On Mayan medicine

A quick disclaimer: of course what is written here is the result of just 2 days in Guatemala, and some of the perspectives and information are liable to modification over time (and rightfully so, I think) as we gain experience and knowledge. So the following entry is really just a representation of where I am and what I’m thinking about right now on this journey. Thanks for your patience. Without further ado…

On Saturday morning I woke up early to make sure I had time to stop by an Internet café to print a copy of my proposal before meeting Peter, who is serving as an advisor on my project in San Lucas Tolimán, in Antigua’s central park. I arrived a bit early, so I sat and reread my proposal briefly. I spotted him after a few minutes, walking quickly to catch up with him and calling out to get his attention. We shook hands and headed to the market—we had spoken the evening before, and he had told me that he needed to stop by the market to purchase some medicines.

I followed closely behind him so that I could hear what he was saying and so that I wouldn’t lose him in the maze of shop stalls. Finally, he stopped in front of a large corner stall full of fresh produce, which he looked at and said, “This is the woman I usually buy stuff from.” I looked more closely at the stall’s wares, searching for strips of pills and bottles of ointment, but saw none; I looked around me at the other stalls, searching for a small stash of allopathic medications or medical supplies, but all I could see was more fresh produce. Peter got the attention of the woman who runs the store and, speaking to her in Kaqchikel, began asking her for things.

The only word I understood was “manzanilla”—chamomile—and I quickly realized that, given Peter’s avid interest in ethnomedicine, when he said he needed some “medicines,” I should have understood that he meant medicinal herbs. He proceeded to collect a sizeable bunch of different herbs and vegetables, and in between speaking in Kaqchikel to the storeowner and her assistant, he explained to me in English the rationale and principles for using alternative medicine. Medicinal herbs are cheaper and, for a physician who has not yet received what will be a nominal license to practice, more easily accessible than allopathic medications. The usual issue of cost and accessibility is compounded by the fact that generics are, according to Peter, virtually impossible to come by in Guatemala. I do not know the reasons for sure, and nor did Peter, but I have a bad feeling that this is the result of predatory, “neoliberal” policies akin to the stipulation that the sums of money recently promised by the United States for the purveyance of anti-retrovirals in sub-Saharan Africa be used to purchase only non-generic medications, converting what could have been a huge humanitarian gesture into a kick-back to First World pharmaceutical companies. (I use quotes around “neoliberal” because I think that cheap drugs should be the outcome of a neoliberalism that fosters and is based upon truly equal competition.)

Reasons other than cost (and Peter’s current student’s-stipend-budget) drive the use of herbs. First, the structural violence that has and continues to characterize relations between indigenous and non-indigenous peoples is manifest between practitioners of Western allopathic medicine and indigenous patients, and the use of medicines that are a part of indigenous Mayan medicine fosters trust and adherence to treatment regimens. On our walks between patients’ houses, Peter explained several examples of patients who quietly refuse to take allopathic medications but whose diseases have nonetheless been brought under relatively good control with only herbal medicines. Second, the use of Mayan medicines, in conjunction with activities such as Peter's financial sponsorship of Mayan religious ceremonies, serves the ostensive mission of Peter’s newly founded NGO, Wuqu’ Kawoq (see sidebar for Internet link), “strengthening Mayan culture and medicine”: the study and use of medicinal herbs contributes to the effort to preserve and revitalize Mayan knowledge and culture. In any case, after this interesting introduction, and after two days of continuing to learn from Peter about medicinal herbs, I am convinced that they should be appropriately incorporated as first-line treatments.

Peter also explained that at this point he is using about 20 or so such remedies, and that an important criterion for use of a specific medicine is scientific literature verifying its benefit—of course, not all of this evidence is from head-to-head randomized controlled trials comparing herbs to allopathic medicines, and Peter also noted wryly that it is a little imperialistic to make decisions based on Western allopathic standards, but that it is an easily rationalized way of selecting from the hundreds of herbal therapies for various ailments.

That's all for now. Thanks for reading! I'll post more soon.