During the summers of 2012 and 2013, Dr. Kathryn Oths led a team of anthropology graduates into the Andean highlands of Northern Peru, to investigate medical treatment choice in the peasant hamlet of Chugurpampa. Oths’ initial relationship with this community began over 25 years earlier when it served as her dissertation research site. Back then, it was a highly productive agricultural zone of more than 900 individuals with good average health status. Since then, however, the once peasant community (comunidad campesina) has become private property and fissioned into two communities – Chugurpampa and Victor Julio (N=~600) – though most inhabitants live in Chugurpampa where the school, church, medical post, soccer field, and stores are located. Climate change has affected the availability of herbs for traditional and home remedies, as well as made it increasingly difficult to earn a living, and the nearby, and potentially soon local, incursion of mining and agriculture companies only adds to daily challenges. Amid these shifting political, economic, and social changes, conditions for maintaining health and treating sickness are transforming as well. The initial goal of research was to assess the link between traditional ecological knowledge and current medical practices. It was hypothesized that, given the tumultuous changes that have occurred in recent years, younger peasants would be less likely to know or put faith in traditional and home remedies for their illnesses, while no difference would be found by gender.
For two weeks in August 2012, the team engaged in participant-observation and conducted formal and informal interviews with a convenience sample of adult peasant farmers currently residing in the hamlet. The survey included questions about demographics, agricultural pursuits, recent income, and socioeconomic changes since the 1990s, and focused specifically on knowledge, use, and availability of various types of remedies and healers. Herbs are still unanimously preferred to biomedicine, and humoral theory is remains the reigning etiological theory. There is little perceived loss of herbal availability, and these treatments are seen as equally effective for young and old community members. Bonesetters are still sought for musculoskeletal problems, and people continue to put much faith in ‘soul calling’ for cultural syndromes like susto, or fright illness, and guinea pig rubdowns (soba de cuy) are common for diagnosis and treatment. As before, certain illnesses, such as severe respiratory ailments, are seen as better treated with biomedicine, though there is still little confidence in hospitals. However, there are areas where some change appears evident. Youth have less interest in learning home remedies, which is particularly distressing to Chugurpampans, considering that herbalists and healers are in shorter supply than in the past. Interestingly, the doctor is now preferred over a health sanitarian, but the most surprising change was the preference for a doctor over a midwife; however, this may be spurred in part by government incentives for biomedical prenatal care and delivery, and in part by lack of option, since now no midwives practice there.
What has changed, or eroded over time, is much less highlanders’ knowledge or beliefs and more the availability of healers. People would like to seek traditional medicine in most cases, but there is hardly anyone left to go to for such care, and while climate change has not affected the availability of herbs for treatment, it has damaged agricultural livelihoods, inciting an exodus of Chugurpampan youth to pursue opportunities in the coastal city of Trujillo. Amid this migration, children no longer aspire to become healers, whereas twenty years earlier, dozens of individuals fulfilled what was then a culturally-valued social role. This realization, that traditional healing roles in Chugurpampa face serious threats to their continued existence, laid the foundation for subsequent investigations. In August 2013, Dr. Oths and her research team returned to the hamlet to host a medical conference and film a documentary centering on the life of Don Felipe Llaro, an 80-year old Chugurpampan bonesetter and one of the few remaining healers in the hamlet. The topic of the documentary was to not only highlight the still critical role traditional healers occupy, but also to recapture community interest and find a protégé to learn from Don Llaro, whose extensive ethnomedical knowledge will one day be lost if not preserved.
The conference – entitled Un Encuentro con Don Felipe: Un Huesero Distinguido, un Tesoro Nacional (An Encounter with Don Felipe: A Distinguished Bonesetter, A National Treasure) – was held in the nearby district hospital, and was a rousing success, attracting biomedical and alternative healers from as far as Lima, to acknowledge the importance of traditional medical knowledge in Peru. For three days, Don Llaro welcomed patients to present their complaints, and shared with a fixated audience his breadth of musculoskeletal treatment knowledge. On an individual level, Don Llaro’s participation in the conference appeared to reinvigorate his passion for providing medical treatment, as he proudly demonstrated his life’s work to a room full of healers. More broadly, the conference will hopefully contribute to preserving Don Llaro’s traditional knowledge, in the form of a protégé. Specifically, his granddaughter, who lives in the city of Trujillo but often cares for her grandfather with her younger siblings, showed interest in continuing his legacy. Dr. Oths’ future research aims to follow this young girl’s journey to become enculturated in this traditional knowledge system, as well as document the continued impact of climate change on ethnomedical healing roles in highland Peru.