San José, Costa Rica, since 1956

Indigenous Medicine: Body, Mind and Spirit

CACHABRI, Talamanca – “Take this four times a day for three weeks. Keep taking it until it is completely gone, even if you feel better,” Lizandro Méndez said, sounding like any other doctor in the world offering a prescription to a patient.But instead of handing over a bottle of pills or a slip of paper with illegible handwriting, Méndez, dressed in gray slacks and a V-neck shirt, hands his patient a small bundle of bark wrapped into a neat package with a large bijagua leaf.Méndez is an awa, or Bribrí indigenous doctor and spiritual guide, in this small community, deep in the Talamanca mountains off the Caribbean coast. Rather than in a sterile doctor’s office, his prescription is given inside the sacred usule, or thatched cone house, where curative and cleansing rituals are performed.Méndez is one of 45 awapa (plural of awa) in the Talamanca region serving the approximately 11,000 Bribrí who live on the indigenous group’s reserve. Earlier this month, the awa took a break from his daily healing practices to welcome a group of outsiders to his home, culture and way of practicing medicine.Eighteen people, from as near as San José and as far as France, filled the usule and, one by one, sat by the fire in the middle of the thatched cone, bent their heads and waited for Méndez to brush a smoking bundle of herbs, lit in the fire, over their heads, shoulders and backs while saying a prayer in Bribrí.This was the cleansing ceremony, a reminder that, despite their modern dress and daily life as typical campesinos producing bananas and cacao, this community’s indigenous roots remain deeply planted.IT was also a reminder that at least 18 nonindigenous people – or blancos, as Méndez refers to them – were looking for a kind of healing they could not find in the offices of Clínica Bíblica or the operating rooms of Hospital Calderón Guardia in San José.One of these blancos was Rosa Collelldevall, a Spanish specialist in alternative medicine who is part of an international movement to bridge the gap between Western and indigenous medicines.“Every day, more and more people become sick with illnesses that go beyond the body,” she said.Collelldevall was in Cachabri making a personal delivery to Méndez. Though the awa rarely makes trips out of the Talamanca mountains, Collelldevall met him last year in Barcelona, Spain. Boarding an airplane for the first time, Méndez made the overseas trip to attend an international conference of indigenous doctors at the 2004 Forum of Cultures in Barcelona, at the invitation of Collelldevall.Collelldevall produced a book as a result of the conference. She decided to bring the book herself to Méndez in Cachabri.WHILE indigenous healers have learned from Western medicine and use it when necessary, the exchange has not been reciprocal, explained Leyla Garro, a trained nurse and former coordinator at the Ministry of Public Health who has worked with indigenous groups for more than two decades.“Western medicine is based on specializing; the more complex the problem, the more specialized the doctor in one part of the body,” Garro said. “Sometimes they lose sight of the greater whole, whereas indigenous medicine has a much more integral vision. Indigenous doctors see the whole body; they see the family and environment around the patient. They see the spiritual side. That is the fundamental difference.”In recent years, the World Health Organization, the Pan-American Health Organization, the Costa Rican Public Health Ministry and health ministries around the world have become increasingly interested in indigenous medicine and the role it could play in curing non-indigenous patients.Yet resistance remains strong among Western doctors, who in no way consider indigenous doctors their equals, Garro explained.“Little by little, respect for their ability to cure is coming,” she said. “We have taken steps, but the path is still long.” MÉNDEZ’S medicine is not just about playing with herbs and saying prayers. The ancient knowledge is learned in a 10-to-15- year training period and apprenticeship.According to Bribrí belief, Sibö (“God” in Bribrí) wanted the indigenous to cure themselves, so he pretended to be sick and told one of his assistants to look for medicine. Sibö gave the names of the herbs that are now used in indigenous medicine, explained Méndez and his brother, also an awa, while seated in the usule.This knowledge is passed down from generation to generation, to hand-selected students. After their decade-long apprenticeships, potential awapa must demonstrate their knowledge of the curative powers of roots, canes, barks and other plants, as well as quantities and medicine schedules, among other things, in an oral exam. If they pass, they are named awapa, Méndez explained, while holding his hardwood staff, which only awapa are allowed to carry and no one else is allowed to touch.Awapa are also given two magic stones, considered Sibö’s sisters. Awapa hold these stones when they are making a diagnosis. Through them they ask Sibö if they are correct in their diagnosis; if they are, the stones bounce.BEYOND tapping into the spiritual side of healing, Western medicine can benefit directly from the medicines preserved in indigenous culture, according to José Carlos Morales, an international leader in indigenous rights and a member of the Boruca indigenous group from southern Costa Rica.“Isolated peoples, for example in the Amazon, are surviving with their own systems of traditional medicine, which have great value to us all,” said Morales, a past president of the World Council of Indigenous People.For example, indigenous people in South America have traditionally used bark from the quina (chinchona) tree to cure diseases, Morales explained. Quinine, extracted from the bark, has since been used by both indigenous and non-indigenous people to treat malaria.In addition, in Mexico, birth control pills are now produced from a plant long used by indigenous people there for its fertility-reducing properties.Mexico is one of the few places where Western doctors have been willing to refer patients to indigenous doctors, Morales added.AWA Méndez said he has no problem sharing his medicine.“We need you, you need us,” he said, accepting that certain diseases – AIDS, cancer and sicknesses brought on by chemicals not known in the traditional Bribrí diet – cannot be cured by the medicine he knows.At the same time, Méndez is worried about intellectual property rights and patents that could come with the adoption of his medicine by outsiders, a stark reminder of the commercialism that can define conventional medicine.“The medicine we use was left to us by Sibö, from the beginning. We use it to save all of us indigenous, first,” Méndez said. “The only thing we want is a little bit of respect for our medicine from people outside. We want the same respect for ourselves that we have for Sibö.”Respect is what it will ultimately take to build a bridge between the two medical paths. And that respect must begin with education, Garro and Collelldevall agree.“Doctors cannot be expected to respect something they don’t understand,” Garro said.The medicines themselves must also be preserved, which is a matter of protecting the cultures from which they come, Morales added.FIFTY years ago, the Bribrí culture and language were dying in Cachabri. It was only in recent decades that they were brought back in this community by Méndez’s father. A picture of him hangs in the usule and watches over the traditional sorbón dance that the community gathers to perform on special days, or when honored guests, such as Morales, Garro, Collelldevall and their friends, are visiting.The dance, learned from Sibö, is not complicated. The men link arms and begin moving around in a circle while singing out in call and response. The women eventually join in, tucking themselves under the men’s linked arms.“The sorbón could go on day and night, as people do more and more turns. Sibö did it when he created his home, the universe, so we do it to inaugurate a new home,” Méndez told his visitors, protected in the cone house from the heat of the Caribbean sun beaming down outside.“The cone is a way to defend our rights, our culture. We must protect it, like we protect the nature that was given to us, as it was given to us… protect it from dams and oil drilling,” he added.IN between whirls of the sorbón dance, community members drink chicha – fermented maize, plantain or pejibaye (peach palm), made by grinding the grains or fruit to a pulp on a large grinding-block stone, brought by 150 Bribrí from miles away, then leaving them to ferment for three days.Community members have come from all over for the celebrations, which also feature bow-and-arrow target practice, trap-making demonstrations for children and a group-cooked meal prepared over an open fire in the electricity-free community.The event offers them a respite from their daily lives and an opportunity to remember their roots.“I knew from the moment I first came here that I was among a strong people,” Morales said. “Where I came from, it was a different, sad story.”Whereas the Catholic Church and public school system entered Boruca communities more than 100 years ago, they arrived in Bribrí villages approximately 40 years ago.“Church and school were the two machetes that struck us down,” Morales said of the Boruca community.Awa Méndez agrees that outsiders who don’t want to respect the Bribrí are the greatest threat to his community. Already, in lower Talamanca, the Bribrí reservation has been infiltrated by outsiders.“But we are at a point where society is starting to value what you have; you have a treasure,” Morales told the awa.

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