Feature

Central America: going back to their roots

Five hundred years after they were invaded by the conquistadors, the people of Central America are having to rediscover the medicines of their ancestors, explains Frank Chalmers

As Europe prepares to indulge in expensive celebrations of its ‘discovery’ of the New World in 1492, poverty is forcing people in Central America to revert increasingly to medicines used by their Mayan ancestors, long before Columbus ever set foot on their soil.

’After 500 years, people are recognising that Western medicine has failed’, says Salvadorian doctor Victory Amaya. In Central America, capitalism has put doctors in the position of forgetting that the main aim of medicine is the patient, he says. ‘For them the main aim is profit.’

Not only are many people unable to pay for medical treatment, but the new world order of the 1990s has meant many Central American countries cannot afford to import pharmaceuticals. The solution for health workers has been to turn to remedies that have survived for centuries by word of mouth.

In Nicaragua, 15,000 interviews with peasants have, over the last few years, led to the identification of at least 950 plants with beneficial medical constituents. In El Salvador, infusions made from lemon grass are now becoming as commonplace as Western pills and in Honduras the poorest sections of the population are drawing on remedies rooted in the time of their Mayan forbears.

The scope for developing traditional medicine is immense, Dr Amaya told a conference on ‘Returning to our Roots’, organised under the auspices of Central America Week. ‘What happened 500 years ago in Central America was not a discovery’, he said, ‘It was a cover-up’.

The Mayans had a complex culture including a sophisticated understanding of anatomy, definitions of 200 symptoms of illness and thousands of herbal remedies.

The Spanish invaders set out to destroy that culture, but now people are rediscovering it.

In Nicaragua, the return to herbal medicines has been accelerated by the deterioration of healthcare under the UNO government. In 1990, under the Sandanistas, the health budget for Nicaragua was a $150m. For 1991-92, under UNO, it has been reduced to $56m, health promoter Marta Cranshaw explained.

’For many people, poverty now makes herbal medicine a necessity,’ she said. ‘At the moment 80 percent of Nicaraguans are living in poverty. Treating an illness with herbal medicine may cost a patient less than $1. To use Western medicine, if it can be obtained, may cost $12, and to get it privately, where its provision can be assured, can cost up to $20 just for a consultation.’

Natural medicines are also being used increasingly in Honduras because of poverty, according to biochemical engineer Carlos Talavera.

Debt servicing, which eats up to 47.8 percent of the country’s exports, has made importing pharmaceuticals impossible. Traditional remedies are the only medicines many poor people can afford, and their use is being promoted by the popular and progressive movements, he said.

In El Salvador, the use of herbal remedies has been pioneered similarly in areas controlled by progressive forces such as the FMLN, added Dr Amaya.

But re-developing traditional medicine in Central America is not accompanied by any romanticised notion of the past, and all plant medicines have to be verified and checked for side-effects.

Rauwolfia Serpentina, for example, has been widely used as a tranquilliser but it reduces blood pressure and can be very dangerous. ‘It is no use if a herbal medicine makes you feel better, then kills you. We want to get rid of the illness not the patient,’ said Carlos Talavera.

The rational use of natural medicines presupposes a minimum level of scientific validation, he explained.

’Drugs are usually activated by linking into receptor sites, triggering physical, chemical or biological changes. So it is important to understand the chemical structure of the plants and their leading active principles.’

In Honduras, a non-government development agency, Communal Education for Health (EDUCASA), has established a traditional medicines programme that includes ethnobotanic and taxonomic studies and aims to identify, clarify and register medicinal plants used by the indigenous communities, he said.

Eventually the organisation hopes the medicines will be produced on a large scale, and promoted nationally through ‘mixed pharmacies’.

But Central American countries do not have the resources to finance fully-fledged research activities and 500 years after the Spanish invasion, pharmaceutical multinationals are the new conquistadors, ready to pounce and exploit biological resources.

Two approaches are being taken to this. The first involves inter-regional co-operation through TRAMIL, a traditional medicines network involving universities and research centres that aims to make practical knowledge of herbal medicines available to health workers. TRAMIL recently produced a handbook cataloguing validated uses for 300 medicinal plants.

The second approach, in which Costa Rica has taken a lead, has been to engage with the multinationals. In Costa Rica, the government-established National Biodiversity Institute (INBIO) has entered an agreement with multinational giant Merck which should offer at least some protection to the country’s biological assets.

Merck has begun providing funds for INBIO to survey the country’s flora and fauna. In return, the company is supplied with plant extracts and has been awarded the right to screen for leading active principles. If any drugs are developed subsequently, INBIO will receive about 50 percent of the royalties and use the money to develop its own screening capacity.

Being a hostage to the multinationals is a bitter pill to swallow, Carlos Talavera recognises but, unlike 500 years ago, people are at least forewarned of the danger of foreign domination. Countries in Central America ‘may have to lose a bit, to gain a bit more’, he said. ‘It is not perfect but it is a matter of trying to avoid complete exploitation.’

Further information on the development of traditional medicines in Central America can be obtained from the Nicaragua Health Fund, 83 Margaret Street, London W1N 8LH. Tel: 071-580-4292.