A Marriage of Medicines
by Owain Johnson, photos ©Keith Dannemiller
A collaborative approach
 Jenny García, in Isla Ratón, credits her predecessors of the past five or six years with establishing friendly relations with the island’s traditional Piaroa and Guajibo practitioners. She speaks enthusiastically about the mutual respect that has developed between the Western medical staff and local shamans.
Patients seek out both kinds of medical care, García explains, and both doctors and shamans respect the others’ abilities. "The shamans also come to us," she says. "Their style of medicine is consultative rather than selfish. If they see a serious case, they will always send the patient to a doctor as well."
Autana’s mayor, Bernabe Arana, himself a Piaroa, says he and other islanders make health choices according to the type of medicine they feel is more appropriate to their individual case or symptoms. "If I have diarrhea, then of course I wouldn’t go to the shaman; I’d go straight to the medical post," Arana explains matter-offactly. "But if it’s an illness that has lasted for three weeks or a month I’d go to a shaman."
García notes that the shamans she knows tend to specialize in ailments caused by the "evil eye," such as psychological problems and headaches or chronic fatigue. Such illnesses are seen as the result of curses, broken taboos or divine displeasure and are treated with prayers, healing spells and purification rituals. But traditional practitioners also employ more practical methods, for example, using medicinal plants and plant infusions to treat conditions ranging from menstrual cramps to skin infections and common wounds. García believes that more serious cases almost always make their way to the medical post with its Western-style care.
Isla Ratón’s residents may be more open to government health workers and Western medicine at least in part because their island, by Amazonian standards, is less remote and has been relatively well served by its contact with outsiders. The island has electricity, and a pump brings fresh water up from underground reserves. There are schools run by the Catholic Salesian Order, and, in addition to García’s small health post, there is a basic medical laboratory. Communications remain difficult, however; radio is the only way to contact the outside world, and motorized canoes are the only transport available.
Two months into her stay here, García is generally positive about the infrastructure and systems in place. "We try to visit an isolated community every week or two," she says. "We carry out check-ups and immunize people, but it’s clearly very limited what we can do in that time. Luckily, the local nurses I’ve seen are excellent."
Indeed, the area’s nurses are a prime example of the cooperative give-and-take approach. They are all members of indigenous communities who have attended courses in "simplified medicine" provided by Venezuela’s Ministry of Health with technical assistance from PAHO. In this way, according to PAHO adviser Prosperi, they learn the basics of Western medicine but also retain their traditional knowledge of indigenous medical techniques.
Graduates of the courses live with their communities in the most remote parts of Autana but are in constant radio contact with the medical post on Isla Ratón. They can ask for advice from or refer patients to García, who in turn can transfer the sickest to a hospital on the mainland. The system generally works well, although the distances involved mean that sick patients sometimes face days of canoe travel to reach the medical post or the mainland hospital if air transport is not available.
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