Joseph William Bastien - Drum and stethoscope: integrating ethnomedicine and biomedicine in Bolivia
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Drum and stethoscope: integrating ethnomedicine and biomedicine in Bolivia
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Drum and Stethoscope : Integrating Ethnomedicine and Biomedicine in Bolivia
author
:
Bastien, Joseph William.
publisher
:
University of Utah Press
isbn10 | asin
:
print isbn13
:
9780874803860
ebook isbn13
:
9780585131917
language
:
English
subject
Medical care--Bolivia, Traditional medicine--Bolivia, Delivery of Health Care--Bolivia, Medicine, Herbal--Bolivia, Medicine, Traditional--Bolivia.
publication date
:
1992
lcc
:
RA461.B37 1992eb
ddc
:
362.1/042/0984
subject
:
Medical care--Bolivia, Traditional medicine--Bolivia, Delivery of Health Care--Bolivia, Medicine, Herbal--Bolivia, Medicine, Traditional--Bolivia.
Page i
Drum and Stethoscope
Page ii
Midwife teaching Aymara women childcare in Peas, Bolivia.
Page iii
Drum and Stethoscope
Integrating Ethnomedicine and Biomedicine in Bolivia
Joseph W Bastien
University of Utah Press Salt Lake City
Page iv
Copyright 1992 University of Utah Press All rights reserved
This symbol indicates books printed on paper that meets the minimum requirements of American National Standard for Information ServicesPermanence of Paper for Printed Library Materials, ANSI A39.38-1984.
Cover illustration by Bailey-Montague & Associates, Salt Lake City
LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA
Bastien, Joseph William, 1935 Drum and stethoscope: integrating ethnomedicine and biomedicine in Bolivia / Joseph W. Bastien. p. cm. Includes bibliographical references and index. ISBN 0-87480-386-1 1. Medical careBolivia. 2. Folk medicineBolivia. I. Title. [DNLM: 1. Delivery of Health CareBolivia. 2. Medicine, HerbalBolivia. 3. Medicine, TraditionalBolivia. WA 395 B326d] RA461.B37 1992 362.1'042'0984dc20 DNLM/DLC 92-53602 for Library of Congress CIP
Page v
For my mother MARY MAGDELEN ARENDT BASTIEN (1892-1972) who cured me of polio when I was three years old after being told by doctors that I would never walk again to which she replied "Only God determines that!"
Page vii
CONTENTS
Preface
ix
Acknowledgments
xv
Part I. Articulation of Biomedicine and Ethnomedicine: Objectives, Problems, and Strategies
1. Biomedical Centrism: Deficiencies of Biomedicine in Primary Health Care
3
2. Quack Doctors, Superstition, and Witchcraft
(with Henri Migala)
19
Part II. Herbalists and Shamans: Opposition and Adaptation to Biomedicine
3. Adaptive Strategies of Bolivian Herbalists to Biomedicine
47
4. Shamans under Siege: Psychosocial Therapy
72
Part III. Mediators between Biomedicine and Ethnomedicine: Community Health Workers and Midwives
5. Community Health Workers: Bridging the Gap between Biomedicine and Ethnomedicine
105
6. Midwives and Maternal and Infant Health Care
(with Nancy Edens)
137
Part IV. Doctors, Nurses, and Vaccinators: Strategies for Joint Therapies
7. Training Doctors to Integrate Ethnomedicine
173
8. The Silver Bullet versus the Hexing Thorn
192
9. Conclusions
215
References
237
Index
259
Page ix
PREFACE
This book provides ethnographic examples of ways in which ethnomedical healers can collaborate with doctors and nurses to improve the health of peasants in regions of the undeveloped world. Many of the examples are from the Aymara and Quechua speakers of the Andes where I have conducted fieldwork from 1963 to the present. The following is a case in point.
In August 1989 I had returned from the mountains, where I was doing fieldwork, because of a swollen and very sore throat. In the rarefied atmosphere of 13,000 feet I had difficulty breathing. I went to an integrated clinic that offers biomedicine and ethnomedicine, located on Calle Santa Cruz of La Paz, Bolivia. As I walked through the doorway, a woman doctor greeted me. She introduced herself as Alicia and then carefully examined me, taking my blood pressure, counting my pulse, and questioning me about my sore throat. She concluded that I had strep throat and gave me some penicillin. Figuring this would cure me, I began to leave when she recommended that I talk with the Kallawaya herbalist in the adjacent office. Alicia introduced me to this herbalist, Lucas Ortiz, who asked a different set of questions: What had I been doing? At what altitudes had I been living? What had I been drinking? And what was I eating? Lucas felt my pulse more thoroughly than Alicia. Collecting a urine sample, he held it in front of the window to reflect the rays of the sun and looked for telltale images. He then prescribed
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