‘Ana’ photographs by Jessica Alva Piedra

On September 9, 2019, the Peruvian psychologist Ana Estrada posted on her blog ‘Ana busca la muerte digna’ (Ana seeks a dignified death) one of the many photographs Jessica Alva Piedra took of her. This first photo, in black and white, captures a bathing ritual involving the arms, hands, and partial torsos of two people: Estrada, lying in bed, and a nurse washing Estrada’s left hand over a metal bowl filled with water. Estrada’s torso is naked, exposing the floral tattoos on her right arm and the opening of her gastrostomy – which is as much the focus of the photograph as is the hand being washed. In the personal essay accompanying the photo, Estrada recounts that, after needing a live-in assistant for years, since 2016 (following months in intensive- and intermediate-care units) she has required the help of 4-5 nurses 24/7. Diagnosed at 12 years of age with polymyositis, a degenerative autoimmune disease that paralyzed most of her body, Estrada started her blog in 2019 to advocate for the right to die. The essay goes on to relate how much Estrada misses the morning rituals of showering and looking at herself in the mirror, which one may take for granted – as now all her bathing happens in bed, assisted by nurses, and she can no longer raise her head to the mirror. In this context, Estrada underscores the importance of photography as a powerful tool in her life, allowing her to see herself: ‘I zoom in on every pore my hands cannot touch, I’m surprised discovering parts of my body I cannot see, and I’m fascinated by this new ritual of contemplating the paths of my wounds. I find beauty where there was pain, and I can now see a caring and attentive hand holding me so I can enjoy the water’ (translated from the Spanish, as the other quotes).

With her pictures of Estrada, Jessica Alva Piedra made a photobook titled Ana (like Estrada’s blog). In the preface to this visual project, Alva Piedra describes the aim of their collaboration as ‘to construct a visual narrative for two’, in which her photographer’s gaze is present, but also Estrada’s gaze and will. Alva Piedra adds that ‘freedom is perhaps the cornerstone of this project’ and explains that, despite the limits imposed by Estrada’s body, she still claims her right to be free within it: ‘free to express herself through her body, free to show herself through images, free to enjoy desire and seek that gaze that often eludes her’. Thus, some of the images in the photobook – extreme closeups and nudes of Estrada laughing in bed, facing the camera, or surrounded by foliage as if in a Frida Kahlo painting – challenge the stereotype of a woman with disability as supposedly asexual or devoid of desire. In her blog, Estrada points out that, ‘when a woman with physical limitations and two strange devices on her body exposes herself, she can provoke criticism, discomfort, and generate censure and rejection’. What began as a self-affirming project between two collaborators has, nonetheless, grown much larger: the photos they produced started appearing in media and social-media outlets around the world, including the newsletters of interest groups such as Derecho a Morir Dignamente and the Due Process of Law Foundation. It is also a photo taken by Alva Piedra that now features on Estrada’s Wikipedia page: a headshot in which Estrada smiles to the camera, wearing a black tank top that leaves her tracheostomy and shoulder tattoos visible. In 2021, Lima’s Eleventh Constitutional Court granted Estrada’s request that, if she chose to pursue an assisted death, it would not be considered a crime – and that ruling was ratified by Peru’s Supreme Court in 2022. On April 21, 2024, Estrada became the first person in Peru to die by legal euthanasia. Even though no photos are explicitly cited in Estrada’s legal proceedings, her blog is – and, as an integral part of the blog, Alva Piedra’s photographs remain a testimony to Estrada’s reclaiming her agency over her own body.