Latin American Rural Practices
Curanderismo is a folk system used in Latin America and among many Hispanic-Americans in the United States. Hispanic-American refers to Americans of Spanish or Spanish-American descent; in the United States most trace their roots to Mexico (63 percent), Puerto Rico (12 percent), and Cuba, but increasing numbers of immigrants are arriving from Central America (Wright, 1990). The population of Hispanics is rapidly growing in the United States, and today about 22 million people call themselves Hispanic. More than half of this population lives in Texas and California, and large populations are also in Colorado, Arizona, Florida, Illinois, New Jersey, New Mexico, and New York. Curanderismo typically includes two distinct components, a humoral model for classifying activity, food, drugs, and illness; and a series of folk illnesses such as "evil eye," "fright," "blockage," and "fallen fontanelle." Curanderismo as described herein is most characteristic of Mexican-Americans, especially those who are little assimilated; variants on the humoral component typify most of Latin America, while the folk diseases and the treatment ~modalities reflect national background. Thus the Cuban-American folk system is not curanderismo, but santeria, and it is African influenced. Although no formal effectiveness studies seem to have been done on this system, its wide popularity and the research suggesting the relevance of the folk diagnoses for biomedical practice indicate the need for further demographic and effectiveness studies. In the humoral component of curanderismo things could be classified as having qualitative (not literal) characteristics of hot or cold, dry or moist. (Harwood, 1971; Messer, 1981; Weller, 1983). According to this theory, good health is maintained by maintaining a balance of hot and cold. Thus, a good meal will contain both hot and cold foods, and a person with a hot disease must be given cold remedies and vice versa. Again, a person who is exposed to cold when excessively hot may "take cold" and become ill.While this model is simple in theory, how people perceive in practice the hotness or coldness of substances varies greatly by region. Thus, while most can be expected to classify chili ~peppers as "hot" and milk as "cold," the classification of pork or penicillin is not so predictable. The second component, the folk illnesses, is actively in use in much of Mexico and among less educated Hispanic U.S. citizens (Rubel, 1960, 1964; Rubel et al., 1984; Young, 1981). Trotter (1985) did more than 2,000 clinic interviews in Texas, Arizona, and New Mexico and found that 32 percent to 96 percent of Mexican-American households (more frequent in the less Americanized communities) treated members for Hispanic folk illnesses. Baer and colleagues found similarly high use patterns among Mexican migrant workers in Florida and Mexico (Baer and Penzell, 1993; Baer and Bustillo, 1993). Four important Mexican-American folk illnesses are mal de ojo, susto, empacho, and caida de mollera. Mal de ojo, or evil eye, is a worldwide disease concept in which a person can make another sick by looking at him or her. The one who gets sick, typically an infant, is usually "weak." The one who causes the illness is usually thought not to do it on purpose--the person just has the misfortune to have a "piercing" glance. Typical symptoms ~of mal de ojo include fussiness, refusal to eat, and refusal to sleep. Infants are protected from evil eye with amulets or by having their faces covered in the presence of strangers. Treatment is primarily symbolic. Caida de mollera, or fallen fontanelle, is an illness of infants before the anterior fontanelle (crown of the head) closes. Common symptoms include diarrhea, excessive crying, fever, loss of appetite, and irritability. Usual folk treatments focus on raising the fontanelle by, for example, pushing up on the palate. Empacho is thought to be caused by something getting stuck in the intestines, causing blockage. Common symptoms are diarrhea, constipation, indigestion, vomiting, and bloating. The commonest treatment is massage along with herbal teas; the former is for dislodging the blockage, and the latter is for washing it out. Susto, or fright (sometimes called magical fright), develops when a person has had a sudden shock--a mother may develop fright if she sees her child nearly drown, or someone may ~experience fright after participating in an unusually intense argument. The sick person experiences such symptoms as daytime sleepiness combined with nighttime insomnia, irritability and easy startling, palpitations, inability to stop thinking about the shocking event, anxiety that it will be repeated, and sometimes a sense of loss or a sadness that will not leave. The mild form is treated with herb tea; more severe cases are treated with ritual cleansings (barridas) to restore the harmony of body and soul. When mild, these folk illnesses are commonly treated at home, but if they persist, the help of specialists--curanderos (men) or curanderas (women)--is sought. The training of curanderos and curanderas varies widely. Most practice a combination of shamanic healing and herbal or practical first aid healing. Most are also astute at manipulating symbols and "reading" the prevailing psychological and social indicators. Some curanderas specialize in midwifery and infant care. In some areas, becoming a healer is a matter of inheritance; the skills are passed from mother to daughter or perhaps aunt to niece. In some areas it is a matter of being called. Typically, curanderos and curanderas spend several years in apprenticeship; their subsequent reputation depends on the number of their patients and how successful their ~patients judge them. Treatment techniques, usually a combination of the shamanic and the naturalistic, vary widely; interested readers should consult specialist texts. An issue of concern is that some curanderismo treatments, particularly for empacho, involve feeding lead-or mercury-based remedies. Investigators' efforts to test whether the amounts ingested were causing medical complications were inconclusive. Although curanderas were found to be largely aware of the danger of the remedies and used them sparingly, intervention programs to limit use of these remedies were begun (Baer et al., 1989; Trotter, 1985). Trotter (1985) collected symptomatology lists from more than 2,000 interviews and submitted symptom clusters to medical doctors for "blind" diagnoses. He found, for example, that caida de mollera appears to be symptomatic of serious dehydration secondary to gastroenteritis or respiratory infection. Trotter also found that people who are sicker than average are more likely to be diagnosed with susto. Baer and Penzell (1993) similarly report that migrant workers most affected in a pesticide poisoning incident were also those most ~likely to report suffering from susto. Susto fits the pattern of "soul loss" (Ingerman, 1991), a shamanically recognized disorder known worldwide that resembles several serious psychotherapeutically recognized conditions, including depression and posttraumatic stress syndrome. Therefore, people being treated for folk diseases could be considered to have conventional illnesses that are being treated outside the conventional biomedical health care system

 

Close Window