off, the community had raised enough
money to pay a portion of the electric bill. The electric company restored power to
the water pump, and the community once again had drinking water. Nonetheless,
authorities reduced the amount of time that the pump ran in order to save electricity.
They also continued to pressure residents to pay their water debts. The drinking
water commission continued to operate for several months and was mobilized each
time an electric bill was due. With pressure from residents, water authorities and the
commission cut off the water supply to a few households and used them as examples
to others who owed water payments. Civil officers also called a number of addi-
tional assemblies to deal with water shortage issues, and each time a couple of hun-
dred people attended. During each community assembly,residentsproposed resolu-
tions and received support (primarily from established residents) to continue to use
customary water management policies. The community relied on such policies to
address suffering associated with ongoing water scarcity.

Discussion and Conclusion: Suffering from Water Scarcity

This ethnographic analysis of suffering in La Purificaci6n shows how people
experience and express forms of bodily discomfort linked to water scarcity.
384 MEDICAL ANTHROPOLOGY QUARTERLY

Ethnography is well suited for highlighting the social context of a water-related

health issue that has not been well studied in medical anthropology. By taking a
critical medical anthropology approach, the study shows the need to go beyond the
usual focus on water quality and examine the health consequences of inadequate
water availability and the pervasive, daily struggles to secure adequate domestic
water supplies. People feel physical discomfort with thirsty, dirty, and aching bod-
ies, unclean domestic settings, and upset family members. At times, it is possible
for people to locate the origins of their pain, anxiety, and bodily discomfort in the
social world. Such forms of bodily distress are not necessarily biomedical or tradi-
tional illness conditions requiring healing of individual bodies. In a sense, I am
showing how people talk about the "social body" (Lock and Scheper-Hughes
1996) and how they recognize and attempt to alleviate their social suffering. Fur-
ther medical anthropological research in diverse settings is needed to describe a
wider range of experiences with water scarcity.
The analysis also shows how local conceptions of water-related suffering
shape the ways people conceive of domestic water as a contested resource that is
unavailable to certain groups. While people responded individually to this issue, I
was struck by their collective responses to the social origins of water scarcity. In La
Purificaci6n, I rarely heard people say,"/ am suffering from water." More often the
expression "we are suffering from water" pointed to various groups of people with
intersecting and diverging interests: families, neighborhoods, poor residents, es-
tablished residents, rural people, or the entire community. Within the community,
poor residents express rage at wealthier residents, nondebtors pressure debtors, fe-
male residents protest to male water authorities, and established residents resist at-
tempts by new residents to change communal water management practices. This
shows how, drawing on a shared identity as sufferers facing a common hardship,
people identify and confront those from outside their particular social groups who
pose a threat to the distribution of domestic water supplies. It would be useful for
future medical anthropological research to focus on drinking water as a contested
resource and examine how local social differentiation based on class, residency
status, and gender shapes conflicts and negotiations among the various groups
competing for water resources. In my view, it is not always clear that access to
drinking water is simply a health service to be installed in a community. Rather,
from a critical medical anthropology approach, water is likely to be a contested re-
source whose access and distribution must be negotiated.
One major way that local groups deal with water issues is to turn to local insti-
tutions and practices embedded in the community's political organization. Local
institutions allow people to pressure groups and to challenge threats to the contin-
ued use of communal water management practices. I show how the community
mobilizes its civil and religious officers to deploy the collective power necessary
for dealing with the unequal water distribution routinely found in other areas of the
Valley of Mexico. During water shortages, residents consider the less desirable al-
ternatives for obtaining water, such as carrying water from streams, using polluted
irrigation water, buying water in urban centers and carrying it home, requesting
water delivery by trucks, and allowing the government to takeover the community
well in exchange for a supply of treated and untreated urban wastewater. Com-
pared to having groundwater piped directly to houses, these alternatives would be
SUFFERING FROM WATER 385

more costly and burdensome and would supply less abundant, less clean water, by
implication generating more suffering.
In addition, control of drinking water may be a source of power, a detail that is
often overlooked in medical anthropological research. Local community authori-
ties who maintain tight control over water distribution may withdraw water as a sanc-
tion against those who do not pay water fees as well as those who do not fulfill cus-
tomary community service. Letting go of this local control means risking the loss
of the water to others with competing economic and political interests, and it
means losing a local source of power used to shape a variety of local matters. This
shows the need for medical anthropologists to consider how people weigh con-
cerns about water quality with equally or more pressing concerns about water
availability and water control.
In addition to local issues, water-related suffering is influenced by local social
differentiation as well as regional, national, and international patterns of social
stratification. This is especially apparent with regard to market-driven patterns of
unequal water distribution in the Valley of Mexico, the national privatization of
water management as part of NAFTA, the national economic crisis, and sub-
sequent decreased state support for drinking water systems and other health serv-
ices. Given such conditions, I see local culture less as a barrier to the installation of
a supposedly beneficial health service than as a potential resource for resisting
macrolevel constraints on access to and control of domestic water. In this commu-
nity, I have shown how the threat of suffering reinforces local interest in nonmar-
ket principles and practices (locally referred to as 'traditions" and "customs") to
regulate access to and distribution of drinking water. Residents in La Purificaci6n,
for example, generally agree that they should preserve the local water management
system and not allow the behavior of a few to put the system at risk of failure and
thereby harm the larger community. Residents with direct authority over water
management continually impress upon other residents the need to participate in
running the drinking water system by paying fees, providing unpaid labor for pro-
jects, and supporting local policies. In many settings, we should be looking at ways
that drinking water management is not simply a matter of exchanging money for a
"service," since people may view provision of drinking water as part of a social
contract between citizen and community. Communities may resist participating in
drinking water projects that do not adequately provide a fair distribution of drink-
ing water to all residents.
This study of suffering in a Mexican community gives attention to cultural,
social, and political-economic dimensions of people's experience with and re-
sponses to water scarcity. Guided by the presupposition that access to and control
of water resources shape health, the research reveals how water-related bodily dis-
tress results from the intersection of local experience with broader structures of in-
equality. Water is a vital resource for health and well-being, but in many areas of
the world it is also becoming an increasingly scarce, contested, and unequally dis-
tributed resource. Consequently, medical anthropologists need to broaden the an-
thropology of water-related suffering beyond a biomedical focus on water quality
and examine the interrelationship of the quality, quantity, and distribution of do-
mestic water supplies. An ethnographic focus on how people construct and use a
discourse of suffering brings attention to the social conditions that limit access to
adequate resources to satisfy basic necessities. Above all, los Purifiquefios remind
386 MEDICAL ANTHROPOLOGY QUARTERLY

us to be attuned to the creative and imaginative ways people conceive of and ad-
dress their suffering from water.

NOTES

Acknowledgments. I wish to give my deepest thanks to the residents of La Purifica-

ci6n for supporting my efforts to understand and write about their lives. I also give special
thanks to Jill Sweet for her encouraging and thoughtful assistance while I wrote this article. I
am grateful to a number of people who shared their views on the ideas presented in this arti-
cle: Eufracio Cubacub Abaya, Johel Brown-Grant, David Dwyer, Janice Harper, Ann V.
Millard, Harry Raulet, Susan Walzer, and Scott Whiteford. Thanks also to Carmen Viqueira
Landa, Roberto Melville, and other anthropologists affiliated with the Programa Pos-
graduado en Antropologfa, Universidad Iberoamericana, in Mexico City. This research was
assisted by an International Predissertation Fellowship from the Social Science Research
Council and the American Council of Learned Societies, with funds provided by the Ford
Foundation; Foreign Area Studies Language Fellowships from the Center for Latin Ameri-
can and Caribbean Studies and the Center for the Advanced Study of International Develop-
ment, Michigan State University, with funds provided by the U.S. Department of Education,
Title VI Program; a Dissertation Fellowship from the Inter-American Foundation; a Small
Grant for Dissertation Research from the Wenner-Gren Foundation for Anthropological Re-
search; and dissertation writing funds from the College of Social Science and the Dean of the
Graduate School, Michigan State University. The views presented in this article are my own
and not those of the people or institutions mentioned above. I dedicate this article to Eufracio
Cubacub Abaya. For your friendship and guidance in all things anthropological, thank you,
my friend.
Correspondence may be addressed to the author at Department of Sociology, Anthro-
pology, and Social Work, Skidmore College, Saratoga Springs, NY 12866. E-mail address
is mennis@skidmore.edu.
1. A broad range of studies using critical approaches in medical anthropology have
called for greater attention to the interrelationships among health, illness, politics, and strati-
fied social relations. For recent reviews, see Armelagos et al. 1992; Baer 1996a, 1996b; Baer
et al. 1997; Lock and Scheper-Hughes 1996; Morgan 1987,1993; Morsy 1996; and Singer
1990.
2. Anthropologists conducting research in indigenous and mestizo Mesoamerican
communities have described the series of civil and religious offices as a civil-religious hier-
archy of cargos. For a review of this work, see Stephen and Dow 1990. The complex rela-
tionship between drinking water management and cargo organization is beyond the scope of
this article.
3. In 1994, the exchange rate was about US$1.00 = MEX$3.00. In 1995-1996, the ex-
change rate was about US$1.00 = MEX$6.00-7.00.
4. This raises an interesting linguistic issue. Speakers of standard Spanish would tend
to say sufriendo por el agua. Use of the preposition por indicates that someone is suffering
because of a situation in which there is no water, but it implies a measure of agency and voli-
tion on the part of the sufferer. In other words, por signals that the sufferer is the source of a
condition (suffering) related to a particular situation at a particular time, a situation requiring
a simple, discrete solution; in other words, the kind of situation resulting from an occasional
cutoff in the water supply. By contrast, members of die speech community described in this
article use the preposition de in the phrase sufriendo del agua. This phrase sounds nonstan-
dard and ungrammatical to many Spanish speakers. Nevertheless, the preposition de signals
that the water is, to a certain extent, an agent causing the suffering and that the suffering is re-
lated to a situation that has an ongoing or chronic quality, much like an endemic disease. For
example, the use of de in the phrase sufriendo de cancer (suffering from cancer) localizes
SUFFERING FROM WATER 387

cancer as the source of the suffering and implies that the sufferer has a limited ability to
change the source of the problem because it is chronic. A more detailed semantic analysis is
needed to test whether the difference in the use of por and de is dialectical or idiomatic (Jo-
hel Brown-Grant, Department of Language, Literature, and Communication, Rensselaer
Polytechnic Institute, personal communication).
5. This issue is covered more extensively in Ennis-McMillan (in press).
6. As I noted in the background section on water scarcity in Mexico, many wealthier
neighborhoods in the Mexico City metropolitan area receive drinking water at subsidized
rates (see Flores 1995).

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Acceptedfor publication February28,2000.