"Here It is Not About Learning Evidence-Based Medicine; It is About Medicine Based on that Which is": Pragmatic Approaches to Liberation Medicine.

Abstract

This article explores the potential of liberation medicine through an ethnographic account of a primary healthcare van operating in Cañada Real, an informal settlement on the margins of Madrid. Drawing from 10 years of clinical experience and anthropological inquiry, the article offers a situated analysis of "context-based medicine"; a mode of practice grounded in relationality, trust, and responsiveness to structural violence. Engaging with María Lugones' concept of pilgrimages and Hannah Arendt's idea of power with, the paper examines how this interstitial program disrupts dominant rationales within the healthcare system (gatekeeping, managerialism, and evidence-based medicine) by fostering collective, care-based alternatives. Through fieldwork and reflective practice, the author argues that the van's displacement (which is physical, institutional, and professional) creates a liminal space where emancipatory practices can emerge. While not a utopian model, the van provides a lens to imagine how clinical work might transgress spatial and institutional boundaries to align more closely with the political and ethical stakes of care.