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

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

doi:10.1186/1746-4269-8-26

Sarah-Lan Mathez-Stiefel, Ina Vandebroek + Show 1 more

Open Access

https://doi.org/10.1186/1746-4269-8-26

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Abstract

BackgroundIt 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.MethodologyOpen-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.ResultsOur 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.ConclusionsThe 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.

Highlights

It is commonly assumed that indigenous medical systems remain strong in developing countries because biomedicine is physically inaccessible or financially not affordable
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
Household health-seeking strategies When faced with illness, almost all participating households from the two study sites first try to cure themselves through self-treatment with natural remedies (18 and 17 of the households from Waca Playa and Pitumarca respectively)

Summary

Introduction

It is commonly assumed that indigenous medical systems remain strong in developing countries because biomedicine is physically inaccessible or financially not affordable. They say that they would rather be treated by modern health care providers, but often traditional services are all they can access or afford”([2], p.24) This quotation summarizes a commonly held assumption among health policy-makers and researchers since the beginning of the 1980s, namely that indigenous medical systems remain strong in developing countries because formal health care is physically inaccessible or not affordable [3,4]. Young and Garro [5], in a comparative study of two Mexican communities that share the same ethnomedical beliefs, observed that inhabitants from the community with better access to biomedicine consulted a physician nearly twice as much as people from the other community The corollary of this assumption is that increased access to biomedicine displaces indigenous medical knowledge and practices through a process of “medical hegemony” [6], a view supported by several authors [7,8,9,10]

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