Hospitals have a 500-year history in the Americas but have received limited study. This is particularly true of Latin American hospitals operating during the Spanish Colonial Period. This work seeks to redress this problem by examining the Hospital de la Real Caridad, an 18th century hospital for Indigenous people, in the colonial city of Riobamba, Ecuador. Combining existing published sources, archival evidence, and archaeology, this work examines the Hospital de la Real Caridad’s role beyond medical provision: namely its social role. Erving Goffman’s study of the “total institution” provides the theoretical framework used to examine the social context in which the hospital operated. Total institutions isolated their inmates, strip them of their identity, and model new behaviour. Using documentary and archaeological evidence, the Hospital de la Real Caridad is shown to engage in this process. Through the use of surveillance, religious teaching, colonial medicine and majolicas, a glazed ceramic associated with the colonial elite, Indigenous people were isolated and modelled behaviour supporting the colonial system. Archaeological testing at the Hospital de la Real Caridad resulted in the recovery of large quantities of brick and carved stone; materials associated with elite structures which demarcated the hospital from the rest of colonial society. Separation of artifacts associated with Indigenous women from those used in preparing drugs confirms the trepidation felt towards female Indigenous medical practitioners by the state.. Majolica recovery rates consistent with mestizo assemblages in the Andes are interpreted to symbolically portray the ideal behaviour the institution sought to model for its patients. Indigenous people did not experience the institutional process universally when engaging with the medical system and were able to use it to their own advantage. A series of applications were made for release from tribute labour, owed to the Crown by Indigenous people, for medical reasons. Changes in the application process are interpreted as an attempt by the state to curb a abuse of medical release from tribute labour. Hospitals were fundamental components of the urban landscape, settings where changes in medical philosophy were implemented, and unique locations where colonial processes were experienced by Indigenous people.
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