A Marriage of Medicines
by Owain Johnson, photos ©Keith Dannemiller
In Venezuela’s Amazon, Western and traditional medical practitioners are learning to work together to meet the health needs of indigenous communities.
An indigenous Venezuelan woman harvests a native Amazonian plant used by traditional healers to treat menstrual cramps. |
It’s a 20-minute journey in a motorized dugout canoe from the Venezuelan mainland to Isla Ratón, a tree-lined island that lies midstream in the Orinoco River, the natural border between Venezuela and Colombia. Even though the island-town is the seat of government for the indigenous-run Venezuelan municipality of Autana, its streets are temporarily deserted while everyone takes shelter from the scorching noontime sun.
Isla Ratón will be home for the next 10 months to Jenny García, a newly qualified Venezuelan doctor who came to the island to fulfill a rural service obligation required of all Venezuelan physicians. García runs the local medical post and is responsible for visiting the dozens of outlying communities in the Autana region. Although she’s been here only a couple of months, she seems right at home, despite the stifling northern Amazonian climate. More important, she has already come to terms with what might be called the local medical competition: the native shamans who have practiced traditional healing on the island in virtually the same manner for centuries.
"We have to respect the popularity of traditional medicine," García explains to a visitor, betraying not a hint of resignation. "The shaman is a very important figure here; we can’t compete with him. What we do instead is alternate traditional medicine with Western medicine. We share information with, and ask for assistance from, traditional medical practitioners.”
García’s attitude reflects a new collaborative approach to traditional medicine that is being promoted by public health advocates, not only in Venezuela, but internationally as well. It parallels a growing interest among people in developed countries in traditional medical practices— from acupuncture to herbal remedies—as "alternative medicine," as well as growing commercial interest in modern pharmacological applications of traditional medicinal plants.
More important, the new approach recognizes that traditional healing practices, based on local cultures and resources and developed over centuries, can be effective and in any case remain the most readily accessible form of health care for millions of people in developing countries.
"Traditional medicine, including collective knowledge about cures, self-care strategies and other traditional practices, is a fundamental part of community resources," says Rocio Rojas, an expert on indigenous health at the Pan American Health Organization (PAHO). "Gaining better knowledge of these practices is essential for developing strategies that will improve access to and quality of health care for indigenous populations."
The Amazon rainforest occupies the heart of South America and is a treasure house of both ethnic and biological diversity. For Venezuela and other governments in the region, providing health care and other basic services to indigenous Amazonian communities is a major challenge that has put relations between Western and traditional medicine on the national political agenda.
In recent years, Venezuelan authorities have drawn up legislation formalizing that relationship in the national health system. Article 122 of the new constitution (which took effect in 2000) recognizes indigenous patients’ right to culturally appropriate treatment and establishes doctors’ duty to take local beliefs and cultural norms into account. A proposed national health law, currently before the National Assembly, expressly states that "indigenous people have the right to use traditional systems of health care and traditional medicine … but this right does not in any way prejudice their right to access state health care systems."
Jorge Luis Prosperi, PAHO adviser on health systems and services in Caracas, believes this new legal framework is one of the most advanced in the Americas. He considers it a "necessary first step toward delivering appropriate services."
The next, and more complicated, step is for Venezuela’s Ministry of Health to understand fully the needs and culture of the indigenous communities it has the responsibility to reach. In some parts of the Amazon, including Isla Ratón, health workers have been working with specific communities for many years and have built up an understanding of the local language, culture and health needs. This has helped them build cordial, cooperative relations with shamans and other local traditional practitioners.
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