Kallawayas:
The Nomadic Medicine Men of Bolivia
By Debbie K. Becht
Isabel Sandoval spent the first month of her life in intensive
care. At 3 months she weighed six pounds, nine ounces-half the normal
weight for her age-and was fading fast. Doctors in La Paz, the capital
of Bolivia, diagnosed hypertension, but the treatment wasn't working.
In desperation, her mother Jacquelinne sought the help of a kallawaya,
a traditional holistic medicine man.
"He read her future with coca leaves, performed a ritual on her,
and gave me various herbs to bathe her with," said Jacquelinne. "He
told me to be patient for the cure, and that she would grow up a
healthy, happy girl."
Kallawayas in Bolivia still heal the sick with traditional herbs
and rituals that date back to pre-Incan times. Their holistic approach
involves a lengthy discussion with the patient concerning the illness
and an examination of the physical surroundings. A kallawaya is
received with respect and an awareness that his knowledge is based on
long years of training and that he acts according to a strict code of
religious and moral values. Faith and patience are vital for a
kallawaya cure to be effective.
At some point in their life, some 80 percent-or over 6 million-of
all Bolivians have called on a natural healer, and according to the
National Institute of Statistics, 40 percent of Bolivians practice
only traditional medicine.
Holistic practices, such as aromatherapy and herbal treatments, have been
used for thousands of years in India and China for the relief of a variety of
physical and emotional disorders. Yet only during the past three decades has
Western medicine gradually and reluctantly begun to grant validity to certain
principles of traditional holistic medicine and allow greater tolerance for
forms of health care other than those officially sanctioned by modern science
and technology.
Bolivia, because of its high altitude, rugged landscape, isolated pockets
of human settlement, and pervasive ethnological remnants of ancient
civilizations, has been called the Tibet of the Americas. This unique
topography and rich cultural legacy have conspired to make the country a
veritable human laboratory in which modern and ancient medical wisdom do not
so much collide as peacefully coexist.
"Everyone of us lives bound by nature," says kallawaya Hilarión Suxo.
"Modern medicine may seem to heal quicker, but I always say, la medicina
natural cura con calmita-natural medicine is still the most pure; it heals
slowly but lasts forever."
Kallawayas, like most Bolivians of indigenous descent, are deeply in tune
with nature and their physical surroundings. They live according to the Andean
cosmovisión, an all-encompassing view of humankind and its place in the
universe based on veneration of the Pachamama, or Mother Earth. They believe
that every mountain has its own resident deity that protects those who live
around it from any possible misfortune and that human beings should respect
and live in harmony with their environment.
Like most of Bolivia's middle class, Isabel's mother Jacquelinne usually
relies on university-trained physicians for her family's health needs. But she
was frustrated by her daughter's lack of progress and questions that went
unanswered. So she went to a kallawaya for advice. "I wanted to see if natural
herbs could do more than the chemicals," she said. "I reached the point where
I would do anything they [the kallawaya and doctor] told me to see Isabel get
better."
Following her doctor's advice, Jacquelline is giving Isabel vitamins, her
own milk, whole milk, and soft foods in order to help her daughter gain
weight. She supplements this with home remedies consisting of water with
oatmeal, quinoa grain, or willkaparu (crushed corned). Isabel's situation has
not improved substantially, but her mother continues to hope that this
combination will slowly nurse her daughter to good health.
Natural
Wealth in a Poor Country
The province of Bautista Saavedra, just north of Lake Titicaca, is 975
square miles of kallawaya country. Here, the venerated healers live with their
families in villages such as Curva, Chajaya, Chari, Inka, Huata Huata, and
Pampablanca. From this lonely region high in the Andean ranges of northwestern
Bolivia, kallawayas have ventured all over Bolivia and into parts of Peru,
Argentina, Chile, Ecuador, and even as far as Panama. With their chuspa, a
colorfully woven bag filled with herbs, and the blessing of the Aymara gods of
pre-Incan times to protect them on their journey and provide for their safe
return, they set off on ancient Inca trails traversing the bleak high plains
and dipping into the tropical lowlands.
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A Kallawaya Medical
Primer
Some historical sources cite the kallawayas
as the first to use the dried bark of the cinchona tree, the source of
quinine, used for many years to prevent and control malaria and other
tropical diseases. Similarly, the main alkaloid of the coca plant,
cocaine, was one of the first effective topical anesthetics used by the
kallawayas and later adopted by medical science. Among the other plants
found in the Bautista Saavedra province and the illnesses they have been
used to treat are:
- the kantuta Bolivia's national red,
yellow, and green bell-shaped flower, which grows in the high valleys
and Los Yungas. The leaves, fresh or dried, are boiled in water and
then used as a poultice over an abscess or tumor. Also, after the
fresh flowers are soaked in clear water for three or four hours, the
liquid may be used to wash tired, inflamed eyes.
- the espino (Colletia spinosissima), a
type of thistle bush that grows in the high valleys of the Charazani
and Chajaya regions. The fresh stalks are ground with three other
plants-copal from the tropical region of Caranavi, incienso (from the
tropical burseaceae family of trees and shrubs, from which incense is
derived), and wairuru from the Santa Cruz region-to make a plaster for
immobilizing fractures and lesions. The boiled bark is used in the
preparation of a sweat bath to alleviate rheumatic pain in the joints.
When crushed and soaked in liquor, the bark is used as a tonic to help
cope with anemia.
- the perlilla (Dalea weberbaueri), which
grows in the high valleys of the Charazani and Cruzpata regions. The
boiled leaves, fresh or dried, have been used against smallpox and
measles. Finely crushed and mixed with pig grease without salt, they
are used to burn warts.
- the dandelion, which grows in all humid
areas of the high valleys. An infusion of the fresh leaves is used to
cure heartburn. The fresh leaves, stems, and roots are used as a
diuretic. The dry, scraped roots are applied to wounds to heal
them.
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Some kallawayas find a home in the major cities, where an urban
clientele composed of people like Jacquelinne Sandoval calls on them.
But most return to Bautista Saavedra. Today, about a hundred authentic
kallawayas live here, a number that is dwindling as fewer sons of
kallawayas learn their fathers' skills.
Bautista Saavedra is one of the poorest areas in Bolivia-the
second-poorest country in the Americas. Locals, including the
kalla-wayas themselves, earn a meager living by growing potatoes,
corn, wheat, and oca and raising sheep and llamas. The minimum monthly
wage in Bolivia is US$ 45 per month, but farmers in Bautista Saavedra
earn less than a quarter of that. Almost everything they grow and
raise is for home consumption.
But the province is blessed with a rich variety of plant and herb
species found on three ecological terrains: the tropics, mountain
valleys, and highland plateaus. Plants are said to grow with greater
aroma and purity in Bautista Saavedra's pristine environment. And if a
certain plant doesn't grow there, it most likely grows in the
subtropical Yungas, a six-to-eight-day walk to the east.
Living in this earthly Garden of Eden has allowed the kallawayas to
amass an encyclopedic knowledge of wild plants and their therapeutic
uses, and enticed them to travel to the four corners of the
once-powerful Incan empire in search of many
more. |
High Prices,
Poor Access
In remote areas throughout Bolivia, when a person becomes ill, he or she
most likely will turn to traditional remedies. The reason is a practical one:
traditional remedies are affordable, and the costs of modern health services
often are not. For most subsistence farmers, paying a doctor's fees or even
purchasing aspirin is simply beyond their means. On the other hand, a typical
kallawaya prescription may be the preparation of a tea infusion made from
plants the farmer probably already has on hand. The most common compensation
for a kallawaya's treatment is the exchange of goods or other services.
But even more important than the cost issue is that of accessibility. In
rural Bolivian villages, there often are no doctors, nurses or medical posts.
Townspeople rarely have a choice-the only health interventions available are
those offered by traditional healers. "Public health services do not reach
that far into the countryside," says Dr. Carlos Linger, who heads Bolivia's
office of the Pan American Health Organization (PAHO) in La Paz. "The presence
of the kallawayas and their medicine provides people with a feasible
alternative."
Alipio Barrera, a youthful kallawaya of 25, would agree. "Doctors really
don't go where we do. We set out several times a year, for one to four months
at a time, trying to visit as many communities as we can. We almost never come
across doctors in these places."
The kallawayas continue to travel on foot, just as they did centuries ago,
despite modern means of transportation. "The roads are getting better now,"
says Suxo, "but when you're out looking for people who might be sick, it is
always better to go from place to place on foot."
The sight of a kallawaya medicine man, wearing a brightly colored
hand-woven poncho of vicuña and his lluchu (knit cap), wending his way along
the crooked path with his walking stick, is a common one in the Bolivian
highlands. "They spot our clothes from far away and know that the kallawayas
are coming," Barrera says.
"They welcome us and feel comfortable with our medicine," he continues,
highlighting a third reason why so many rural dwellers turn to kallawayas for
health advice: the kallawayas share the same indigenous roots and traditional
world view. Thus, even in rural areas where modern physicians and services are
available, many Bolivians are wary of them, perceiving them as too clinical
and foreign to their culture.
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Of Medicine and
Mangoes
Deep in the highlands of Guatemala, Médicos
Descalzos, a French nongovernmental organization, is working with the
Pan American Health Organization (PAHO) to better the health and living
conditions of the numerous indigenous groups living in the departments
of Huehuetenango, El Quiché, and Baja Verapaz. The innovative Medicinal
Plants project is not only reviving interest in the value of traditional
medical wisdom and techniques, but also extending the coverage of
primary health care.
More than 1,500 rural health promoters and
public health practitioners, as well as hundreds of indigenous women,
are being trained in the use of 26 medicinal plants commonly found in
Guatemala whose therapeutic properties have been proven scientifically
to prevent and/or treat the 10 most common digestive, respiratory, and
skin disorders affecting the majority of the area's residents, as well
as a host of other maladies.
The list includes annatto (achiote), garlic,
plantain, cinnamon, eucalyptus, guava, mango, jacaranda, ginger, lemons
and limes, okra, ocote, chamomile, mint, and thyme. In simple language,
charts, and illustrations, the training manuals explain how to utilize
the various parts of the plant, including the seeds, stalks, leaves,
roots, fruit, skin, bark, juice, and essential oils, used to prepare
infusions, tinctures, syrups, ointments, unguents, salves, and
poultices.
The Phytotherapeutic Manual, a basic guide
in the teaching materials, includes detailed information on each plant's
botanical identification, medicinal uses, proven effects, chemical
composition, toxicity, methods of extraction, and bibliographical
cross-references citing the scientific source studies. The plants, in
their various forms, are used as antiseptics, antacids, expectorants,
analgesics, laxatives, diuretics, astringents, emollients, muscle
relaxants, and anti-inflammatory, antibacterial, antifungal,
antimalarial, and anticonvulsive agents, among others. They are used to
treat sore throats, colds, strep throat, tonsillitis, asthma, sinusitis,
bronchitis, indigestion, morning sickness, menstrual pain, earaches,
influenza, toothaches, insomnia, high blood pressure, diabetes, gall
bladder stones, worms, urinary tract infections, conjunctivitis,
ringworm, eczema, sunburn, insect bites, pimples, wounds, bruises, and
burns.
They may not be a cure-all, but medicinal
plants are proving their worth in lowering morbidity and mortality
rates, restoring faith in the knowledge of ancient precepts about health
and disease, and empowering people in the Guatemalan highlands to take
control of their well-being and that of their loved ones. - Roberta
Okey |
A
Dynamic Mixture
"Western medicine focuses on the individual, giving much less
importance to the family, community, and psychological and
socioeconomic background as determinants of health," says Dr.
Jeannette Aguirre, a national health services consultant in PAHO's La
Paz office who works with indigenous groups. "Kallawaya practices are
based on a profound knowledge of the patient within his or her natural
environment, and on listening to the patient."
Marco Villareal is an agronomist of Aymara descent who lives on the
outskirts of La Paz in El Alto. The neighborhood is composed of
numerous recent rural migrants, and potato fields sprout up next to
thriving micro-businesses. This eclectic mix of the new and the old,
the modern and the traditional, spills over into the people's
syncretic approach to health care, as well. When Villareal was
diagnosed with rheumatism and high blood pressure, "I decided to be
treated by a kallawaya, because it is an ancient custom and I've seen
the work they do in rural areas. I have faith in them."
But will faith and cultural traditions alone be enough to preserve
the kallawayas' ancient healing practices for the future? Fortunately,
health professionals and traditional healers in Bolivia are taking
steps to integrate the two approaches, with the goal of preserving
traditional kallawaya medicine while enhancing the quality and
cultural sensitivity of modern medicine.
"Modern medicine has attained a technological level that has proved
useful in controlling many diseases," says Aguirre. "However, it does
not have many answers for some chronic diseases whose treatment might
benefit from a more holistic approach. There are obvious advantages to
capitalizing on what both perspectives have to offer us."
"There is a growing emphasis [in the medical profession] on
recuperating indigenous medical traditions, especially herbal
treatments," adds Linger. "Kallawaya medicine is deeply rooted in
indigenous beliefs and customs, which in turn form an integral part of
Bolivia's cultural heritage."
PAHO
in Bolivia
Since as far back as the 1950s, PAHO has recognized the importance
of collecting information on the customs and beliefs of people
regarding illness and traditional therapeutic methods. In the 1970s it
helped produce a seminal work on kallawaya medical techniques and
practices, and in 1994 supported a research project in Cochabamba that
studied the methods used by itinerant practitioners of traditional
medicine. More recently, PAHO supported the compilation of a
two-volume Encyclopedia of Traditional Aymara Medicine by Dr. Gregorio
Loza Balsa, who has authored two other books on medicinal plants and
Aymara medicine for PAHO. |
Through its Health of Indigenous Peoples Initiative in Bolivia and the
other countries of the Americas, PAHO works with local and international
partners to improve the health and living conditions of this social group.
Aware that large segments of the population in countries such as Bolivia,
Ecuador, Guatemala, and Peru rely on traditional medicine for primary health
care, PAHO works with the academic and scientific community as well as rural
health promoters and holistic practitioners to study the potential usefulness
of traditional medicine, including evaluation of practices and examination of
the safety and efficacy of remedies, and to upgrade the knowledge of
traditional and modern health practitioners.
At 390 per 100,000 live births, Bolivia's rate of maternal mortality is the
Region's second-highest (Haiti's is first). In a country where 60 percent of
all births take place at home and the number of rural home deliveries is high,
Linger feels that traditional birth midwives can play an unparalleled role in
helping reduce both maternal and child mortality.
"We work with this group, teaching them what to do in situations of
complicated deliveries," says Linger. "Although traditional kallawaya medicine
helps midwives in their work, they need more training in areas such as
prenatal care and hygiene."
Dr. Sandra Land, PAHO's Regional Advisor on Local Health Services and focal
point for the Health of Indigenous Peoples Initiative, believes encouraging
more indigenous youth to pursue professional careers in health and providing
opportunities for indigenous community leaders would help make public health
services more culturally appropriate and acceptable to indigenous groups.
"Every country has a different cultural reality," says Land, "and community
health services must respond to local circumstances and reflect diversity when
that is the case."
Preserving
Holistic Traditions
Paulino Rasguido, Director of Bolivia's Center for Comprehensive Training
and Services for Development (CISED) is devoted to preserving the kallawayas'
oral traditions. The small, independent center documents the teachings of
kallawayas like Suxo and Barrera, creating a permanent record of their
holistic knowledge and practical applications of medicinal plants.
Kallawayas collaborating with CISED relay their wisdom to young residents
of Bautista Saavedra through formal lessons and train them to be health
promoters. Though economically limited, the Center also trains modern health
practitioners because it believes that natural medicine can play an integral
role in modern medical practice. "Bolivia has a rich natural plenitude that
can greatly compliment modern medicine, especially at the primary health care
level," Rasguido says.
Young people in Bautista Saavedra have a privileged opportunity to
grow up learning about medicinal plants and herbs, he explains, but
what is really needed is a systematic teaching of their value and
unique properties, one that preserves the elderly kallawayas'
experiences.
Kallawaya knowledge is passed from father to son by a secret
language known only to the kallawayas. Barrera and Suxo are grateful
for the skills their fathers taught them but are concerned that
today's generations do not regard traditional medicine with the same
profound reverence as theirs did. "My sons aren't really interested,"
shrugs Suxo. Barrera shares Suxo's conviction that kallawaya
traditions are in danger of being lost if they are not shared with
others.
The Old and
the New
Young Barrera sees no quarrel with modern medicine. He says his blending of
modern and traditional techniques has made him more useful to the villages
that rely on his knowledge. "In delicate cases," he says, "I need to know
first aid, because natural medicine cures more slowly."
Unlike Barrera, Suxo, who is older, no longer travels so extensively and
instead spends most of his time teaching in Bautista Saavedra. He does,
however, makes occasional trips along the old Inca trail to Cuzco, Peru,
legendary capital of the former empire, and to visit other small groups
interested in acquiring his holistic skills.
"They know very little," says Suxo. "I teach them because I know when I
die, my knowledge might not live on. I tell my students I leave them an
important legacy, because there is no virtue in the kallawaya tradition
becoming lost."
Debbie K. Becht is a freelance journalist, at the time of
the publication of this article (1998), residing in La Paz, Bolivia.
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