Using home gardens to decipher health and healing in the Andes

Home gardens are a pervasive component of Andean agricultural systems, but have been ignored in anthropological and agronomic research. Recent research in the indigenous community of Saraguro, Ecuador, employed a combination of in-depth interviews, free-listing, videotaped walk-throughs, and mapping to explore the role of home gardens, which are established and controlled by women. Findings reveal that, although gardens offer multiple benefits, they are overwhelmingly devoted to the cultivation of medicinal plants, operating as de facto medicine cabinets that supply women with most of the resources they need to treat family illnesses. Results also suggest that the natural history of home gardens mirrors transformations within the family, and that Saraguro women study the contents of their neighbors' gardens, using this knowledge as a foundation for deciphering the owners' economic and health status. New threats to the sustainability of home gardens threaten the foundation of Saraguro's ethnomedical system and women's authority in the home and community.     

Plants Used for Reproductive Health by Nahua Women in Northern Veracruz,Mexico

Plants Used for Reproductive Health by Nahua Women in Northern Veracruz, Mexico. This paper reports the use of medicinal plants by Nahua women in the state of Veracruz, Mexico. It documents the women’s plant knowledge for reproductive purposes, which includes uses such as conception, pregnancy, birth, contraception, menstruation, post-partum, and general reproductive health. The concept of equilibrium is very important in regaining health among the Nahua; consequently, many of the medicinal plants have this as their primary purpose. The introduction of biomedical clinics and hospitals in the region has had a significant effect on the loss of knowledge about medicinal plants. Additionally, the midwives are not taking any new apprentices and laywomen are not passing on their knowledge to future generations. This generational gap contributes to the loss of knowledge about medicinal plants. This research contributes to the study of indigenous ethnobotany by (a) creating a record of the plant knowledge possessed by indigenous women, (b) giving voice to some of their health concerns, (c) indicating how the introduction of biomedicine has affected their plant use, and (d) providing a framework for understanding how marginal peoples around the world respond to the impact that globalization and change has on their health needs and local ethnobotanical knowledge.     

Indigenous Medicinal Plants in Mexico: the Example of the Nahua (Sierra de Zongolica)

As in most peasant cultures medicinal plants are a very important resource for the Nahua of the Sierra de Zongolica (Mexico). Documentation of the current indigenous medicinal uses of 203 plants in this region was conducted during 18 months of fieldwork. The 816 individual reports documented were divided into nine groups of indigenous uses. The frequency of usage of the individual plants reported was employed in the analysis of the ethnobotanical importance of the respective plants. Plants cited more frequently in a group of indigenous uses are regarded as of greater ethnobotanical importance than those cited only by a few informants. Data on phytochemistry, pharmacology and ethnobotany from the scientific literature were used to evaluate possible biological or pharmacological and toxicological effects of some particularly important plants. For most plants detailed studies on these actions are still lacking, which would allow a conclusive evaluation. This ethnobotanical evaluation forms the basis for such studies which have been started on some plants, and for better understanding their potential as minor economic products of the region. These uses may also give incentives to the conservation of the local biodiversity.     

Disease concepts and treatment by tribal healers of an Amazonian forest culture

Background

The extensive medicinal plant knowledge of Amazonian tribal peoples is widely recognized in the scientific literature and celebrated in popular lore. Despite this broad interest, the ethnomedical systems and knowledge of disease which guide indigenous utilization of botanical diversity for healing remain poorly characterized and understood. No study, to our knowledge, has attempted to directly examine patterns of actual disease recognition and treatment by healers of an Amazonian indigenous culture.

Methods

The establishment of traditional medicine clinics, operated and directed by elder tribal shamans in two remote Trio villages of the Suriname rainforest, presented a unique investigational opportunity. Quantitative analysis of clinic records from both villages permitted examination of diseases treated over a continuous period of four years. Cross-cultural comparative translations were articulated of recorded disease conditions through ethnographic interviews of elder Trio shamans and a comprehensive atlas of indigenous anatomical nomenclature was developed.

Results

20,337 patient visits within the period 2000 to 2004 were analyzed. 75 disease conditions and 127 anatomical terms are presented. Trio concepts of disease and medical practices are broadly examined within the present and historical state of their culture.

Conclusion

The findings of this investigation support the presence of a comprehensive and highly formalized ethnomedical institution within Trio culture with attendant health policy and conservation implications.     

Assessment of Heavy Metals in Pharmacological Important Medicinal Plants Consumed in the Bannu District,Pakistan

This study assesses the contents of heavy metals in the four most commonly used indigenous medicinal plants in the Bannu District, Pakistan. The rapid appraisal approach was used along with semi-structured interviews with elderly people and herbalists for selection of indigenous plants. Heavy metals were determined via flame atomic absorption spectrometer by acid digestion of samples. Four medicinal plants were selected after interviews of 53 local residents and herbalists. Plant and soil samples were obtained for evaluations from a wastewater zone (WWZ) and a clean water zone (CWZ). Indigenous plants from the WWZ showed considerably higher metal contents compared to the CWZ. The trend of metals for indigenous medicinal plants grown in clean water was Mn > K > Na > Zn > Co > Fe > Cu while for wastewater the trend appeared as Co > K > Na > Zn > Fe > Mn > Cu. An alternative significant extent of research is needed to qualify the assessment of the human health insinuations of consumption of indigenous remedies. The heavy metal content of administering herbal medicine should be screened, as formulation and processing of medicine may affect heavy metal contents of the remedies.     

Ethnomedical Syndromes and Treatment-Seeking Behavior among Mayan Refugees in Chiapas,Mexico

This survey investigated the prevalence of ethnomedical syndromes and examined treatments and treatment-seeking in Mayan Guatemalans living in United Nations High Commissioner for Refugee (UNHCR) camps in Chiapas, Mexico. Methods included a rapid ethnographic assessment to refine survey methods and inform the cross-sectional survey, which also examined mental health outcomes; 183 households were approached for interview, representing an estimated 1,546 residents in five refugee camps and 93% of all households. One adult per household (N = 170) was interviewed regarding his or her health; an additional 9 adults in three surveyed households participated and were included in this analysis; of the 179 participants, 95 primary child-care providers also answered a children’s health questionnaire for their children. Results indicated that ethnomedical syndromes were common in this sample, with 59% of adults and 48.4% of children having experienced susto (fright condition) and 34.1% of adults reporting ataques de nervios (nervous attacks); both conditions were significantly associated with symptoms consistent with posttraumatic stress disorder, anxiety and depression and are mental health conditions recognized by the American Psychiatric Association. Combining healthcare provider and indigenous treatments such as physician prescribed medication (65%), medicinal plants (65.7%), and limpias (spiritual cleansings) (40.6%) was reported. Most participants (86%) sought routine medical treatment from UNHCR trained health promoters in their camp. Assessing ethnomedical health is important for informing mental health programs among this population.     

Small ruminant feed systems: perceptions and practices in the transitional zone of Ghana

Background

Medicinal plants are used by 80% of people from developing countries to fulfill their primary health needs, occupying a key position on plant research and medicine. Taking into account that, besides their pharmaceutical importance, these plants contribute greatly to ecosystems' stability, a continuous documentation and preservation of traditional knowledge is a priority. The objective of this study was to organize a database of medicinal plants including their applications and associated procedures in Canhane village, district of Massingir, province of Gaza, Mozambique.

Methods

In order to gather information about indigenous medicinal plants and to maximize the collection of local knowledge, eleven informants were selected taking into account the dimension of the site and the fact that the vegetation presents a great homogeneity. The data were collected through intensive structured and semi-structured interviews performed during field research. Taxonomical identification of plant species was based on field observations and herbarium collections.

Results

A total of 53 plant species have been reported, which were used to treat 50 different human health problems. More than half of the species were used for stomach and intestine related disturbances (including major diseases such as diarrhea and dysentery). Additionally, four species with therapeutic applications were reported for the first time, whose potential can further be exploited. The great majority of the identified species was also associated with beliefs and myths and/or used as food. In general, the community was conscientious and motivated about conservational issues and has adopted measures for the rational use of medicinal plants.

Conclusions

The ethnomedicinal use of plant species was documented in the Canhane village. The local community had a rich ethnobotanical knowledge and adopted sound management conservation practices. The data compiled in this study show the social importance of the surveyed plants being a contribution to the documentation of PGR at the national and regional level.     

Ethnophytotherapeutical research in the high Molise region (Central-Southern Italy)

Background

Interest in ethnomedicine has grown in the last decades, with much research focusing on how local medicinal knowledge can contribute to Western medicine. Researchers have emphasized the divide between practices used by local medical practitioners and Western doctors. However, researchers have also suggested that merging concepts and practices from local medicinal knowledge and Western science have the potential to improve public health and support medical independence of local people. In this article we study the relations between local and Western medicinal knowledge within a native Amazonian population, the Tsimane'.

Methods

We used the following methods: 1) participant observation and semi-structured interviews to gather background information, 2) free-listing and pile-sorting to assess whether Tsimane' integrate local medicinal knowledge and Western medicine at the conceptual level, 3) surveys to assess to what extent Tsimane' combine local medicinal knowledge with Western medicine in actual treatments, and 4) a participatory workshop to assess the willingness of Tsimane' and Western medical specialists to cooperate with each other.

Results

We found that when asked about medical treatments, Tsimane' do not include Western treatments in their lists, however on their daily practices, Tsimane' do use Western treatments in combination with ethnomedical treatments. We also found that Tsimane' healers and Western doctors express willingness to cooperate with each other and to promote synergy between local and Western medical systems.

Conclusion

Our findings contrast with previous research emphasizing the divide between local medical practitioners and Western doctors and suggests that cooperation between both health systems might be possible.     

Gendering Local Knowledge: Medicinal Plant Use and Primary Health Care in the Amazon

Local knowledge is becoming increasingly important in primary health care projects. However, these projects often incorporate local knowledge in an uncritical manner. One area where this is apparent is in the lack of attention paid to the gendered nature of local knowledge. I use one example, women's knowledge and use of medicinal plants in a low-income community in the Brazilian Amazon, to illustrate the links among authority, knowledge, and gender. In this article I argue that policy makers must pay attention to the relationships among authority, gender, and local knowledge and examine how the use of local knowledge in development strategies can affect existing (gendered) power relationships. Women's roles as managers of household health (which includes medicinal plant use) are a source of authority for them. Because of that, the way in which local knowledge is incorporated into primary health care programs can have a significant impact on women's authority.     

Dermatological remedies in the traditional pharmacopoeia of Vulture-Alto Bradano, inland southern Italy

This study documents indigenous medicinal plant utilization, management and the threats affecting them. The study was carried out in Mana Angetu district between January 2003 and December 2004. Ethnobotanical data were collected using semi structured interviews, field observations, preference and direct matrix ranking with traditional medicine practitioners. The ethnomedicinal use of 230 plant species was documented in the study area. Most of the plants (78.7%) were reportedly used to treat human diseases. The most frequently used plant part were roots (33.9%), followed by leaves (25.6%). Most of the medicinal species (90.4%) were collected from the wild. Direct matrix analysis showed that Olea europaea L. Subsp. cuspidata (Wall. ex G. Don) was the most important species followed by Acacia tortilis (Forssk.) Hayne (120) indicating high utility value of these species for the local community. The principal threatening factors reported were deforestation (90%), agricultural expansion (85%) and fire (53%). Documenting the eroding plants and associated indigenous knowledge can be used as a basis for developing management plans for conservation and sustainable use of medicinal plants in the area.     

Tropical Forest Healers and Habitat Preference

Tropical forests represent repositories of medicinal plant species and indigenous ethnomedical knowledge. These biotic and cognitive resources are threatened by forest removal and culture change. It has, however, yet to be demonstrated quantitatively that tropical pharmacopoeias are concentrated in primary as opposed to disturbed forests, nor that folk ethnomedical knowledge is disappearing. I examined these questions by means of a useful species enumeration of 1-hectare primary and secondary forest plots, and a survey of the regional plant pharmacopoeia of the Atlantic forests of Bahia, Brazil, a region that has witnessed significant human and biological modification. Healers demonstrated a strong preference for disturbed over primary forest. Second growth forest plots yielded 2.7 times the number of medicinal species identified in primary forest plots. The regional survey likewise elicited an ethnoflora characterized by herbaceous, weedy, cultivated, and exotic taxa. These results may reflect the availability and intrinsic medicinal value of disturbance species, as well as the increasing rarity of the region’s primary forests. They may also represent the long term outcome of culture change, cognitive erosion, and reformulation of the region’s perceived healing flora.     

Traditional zootherapeutic studies in India: a review

Background

The objective of the present study was to reveal patterns in the treatment of health conditions in a Quechua-speaking community in the Bolivian Andes based on plant use data from traditional healers and patient data from a primary health care (PHC) service, and to demonstrate similarities and differences between the type of illnesses treated with traditional and biomedical health care, respectively.

Methods

A secondary analysis of plant use data from semi-structured interviews with eight healers was conducted and diagnostic data was collected from 324 patients in the community PHC service. Health conditions were ranked according to: (A) the percentage of patients in the PHC service diagnosed with these conditions; and (B) the citation frequency of plant use reports to treat these conditions by healers. Healers were also queried about the payment modalities they offer to their patients.

Results

Plant use reports from healers yielded 1166 responses about 181 medicinal plant species, which are used to treat 67 different health conditions, ranging from general symptoms (e.g. fever and body pain), to more specific ailments, such as arthritis, biliary colic and pneumonia. The results show that treatment offered by traditional medicine overlaps with biomedical health care in the case of respiratory infections, wounds and bruises, fever and biliary colic/cholecystitis. Furthermore, traditional health care appears to be complementary to biomedical health care for chronic illnesses, especially arthritis, and for folk illnesses that are particularly relevant within the local cultural context. Payment from patients to healers included flexible, outcome contingent and non-monetary options.

Conclusion

Traditional medicine in the study area is adaptive because it corresponds well with local patterns of morbidity, health care needs in relation to chronic illnesses, cultural perceptions of health conditions and socio-economic aspects of health care. The quantitative analysis of plant use reports and patient data represents a novel approach to compare the contribution of traditional and biomedical health care to treatment of particular health conditions.     

A new approach to decision making in primary health care

The village health worker has two basic tasks: (1) to prevent health problems; (2) to identify and provide effective management of illness in the village. The village health worker has limited education and the length of basic health training is usually 12 weeks. This training can only be considered appropriate if it enables the village health worker to practise effectively within the cultural, social, economic and educational constraints of the village. How far does the training help this worker to work with other members of the village community to prevent illness? These others include mothers, children, school teachers, village leaders, religious leaders, traditional birth attendants, and traditional healers; training needs to be problem-oriented. The management decisions that have to be made in situations of shortage of resources are complex to analyse. A W.H.O. research project has been undertaken to determine the feasibility of developing and using flow charts to provide alternative and more appropriate methods to help the village health worker to provide optimal management in suboptimal situations. Some examples of these new methods are presented.     

Reasons for Preference of Home Delivery with Traditional Birth Attendants (TBAs) in Rural Bangladesh: A Qualitative Exploration

Background and Objectives

Although Bangladesh has made significant progress in reducing maternal and child mortality in the last decade, childbirth assisted by skilled attendants has not increased as much as expected. An objective of the Bangladesh National Strategy for Maternal Health 2014–2024 is to reduce maternal mortality to 50/100,000 live births. It also aims to increase deliveries with skilled birth attendants to more than 80% which remains a great challenge, especially in rural areas. This study explores the underlying factors for the major reliance on home delivery with Traditional Birth Attendants (TBA) in rural areas of Bangladesh.

Methods

This was a qualitative cross-sectional study. Data were collected between December 2012 and February 2013 in Sunamganj district of Sylhet division and data collection methods included key informant interviews (KII) with stakeholders; formal and informal health service providers and health managers; and in-depth interviews (IDI) with community women to capture a range of information. Key questions were asked of all the study participants to explore the question of why women and their families prefer home delivery by TBA and to identify the factors associated with this practice in the local community.

Results

The study shows that home delivery by TBAs remain the first preference for pregnant women. Poverty is the most frequently cited reason for preferring home delivery with a TBA. Other major reasons include; traditional views, religious fallacy, poor road conditions, limited access of women to decision making in the family, lack of transportation to reach the nearest health facility. Apart from these, community people also prefer home delivery due to lack of knowledge and awareness about service delivery points, fear of increased chance of having a caesarean delivery at hospital, and lack of female doctors in the health care facilities.

Conclusions

The study findings provide us a better understanding of the reasons for preference for home delivery with TBA among this population. These identified factors can inform policy makers and program implementers to adopt socially and culturally appropriate interventions that can improve deliveries with skilled attendants and thus contribute to the reduction of maternal and neonatal mortality and morbidity in rural Bangladesh.     

The Ethnoecology of Dengue Fever

This article employs an ethnoecological analysis to link indigenous, ethnomedical, and Western biomedical ideas of infectious disease causation/ prevention. The ethnoecological analysis is expanded to include the cultural and historical context of political will and community participation in dengue fever control activities in an urban neighborhood in the Dominican Republic. Findings indicate that a key source of dengue fever transmission has been overlooked because it falls between established gender-role boundaries, and that mala union, an explanatory concept central to the failure of previous community-based interventions, emerges from local views of national political history. Data were generated through a neighborhood household survey, key respondent interviews, and participant-observation. [Ethnoecology, Caribbean, gender roles, dengue fever, Dominican Republic]     

Tradisi and Moderen,Village and State: Emergent Tensions in a Sasak Health Quest

On Lombok island, in the province of West Nusa Tenggara, Indonesia, indigenous medicine and biomedicine coexist. Nevertheless, biomedicine, a product of modernity and the development of the state has been superimposed on village life along with other state institutions such as education. In this paper I analyse the processes involved in Sasak villagers' quest for health. Operating within various and sometimes overlapping social fields and conflicting discourses, villagers utilise both local indigenous practices as well as the Indonesian national health system in their quest. Because local or ordinary knowledge is a rich resource for interpretation, I describe the health quest through the participant individuals: family members, neighbours, doctors and nursing personnel involved. The subjectivity of the individual participants contributes to the intricate unfolding of health seeking quests to expose the various tensions which emerge between tradition (tradisi [I]) and modernity (moderen [I]) and between state and village.     

Understanding users' perspectives of barriers to maternal health care use in Maharashtra, India.

This paper uses data collected using in-depth, semi-structured interviews to examine utilization of maternal health care services among two rural and urban populations of Pune and Mumbai in Maharashtra, India. The study aims to identify key social, economic and cultural factors influencing women's decisions to use maternal health care and the places used for child delivery, whilst considering the accessibility of facilities available in the local area. Socioeconomic status was not found to be a barrier to service use when women perceived the benefits of the service to outweigh the cost, and when the service was within reasonable distance of the respondent's place of residence. A large number of women perceived private services to be superior to those provided by the government, although cost often meant they were unable to use them. The provision of services did not ensure that women used them; they had to first perceive them to be beneficial to their health and that of their unborn child. Respondents identified the poor quality of services offered at government institutions to be a motivating factor for delivering at home. Thus further investigation is needed into the quality of services provided by government facilities in the area. A number of respondents who had received antenatal care went on to deliver in the home environment without a trained birth attendant. Further research is needed to establish the types of care provided during an antenatal consultation to establish the feasibility of using these visits to encourage women, particularly those with high-risk pregnancies, to be linked to a trained attendant for delivery.     

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

ABSTRACT: BACKGROUND: It is commonly assumed that indigenous medical systems are 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: Interviews were conducted between June 2006 and December 2008 with 18 households at each study site. Qualitative identification and analysis of households' therapeutic strategies and use of remedies was complemented by quantitative assessment of the incidence of culture-bound illnesses in local ethnobiological inventories. RESULTS: Our findings indicate that the health-seeking behavior of Andean households 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 coexisted with biomedical healthcare that was 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 improved 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.     

Local Perceptions,Cultural Beliefs and Practices That Shape Umbilical Cord Care: A Qualitative Study in Southern Province,Zambia

Background

Global policy regarding optimal umbilical cord care to prevent neonatal illness is an active discussion among researchers and policy makers. In preparation for a large cluster-randomized control trial to measure the impact of 4% chlorhexidine as an umbilical wash versus dry cord care on neonatal mortality in Southern Province, Zambia, we performed a qualitative study to determine local perceptions of cord health and illness and the cultural belief system that shapes umbilical cord care knowledge, attitudes, and practices.

Methods and Findings

This study consisted of 36 focus group discussions with breastfeeding mothers, grandmothers, and traditional birth attendants, and 42 in-depth interviews with key community informants. Semi-structured field guides were used to lead discussions and interviews at urban and rural sites. A wide variation in knowledge, beliefs, and practices surrounding cord care was discovered. For home deliveries, cords were cut with non-sterile razor blades or local grass. Cord applications included drying agents (e.g., charcoal, baby powder, dust), lubricating agents (e.g., Vaseline, cooking oil, used motor oil) and agents intended for medicinal/protective purposes (e.g., breast milk, cow dung, chicken feces). Concerns regarding the length of time until cord detachment were universally expressed. Blood clots in the umbilical cord, bulongo-longo, were perceived to foreshadow neonatal illness. Management of bulongo-longo or infected umbilical cords included multiple traditional remedies and treatment at government health centers.

Conclusion

Umbilical cord care practices and beliefs were diverse. Dry cord care, as recommended by the World Health Organization at the time of the study, is not widely practiced in Southern Province, Zambia. A cultural health systems model that depicts all stakeholders is proposed as an approach for policy makers and program implementers to work synergistically with existing cultural beliefs and practices in order to maximize effectiveness of evidence-based interventions.