WMU cultural anthropologist examines migration and lupus in Ecuador
By Jerry Malec
Touching saltwater marks at the waterline of a cargo ship in Lake Michigan when she was just nine years old planted the question in the mind of Dr. Ann Miles: Where has this ship been?
“I went to work one morning with my father, a marine surveyor at the Port of Chicago,” said Miles, a professor in Western Michigan University’s Sociology Department. “He boarded the ships right before they were set to sail and inspected the cargo. I remember climbing up the gangway, which was made of rope—it was a well-made rope, but you had to hang on. It was an Italian ship, and I remember seeing on the hull of the ship these salt marks, then putting my hand on the salt marks and wondering: Where has this ship been? At that moment, I realized that there was a lot more about the world I wanted to explore.”
For nearly 20 years now, Miles has been teaching at WMU and spending summers conducting field research in South America. She works primarily in the southern Ecuadorian highland city of Cuenca. Her first and longest project involves documenting the changing lives of families who first came to the city as rural-to-urban migrants, and who then engaged in transnational migration to the United States. More recently, Miles has developed a second area of focus in conducting an ethnographic investigation of the experiences of urban Ecuadorian women suffering from the chronic illness, lupus. The WMU College of Arts and Sciences recognized her scholarly work in 2012, when Miles received the college’s Gender Scholar Award.
The youthful passion for world travel that was sparked by visiting that Italian cargo ship increased while Miles attended the University of Chicago, where she was inspired in a freshman-year 
general education class by an African studies professor trained in anthropology. One day, she saw a flier on campus promoting a volunteer program in Africa titled, “Crossroads Africa,” which was a summer volunteer program for American college students to participate in community development projects. Miles interest was piqued, but she was concerned that she was too working class and not sophisticated enough to become a world-traveling anthropologist.
“I remember showing the flier to my college roommate, Lindsey, and telling her that I really would love to do this program,” Miles said. “Lindsey replied: ‘So why don’t you do it?’ I said, ‘Well Lindsey, people like me don’t do things like that…it is too exciting…it is too big.’ She looked at me and laughed, and said, ‘Of course you can do it if you want to!’ Simple as that encouragement was, it was really formative. I am still in touch with Lindsey and I thank her all the time for telling me that.”
Miles earned the money for the trip by washing dishes in her dorm cafeteria (the worst job she said she ever had) and she also received a generous donation from the Chamber of Commerce in her hometown of Calumet City, Ill. The volunteer experience in Africa forced her to mature rapidly and dispelled the somewhat ivory tower view of anthropology and culture she had developed in the classroom before she planted her feet on the ground. “When I saw the lived reality of poverty in West Africa, there was a disjuncture there for me, and I couldn’t put those two things, academic anthropology and people’s real lives, together very well,” she said.
After completing a bachelor’s degree in anthropology, Miles pursued opportunities that delivered “hands on” practical experiences. She earned a master’s degree in public health at Columbia University, which enabled her to work in international development. After graduating from Columbia, she worked on a health project in Cusco, Peru for one year. She learned Spanish beforehand by taking classes and talking with Puerto Rican and Dominican neighbors in her New York City neighborhood. After she returned to the United States from Peru, Miles worked for nine months at a non-profit agency in Washington D.C. engaged in international health, then attended Syracuse University to earn a Ph.D. “I went in thinking I would always work in development, but I ended up really liking teaching,” said Miles who taught at Ithaca College for two years before coming to WMU.
Miles has visited Cuenca, Ecuador, where she did her original dissertation work 14 times since 1994. She has formed very strong bonds with two Cuencan families—one in particular that became the basis for her 2004 book, “From Cuenca to Queens: An Anthropological Story of Transnational Migration.” The book chronicles a young man’s migration to the United States at the age of 19, and the challenges he experienced adjusting to life in a radically different culture.
“That book kind of wrote itself because I had known the family for 12 years,” she said. “They were very comfortable telling me their story. I wanted to write the book because I thought transnational migration had become very political. One of the goals of this book was to show the structural reasons why people leave, and it’s not an easy story: it is a story that dates back to colonialism and that continues today in global inequality and everyday privilege by elites. The idea was to help people understand migration through the perspective of an individual family—through the lived experiences of it. When you go somewhere to have a better life, you leave a tremendous amount of things behind, and that’s not easy to do.”
As she was finishing up that book, the mother of the family she was profiling suddenly became very ill. After months of doctor’s visits and testing, the mother was diagnosed with lupus, an autoimmune disease in which the body's immune system becomes hyperactive and attacks normal, healthy tissue, resulting in symptoms such as inflammation and damage to joints, skin, kidneys, blood, the heart, and lungs.
“The mother had access to cash, but only a third-grade education,” Miles said. “Lupus is a pretty complicated illness to manage, and I began wondering how she was going to make it. The 
mother’s struggle ultimately led me to my next book, “Living with Lupus: Women and Chronic Illness in Ecuador,” in which I looked at the cultural dynamics of women suffering with lupus to learn how they understand living with a chronic illness in a place where, until recently, people often died from the disease. Today, women with lupus in Ecuador are better able to make this transition to living with a chronic illness—something that might not have been possible from as little as five to ten years ago.”
Miles said survival statistics for lupus victims, even in the U.S. over the last 20 years, have improved greatly. The lupus research also allowed Miles to get a close look at Ecuador’s health care system.
“In the United States, if you’ve got money and you’ve got good health insurance, you get good health care,” she said. “The same is true in Ecuador, but where the systems differ is that poor Ecuadorians also have access to health care. They can walk into any public clinic or hospital and see a doctor for free, and it’s more than likely that certain tests will be free, and some medications. But, the health care system in Ecuador also fails where our health care system fails; it doesn’t do enough for the urban poor, and rural residents, in Ecuador this is often indigenous populations, have little access to care. The public health care system in Ecuador remains challenged and overburdened with too many patients to serve.”
In the classroom, Miles aims to shake things up a bit for her students, spinning off from a quote by the infamous anthropologist, Margaret Mead, who once said, “The job of the anthropologists is to make the familiar strange, and the strange familiar.”
“I strongly believe in critical thinking and in asking hard questions--my mission is to make people want to ask questions about their world and to expand their points of view,” said Miles, recalling a related incident. “Recently, a young student came into to my office after one of my classes and said that she had never thought about the world in this way before. I could not have been happier.”