CONTEMPORARY THREATS TO ETHNOMEDICINE
Stanley Krippner, Ph.D.
Saybrook Graduate School & Research Center
San Francisco, CA, USA
Less than 20 percent of the world’s population is serviced by Western allopathic biomedicine; the rest of the world’s population is served by other medical systems. The term “ethnomedicine” refers to the comparative study of these health care systems, many of which are becoming endangered. The major threats to native, indigenous medical systems are the hegemony of Western medicine, the emergence of new diseases (such as AIDS) that indigenous practitioners can not treat effectively, and the lack of new practitioners willing to spend the time it takes to complete the rigorous study of herbs, rituals, and diagnostic procedures that have marked these practices over the millennia. There are some signs of rapprochement and collaboration between Western medicine and the enthomedicines it is supplanting, a cooperation that might expand effective health care in developing countries and isolated areas of the world.
The term “ethnomedicine” refers to the comparative study of medical and other health
care systems. It focuses on beliefs and practices in various human populations concerning sickness and health. Ethnomedicine observes and describes hygienic, preventive, and treatment practices, taking temporal and spatial considerations into account. Primary foci of this field are surgery, healing rituals, and the application of phytomedicines (plant preparations), practices that date back to the dawn of human civilizations.
Typical ethnomedical topics include etiology of sickness, medical and other health care practitioners and their roles, and the specific treatments utilized. The explosion of ethnomedical literature has been stimulated by an increased awareness of the forced displacement and acculturation of indigenous people and their consequences, as well as by the recognition of indigenous health concepts as a means of maintaining ethnic identities. In addition, the search for new phytomedicines and medical technologies has motivated researchers to study widely diverse systems of healing. Kleinman (1995) found this line of investigation an “appropriate means of representing pluralism…and of drawing upon those aspects of health and suffering to resist the positivism, the reductionism, and, regrettably, the wider society privilege” (p. 195). It is ironic that at the same time that an interest in ethnomedicine is growing, both in academic and medical circles, there are threats to the very pluralism that Kleinman hailed.
Basic Concepts, Terms, and Principles
There are two basic conceptual frameworks within traditional medical belief systems, the endogenous and the exogenous concepts. As an example of the former, sickness is caused by the loss or capture of a client’s soul, or part of the soul, or one of the souls. As a result, the soul has left the client’s body, has entered another realm, and the client suffers as a result. Treatment involves the practitioner’s intervention to recapture the soul and restore the balance of the client’s spiritual forces.
In the latter instance, sickness is caused by the intrusion of a real or symbolic object within the individual; these objects range from pebbles to small animals to chunks of plastic to toxic substances such as viruses. Treatment involves an intervention to remove, kill, or neutralize the intruding objects, restoring the client to health (Morley & Wallis, 1978).
In his exhaustive study of cross-cultural practices, Torrey (1986) concluded that effective treatment inevitably contains one or more of four fundamental principles:
1. A shared world view that makes the diagnosis or naming process possible;
2. Certain personal qualities of the practitioner that appear to facilitate the patient's recovery;
3. Positive patient expectations that assist recovery;
4. A sense of mastery that empowers the patient.
If a traditional medical system yields treatment outcomes that its society deems effective, it is worthy of consideration by biomedical investigators. This consideration is to those who are aware of the fact that less than 20 percent of the world’s population is serviced by Western allopathic biomedicine (Mahler, 1977). However, what is considered to be “effective” varies from society to society. Western biomedicine places its emphasis upon "curing" (removing the symptoms of an ailment and restoring a patient to health), while traditional medicine focuses upon "healing" (attaining wholeness of body, mind, emotions, and/or spirit).
Some patients might be incapable of being “cured” because their sickness is terminal. Yet those same patients could be “healed” mentally, emotionally, and/or spiritually as a result of the practitioner’s encouragement to review their life, finding meaning in it, and becoming reconciled to death. Patients who have been "cured," on the other hand, may be taught procedures that will prevent a relapse or recurrence of their symptoms. This emphasis upon prevention is a standard aspect of traditional medicine, and is becoming an important part of biomedicine as well.
A differentiation also can be made between "disease" and "illness." From either the biomedical or the ethnomedical point of view, one can conceptualize "disease" as a mechanical difficulty of the body resulting from injury or infection, or from an organism's imbalance with its environment. Orellana (1987) adds that a “disease” exists whether or not a culture recognizes it, and whether or not the patient is aware of its existence (p. 27). "Illness," however, is a broader, socially contextualized term implying dysfunctional behavior, mood disorders, or inappropriate thoughts and feelings. These behaviors, moods, thoughts, and feelings can accompany an injury, infection, or imbalance – or can exist without them. These sicknesses to a large degree are “socially constructed,” and the way that they are constructed varies from society to society.
Thus, English-speaking people refer to a "diseased brain" rather than an "ill brain," but of "mental illness" rather than of "mental disease." Cassell (1979) goes so far as to claim that allopathic biomedicine treats disease but not illness; "physicians are trained to practice a technological medicine in which disease is their sole concern and in which technology is their only weapon" (p. 18).
Threats to Ethnomedicine Posed by Western Biomedicine
Despite these caveats, in many parts of the world, Western biomedicine is becoming the treatment of choice. In 1996, I spent five days in La Paz, Bolivia, and vicinity interviewing practitioners of a unique form of ethnomedicine, the Andean Kallawaya system. I interviewed several Kallawaya practitioners including the president of the Bolivian Society of Traditional Medicine and the president of the La Paz Association of Traditional Spiritual Kallawaya Practitioners. The former group has thousands of members (about half of them women) while the latter is an affiliated group.
Kallawaya herbalists trace their tradition back to the legendary Tiahuanaco cultures of 400-1145 C.E., continuing through the eras of other pre-Inca cultures, the Inca Empire, and the Spanish conquest, to present times. Kallawaya healers are members of the Kallawaya ethnic group that speaks Aymara, Quechua, and/or Spanish; both the earlier Aymara and the later Quechua cultures had Kallawaya healers.
Traditional Kallawaya follow three injunctions: ama swa, do not steal; ama llulla, do not lie; ama khella, do not be slothful. Kallawaya also believe in a principle of nature they refer to as the “boomerang law”: if you harm others, malevolent acts will return to you. Living by these precepts is felt to be fundamental in establishing and maintaining harmony within the community. A life of moderation, peace, and harmony is in accord with the Kallawaya maxims, and a dynamic equilibrium is needed to produce a healthy balance.
The goal of the Kallawaya medical model is to maintain and restore the harmonious relationship of community members, the community as a whole, and the natural environment. The Kallawaya practitioner needs to assure the availability of medicinal plants and proficient healers who are conversant with health, sickness, the natural realm, and the world of spirits. Prevention involves the practice of moderation in daily life, and the maintenance of trust among members of the community.
Kallawaya healers mediate between the ill person's body and the environment, attempting to restore the balance that has been lost. However, restoration of this balance is dependent on a number of factors--the sickness itself, its severity, and the cooperation of patients and their families. The confidence and the faith of the patient are key factors because herbal treatment is a slow process that requires a great deal of patience. Belief is felt to activate the self-regulatory mechanisms that are fundamental to recovery. In addition, considerable emphasis is placed on prevention; proper nutrition is seen as essential to the maintenance of health.
The Kallawaya healers employ more than one thousand medicinal plants, about one third of which have demonstrated their effectiveness by allopathic biomedical standards, and another third of which have been judged “likely” to be effective (Bastien, 1992, p. 47). These plants are divided according to the three distinct “weathers” that Pachamama (Mother Earth) and Tataente (Father Sun) have given to their ayllu, namely hot, mild, and cold.
Coca plays a major role in many of the healing procedures because it is felt that the plant grows between the world of human beings and the world of the spirits. A coca and quinine mixture has been used to treat malaria--most notably, as Kallawaya healers tell the story, during the digging of the Panama Canal, a triumph that brought them to world-wide attention. The fungus of corn or bananas produces a substance similar to penicillin that is used for local infections. More serious infections are treated by a preparation similar to tetramycin yielded by fermented soil; this preparation is also used for ulcerated skin and chronic conditions.
Herbal preparations usually are ingested but occasionally are used in conjunction with a “steam box”; the naked patient enters a receptacle that has been filled with steam created from the medicinal mixture. The active ingredients of the herbs enter the pores of the patient at the same time as the sweat cleanses the toxins. I observed a patient in one of these steam boxes in the Tambillo Hospital I visited on the outskirts of La Paz. In addition to the steam boxes and their cleansing therapy, the hospital was replete with hundreds of Kallawaya herbal preparations, all carefully prescribed, measured, and given to patients with explanatory procedures.
In the 1950s and 1960s, Bolivian pharmacists and physicians successfully curtailed the influence of Kallawaya practitioners by public humiliation, restrictive laws (and imprisonment for their violation), and denial of licenses (Bastien, 1992). Even though some Kallawaya practitioners incorporated various aspects of biomedicine into their procedures, physicians and politicians portrayed these healers, at best, as members of an antiquated tradition and, at worst, as charlatans. The success of Kallawaya treatment and the increasing surplus of allopathic physicians in Bolivia exacerbated the situation.
Mounting a counterattack, many Kallawaya healers stereotyped physicians as kharisris, mythic figures who steal fatty tissue, the source of force and energy in folk tradition. As a result, however, those Kallawaya practitioners who had adopted a few biomedical practices often lost patients.
In the 1980s, most Bolivian physicians and nurses discontinued efforts at integrating ethnomedicine because their superiors did not promote it (Bastien, 1992, p. 38). At the same time, there was a sharp resurgence in Kallawaya practice as the value of their medicinal plants was touted by biomedical research, and because Bolivian peasants could not afford biomedical treatments (in 1984 the cost of a penicillin injection was about $10.00 U.S., several days wages for peasants).
In the 1990s, communication between physicians and herbalists in Bolivia improved because of the interest in ethnomedicine; the two groups collaborated on several conferences and even jointly staffed a few clinics. Walter Alvarez, a gynecologist and surgeon as well as a Kallawaya practitioner, was instrumental in helping the Kallawaya of one ayllu obtain a clinic staffed by both a physician and an herbalist. In summary, biomedical techniques are now finding their way into Kallawaya practice without a loss of the tradition’s unique identity.
Other ethnomedical traditions have not fared so well. In 1985, I visited Denny Thong (1993) a psychiatrist who took me on a tour of the first mental hospital in Bali, Indonesia. One of his innovations was a “Family Ward,” which involved organizing the staff into a bajaar, the traditional unit of social organization. A small chapel was constructed and the staff chose Djero Gede as the traditional deity who would empower the temple. A piodalan festival, replete with dances, shadow puppet plays, and traditional foods, was a highlight of the year. Soon, family members and friends of patients hospitalized in the Family Ward came to worship in the temple and attend the annual festival.
Instead of the large halls characterizing Western mental hospitals in Bali, the Family Ward consisted of small compounds built from local materials, each of which could house a patient and a few of his or her family members. The latter would cook for the patient, provide social support, and spend time discussing the patients’ problems and progress. Both patients and their families were taught how to administer their own medication; in addition they were allowed to utilize the services of the local balian or traditional healer; many of these healers employed a treatment consisting of applying pressure points to areas of a patient’s skin felt to harbor toxic materials planted there by sorcerers. Thong (1991) remarked, “Astonishingly enough…, several patients…showed remarkable improvement” after being treated by a balian (p. 68).
At the end of the first year, Thong and his staff evaluated the results of the Family Ward; 14 patients had been admitted. Most recovered and did not appear for additional treatment, one was sent to the regular ward, and the others were treated as outpatients. The average amount of time spent in the Family Ward was 40 days. However, Thong’s use of traditional practices aroused considerable controversy in the national capital of Jakarta. The Indonesian Medical Association accused him of “dabbling with superstition and unscientific methods” (p. 68) and, at the end of 1987 the Family Ward was closed. Thong was transferred to another island in Indonesia despite the success of his procedures and their cost-effectiveness.
Threats to Ethnomedicine Posed by a Lack of Practitioners
There are several instances on record of cooperation between traditional healers and biomedical practitioners. Anthony Okello, a traditional healer in Uganda, treats minor aches, pains, and fevers with local herbs; however, he has been trained to recognize symptoms of HIV and sends these patients to the local hospital for antiretroviral drug treatment. The supply of these expensive medications has increased as a result of such donors as the Bill and Melissa Gates Foundation, and Uganda has pledged that they will be supplied to any Ugandan who needs them. The major roadblock is the infrastructure; there is one allopathic physician for every 20,000 citizens. However, there is only one traditional healer for every 150 citizens. The reluctance of young people to enter training programs is decimating the ranks of traditional healers at the same time that the World Health Organization and national governments are fostering schools that offer training in both ethnomedicine and Western procedures.
Anthony Okello and other African practitioners are playing important roles. Training is being made available by the Traditional and Modern Health Practitioners Together against AIDS, a group based in the capital city of Kampala and representing a synthesis of the two bodies of medical practice. Another group, Prometra, is based in Senegal. A member of the group, Yahaya Sekagya, runs an outdoor school for traditional healing. He admits that Western medicine works better for bone fractures and blood transfusions, but teaches the identification and use of local plants for many ailments, accompanied by chanting, drumming, and dancing to “call the spirits” for consultation and assistance (Faris, 2006).
Nevertheless, in many parts of the world there is a lack of young people to “call the spirits.” The lure of the big cities is too great, the rumors of high-paying jobs in urban areas is seductive, and—in many parts of the world—civil wars, ethnic cleansings, invasion from foreign troops, and local criminal activity have disrupted the ambience that is needed for the concentrated study needed for plant investigation, mastery of rituals, and step-by-step instruction in complicated surgical procedures. During my visits to China, I have often spoken at schools where practitioners of Chinese medicine are trained. Over the years, I have been told that the enrollment in these training programs has dropped; one of the schools, The Guangzhou University of Traditional Chinese Medicine, has had to create additional programs to sustain its enrollment.
In addition, natural disasters, such as hurricanes, floods, earthquakes, and droughts, have hindered efforts to provide the training in ethnomedicine that would replenish the ranks of practitioners. Both natural and human cataclysms also have drained local economies of the funds needed to implement suitable training programs in ethnomedicine.
Gunn (1966), in commenting on indigenous healers in the Pacific Northwest, called them "remnants of a dying caste" (p. 118) and Fiddes added that in many parts of the world, "the shaman has taken down his shingle" (p. 9). However, the Amazon Conservation Team, a U.S.-based organization operating in the Amazon basin, has been collecting medical remedies and soliciting new students. A hierarchy of senior and junior shamans oversees the apprentices who are taught how to collect and apply plants. One of the elders pleaded with the team’s founder, Mark Plotkin, “Don’t let the medicine die” (Isaacson, 2007, p. 5).
Threats to Ethnomedicine Posed by New Diseases
The future of ethnomedicine also depends on how traditional medical systems cope with new sicknesses, those ailments for which there is no traditional treatment. Use of pesticides has produced insects who have inherited a resistance to once-dependable ethnomedical treatments. Leprosy, malaria, and other diseases once thought to have succumbed to sanitation and vaccination, have crept back into several communities.
Sometimes the evidence dictates that traditional treatments need to be replaced, notably in regard to prevention and treatment of AIDS in Sub-Saharan Africa. In some parts of the area folk tales abound that AIDS among men can be cured if the afflicted has sex with a virgin. This superstitious belief has had disastrous consequences. In other parts of Africa the alleged cure is to have sex with a post-menopausal woman, and in still others the cure is to have sex with an infant. These traditional treatments are dysfunctional, representing extremely irrational ways of removing an intruding agent, in this case the HIV virus. In the meantime, one in ten people test as HIV positive in Tanzania and South Africa, with similar rates in neighboring countries. Many traditional healers have admitted to their community that they have no effective treatment for people who have contracted the AIDS virus, but work with the Western or Western-trained personnel, especially in the area of AIDS prevention. In addition, there are several ways traditional practitioners can help their patients slow the increase of HIV viruses and treat those infections that flourish once a patient’s immune system is compromised.
One of these treatments is the use of the Chinese herbal medicine Qian-Kun-Nin for opportunistic diseases because of its anti-infection, anti-retroviral, and anti-tumor properties. This medicine, a mixture of 14 different herbs, has been found to inhibit HIV and modulate immune functions in AIDS patients (Yue & Guangming, 2000). A number of Chinese herbal preparations have been found to possess an ability to fight infections and strengthen the immune system. In addition, some herbal medicines have the ability to attack tumor tissue alone or in combination with anti-cancer drugs (Tatsua, Iishi, Nakaizumi, & Uehara, 1994). As a result, there are Chinese hospitals where physicians trained in Western biomedicine collaborate with traditional Chinese physicians.
Threats to Traditional Ethnomedicine Posed by Ineffective Treatment
The World Health Organization (Mahler, 1977) has defined health as “a complete state of physical, mental, and social well-being, not merely an absence of disease or infirmity” (p. 9). The value of ethnomedical practitioners and their collaboration with biomedical systems has become widely heralded since their advocacy by the World Health Organization, but the high cost of training ethnomedical practitioners, the reluctance of many biomedical bureaucracies to accept them, and the lack of prospective practitioners have dimmed many prospects for collaboration. In addition, some of the phytomedicines used in folk healing have been tested and found wanting (Bastien, 1992, p. 27).
Many ethnomedical practitioners use adaptive strategies that represent living and dynamic systems but others use methods and materials that should have been discarded decades if not centuries ago. Lead content is very high in some traditional medicines, including those used by certain ethnic groups in the United States. For example, a one-year-old boy in the United States was diagnosed with brain damage by a practitioner of Tibetan medicine. He was administered a Tibetan medicine and told to ingest it three times a day. After four years the boy was diagnosed with neonatal asphyxia, attributed to the Tibetan remedy, one which had a high degree of lead content (Moore & Adler, 2000).
Ayurvedic medicine, widely used in India and many parts of the United States, is usually made of vegetable products but sometimes of metals and minerals. The latter may include lead, mercury, and arsenic, all of which may prove toxic if taken over a period of time (Saper et al,. 2004). In some Mexican communities, two remedies known as Azarim and Grota are commonly prescribed for digestive ailments by folk healers. Litargio is frequently prescribed as a deodorant. All three have extremely high lead contents and are harmful even if used for short periods of time (Smolinske, 2005).
Physicians who treat diverse ethnic populations need to become aware of traditional medicines often used in these communities. In addition, there is an increasing use by the general U.S. population of folk remedies as alternatives to allopathic medical prescriptions. Physicians, including naturopathic physicians, need to inquire about their use and to be knowledgeable about both their benefits and their risks.
Collaboration between Traditional Ethnomedicine and Western Biomedicine
The degree of collaboration between Western biomedical personnel and ethnomedical practitioners varies from country to country; Nigeria, Mali, and Equatorial Guinea, as well as Uganda, are mainstreaming traditional practitioners. South African physicians, however, balk at legislation that would formalize the isangoma and other traditional healers (Faris, 2006). However, Canada has over 100 native treatment facilities, more than any other country in regard to its population, where dances, songs, and ceremonies are integrated into the treatment programs. In New Zealand, Maori practitioners have played an important role in preventive medicine and AIDS education for decades, and in Australia, aboriginal healers have used sand pictures and “dreamtime” to portray safe sexual practices (MacLennan, 1992).
One form of synthesis is the emergence of “narrative medicine.” Just as traditional practitioners listened carefully to their patients and responded by telling a mythical story about their sickness, an experimental group of medical students from around the world was asked to write a description of a recent patient who had moved them deeply. Rita Charon (2006), the originator of the pilot program, held at an Israeli medical school, gave the students five minutes to write a story, poem, or dialogue about the patient. One student told of a dying patient, with no family, who had three wishes: “Sit with me.” “Bring me for a walk in the fresh air.” “Listen to my autobiography.” Charon concluded that her pilot experiment had been successful and that “narrative medicine” can develop skills that enable physicians to recognize, absorb, and be moved by stories of illness. They develop the ability to pay attention, and to develop rapport with those who suffer in a manner similar to that practiced by shamans, medicine men, and medicine women for millennia.
Such groups as the Society for Shamanic Practitioners are making active efforts to provide a synthesis between shamanic procedures and those of Western medicine and psychological therapy. The 178-member World International Property Organization is attempting to protect indigenous people from outside exploitation of their herbal remedies. The future of ethnomedicine will depend upon projects of this nature, collaboration that nurtures a careful examination of existing evidence regarding the effectiveness of traditional treatments, the resolution of quality control of the substances used, and the provision for research when no data are available (e.g., Albuquerque, 2006; Orellana, 1987).
There are several procedures and skills practiced in ethnomedicine that could be emulated by Western health care practitioners. One of these is palliative care, the soothing of patients whether or not they are expected to recover. The notion of easing pain and improving a patient’s quality of life may not seem radical, but mainstream medical education generally ignores it, preferring to focus on sicknesses themselves. Most physicians claim they do not have the time to check up on their patients, asking them how they feel. Others have never acquired the training needed to ease patients’ anxiety, depression, pain, or even severe nausea. Palliative care could be practiced by nurses, social workers, and physical therapists as well as by physicians.
As of 2005, over one thousand U.S. hospitals had units where palliative care was practiced. One out of three hospitals now teaches palliative care procedures. Most palliative care units encourage family visits, and keep both families and patients posted on prognosis and future plans (returning to patients’ homes, to their families’ homes, to a nursing home, or to a hospice) (Kenen, 2007).
Palliative care is not to be confused with hospice care. The latter focuses on terminally ill patients, people who no longer seek or expert treatments that will cure them. Palliative care teams can follow patients for several years. Hospice care is a fairly new development in Western medicine. However, it has been described by observers of traditional medicine for centuries. In 1997, I visited a home run by the Sisterhood of Our Lady of Good Death in Salvador, Brazil. Organized in 1821, in conjunction with the Festival of Our Lady of Good Death, the “sisters” look after their dying patients with compassion and consideration, devoting their waking hours to be sure that the men and women in their care make their transition to “the other world” as comfortably and easily as possible (Ribeiro & Kennedy, 2002). Traditional music, ritual, and dance are provided along with humorous stories and delicious meals. The sisterhood is composed of descendents of slaves and requires a 3-year initiation, whether the members are Roman Catholic or are affiliated with one of the Afro-Brazilian religions. In the past, membership exceeded 200, but during my visit there were only a few dozen “sisters”; like many other folk traditions, it is difficult to recruit new members.
The “Tomato Effect” in Medicine
The momentum of the past few centuries has been the waning of traditional practices in developing countries. This may be an example of the “Tomato Effect” in medicine, a term that refers to the rejection of worthwhile traditional procedures and treatments because they clash with those that are accepted by mainstream practitioners. The tomato, brought to Europe from the Americas in the 1600s, was not seen as fit for human consumption by physicians because it was a member of the nightshade family. The fact that Native Americans had eaten tomatoes for centuries without ill effects was ignored by the members of the medical establishment. After two centuries of tomato-eating by Europeans who rejected the medical establishment’s prohibitions without falling ill, physicians stopped objecting in the 1820s. In this case, ingestion of the tomato represented a counter-myth that was rejected by the European physicians who championed the old myth that nightshades were poisonous.
Objections to the tomato aside, power began to gravitate away from folk healers and neighborhood doctors to highly technical allopathic biomedicine with its pills, procedures, instruments, and immunizations. Authorities in white coats replaced the friendly folk healers and bedside physicians, multiplying like sorcerer’s brooms into a myriad of specialists sweeping in and out of examination rooms. Costs went up, caring went down, and patients became seen as consumers as they struggled for survival and autonomy. Lives were prolonged, but patient satisfaction and practitioner gratification plummeted.
Even so, in its 2000 report on world health, the World Health Organization estimated that 36 countries have more successful health care programs than those in the United States, even though that country ranks number one in the amount of money spent on health care. In the United States, life can be prolonged with medical technology; emergency medical treatment is excellent and the genome has been mapped. However, 120 million Americans have chronic degenerative diseases. Over 50 million more have autoimmune diseases. Nine out of ten medications suppress symptoms but do not cure these two types of diseases. Hence, many Americans seek other treatments, among them ethnic minorities whose standard of health care is decades removed from care given to the Euro-American majority (Satcher & Pamies, 2006).
In 1998, David Eisenberg and his colleagues published some noteworthy statistics in the Journal of the American Medical Association. They estimated that there are over two million hospitalizations in the United States each year and more than 100,000 deaths from the “side effects” of pharmaceutical drugs. These numbers, combined with previously documented information that takes into account the mistakes and misuses of pharmaceutical drugs, brings the number to over 5 million hospitalizations and more than 250,000 deaths annual, in other words, nearly 700 deaths per day. A 2006 study came to similar conclusions. This makes mainstream medical treatment the third leading cause of death in the United States. In addition, over one third of the 5,000 hospitals in the United States are losing money and as many as 1,000 have closed. In the meantime, the active ingredients in prescription medications cost a fraction of the price paid by consumers; For example, 100 tablets of Celebrex cost the consumer about $130.00 (U.S.), while the cost of the active ingredients in 100 tablets are about sixty cents, a markup price of 22,000% (Eisenberg et al., 1998).
There are both ecological psychologists and traditional practitioners who believe that healing the planet has become a healing journey. If so, traditional ethnomedical systems can play a vital role in this endeavor. Yet, while herbal medicine, indigenous treatments, and even shamanism are becoming faddish in many Western countries, ethnomedical systems in indigenous areas are becoming increasingly endangered. It is crucial to learn what traditional ethnomedicine may have to offer the quest to provide planetary healing. The longevity of these systems indicates that they have served many populations well over the millennia. Their survival may be well be linked to the survival of the planet.
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The preparation of this paper was supported by the Chair for the Study of Consciousness, Saybrook Graduate School and Research Center, San Francisco, California, U.S.A. It was presented at a keynote address at the World Congress of Ethnomedicine, Munich, Germany, 12-15 October 2007.