At an intertribal gathering of shamans held last spring deep in Amazonia's northern fringe, a stout elder from Brazil's Waura tribe offered an impassioned plea. 'Please,' he urged fellow healers from Colombia and Suriname, 'don't let the medicine die.'
His appeal did not fall on deaf ears. In Kwamalasamutu, Suriname, where the shamans convened, an innovative model is leading the effort to preserve centuries of indigenous medicine by integrating traditional and Western practices into a thriving community health care system.
The cooperative nature of the effort is evident across the soccer field from where the shamans gathered. In a concrete building, a former missionary organization provides free primary health care, while next door, in a thatched-roof clinic, shamans wield medicines brewed from leaves, vines, and tree barks.
Five mornings a week, villagers trickle into the traditional clinic seeking remedies for a range of common complaints, from yeast infections to diarrhea. The shamans might look at the tendons of patients' fingers or peer into their eyes before turning to the bottled elixirs they keep in a solar-powered freezer. Or the shamans might refer them to their neighbors for treatment.
So far, three other rural villages in southern Suriname have built similar clinics, replicating a cost-effective model for indigenous health care that's been hailed by UNESCO and the World Bank and was one of 10 finalists this year for the prestigious Seed Award for innovation in local sustainable development.
The project was conceived by the Amazon Conservation Team (ACT), a Virginia-based organization that partners with tribes in Suriname, Colombia, and Brazil to preserve traditional rainforest culture as a means of saving the rainforest itself. In ACT's view, those fates are intrinsically linked: If the value indigenous cultures place on their ancestral land, culture, and resources erodes, so too might their will to steward the forest.
When ACT's founder, Mark Plotkin, first visited Kwamalasamutu in the early 1980s, shamanism was in remission. Missionary trailblazers had collectivized several dispersed tribes into one village, under God. Gym shorts replaced breechcloths. American evangelicals' pills displaced faith in traditional medicine, and many shamans publicly renounced their practices.
Plotkin, then a Harvard researcher studying indigenous healing, spoke with the shamans and explained to the tribes that many of the white man's medicines were derived from plants within their own forest. (The World Health Organization, or WHO, estimates that one-quarter of modern medicines are made from plants that were first used traditionally.) In 1988, after several visits, Plotkin presented a 300-page manuscript to the villagers' chief that inscribed, for the first time, generations of medicinal knowledge. Holding the only book to have been written in the Trio language other than a translated Bible, the chief pledged to pass its contents on to future generations.
To institutionalize that effort, Plotkin helped the village create a shamans and apprentices program with stipends from ACT. Today, a hierarchy of senior and junior shamans oversees a handful of younger apprentices who shadow elder healers in the clinic and on trips into the forest to collect plants. Twice a week, schoolchildren gather next door to the clinic for lessons on plants and handicrafts.
The revival of traditional healing practices comes as cutbacks in government subsidies and spiraling costs have limited the reach of primary health care in Suriname's rural interior. Operating symbiotically, the two clinics have helped to fill the gap. Joint workshops inform the Western-trained caregivers about indigenous concepts of illnesses, and shamans learn about preventive health practices. They often refer patients to each other. For instance, villagers who show up at the Western clinic suffering from the parasitic disease leishmaniasis will be sent next door to the shamans for an ointment that's more effective than any modern tincture.
'It's not some mash-up where you've got shamans handing out antibiotics,' says Plotkin. 'It gives [locals] a lot more free choice than I have with my health plan and has demonstrably reduced the expense for outside medicine by 20 to 50 percent.'
The clinics' practices are also helping in a larger effort, pushed by the WHO, to develop stronger evidence of traditional medicine's quality, safety, and efficacy. The clinics in Suriname have begun keeping records, and pharmacists there have introduced shamans to standardized measurement methods for collecting, preparing, and storing their medicines--efforts that will shed light on their efficacy and facilitate the production of medicines. They're now experimenting with more user-friendly (and potentially marketable) forms, such as a dry tea bag.
Ultimately, though, the broader intention of the program, explains Plotkin, is for tribes to find their own answers to some pressing questions: 'How do we interface with Western science? What are we willing to share? . . . And how do we take an approach that benefits our culture, our forests, and, in the end, everybody?'