Skip to main content
Top
Published in: Journal of Ethnobiology and Ethnomedicine 1/2012

Open Access 01-12-2012 | Research

Can Andean medicine coexist with biomedical healthcare? A comparison of two rural communities in Peru and Bolivia

Authors: Sarah-Lan Mathez-Stiefel, Ina Vandebroek, Stephan Rist

Published in: Journal of Ethnobiology and Ethnomedicine | Issue 1/2012

Login to get access

Abstract

Background

It is commonly assumed that indigenous medical systems remain strong in developing countries because biomedicine is physically inaccessible or financially not affordable. This paper compares the health-seeking behavior of households from rural Andean communities at a Peruvian and a Bolivian study site. The main research question was whether the increased presence of biomedicine led to a displacement of Andean indigenous medical practices or to coexistence of the two healing traditions.

Methodology

Open-ended interviews and free listing exercises were conducted between June 2006 and December 2008 with 18 households at each study site. Qualitative identification of households’ therapeutic strategies and use of remedies was carried out by means of content analysis of interview transcriptions and inductive interference. Furthermore, a quantitative assessment of the incidence of culture-bound illnesses in local ethnobiological inventories was performed.

Results

Our findings indicate that the health-seeking behavior of the Andean households in this study is independent of the degree of availability of biomedical facilities in terms of quality of services provided, physical accessibility, and financial affordability, except for specific practices such as childbirth. Preference for natural remedies over pharmaceuticals coexists with biomedical healthcare that is both accessible and affordable. Furthermore, our results show that greater access to biomedicine does not lead to less prevalence of Andean indigenous medical knowledge, as represented by the levels of knowledge about culture-bound illnesses.

Conclusions

The take-home lesson for health policy-makers from this study is that the main obstacle to use of biomedicine in resource-poor rural areas might not be infrastructural or economic alone. Rather, it may lie in lack of sufficient recognition by biomedical practitioners of the value and importance of indigenous medical systems. We propose that the implementation of health care in indigenous communities be designed as a process of joint development of complementary knowledge and practices from indigenous and biomedical health traditions.
Appendix
Available only for authorised users
Literature
1.
go back to reference WHO: Traditional Medicine, in Fact Sheet N°134. 2008, Geneva: World Health Organization WHO: Traditional Medicine, in Fact Sheet N°134. 2008, Geneva: World Health Organization
2.
go back to reference Dodd R, Munck L: Dying for Change: Poor People's Experience of Health and Ill-health. 2001, Geneva: World Health Organization, 38- Dodd R, Munck L: Dying for Change: Poor People's Experience of Health and Ill-health. 2001, Geneva: World Health Organization, 38-
3.
go back to reference Bussmann RW, Sharon D: Traditional medicinal plant use in Northern Peru: tracking two thousand years of healing culture. Journal of Ethnobiology and Ethnomedicine. 2006, 2 (47): 18- Bussmann RW, Sharon D: Traditional medicinal plant use in Northern Peru: tracking two thousand years of healing culture. Journal of Ethnobiology and Ethnomedicine. 2006, 2 (47): 18-
4.
go back to reference Quinlan MB, Quinlan RJ: Modernization and medicinal plant knowledge in a Caribbean horticultural village. Medical Anthropology Quarterly. 2007, 21 (2): 169-192. 10.1525/maq.2007.21.2.169.PubMedCrossRef Quinlan MB, Quinlan RJ: Modernization and medicinal plant knowledge in a Caribbean horticultural village. Medical Anthropology Quarterly. 2007, 21 (2): 169-192. 10.1525/maq.2007.21.2.169.PubMedCrossRef
5.
go back to reference Young JC, Garro LY: Variation in the choice of treatment in two Mexican communities. Social Science & Medicine. 1982, 16 (11): 1543-1465. Young JC, Garro LY: Variation in the choice of treatment in two Mexican communities. Social Science & Medicine. 1982, 16 (11): 1543-1465.
6.
go back to reference Elling RH: Political economy, cultural hegemony, and mixes of traditional and modern medicine. Social Science & Medicine. 1981, 15A: 89-99. Elling RH: Political economy, cultural hegemony, and mixes of traditional and modern medicine. Social Science & Medicine. 1981, 15A: 89-99.
7.
go back to reference Hanazaki N, et al: Diversity of plant uses in two Caiçara communities from the Atlantic Forest coast. Brazil. Biodiversity and Conservation. 2000, 9: 597-615. 10.1023/A:1008920301824.CrossRef Hanazaki N, et al: Diversity of plant uses in two Caiçara communities from the Atlantic Forest coast. Brazil. Biodiversity and Conservation. 2000, 9: 597-615. 10.1023/A:1008920301824.CrossRef
8.
go back to reference Caniago I, Siebert SF: Medicinal plant ecology, knowledge and conservation in Kalimantan, Indonesia. Econ Bot. 1998, 52 (3): 229-250. 10.1007/BF02862141.CrossRef Caniago I, Siebert SF: Medicinal plant ecology, knowledge and conservation in Kalimantan, Indonesia. Econ Bot. 1998, 52 (3): 229-250. 10.1007/BF02862141.CrossRef
9.
go back to reference Ngokwey N: Home remedies and doctors' remedies in Feira (Brazil). Social Science & Medicine. 1995, 40 (8): 1141-10.1016/0277-9536(94)00241-K.CrossRef Ngokwey N: Home remedies and doctors' remedies in Feira (Brazil). Social Science & Medicine. 1995, 40 (8): 1141-10.1016/0277-9536(94)00241-K.CrossRef
10.
go back to reference Madge C: Therapeutic landscapes of the Jola, The Gambia, West Africa. Health & Place. 1998, 4 (4): 293-311. 10.1016/S1353-8292(98)00033-1.CrossRef Madge C: Therapeutic landscapes of the Jola, The Gambia, West Africa. Health & Place. 1998, 4 (4): 293-311. 10.1016/S1353-8292(98)00033-1.CrossRef
11.
go back to reference Baer HA: Contributions to a critical analysis of medical pluralism. An examination of the work of Libbet Crandon-Malamud. Medical Pluralism in the Andes. Edited by: Koss-Chioino JD, Leatherman T, Greenway C. 2003, London and New York: Routledge, 42-60. Baer HA: Contributions to a critical analysis of medical pluralism. An examination of the work of Libbet Crandon-Malamud. Medical Pluralism in the Andes. Edited by: Koss-Chioino JD, Leatherman T, Greenway C. 2003, London and New York: Routledge, 42-60.
12.
go back to reference Chrisman NJ, Kleinman A: Popular health care, social networks, and cultural meanings: the orientation of medical anthropology. Handbook of Health, Health Care, and Health Professions. Edited by: Mechanic D. 1983, New York: Free Press, 569-590. Chrisman NJ, Kleinman A: Popular health care, social networks, and cultural meanings: the orientation of medical anthropology. Handbook of Health, Health Care, and Health Professions. Edited by: Mechanic D. 1983, New York: Free Press, 569-590.
13.
go back to reference Vandebroek I, et al: Use of medicinal plants and pharmaceuticals by indigenous communities in the Bolivian Andes and Amazon. Bulletin of the World Health Organization. 2004, 82 (4): 243-250.PubMedCentralPubMed Vandebroek I, et al: Use of medicinal plants and pharmaceuticals by indigenous communities in the Bolivian Andes and Amazon. Bulletin of the World Health Organization. 2004, 82 (4): 243-250.PubMedCentralPubMed
14.
go back to reference Crandon-Malamud L: From the Fat of Our Souls. Social Change, Political Process, and Medical Pluralism in Bolivia. 1991, Berkeley: University of California Press, 267- Crandon-Malamud L: From the Fat of Our Souls. Social Change, Political Process, and Medical Pluralism in Bolivia. 1991, Berkeley: University of California Press, 267-
15.
go back to reference Press I: Urban illness: physicians, curers and dual use in Bogota. J Heal Soc Behav. 1969, 10 (3): 209-10.2307/2948391.CrossRef Press I: Urban illness: physicians, curers and dual use in Bogota. J Heal Soc Behav. 1969, 10 (3): 209-10.2307/2948391.CrossRef
16.
go back to reference Nall FC, Speilberg J: Social and Cultural Factors in the Responses of Mexican-Americans to Medical Treatment. J Heal Soc Behav. 1967, 8 (4): 299-10.2307/2948424.CrossRef Nall FC, Speilberg J: Social and Cultural Factors in the Responses of Mexican-Americans to Medical Treatment. J Heal Soc Behav. 1967, 8 (4): 299-10.2307/2948424.CrossRef
17.
go back to reference Giovannini P, et al: Do pharmaceuticals displace local knowledge and use of medicinal plants? Estimates from a cross-sectional study in a rural indigenous community, Mexico. Social Science & Medicine. 2011, 72: 928-936. 10.1016/j.socscimed.2011.01.007.CrossRef Giovannini P, et al: Do pharmaceuticals displace local knowledge and use of medicinal plants? Estimates from a cross-sectional study in a rural indigenous community, Mexico. Social Science & Medicine. 2011, 72: 928-936. 10.1016/j.socscimed.2011.01.007.CrossRef
18.
go back to reference Giovannini P, Heinrich M: Xki yoma' (our medicine) and xki tienda (patent medicine) - Interface between traditional and modern medicine among the Mazatecs of Oaxaca, Mexico. J Ethnopharmacol. 2009, 121 (3): 383-399. 10.1016/j.jep.2008.11.003.PubMedCrossRef Giovannini P, Heinrich M: Xki yoma' (our medicine) and xki tienda (patent medicine) - Interface between traditional and modern medicine among the Mazatecs of Oaxaca, Mexico. J Ethnopharmacol. 2009, 121 (3): 383-399. 10.1016/j.jep.2008.11.003.PubMedCrossRef
19.
go back to reference Mignone J, et al: Best practices in intercultural health: five case studies in Latin America. Journal of Ethnobiology and Ethnomedicine. 2007, 3 (31): 11- Mignone J, et al: Best practices in intercultural health: five case studies in Latin America. Journal of Ethnobiology and Ethnomedicine. 2007, 3 (31): 11-
20.
go back to reference Etkin NL, Ross PJ, Muazzamu I: The indigenization of pharmaceuticals: therapeutic transitions in rural Hausaland. Social Science & Medicine. 1990, 30 (8): 919-928. 10.1016/0277-9536(90)90220-M.CrossRef Etkin NL, Ross PJ, Muazzamu I: The indigenization of pharmaceuticals: therapeutic transitions in rural Hausaland. Social Science & Medicine. 1990, 30 (8): 919-928. 10.1016/0277-9536(90)90220-M.CrossRef
21.
go back to reference Hausmann Muela S, et al: Medical syncretism with reference to malaria in a Tanzanian community. Social Science & Medicine. 2002, 55 (3): 403-413. 10.1016/S0277-9536(01)00179-4.CrossRef Hausmann Muela S, et al: Medical syncretism with reference to malaria in a Tanzanian community. Social Science & Medicine. 2002, 55 (3): 403-413. 10.1016/S0277-9536(01)00179-4.CrossRef
22.
go back to reference Cosminsky S, Scrimshaw M: Medical pluralism in a Guatemalan plantation. Social Science & Medicine. 1980, 14: 267-278. Cosminsky S, Scrimshaw M: Medical pluralism in a Guatemalan plantation. Social Science & Medicine. 1980, 14: 267-278.
23.
go back to reference Pool R, Geissler W: Medical Anthropology. Understanding Public Health. 2005, London: Open University Press, 172- Pool R, Geissler W: Medical Anthropology. Understanding Public Health. 2005, London: Open University Press, 172-
24.
go back to reference Calvet-Mir L, Reyes-García V, Tanner S: Is there a divide between local medicinal knowledge and Western medicine? A case study among native Amazonians in Bolivia. Journal of Ethnobiology and Ethnomedicine. 2008, 4 (18): 11- Calvet-Mir L, Reyes-García V, Tanner S: Is there a divide between local medicinal knowledge and Western medicine? A case study among native Amazonians in Bolivia. Journal of Ethnobiology and Ethnomedicine. 2008, 4 (18): 11-
25.
go back to reference Bastien JW: Cross-cultural communication between doctors and peasants in Bolivia. Social Science & Medicine. 1987, 24 (12): 1109-1118. 10.1016/0277-9536(87)90025-6.CrossRef Bastien JW: Cross-cultural communication between doctors and peasants in Bolivia. Social Science & Medicine. 1987, 24 (12): 1109-1118. 10.1016/0277-9536(87)90025-6.CrossRef
26.
go back to reference Bussmann RW, Sharon D, Lopez A: Blending traditional and Western medicine: medicinal plant use among patients at Clinica Anticona in El Porvenir, Peru. Ethnobotany Research & Applications. 2007, 5: 185-199. Bussmann RW, Sharon D, Lopez A: Blending traditional and Western medicine: medicinal plant use among patients at Clinica Anticona in El Porvenir, Peru. Ethnobotany Research & Applications. 2007, 5: 185-199.
27.
go back to reference Shukla S, Gardner J: Local knowledge in community-based approaches to medicinal plant conservation: lessons from India. Journal of Ethnobiology and Ethnomedicine. 2006, 2 (20): 9- Shukla S, Gardner J: Local knowledge in community-based approaches to medicinal plant conservation: lessons from India. Journal of Ethnobiology and Ethnomedicine. 2006, 2 (20): 9-
28.
go back to reference Vandebroek I, et al: Comparison of health conditions treated with traditional and biomedical health care in a Quechua community in rural Bolivia. Journal of Ethnobiology and Ethnomedicine. 2008, 4 (1): 12-10.1186/1746-4269-4-12.CrossRef Vandebroek I, et al: Comparison of health conditions treated with traditional and biomedical health care in a Quechua community in rural Bolivia. Journal of Ethnobiology and Ethnomedicine. 2008, 4 (1): 12-10.1186/1746-4269-4-12.CrossRef
29.
go back to reference Saethre EJ: Conflicting traditions, concurrent treatment: medical pluralism in remote aboriginal Australia. Oceania. 2007, 77 (1): 95-110.CrossRef Saethre EJ: Conflicting traditions, concurrent treatment: medical pluralism in remote aboriginal Australia. Oceania. 2007, 77 (1): 95-110.CrossRef
30.
go back to reference Lee RPL: Comparative studies of health care systems. Social Science & Medicine. 1982, 16: 629-642. 10.1016/0277-9536(82)90453-1.CrossRef Lee RPL: Comparative studies of health care systems. Social Science & Medicine. 1982, 16: 629-642. 10.1016/0277-9536(82)90453-1.CrossRef
31.
go back to reference Miles A, Leatherman T: Perspectives on medical anthropology in the Andes. Medical Pluralism in the Andes. Edited by: Koss-Chioino JD, Leatherman T, Greenway C. 2003, London and New York: Routledge, 3-15. Miles A, Leatherman T: Perspectives on medical anthropology in the Andes. Medical Pluralism in the Andes. Edited by: Koss-Chioino JD, Leatherman T, Greenway C. 2003, London and New York: Routledge, 3-15.
32.
go back to reference AGRUCO, ETCAndes, and EcoCiencia: Revalorización y conservación de la diversidad biocultural andina: Experiencias y aprendizajes del programa regional BioAndes. 2011, Cochabamba: AGRUCO, 101- AGRUCO, ETCAndes, and EcoCiencia: Revalorización y conservación de la diversidad biocultural andina: Experiencias y aprendizajes del programa regional BioAndes. 2011, Cochabamba: AGRUCO, 101-
33.
go back to reference Stöckli B, Wiesmann U, Lys J-A: A Guide for Transboundary Research Partnerships: 11 Principles. 2012, Bern: Swiss Commission for Research Partnerships with Developing Countries (KFPE), 30- Stöckli B, Wiesmann U, Lys J-A: A Guide for Transboundary Research Partnerships: 11 Principles. 2012, Bern: Swiss Commission for Research Partnerships with Developing Countries (KFPE), 30-
34.
go back to reference Olson DM, et al: Terrestrial ecoregions of the World: A new map of life on earth. BioScience. 2001, 51 (11): 933-938. 10.1641/0006-3568(2001)051[0933:TEOTWA]2.0.CO;2.CrossRef Olson DM, et al: Terrestrial ecoregions of the World: A new map of life on earth. BioScience. 2001, 51 (11): 933-938. 10.1641/0006-3568(2001)051[0933:TEOTWA]2.0.CO;2.CrossRef
36.
go back to reference AGRUCO: Diagnostico participativo comunitario del "Municipio de Tapacarí" y las zonas bioculturales de la Subcentral de Waca Playa y comunidad Tallija-Confital". 2006, Cochabamba: AGRUCO, 227- AGRUCO: Diagnostico participativo comunitario del "Municipio de Tapacarí" y las zonas bioculturales de la Subcentral de Waca Playa y comunidad Tallija-Confital". 2006, Cochabamba: AGRUCO, 227-
37.
go back to reference INC: Diagnostico Situacional y Socioeconómico del Distrito de Pitumarca – Canchis. 2008, Cusco: INC, 85- INC: Diagnostico Situacional y Socioeconómico del Distrito de Pitumarca – Canchis. 2008, Cusco: INC, 85-
38.
go back to reference Carey JW: Distribution of culture-bound illnesses in the Southern Peruvian Andes. Medical Anthropology Quarterly. 1993, 7 (3): 281-300. 10.1525/maq.1993.7.3.02a00030.CrossRef Carey JW: Distribution of culture-bound illnesses in the Southern Peruvian Andes. Medical Anthropology Quarterly. 1993, 7 (3): 281-300. 10.1525/maq.1993.7.3.02a00030.CrossRef
39.
go back to reference Strauss AL, Corbin JM: Grounded Theory in Practice. 1997, Sage Publications: Thousand Oaks Strauss AL, Corbin JM: Grounded Theory in Practice. 1997, Sage Publications: Thousand Oaks
40.
go back to reference Ruiz Ruiz J: Sociological discourse analysis: Methods and logic. Forum Qualitative Sozialforschung/Forum. Qualitative Social Research. 2009, 10 (2): 1-30. Ruiz Ruiz J: Sociological discourse analysis: Methods and logic. Forum Qualitative Sozialforschung/Forum. Qualitative Social Research. 2009, 10 (2): 1-30.
41.
go back to reference Greenway C: Hungry earth and vengeful stars: soul loss and identity in the Peruvian Andes. Social Science & Medicine. 1998, 47 (8): 993-1004. 10.1016/S0277-9536(98)00163-4.CrossRef Greenway C: Hungry earth and vengeful stars: soul loss and identity in the Peruvian Andes. Social Science & Medicine. 1998, 47 (8): 993-1004. 10.1016/S0277-9536(98)00163-4.CrossRef
42.
go back to reference Foster GM: Medical anthropology and international health planning. Social Science & Medicine. 1977, 11: 527-CrossRef Foster GM: Medical anthropology and international health planning. Social Science & Medicine. 1977, 11: 527-CrossRef
43.
go back to reference Aguiló F: Enfermedad y salud según la concepción Aymaro-Quechua. 1985, Sucre: Qori Llama, 232-3 Aguiló F: Enfermedad y salud según la concepción Aymaro-Quechua. 1985, Sucre: Qori Llama, 232-3
44.
45.
go back to reference Crandon L: Changing times and changing symptoms. The effects of modernization on mestizo medicine in rural Bolivia (the case of two mestizo sisters). Medical Anthropology. 1989, 10 (4): 255-264. 10.1080/01459740.1989.9965972.PubMedCrossRef Crandon L: Changing times and changing symptoms. The effects of modernization on mestizo medicine in rural Bolivia (the case of two mestizo sisters). Medical Anthropology. 1989, 10 (4): 255-264. 10.1080/01459740.1989.9965972.PubMedCrossRef
46.
go back to reference Staiano KV: Alternative therapeutic systems in Belize - A semiotic framework. Social Science & Medicine. 1981, 15 (3): 317-332. 10.1016/0271-7123(81)90061-4. Staiano KV: Alternative therapeutic systems in Belize - A semiotic framework. Social Science & Medicine. 1981, 15 (3): 317-332. 10.1016/0271-7123(81)90061-4.
47.
go back to reference Waldstein A: Mexican migrant ethnopharmacology: pharmacopoeia, classification of medicines and explanations of efficacy. J Ethnopharmacol. 2006, 108 (2): 299-10.1016/j.jep.2006.07.011.PubMedCrossRef Waldstein A: Mexican migrant ethnopharmacology: pharmacopoeia, classification of medicines and explanations of efficacy. J Ethnopharmacol. 2006, 108 (2): 299-10.1016/j.jep.2006.07.011.PubMedCrossRef
48.
go back to reference Mathez-Stiefel S-L, Gianella Malca C, Rist S: Abriendo nuevas perspectivas para la juventud campesina de los Andes a través de la valorización de productos de la agrobiodiversidad. LEISA Revista de Agroecología. 2011, 21 (1): 34-38. Mathez-Stiefel S-L, Gianella Malca C, Rist S: Abriendo nuevas perspectivas para la juventud campesina de los Andes a través de la valorización de productos de la agrobiodiversidad. LEISA Revista de Agroecología. 2011, 21 (1): 34-38.
49.
go back to reference Rist S, Delgado F, Wiesmann U: Social learning processes and sustainable development: the emergence and transformation of an indigenous land use system in the Andes of Bolivia. Social Learning Towards a Sustainable World. Edited by: Wals A. 2007, Wageningen: Wageningen Academic Publishers, 229-244. Rist S, Delgado F, Wiesmann U: Social learning processes and sustainable development: the emergence and transformation of an indigenous land use system in the Andes of Bolivia. Social Learning Towards a Sustainable World. Edited by: Wals A. 2007, Wageningen: Wageningen Academic Publishers, 229-244.
Metadata
Title
Can Andean medicine coexist with biomedical healthcare? A comparison of two rural communities in Peru and Bolivia
Authors
Sarah-Lan Mathez-Stiefel
Ina Vandebroek
Stephan Rist
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Ethnobiology and Ethnomedicine / Issue 1/2012
Electronic ISSN: 1746-4269
DOI
https://doi.org/10.1186/1746-4269-8-26

Other articles of this Issue 1/2012

Journal of Ethnobiology and Ethnomedicine 1/2012 Go to the issue