Traditional Medicine/CURANDERISMO within the Hispanic/Latino

Traditional Medicine/CURANDERISMO
within the Hispanic/Latino population
What’s the point???
When we’re selective about the options we
consider. This limits our ability to solve
problems. It’s far better to open our
minds to all possible solutions/options.
Latino and Asian Populations in
the US and NC, 2000
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•
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The Latino population
13% of the US population (35.3 million)
5% of the NC population (378,963)
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•
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The Asian Population
3.6% of the US Population (10.2 million)
1.4% of the NC population (113,689)
• U.S. Census Bureau, 2000
Racial Breakdown
(Mexico)
Mestizo (Amerindian and Spanish) 60%
Amerindian
30%
Anglo
9%
Other
1%
Demographic Data - Latinos in US
• Majority of Latino immigrants employed in
agriculture, construction, food services,
landscaping, and factories
• Despite high levels of employment, nearly 60%
of Latinos live in families with incomes below
200% of the poverty level (US)
Hispanic Myths/Sterotypes
 All Hispanics are the same
 All Hispanics are on Federal Assistance
 “They can speak English, they just act dumb”
 All Hispanics are illegal
 Hispanics are taking our jobs
 All Hispanics come from Mexico
Hispanic Cultural Views
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•
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Respeto/Respect
Famialismo
Non-Verbal
expressions
• Time Concept
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•
•
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Machismo
Chauvinism
Religious Values
Marianismo
Latino Cultural Values
• The important value of collectivism and familism.
– Collectivism is a value in loyalty to, and the contribution of, the
group-as opposed to focusing on a particular individual (Toro,1996).
– Familism is a value that underlies the strong Latino identification
with members of the extended family (Toro, 1996). Latino families
have a strong sense of family identification and structure as well as
support for extended family.
• “Hierarchical regard," or respect toward those with power and positions
of authority.
– Doctors, clergymen, teachers, etc.
• Religion has a major influence in Latino families.
– They believe strongly in the importance of prayer and going to
church.
– Latinos tend to consider problems or events as something that is
meant to be and cannot be changed (fate vs. personal control over
environment).
La Familia (The Family)
• The family is central to social networks and
decision making in this culture
• Patients may bring family to appointments.
– Be certain to ask to whom medical results should be
given and who is included in the treatment plan
• Eldest male may be key decision maker.
– Respect these family preferences in clinical
encounters
• Mother holds greater influence over the kids
throughout their lifetime.
– Important to consider when composing plans of care
for adolescents and young adults.
Understand your patients
• Personalismo: personal relationships . . .
– Latinos tend to appreciate personal
discussion before formal interviews.
– Due to the personal nature of the
clinical encounter, the patients often
want to have a relationship with the
provider.
– Taking time to ask about family, work,
personal life prior to the medical
interview will set patient at ease.
Barriers to Care
•
•
•
•
•
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Language
Cultural differences
Lack of insurance
Lack of transportation
Knowledge of services
No phone
• Hours of services
•
•
•
offered
Immigration status
Residency
requirement
Distrust of the
system
FACTS
• Only 41.6-50% of Mexican Americans have
•
health insurance.
They are less likely to utilize health services
because:
• Language barriers
• Distrust of the system
• Perceived discrimination by agencies or service
providers
• Limited knowledge of systems and services
• Unfamiliarity with acceptable help-seeking
behaviors
How to Avoid Communication
Problems
• El respeto (respect) – use titles (Mr., Mrs., Ms.)
– Patients also expect respect to be expressed
based on age, sex, professional status, etc.
• Be sure to emphasize when adherence to clock
time for medicines or when appointments are
critical.
• It can be taboo to express negative feelings.
Take time to talk with patients to get as much
insight as possible. Ask follow up questions
such as, “How do these recommendations fit
into your present treatment plan?”
Culturally Sensitive interview
(Non Verbal Communication
Styles)
• Hispanics tend to touch people with whom
they are speaking.
• They tend to sit and stand closer than
Anglos.
• Shake hands or engage in an introductory
embrace kissing on the cheek, hugging.
• Interpret prolonged eye contact as
disrespectful.
Guidelines for Health Practitioners:
LEARN
•L
Listen with sympathy and understanding to the
patient’s perception of the problem
•E
Explain your perceptions of the problem
•A
Acknowledge and discuss the differences and
similarities
•R
Recommend treatment
•N
Negotiate agreement
WHAT CAN WE DO?
• ASK PROPER QUESTIONS WHEN GETTING
PATIENT HISTORY!
• ENCOURAGE PATIENTS TO TALK ABOUT
REMEDIES USED IN MEXICO!
• DON’T THEARTEN TO TAKE MEDS AWAY
IF THEY BRING IN TO SHOW YOU WHAT
THEY ARE!
Health Problems
What do you think caused your problem?
Do you have an explanation for why it started and when it
did?
What does your sickness do to you; how does it work?
How severe is your sickness? How long do you expect it to last?
What problems has your sickness caused you?
What do you fear about your sickness?
What kind of treatment do you think you should receive?
What are the most important results you hope to receive
from this treatment?
•Antojos are cravings in a pregant woman. It is thought by many that
failure to satisfy the cravings may lead to injury to the baby, including
genetic defects.
• Ataque de nervios are episodic, dramatic outbursts of negative
emotion - usually in response to a current stressor (but often related
to a significant childhood stressor).
• Barrevillos are obsessions.
•Bilis is thought to be bile flowing into the blood stream after a
traumatic event, with the end result of nervousness.
•Caida de la mollera is the presence of a sunken fontanelle in an
infant.
•Decaiminientos is fatigue and listlessness from a spiritual cause.
•Dercernsos are fainting spells.
Empacho is intestinal obstruction and is characterized by abdominal pain,
vomiting, constipation, anorexia, or gas and bloating. Post-partum women
and infants and children are most susceptible.
Mal de Ojo is the "Evil Eye" that may affect infants or women. It is caused
by a person with a "strong eye" (especially green or blue) looking with
admiration or jealousy at another person. Mal de Ojo is avoided by
touching an infant when admiring or complimenting it.
Nerviosimo is "sickness of the nerves" and is common and may be treated
spiritually and/or medicinally.
Pasmo is paralysis or paresis of extremities or face and is treated with
massage.
Susto is fright resulting in "soul loss." Susto may be acute or chronic and
includes a variety of vague complaints. Women are are affected more than
men.
COMMON HOME REMEDY
Tea from Herbs, Spices or Fruits
Not unusual for Sick Person to use:
Prayer
Folk/Herbal Medicine
All at the same time
Prescription Drugs from Friends
Prescription Drugs from Physicians
Folk Remedies Everyone Should Know (+ indicates
yes, with + being least and +++ being most; - indicates
no, with - being least and - - - most, i.e., - - - in the safety
column indicates the treatment is significantly
dangerous. ? ? ? indicates the information is not known
to the author.)
Spanish
English Name
Name
Uses
Efficacy
Safety
Ajo
Garlic
Hypertension, antibiotic, cough syrup, tripaida
+
+++
Azarcón/
Greta
Lead/mercury
oxides
Empacho, teething
--
---
Damiana
Damiana
Aphrodisiac, frio en la matriz, chickenpox
0
+
Estafiate
Wormwood
Worms, colic, diarrhea, cramps, bilis, empacho
+ purge
--
Eucalipto
Eucalyptus (Vicks
Vapor Rub)
Coryza, asthma, bronchitis, tuberculosis
+ respiratory Sx; 0
TB
+
Goberna
dora
Chaparral
Arthritis (poultice); tea for cancer, venereal disease,
tuberculosis, cramps, pasmo, analgesic
+ as a poultice
0 as a tea
--(internal)
Gordolob
o
Mullein
Cough suppressant, asthma, coryza, tuberculosis
+ Cough; 0 asthma,
TB, coryza
+ + (if right
species)
Manzanilla
Chamomile
Nausea, flatus, colic, anxiety; eyewash
+ except eyewash =
0
+ + (if no
allergy)
Orégano
Oregano
Coryza, expectorant, menstrual difficulties, worms
0/ + except worms =
0
+
Pasionara
Passion flower
Anxiety, hypertension
+ + + sedative
+ + (if right
species)
Rodigiosa
Bricklebush
Adult onset diabetes, gallbladder disease
???
???
Ruda
Rue
Antispasmodic, abortifacient, empacho, insect
repellent
???
- - - (internal,
external)
Saliva
Sage
Prevent hair loss, coryza, diabetes
???
- - (chronic use)
Tilia
Linden flower
Sedative, hypertension, diaphoretic
+ sedative, other = ?
??
- - (chronic use)
Tronadora
Trumpet flower
Adult onset diabetes, gastric symptoms,
chickenpox
???
???
Yerba buena
Peppermint
Dyspepsia, flatus, colic, susto
++
+
Zábila
Aloe vera
External - cuts, burns
Internal - purgative, immune stimulant
External + + +
Internal +/? ? ?
External + +
Internal - - -
Zapote blanco
Sapodilla
Insomnia, hypertension, malaria
???
???
CURANDERISMO
• There is a widespread belief in Mexico that when
•
a rich person is ill, it is time to go to a doctor.
When the rich person is desperately ill, it is time
to seek the help of a curandero (healer). When
the poor person is ill, the first alternative is to
find a curandero. It is only when the poor
person is desperately sick that it is time to go to
a doctor.
Most Mexicans, especially those who live in the
less developed areas, use herbal remedies and
other folk treatment, such as healing massage,
with such confidence as a U.S. citizen might in
taking an aspirin.
CURANDERISMO
• Curanderismo is the art of folk healing by
a curandero.
• Healers can be either male or female and
may even specialize in their practice.
Origins of Curanderismo
• Curanderismo in Mexico is based on Aztec,
Mayan, African, and Spanish influences.
• The ancient natives believed that the
delicate balance existed between health,
nature, and religion.
• Illness occurred when one of these areas
were out of balance
Three most common types
of Curanderos
• Yerbero (herbalist)
• Partera (midwife)
• Sobador (masseur)
• The Curandero has the skill to treat a wide variety of
illnesses, he is the only healer in the culture who can
treat mal puesto, illnesses caused by witchcraft
Curandero’s Treatments
• Curandero’s treatments may consist of
• ceremonies
•
•
•
•
rituals
herbal remedies
potions
countermagic
CURANDEROS
• Curandero’s work on three levels
• the material
• the spiritual
• the mental
• He may prescribe a herbal remedy or conduct a religious
ritual. Quite often a curandero is called upon to treat
the physical symptoms that patients believe come from
supernatural causes
CURANDERISMO
• The practice of Curanderismo teaches that
it is not enough to simply diagnose a
physical problem but the Curandero needs
to look at the heart and the soul of the
person to understand the true illness.
• Only medicine that deals with the “whole
being” can effectively create a “whole
cure”
CURANDERISMO
• True healing can only be effective if it has some
•
•
spiritual basis.
The patient will need to call upon that divine
energy to help guide them in their healing.
The belief with modern medicine is that the
body goes to the doctor, the mind to the
psychiatrist, and the soul and spirit go to the
church.
CURANDERISMO
• The Curandero treats the person on three
levels
• The Plática
• The Limpia
• The Soul Retrieval
CURANDERISMO
• THE PLATICA is the portion of the healing
process in which the Curandero learns
about the patient through stories and also
is an important part in educating the
patient and beginning the healing session.
• Items used : candles, incense, pictures of
saints and lot of flowers present
CURANDERISMO
• THE LIMPIA is the portion of the healing
process that starts the healing of the soul,
the mind, and the body.
• Objects used: whole raw egg. glass of
water, Copal, hot charcoal, herbs
(rosemary), variety of candles,
feathers(Eagle) and prayer and/or chants.
CURANDERISMO
• THE SOUL RETRIEVAL is the process in
which the Curandero attempts to find
where the soul was lost.
• Items used: Drums, chants, rattles and
on some occasions music
Other objects used in their
healing sessions
• Herbs and spices
• eggs and lemons
• flowers and fruits
• holy water and pictures of saints
• crucifixes and candles
• incense and oils
*Each object has a specific purpose.
Symptom Profiles for Common
Curandero Syndromes
• Mal de Ojo (evil eye)
• One may interpret this
behavior of the (Evil Eye)
look, glance, or state of
someone who is an enemy
or a stranger as an attempt
to inoculate someone with
this illness. Headaches,
crying, irritability, and
restlessness are common
symptoms, accompanied by
stomach ailments
• Susto (extreme fright/fear)
• Susto is typically the result of
a traumatic experience. In
particular the symptoms of this
disorder mimic those of Post
Traumatic Stress Disorder.
These symptoms include
feeling keyed up or on edge,
fatigue, restlessness, a
significant change in appetite,
bodily complaints, withdrawal
and other symptoms of
depression.
• Mal puesto (hexing)
• Hexes may be placed by
someone who is familiar
with witchcraft. Symptoms
may include a host of
somatic complaints and
gastrointestinal problems.
Paranoia and anxiety may
also be symptoms.
• Empacho
• A condition in which food
becomes stuck in the
intestines causing a blockage.
It is caused by eating the
wrong kinds of foods, or
mixing infant formula with
milk. Symptoms include
nausea, diarrhea, stomach
cramps, and a lump in the
abdomen. It is treated with
herbal teas, abdominal
massage, and a restricted diet
at home or in combination
with a folk healer’s care.
ENVIDIA (ENVY)
• ENVIDIA is when someone envies you.
• Symptoms may include feeling sick on the
stomach, having a since of dread, feeling
sad but not knowing why. It can lead to a
person having “bad luck”.
• It is believed that if a pregnant woman
has envidia the baby can be born with
birth defects or be born very sick.
Benefits of Curanderismo
• Curanderismo is used to treat ailments
arising from physical, psychological,
spiritual, or social conditions.
• Illness is said to be caused by either
natural or supernatural forces.
Training & certification
• Curandero’s are generally trained
informally. The information is passed
from generation to generation.
• Often a curandero starts out as an
apprentice to a more experienced
curandero.
HERBAL TEAS
TE RUDA CON CHOCOLATE
USED TO HELP SPEED UP CHILD
BIRTH
HERBAL TEAS
TE ESTAFIATE
• USED FOR STOMACH PROBLEMS/
GASTRITIS, ETC.
HERBAL TEAS
TE MANZANILLA
(CHAMOMILE)
USED FOR BABIES WITH COLIC, CALM
MINOR STOMACH PROBLEMS
HERBAL TEAS
TE ROMERO
(ROSEMARY)
(BATH)
USED TO CALM CHILLS, CAUSED BY
INFECTIONS
HERBAL TEAS
BATH
(LIMON, CEBOLLA, SAVILA Y ALCHOOL)
USED TO LOWER BODY
TEMPERATURE /FEVER
HERBAL TEAS
TE EPAZOTE
USED TO CLEAN THE STOMACH OUT
AFTER CHILD BIRTH
HERBAL TEAS
TE ARTRIZAN
(ALSO APPLY TO INFLAMED AREA OF THE BODY)
USED TO TREAT ARTHRITIS,
HELPS WITH INFLAMATION
HERBAL TEAS
TE DAMIANA
USED TO HELP MAKE MENSTRUAL
CYCLE MORE REGULAR (STORY)
HERBAL TEAS
TE NEGRO
USED TO HELP GET PREGNANT
(FOR LA MATRIZ FRIA)
HERBAL TEAS
TE TRES MILAGROS
(MANZANILLA, YERBA BUENA, ANIS ESTRELLA)
USED TO CALM THE NERVES, RELAX,
USED WITH CHILDREN WHO HAVE A
HARD TIME SITTING STILL
WHAT CAN WE DO?
• ASK PROPER QUESTIONS WHEN GETTING
PATIENT HISTORY!
• ENCOURAGE PATIENTS TO TALK ABOUT
REMEDIES USED IN MEXICO!
• DON’T THEARTEN TO TAKE MEDS AWAY
IF THEY BRING IN TO SHOW YOU WHAT
THEY ARE!
Health Problems
What do you think caused your problem?
Do you have an explanation for why it started and when it
did?
What does your sickness do to you; how does it work?
How severe is your sickness? How long do you expect it to last?
What problems has your sickness caused you?
What do you fear about your sickness?
What kind of treatment do you think you should receive?
What are the most important results you hope to receive
from this treatment?
STEVE DAVIS
252-560-3168
DIRECTOR, OUTREACH SERVICES
GREENE COUNTY HEALTH CARE
SDAVIS@GREENECOUNTYHEALTHCARE.COM