Wednesday, May 30, 2007
Healers and Doctors in the Andes, RandolphCollege
On June 2, a group of RandolphCollege students, staff and professors will embark on a 15 day journey to Ecuador to study indigenous healing and medicinal practices. We will be accompanied by Mario Incayawar and his wife Lise Bouchard. Mario is originally from Ecuador--growing up in the Quichua community. He is a medical doctor and anthropologist and has been our visiting Quillian Scholar this past year. Travelers include students Amber Bennett, Jessica Malachowski, Rachel Martinez, Jennifer Powers, Justine Wiley, Kathleen Wilson, , our trip planner Tina Johnson (Director of International Programs), and faculty members Kathy Schaefer (Biology), Ron Gettinger (Biology), and John Abell (Economics). Much of our time will be spent in Otavalo, in the northern highlands of Ecuador. Assuming I will be able to locate an internet cafe with sufficient computing power to upload photos and commentary, I will attempt to communicate on a daily basis.
The following executive summary describes our trip:
Healers and Doctors in the Andes
An Experiential Seminar
June 2 – 17, 2007
Study abroad programs are rarely organized by Indigenous Peoples of the Americas. Runajambi is offering probably for the first time this educational opportunity to American students. The location for this program is the Otavalo region, recognized as a highly safe and friendly area in the Andes.
OBJECTIVES
- To provide students interested in health issues and healing practices the opportunity to study the Quichuas’ health and traditional medical system.
- To facilitate a rich intercultural learning experience for American students through first hand and close interaction with the Quichuas (Indigenous People) in the Andes.
Students will also be introduced to the Quichua culture and language. Through historical and anthropological readings, they will learn about the socio-economic status of the Quichua people within the Ecuadorian state as well as elements of the Quichua culture. They will learn some basics of Quichua language, including grammar and vocabulary and develop the ability to understand and generate simple sentences.
Runajambi will host the seminar in the beautiful area of Otavalo, a town located in the Northern highlands of Ecuador. Students will spend 2 weeks in Otavalo and the surrounding Quichua communities. Supplementary activities include a field trip to Ilumán a Quichua healers’ community; Santo Domingo a Tsachila healers’community; Ibarra for the medicinal plant market, and the Museo Nacional de la Medicina in Quito, among others.
Saturday, June 2, 2007
Quito, Ecuador
Our group has arrived safely in Quito, Ecuador. We are staying in a most charming bed and breakfast called La Casa Sol. The following photo shows one of the very comfortable sitting rooms available. The breakfast menu looks healthy and inviting.
Tomorrow (after the tasty breakfast), we head to Otavalo to begin our program. Hopefully, I’ll have access to a decent computer and have something more substantive to share with you.
Sunday, June 3, 2007
As proof that we actually did arrive safely as I indicated in last night’s blog, the photo below shows our group posed in front of the hotel La Casa Sol.
Driving from Quito to Otavalo by bus, we crossed the equator (latitude 0.0.0) from south to north. In the photo below Ron Gettinger is standing in the center of an official marker. Volcano Cayambe is mostly hidden behind him.
After lunch and a brief orientation, we had the afternoon to ourselves. Most of us visited the downtown artisans market. Later a couple of us went exploring and walked up into some of the hillside barrios where we encountered this adorable little boy. His mother insisted that he have on a proper hat before we could take his picture.
Monday, June 4, 2007
Otavalo, Ecuador
We started into the academic portion of our travel seminar today. From Mario's sister Gina Maldonado, pictured below in traditional Quichua clothing, we learned that the country has 13 million people, of which, 52% are indigenous. Also, there are 13 individual nationalities inside Ecuador, of which the Quichua people represent the largest group. However, if you were to ask a government official or a Latino person on the street about the 52%, they would likely disagree, suggesting a much smaller number. There appears to be a general denial of the numbers and importance of the indigenous population.
When our conversation turned to health issues, Marioindicated that 98% of the indigenous people experience at one time or another a stress-induced mental health condition referred to as llaqui (rhymes with jockey). There are two primary sources of this infirmity: 1) bad relationships with spirits and 2) poor social reciprocity. Spirits are found in numerous places, in plants, animals, and in the land itself. Mistreatment of the land, for example, unnecessary cutting of trees, could lead to a variety of problems because the spirits that reside in the forest have been disturbed. Also, it is important for Quichua people to have good relationships with their neighbors--relationships based on reciprocity. Ill treatment of or from a neighbor could lead to stress-induced llaqui. More specifically, land disputes are the leading cause of llaqui. In a country where one's well being is intricately tied to the land, but where the land is unequally divided, it is easy to imagine that land-related stress is a serious problem.
During our free time today, a few of us strolled through the farmers market (the market oriented toward locals, rather than tourists). The following picture is exactly what you think it is--a pig's head. And it is sitting in a giant pan of pig parts cooking in animal fat.
The following photo is of one of the many varieties of corn found in this region. Corn is eaten in a variety of ways here; fried, as hominy, in tamales, but, unlike Mexico and Central America, it is not used in the making oftortillas.
The market itself, in general is a riot of color. Shown below: grapes, apples, tree tomatoes, and citrus.
More tomorrow...
Tuesday, June 5, 2007
Otavalo, Ecuador
We continued our conversations today about health care in Ecuador and, as well, visited a regional public hospital: Hospital San Luis de Otavalo. It is the only hospital in the area and serves a population of approximately 100,000. We received a tour from the newly appointed director Dr. José Terán. What makes this discussion worth sharing in this web blog is the fact that Dr. Terán is the first ever non-Latino director. He is a Quichua Indian. According to Mario Incayawar, there is a 500 year old sense of distrust between Latinos and Quichua people that dates to the Spanish conquest. This distrust is especially acute when it comes to health care. To the Quichua, a Latino-run hospital is simply an institution where you are likely to go in sick and return to your family in a casket. In the past, outright discrimination and neglect made this a likely outcome. One might, therefore, hope that the appointment of Dr. Terán might represent a turning of the corner of this long period of poor relationships, that his regime might lead to improved care for the region's indigenous population. Unfortunately, it would appear that the tenure of the very soft-spoken Dr. Terán is at risk. Whether or not he is capable of mustering the clout necessary to administer a hospital consisting of a medical staff made up of nearly 100% Latinos is unclear.
One might also hope that the election of Ecuador's new progressive president, Rafael Carrea, might represent a move in the right direction. He has already made what would superficially appear to be a bold move in the right direction--as far as health care goes--by approving an emergency health care budgetary supplement. This additional money has allowed the hospital here in Otavalo to hire an additional 20 doctors, taking the total to 50. Unfortunately, there is no evidence that any of this money or personnel is directly benefiting the Quichua people. Perhaps time will tell.
One particular hospital program that seems to having a beneficial public health outcome--that cuts across all racial or nationality boundaries--is a free animal vaccination program. Cases of rabies have been drastically reduced. The following poster is posted prominently and exhorts citizens to have their pets vaccinated (for free).
In strolling about the city today, we came upon a rather large, graphic wall mural with an anti-Iraq war theme. The following segment is fairly clear in its meaning (in Spanish it translates to: No more blood for oil).
As a reminder of how hard the majority of the world's population has to work in order to put food on the table each day, I thought I would share the following photo with you. This gentleman is carrying at least 100 lbs. (probably a lot more) of marketplace textile goods on his back at the end of the day.
Wednesday, June 6, 2007
Otavalo, Ecuador
How about that photo for an uninspiring start to today's blog! As an extension of yesterday's trip to the regional hospital, today we were supposed to visit one of the many field clinics that are supposed to bring health care closer to the people in rural areas. As the photo suggests, however, the clinic was closed. We arrived at 2:00 PM with a promise that we would be able to meet with the attending physician. Unfortunately, the facility was closed as shown in the above photo. Apparently, they are frequently closed, with doctors showing up for only one or two days per week, and even then, only two or three hours per day. Even when they are open, patients are typically told that they need to go to the regional hospital. So, what seems to be happening here is that Latino doctors have a racket going whereby they are paid for a full-time job, but only work a few hours a week. Those who suffer the most from this system are the Quichua poor. Specific statistics on this forthcoming tomorrow.
From the closed field clinic we walked to nearby Lago San Pablo for a boat tour of the lake.
Ron, Jessica, Kathy, and Katie are shown out on the lake near the shore with Volcan Imbabura behind them. Unfortunately, our day which started off so warm, sunny, and promising, took a turn for the worse. The second half of our tour took place in the rain. Justine and Rachel don't appear to be suffering too badly despite the conditions.
Amber and Jenn, on the other hand... well..., I'm not exactly sure what is the appropriate commentary to explain the following photo:
After the rains stopped, we decided to stick with our itinerary which included a trek to the top of the hilltop overlooking Otavalo where the legendary tree Lechero is located at the peak. It is an ancient rubber tree that still oozes a gooey white sap. From this location, there is an incredible 360 degree panoramic view--of the lake, of the volcano, of Otavalo, of the surrounding farm communities...
Thursday, June 7, 2007
Otavalo, Ecuador
We visited the nearby community of Iluman this morning. It is known as a "healers community" because of the 200 or so Quichua spiritual healers located there. Ironically, as we were walking along the street toward our meeting with a particular Yachac (or healer), we came upon a field clinic that was open. Recall that in yesterday's blog, I commented on the lack of official government health clinics available/or open to the indigenous population. So, here we were in a community of indigenous healers and the government sponsored health clinic was open for business.
The following photo shows Amber bravely receiving the attentions of a spiritual healer.
She was the only one of us who volunteered. So, when I say "bravely," I'm referring to the fact that this "healing" entailed having the Yachac blow a mist of alcohol as well as tobacco smoke over her from a variety of positions.
In a later conversation, we discussed what we had observed and the efficacy of indigenous healing practices in general. There was a consensus among our group that in the case of infections and diseases caused by parasites, the most efficacious approach would require Western medicines. However, in the case of mental health problems, there was a bit of disagreement, part of which stemmed from recent research we learned about that suggested that psychotropic medicines may not be any more effective than placebos. To those of us raised on Western medicine, alcohol, tobacco smoke, and incantations seem like less than desirable solutions, regardless of new medical findings. However, to the extent that faith plays an important role in the healing process, then in the indigenous community, where there already is serious doubt and distrust about Western medical approaches, spiritual healers likely will be able to play a positive role.
During our stroll through Iluman, I witnessed this Quichua man deep in thought:
Later, the clouds which have obscured Volcan Imbabura every day, finally parted enough to see the peak (almost).
Friday, June 8, 2007
Otavalo, Ecuador
We had a free day and took full advantage. We employed the services of a local eco-tour operator and visited the following nearby places: 1) Cascada de Taxopanba, 2) Mt. Fuya Fuya, and 3) Lagunas de Mojanda.
The first stop was at Cascada de Taxopanba, a seriously cool waterfall. It was a bit of a challenge to get there given that the day was overcast and rainy. The trail system was steep and slippery. More than a couple of us received cuts from barbed wire as we reached out for something to hold on to as our footing gave way. Fortunately, we were armed with cleansers, antiseptics, and bandaids, and thus a good time was had by all. Here are two shots of the falls (Ron is in the right photo).
When we reached Lagunas de Mojanda and Mt. Fuya Fuya, the group split in two. About half us explored the lake and the other half climbed the mountain. I only have photos from the mountain climb. I would like to tell you that we made it all the way to the peak--over 14,000 ft.--but bad weather forced us to halt just short of 13,000 ft. It was quite cold and the wind and rain were relentless. We had not anticipated such conditions, and by the time we stopped, our shoes, socks, and pants were soaked, and our feet and hands were frozen. Here we are in the following photo at our stopping point--from l to r, Jorge, our guide, Jessica, John, Justine, Kathy, Jenn, and Ron.
In this photo of Jorge and John, you get a sense of the view of the lake from our vantage point on the mountain side.
Finally, here is a shot of our trek down the mountain side, giving you a different view of the incredible scenery that surrounded us. The lake is to the bottom right of the picture.
Saturday, June 9, 2007
Otavalo, Ecuador
As in most Latin American cities, Saturday is market day. We took in three different markets today. Here in Otavalo, the animal market starts early. Only a couple of us made the trek to this market. We arrived around 6:30 AM and things were well under way. People from Otavalo and nearby communities were selling and buying pigs, goats, sheep, and cattle. It appeared to be a low key affair, unlike the high pressure selling in the tourist market.Sellers simply stood with sometimes balky, sometimes quiet animals on tethers, waiting for buyers to initiate a transaction. From an observer’s perspective, things really became interesting once a transaction was completed. The buyer was, of course, obligated to haul off his new acquisition. The photo below shows a couple of buyers attempting to get a recalcitrant, squealing pig into the back of a pickup truck. Take careful note of the woman’s attire. She appears to have pulled out her best pair of high-heeled pumps for the occasion.
Ourfull group boarded a bus later in the morning for the capital of the province, Ibarra. Our goal was to observe the portion of Ibarra’s Saturday market devoted to medicinal herbs and spices.You are, of course, well acquainted withchamomile--used in teas and other treatments. It is the most prominent in the display below.
Finally, we returned to Otavalo to take in the tourist market, one with which we were already well familiar, since it is open seven days a week. However, the market had doubled, or perhaps tripled in size for the Saturday tourist crowd. Streets normally full of car traffic were set aside for venders´ stalls. Shown below are a little boy and his puppy playing in a pile of textiles while his mother tends to customers.
I’ll conclude with a shot of beauty and color:
Monday, June 11, 2007
Otavalo, Ecuador
Sorry for no entry yesterday. It was essentially a free day and the cameraman--that would be me--didn't go along on any of the optional activities. The students had a big day of horse riding. Apparently, this was the real deal, with something other than nose to tail slogging along. They returned pretty jazzed about the whole affair. I went on a hike instead.
Today, we returned to the classroom for more discussions about indigenous health care. We encountered a number of studies to suggest that the approaches of Western psychiatrists and indigenous (faith) healers were not very different and that the outcomes were similar in terms of patient healing. Here are a few of the similarities: 1) Apparently, the decision to seek the help of a healer in the first place has a salutary effect, raising one's expectations and emotions. 2) When a healer is actually able to apply a name or label to one's problems, that is of great benefit to the patient, because if the healer can actually identify a problem, then presumably he or she should have the abilities to deal with it. 3) The personality of the healer--being able to empathize, for example--and the physical ambience of the healing site are also of great importance. To one accustomed to Western mental health norms, a faith healer's (and by the way, the designation of witch doctor is a misnomer--there is no more of a connection to witches than to witch hazel) approach might seem completely inappropriate. For example, the blowing of smoke, spraying of alcohol, and uttering of incantations--as noted in a previous blog--might seem to have no connection to the mental healing process, but if an indigenous patient has faith in the healer and the process, then healing may well take place.
I thought I would share a photo of one tiny piece of the school that is allowing us to use one of their classrooms. The following mural states (in English), "Raise your hands and look for peace." That is rather pleasant to see every day when we walk onto the campus.
Kathy, Tina, Ron, and I took a hike this afternoon to the CondorPark--about 4 miles round trip. The park was closed, but the scenery along the way and the exercise was good. Kathy--in the photo below--stopped to try an interesting technique we recently learned about. Supposedly, when you scratch a pig on its belly in front of the hind leg it will lay down and settle into a state of fairly deep relaxation. Well, it works!
I'll close with some more flowers.