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Mignone J, Bartlett J, O’Neil J, Orchard T. Best practices in intercultural health: five case studies in Latin America.
J Ethnobiol Ethnomed. 2007 Sep 5;3:31. PMID: 17803820

Health researchers from the University of Manitoba and Simon Fraser University in British Columbia surveyed five integrative medicine programs in Latin America. In this comprehensive article, they analyze the programs from the perspective of intercultural health, which they define as “practices in health care that bridge indigenous medicine and western medicine, where both are considered as complementary.”

From the abstract:

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria.

The authors report on five collaborations between western allopathic practitioners and traditional shamans, comadronas (midwives), herbalists, and other indigenous healers in both urban and rural locations:

• Suriname: Medical Mission & Amazon Conservation Team clinics in Trio villages (Kwamalasamutu & Pëlele Tëpu)
• Guatemala: Comadronas (Midwives) Association in Comalapa, Kaslen Foundation, health center (Comalapa & surrounding areas)
• Chile: Makewe Pelale Hospital, Boroa Health Centre, Mapuche Pharmacy (Temuco & surrounding areas)
• Ecuador: Jambi Huasi Clinic/Midwife Association/Yachac Association (Otavalo & surrounding areas)
• Colombia: Consejo Regional Indígena del Cauca/Asociación Indígena del Cauca/Instituciones Prestadores de Servicios de Salud (Popayan & other areas in Cauca region)

Among the constraints and risks was, interestingly, resistance from some churches (for example, opposition to shamanic healing). Others included resistance from some allopathic practitioners; uncertain legal/regulatory status of indigenous practitioners; lack of secure funding; iatrogenic risks; and lack of adequate systems for data collection.

The authors note several positive effects of these intercultural collaborations, including an apparent increase in access to both types of health care; low cost of indigenous health care compared to western medicine; and benefits to “indigenous community development” (reappraisal of indigenous knowledge and cultural continuation, and other positive effects in key health determinants such as nutrition and employment).

Several of the authors work at the Centre for Aboriginal Health Research in Manitoba. The center’s website maintains, among other resources, a comprehensive database of global indigenous health research resources and links.

For new posts about free-access, peer-reviewed articles reviewing complementary medicine theory, practice and policy, visit my new blog CAMWATCH.

complementary medicine complementary and alternative medicine integrative medicine ethnomedicine intercultural health

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