In El Alto, Bolivia, the communicative and affective capacities of local neighborhood women are often valorized as strategic sites for circulating governmental discourses across ethnolinguistic boundaries. Nowhere is this more evident than in the domain of public health. As this article explores, municipal health projects in El Alto increasingly cast neighborhood women in para‐governmental roles, hoping to tap into the networks of community‐based belonging they create and maintain through their everyday communicative labors. By focusing on the work performed by an often‐overlooked genre of gendered discourse—comadreando, or “co‐mothering” speech—this article calls attention to the concrete semiotic forms that mediate this kind of local governmentality. As I argue, everyday events of comadreando enact rituals of commiseration that build mutual trust and sympathy (confianza) between women and the households they head. But when figured in public health projects, they become vehicles of a broader politics of commiseration, one that aims to forge reliable channels of trust, goodwill, and sympathetic understanding between neighborhood actors and the state. However, as I also argue, the mobilization of such forms can open up such governmental strategies to unanticipated reappropriations, as the affective and communicative labors of women are diverted to more ambiguous ends.