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A funeral procession to the Kichwa cemetery in Otavalo, Ecuador, July 2010. Photo by Jessie M. Vallejo


  • The Cultural Toll of the Cholera Epidemic in Otavalo, Ecuador

    I spent the summer of 2010 in Otavalo, Ecuador, an Andean market town surrounded by peaks and volcanos. My goal was to take Kichwa language classes with Patricio Maldonado and to study that language through immersion at his home. I ended up learning so much more about his family, the local music traditions, and the struggles of the community.

    My first evening in Otavalo’s Kotama community was the last evening of Hatun Puncha, the summer solstice festival. I brought my violin expecting to play and sing sanjuanitos; however, Patricio offered to teach me the transverse cane flute that has been central to this and other festivals for centuries. “It’s just a little thing we do here,” Patricio stated as he smiled and took me to dance and eat at neighbors’ home patios.

    I began attending classes at Hatun Kotama, a new flute school and cultural center, to practice Kichwa and learn more about the music. It quickly became apparent to me that Kichwa flute music and its associated dances are central to Kichwa theories about our cosmos and life experiences.

    The summer solstice festivities are the most important pre-Hispanic festivals still observed in many Kichwa communities today. The weeklong celebrations not only mark the end of the harvest of staple crops (corn and beans), but the music and dance associated with this time of year express gendered concepts of space-time and spirituality. Families and friends gather to play music, dance, and eat together throughout the week, usually dancing all night and throughout their communities and neighboring towns. This is also a time when spirits can cross back into the world of the living to celebrate, similar to the Day of the Dead.

    The Cholera Epidemic of the 1990s

    I began interviewing flutists about the history of Otavalan transverse flute music. For centuries, the music had weathered sociopolitical, economic, and religious changes, but it nearly disappeared from many of the region’s communities after the 1990s. The sharp decline in players, as well as the disruption of the music’s transmission, they claimed, was due in part to the cholera epidemic that struck Ecuador and South America.

    Mariano Maldonado, Patricio’s father, was one of the first to suggest this connection to me. He had noticed a real decline in some villages well known for their flute players. Research has shown that adult males were most susceptible to cholera, so it made sense to me that flute players would have been taken. As Mariano was not aware of any local players who had succumbed to cholera, he suggested that the music community in Kotama was strong and should take action to safeguard the tradition.

    Transmitted through contaminated food and water, cholera spread in Ecuador from 1991 to roughly 1996. In 1991 alone, roughly 46,000 cases and 650 deaths were recorded nationwide. The Imbabura province, in which Otavalo is located, was consistently one of the provinces with the most cholera-related illnesses and deaths. Approximately 2,000 cases occurred in Imbabura during 1991, and a majority of these happened during April and May, just prior to the solstice festival in June and its weeks-long preparations.

    As Patricio and I set out to explore these claims, we encountered more questions. Although we came up with no concrete figures on the number of flute players lost to cholera, we found ourselves immersed in a far more complicated puzzle than we had expected to find.

    Institutionalized Racism Against Indigenous Communities

    The early 1990s were a turbulent time in Ecuador due to neoliberal policies that caused extremely high rates of poverty across the nation. Indigenous peoples led major uprisings, while the elite played the victim of “Indigenous violence” and debated the extreme “Indigenous problem” in the news.

    Many government officials began smear campaigns that scapegoated Indigenous communities and their “unhygienic” ways of life for spreading cholera. According to them, the epidemic was caused by Indigenous people’s lack of sanitary precautions when performing tasks such as preparing food or carrying out funeral procedures. This was all despite the fact that the original sources of cholera—especially within Indigenous communities—was not officially identified.

    In the highlands, Kichwa summer solstice celebrations became the focus of the government’s racist claims. Health officials campaigned to have these public festivals banned forever. Authorities also began shutting down Kichwa cantinas known as chicherías that sold traditional corn beer (aswa in Kichwa or chicha in Spanish).

    The public’s unease about government measures to control the sudden outbreak is also reflected in the news, especially in the form of political cartoons. Enrique “Quique” Vallejos, one of El Norte’s main editorial cartoonists since 1988, critiques the government through sharp humor.

    Ecuadorian cholera epidemic political cartoon
    Cartoonist Quique depicts Imbabura’s Provincial Governor Mauricio Larrea (labeled as gobernación) foolishly attacking cholera by using a whip and telling a healthy-looking street vendor that he did not want to see her or her fish. The woman is drawn to reflect the general attire of a Kichwa woman (note her traditional sandals, which are typically not worn by non-Indigenous Ecuadorans).
    Image courtesy of Diario del Norte
    Ecuadorian cholera epidemic political cartoon

    Another cartoon by Quique titled “Responsibility?...Disinformation?...” which appeared in the May 1, 1991, edition of El Norte. In the cartoon, the following is pictured to criticize the public’s anxiety about cholera and disappointment with the government’s reactions to the epidemic:
    • A person reads the newspaper headline: “There are 100 cases of cholera!”
    • A person listens to a radio announcement: “There are 450 cases [of people] with the malady.”
    • A cartoon version of Dr. Ramiro Silva (Provincial Director of Health of Imbabura), stands with his eyes closed and states, “There are only 10...deaths.”
    • A cartoon version of Dr. Plutarco Naranjo Vargas, Ecuador’s Minister of Health during the 1990s, is pictured on a television screen saying, “Cholera isn’t grave, it’s esdrújula.”

    Image courtesy of Diario del Norte

    Dr. Naranjo Vargas’ statement is a play on words: grave, which in Spanish may mean “serious” or “severe,” is also a grammatical term referring to a word that is pronounced with an accent on the penultimate syllable. Esdrújula is the name for a word, like cholera, that is pronounced with an accent on the third-to-last syllable.

    Whose Ignorance?

    After hearing from flutists about how they felt the cholera epidemic impacted their communities, I followed up with staff at Otavalo’s San Luis Hospital. People recounted their experiences of working in crowded and hectic conditions, but the staff made sure to emphasize that treatment was free and that every cholera patient who made it to the hospital was cured. Scholars have disagreed, however, and published critiques of Ecuador’s health care system and hospital management not long after the epidemic ended.

    When I inquired about how cholera may have impacted Kichwa communities specifically, most of the staff assumed that higher death rates among Kichwa Otavalans were due to ignorance of how to identify cholera symptoms and prevent spreading the bacteria.

    Considering the typical ailments that people in rural, isolated mountain communities may experience, Patricio and I reasoned it was plausible that people may have initially mistaken early cholera symptoms for less severe infections. Many Kichwa Runakuna (Indigenous people) avoided Western doctors due to the discomfort and discrimination that was common throughout the twentieth century. Once it became obvious that one’s illness was more serious, it would have likely been too difficult to move someone to a hospital for help.

    In the 1990s, it was less common for people living in rural Kichwa communities to own cars, so they would have had to rely on public transit or a taxi to go to the nearest hospital. Bus rides were, and often still are, long and bumpy, requiring as much as a forty-five-minute walk up- or downhill to a bus stop, an hour-long wait, and about an hour of travel to town. In 2012, cars and ambulances would not enter many of the communities that Patricio and I visited because the roads were unpaved.

    Taxi and ambulance rides would have been prohibitively expensive for most people, and public landlines, house phones, and mobile phones were not common or easily accessible to call for outside help. Furthermore, many taxi drivers regularly discriminated against healthy Kichwa patrons by denying them service during the 1990s. Finally, many of the anecdotal and scholarly critiques of the hospital management during this time mention that the hospital was frequently so full that even when people were able to make it to the hospital’s steps, they were turned away.

    Kichwa cemetery, Otavalo, Ecuador
    The Kichwa cemetery overlooking downtown Otavalo and Kotama, 2010.
    Photo by Jessie Vallejo

    Fausto Jimbo Amaguaña, a Kichwa politician and the Socialist Council Member for Imbabura at the time, spoke out against the discrimination the government directed at Indigenous communities and festivities. He cited the ways that politicians neglected to provide or maintain adequate necessities (e.g., medical outreach, potable water, sewage and water waste management systems, etc.) to rural and Kichwa towns, despite promises made to provide these services in their election campaigns. Amaguaña also highlighted how grassroots community efforts to combat cholera in various communities were ignored.

    The racial, ethnic, and class conflicts were so intense that a rumor surfaced: cholera may have been planted in water sources serving Kichwa communities as a form of biological warfare and genocide against Indigenous peoples. I have not come across definitive evidence that supports or denies this; however, these rumors speak to the levels of distrust in the society at the time.

    The Northern Technical University’s Assistant Dean of Health Sciences Dr. Carlos Vélez also outlined the government’s incompetence in a newspaper column published in May 1991. He wrote, “It’s not the time to offer rhetorical answers but to take real action.” He blamed a lack of investment in education and public infrastructure. Unfortunately, many communities were left to fight for access to clean water sources from their municipal governments during the next few years. These fights have continued through today.

    Dr. Vélez and Diario del Norte cartoonist Quique both pointed to the government’s poor attempt to educate the public about cholera. Dr. Ramiro Silva, health director of Imbabura province, outlined cholera prevention tips for students in schools, but most of the education efforts for the general population were focused on Spanish-language print sources and media broadcasts. Small boxes of text appeared regularly in newspapers in between columns and advertisements that reiterated general advice: “Hierva el agua, tape los alimentos, evitemos el cólera,”—“Boil water, store foods properly, let’s avoid cholera.”

    Limiting virtually all outreach efforts to these modes excluded a large number of Kichwa speakers in the region, especially those in more remote communities without easy access to newspapers or television. Kichwa language announcements were not even produced until mid-June, two months after the onset and worst spikes in cases of cholera across Imbabura.

    Whether or not the government was intentionally spreading false information, the front page of Diario del Norte’s April 21 paper reported about information being withheld, specifically by Dr. Silva, who prohibited the director of San Luis Hospital from sharing information with the press during the epidemic.

    Throughout the 1990s, government authorities regularly demonstrated ignorance about Kichwa practices related to funeral rites, which Fausto Jimbo Amaguaña addressed in one of his speeches. Contrary to what the authorities claimed, it is not and has not been customary for Kichwa Otavalans to bathe recently deceased corpses in areas that would contaminate water sources. Further, the deceased are buried in cemeteries, and every death is reported to the civil registries.

    One of the most disturbing issues Patricio and I stumbled upon during this research was the number of Kichwa Otavalans whose deaths were likely caused by cholera but were not officially examined by a coroner. As a result, the impact and devastation caused in Kichwa communities has been severely underreported, distorted, and—to an extent—erased through omission.

    Kichwa flute trio
    Mariano Maldonado, Patricio’s father, 2011
    Photo by Daniel Sheehy

    Patricio and I only had time to visit the civil registries of four parishes. In the archives, we focused our attention on the deaths of men over the age of sixteen who likely would have been flutists or learning flute in years of 1991 through 1993. We kept track of the number of adult Kichwa women who passed away, since male flutists often stop playing if their wives or partners pass away. Although we did not record deaths of children, we noticed that in some parishes, there were high numbers of children who died of cholera-related symptoms that could have had a negative impact on the number of young adult flutists in the early 2000s.

    Across the four parishes and during the time span of our study, there were 1,674 total deaths. Approximately ten percent (163 that we could count) of those deaths were Kichwa Otavalan adults who passed away due to cholera or cholera-related symptoms: dehydration, colic, vomiting, headaches, diarrhea, colitis, gastroenteritis, malnutrition, shock, cardiac issues, circulatory system collapse, and anemia (which can make one more susceptible to cholera). Official cholera cases among Kichwa Otavalans accounted for 41 of the 163 deaths (25 percent).

    Curiously, we noticed that “old age” was given as a cause of death for some people who were not elderly, such as one man who was sixty years old and suffering from colic. Even more suspicious were the deaths attributed to alcoholism. We did not include these deaths into our counts, but we realized these should have been recorded after we more clearly understood how government officials justified discrimination by relying on the tired stereotype of “drunk Indians.”

    It was not uncommon for people to die at home from cholera if they did not recognize the symptoms or could not make it to the hospital in time, but the reporting between home deaths of non-Kichwa and Kichwa people is quite distinct.

    For example, in May 1991, Alejandro Ruiz (aged sixty-eight) and his wife Rosa Sarabina (aged seventy) were found dead in their Otavalo home. Their bodies were examined and found to have suffered severe dehydration, so authorities deemed both cases of cholera. The article uses honorific terms of don (sir) and doña (madam) when listing their names. Neither Ruiz nor Sarabina were Indigenous.

    In another article published on June 7, 1991, Simón Brusil from La Esperanza, a rural Kichwa-Karanki community, was found dead in his home at approximately age fifty-two. It is likely he passed away on or around May 28, about ten days earlier and almost a month prior to Hatun Puncha. There were no reports of his body being tested for cholera. Instead, his death was immediately attributed to alcoholism and corn beer, due to his Indigenous heritage. Despite being close in age to Alejandro Ruiz and Rosa Sarabina, no honorifics were used.

    Despite the concerted efforts of the government and media to erase the solstice festivals, they eventually softened their approach due to public pressure. In one article published in Diario del Norte on June 25, 1991, officials urged those celebrating to stay in their homes, even though movement through specific outdoor spaces over time are essential to Kichwa beliefs and Hatun Puncha. Above all, officials still stressed that everyone should avoid consuming Indigenous foods and beverages.

    “Boil the Water Well”: Fermented Beverages and Health

    Chicha, or aswa in Kichwa, is a type of traditional fermented corn beverage of the region. Each family has its own recipe, but in general the flavor is similar to kombucha (fermented tea) flavored with ginger and lemon. This drink is an essential part of solstice festivities and flute playing. When flutists are served aswa in between dancing, they offer some of the drink to their flutes, pouring the beverage into the flutes, swishing it around to humidify the cane, and then serving it to the earth as they empty the flute on the ground.

    The government’s focus on blaming Indigenous people and their production as well as consumption of aswa as a threat to society is perhaps one of the strongest pieces of evidence that ignorance and racism blinded authorities from acting effectively to combat cholera.

    Fermented beverages offer many health benefits if consumed in moderation; one of the primary advantages is that fermentation prohibits the growth of harmful bacteria. Traditionally, aswa is boiled for multiple hours: the exact precautionary measure against cholera advertised in newspapers.

    Patricio’s mother taught me her family’s process and recipe for aswa. First, you harvest corn and separate germinating kernels from the kernels that will be used for planting, soups, and food dishes. This type of kernel is known as hora in Kichwa. The kernels are picked off the cob and left to dry in the sun for a few days or more. Eventually the dried kernels are ground into flour that is added to boiling water.

    The process of making aswa or chicha (corn beer)
    Germinating corn kernels, called hora, are left in the sun to dry over a few days.
    Photo by Jessie Vallejo
    The process of making aswa or chicha (corn beer)
    Once dried, the kernels are ground into flour, called haku.
    Photo by Jessie Vallejo
    The process of making aswa or chicha (corn beer)
    The flour is gradually added to boiling water and cooked for at least two hours.
    Photo by Jessie Vallejo
    The process of making aswa or chicha (corn beer)
    Jessie Vallejo pours the mixture to strain it and leave it in a container for fermentation.
    Photo courtesy of Jessie Vallejo
    The process of making aswa or chicha (corn beer)
    The strained beverage
    Photo by Jessie Vallejo
    The process of making aswa or chicha (corn beer)
    Pineapple rinds are added to the beverage, and it is left to cool and ferment.
    Photo by Jessie Vallejo

    After the beverage boils sufficiently, you pour small amounts of the mixture and strain it into a container. You may add sweeteners to help with the fermentation process (pineapple rinds in this case) and leave it to rest, covered for at least a few hours and as long as several days.

    Drinking aswa likely became a problem if people washed their cups, plates, or hands in contaminated water immediately before serving, drinking, or eating. The fermented beverage wouldn’t have enough time to kill off the bacteria.

    The Cultural Toll of a Public Health Crisis

    When we read about the number of people who fall ill, become injured, or perish during an epidemic or natural disaster, we rarely hear about the consequences these events may have on the cultural aspects we celebrate during heritage months or festivals.

    The cholera epidemic could have had a devastating impact on flutists for a number of reasons. Flutists are commonly asked to serve corn beer throughout Hatun Puncha and other festivities. Attendees will often respond by saying, “upyapashun” (let’s drink together). The phrase obligates the flutist to take a shot of the beverage before serving the person who toasted him. They often end up drinking much more than the average participant. If a cup were to be rinsed out immediately prior to serving corn beer, the odds of contamination would be high.

    Patricio believed the death of a single flutist would have had a severe effect on the tradition in a given community. He estimated that, based on the small size of many Indigenous communities, it is likely that each had only one or two groups of experienced flutists—maybe four to six individuals—prior to and during the epidemic. As most perform in duos, one death meant no accompaniment.

    Players of Otavalan transverse flutes are often competitive and stick with their performance partners, forming rival groups within a community. If even one master flutist fell victim to cholera or stopped playing due to losing his partner, a community could lose up to fifty or one hundred percent of its flutists because a replacement partner could be hard to come by.

    Close to three decades after the epidemic, flute playing has dwindled severely, but due to efforts of musicians like members of Hatun Kotama, there are some communities who are revitalizing this music. Chicherías remain closed, however, and sodas, commercial beers, and liquors have replaced aswa in some communities as the preferred drinks served during festivities. The higher levels of sugar, sodium, and alcohol in these newer drinks have contributed to some contemporary health concerns and worries about traditional foodways being forgotten or abandoned.


    I began writing this article after the October 2019 Indigenous uprisings in Ecuador, which were directly related to many of the same environmental issues and human rights abuses that occurred in the 1990s. Leaders continue making anti-Indigenous comments today.

    Across Ecuador, primary water sources for Indigenous communities continue to be polluted by townships and private corporations. A paint company in Otavalo regularly dumps its refuse in Hatun Yaku, the main river through Kotama. I have watched the waters flow by in various colors (red, blue, white, green) while carrying garbage that comes from the non-Kichwa neighborhoods upstream.

    Kotoma, Otavalo, Ecuador
    Hatun Yaku discolored from red paint flows past Kotama, 2015.
    Photo by Jessie Vallejo
    Kotoma, Otavalo, Ecuador
    Patricio watches Hatun Yaku flow with red paint, 2015.
    Photo by Jessie Vallejo

    In Ecuador and across the Americas, water, land, and the environment are frequently at the center of discussions about Indigenous sovereignty and human rights. Although the names of prominent leaders and activists in Ecuador may not be as well-known among English-speaking audiences as other environmental activists, like Greta Thunberg, I encourage readers to take a moment to read more about the following water protectors and Indigenous activists from Ecuador:

    • Dolores Cacuango (Kichwa Kayampi; feminist and activist)
    • Nina Gualinga (Pueblo Kichwa Sarayaku; Amazon Watch spokesperson)
    • Leonidas Iza Salazar (Pueblo Panzaleo; President of Movimiento Indígena y Campesino de Cotopaxi)
    • Nemonte Nenquimo (Head of Waorani Organization of the Pastaza Province)
    • Jaime Vargas Vargas (Pueblo Achuar; President of CONAIE)

    Similarly, in North America, some of the leading voices pushing for water rights and sustainability include:

    • Madonna Thunder Hawk (Oohenumpa Band of the Cheyenne River Sioux Tribe; Lakota People’s Law Project)
    • Autumn Peltier (Wiikwemkoong; Anishinabek Nation Chief Water Commissioner)
    • Tokata Iron Eyes (Standing Rock Sioux)

    As we commemorate Native American Heritage Month in the United States, it is important that we take the time to learn more about and reflect upon the struggles, celebrate the achievements, and listen to the voices of Native Americans and Indigenous peoples from the American continents. It is critical that we do not relegate thinking about these topics and issues to just one month a year, but that we keep these lessons in mind throughout the months and years to come.

    Jessie M. Vallejo is an assistant professor of music at Cal Poly Pomona. She identifies as Mexican Italian American; she is fluent in Kichwa and is a comadre of the Maldonado family in Kotama. She co-produced the Smithsonian Folkways album ¡Así Kotama! The Flutes of Otavalo, Ecuador, released in 2013.


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