Abstract
BackgroundThe new paradigm of intercultural policies focuses on rethinking the common public culture. In Ecuador, the “Buen Vivir” plan seeks to incorporate the ancestral medical knowledge, experience and beliefs of traditional healers into the formal health services. This study explores views on the formal health system from the perspective of the healers belonging to the Kichwa and Shuar ethnicities in the South of Ecuador.MethodsA qualitative study with a phenomenological approach was performed. Focus groups were conducted in three locations in Southern Ecuador. Shuar, Kichwa and Mestizo ethnic groups were included in the research.ResultsEleven focus groups with a total of 110 participants belonging to the Shuar, Kichwa and Mestizo ethnic groups participated in the study. Six themes were created through analysis: 1) conflicts with health professionals, 2) acceptance of traditional healers, 3) respect, 4) work as a team, 5) environment and patient care, and 6) salary and recognition.ConclusionThis study indicated the perceived barriers compromising respectful collaboration between health staff and traditional healers from an indigenous perspective. Power inequalities and a historically unidirectional relationship and, in addition, differences in health beliefs, seem to create misunderstandings regarding each other’s approach when faced with health and disease. However, insight in these barriers can create opportunities towards collaboration, which will have a positive effect on patient confidence in one or both systems and support continuity between traditional healers and the formal health system.
Highlights
The new paradigm of intercultural policies focuses on rethinking the common public culture
Related to a project in which we study the needs and the conditions that compromise intercultural health care in the Kichwa and Shuar communities in Ecuador, we feel the need to explore, from an indigenous perspective, the barriers that compromise the relationship between healers and health staff
We propose the following recommendations to facilitate intercultural collaboration: 1) The government can help with laws or programs that actively involve indigenous healers in a care team, especially in rural health
Summary
The new paradigm of intercultural policies focuses on rethinking the common public culture. In Latin America, interculturality is born from the struggle of indigenous organizations that seek recognition, equality, respect and inclusion, mainly in areas of health and education [1]. This paradigm establishes interculturality as a tool to support the consolidation of a more equitable and participatory social system [2, 3]. The 1998 Constitution defined the Ecuadorian state as multicultural, multiethnic, and which incorporated “traditional medicine” into the National Health System [4] This concept was strengthened in the 2008 “Montecristi” Constitution by creating laws, projects, and plans that regulated indigenous participation with the State [5]. It promotes knowledge exchange between the different health system actors and healers [6]
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