Abstract
BackgroundsAn intercultural society facilitates equitable and respectful interrelations. Knowing and understanding each other’s sociocultural and linguitic contexts is a prerequisite for an intercultural society. This study explores the concepts of health and illness among healers of indigenous ethnicities in Southern Ecuador.MethodsA qualitative observational study with eleven focus groups was conducted in three locations in Southern Ecuador; a total of 110 participants the Shuar, Kichwa and Mestizo ethnic groups were included. A phenomenological and hermeneutic analysis was conducted.ResultsFourteen main subtopics around of two predefined themes, i.e., “Health” and “Illness” were identified: 1) four bodies, 2) religiosity, 3) health as a good diet, 4) health as god’s blessing or a gift, 5) health as balance/ harmony, 6) health as community and social welfare, 7) health as potentiality or a skill, 8) health as peacefulness, 9) heath as individual will, 10) illness as an imbalance, 11) illness as bad energy, 12) illness as a bad diet, 13) illness as suffering or worry, and 14) illness from God, Nature and People illness. By analysing all the topics’ and subtopics’ narratives, a health and illness definition was developed. The principal evidence for this new framework is the presence of interculturality as a horizontal axis in health. The indigenous perspective of health and illness focus on a balance between 4 bodies: the physical, spiritual, social and mental bodies. Additionally, “good health” is obtained through of the good diet and balanced/harmony.ConclusionIndigenous healers in Southern Ecuador have views on health and illness that differ from the Western biomedical model of care. These different views must be recognized and valued in order to build an intercultural (health) system that empowers both ancestral and modern medical knowledge and healing.
Highlights
In all societies, different views on health, illness and medicine, and on preventive and therapeutic approaches coexist
The indigenous community of southern Ecuador (Saraguros, Cholos cuencanos and Shuar) was chosen because a) this community is a center for indigenous people to meet and participate in traditional ceremonies; b) the community has a council healers who are in regular contact through meetings and telephone; and c) this indigenous community has some degree of power in the region
At the end of this section, we propose a new defition of Health and Illness based on the views that emerged
Summary
Different views on health, illness and medicine, and on preventive and therapeutic approaches coexist. The Western biomedical model of care dominates over other systems and is able to resolve many health problems. The domination of one model can cause difficulties in diagnosis, treatment and Interculturality has been described as “the equitable and respectful interrelations of political, economic, social, cultural, age, linguistic, gender and generational differences established in the space between different cultures (peoples, ethnic groups) to build a just society” [3]. Indigenous communities in Latin America use the term “interculturality” to reinforce their dignity and Bautista-Valarezo et al International Journal for Equity in Health (2020) 19:101 identity, to rebuild their relation town and to achieve mutual recognition [4]. In addition to the recognition of indigenous laws, indigenous languages and bilingual education, a “multicultural health policy” (Plan Nacional Buen Vivir - Sumak Kawsay” [5]) has been implemented
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