excerpt from The Anthropology of Ethnopharmacology
The third issue is that a plant medicine usually has more than one meaning. Its physiological
effect cannot be separated from its anticipated other meanings – emotional or spiritual – by the
people who use or sell the plant. Another botánica-related story illustrates this. A Puerto Rican
man in his 50s has been a needle user for about 20 years. He has been in and out of different
drug programmes and travels back and forth to Puerto Rico to detox.When he comes back to
New York City, he often relapses. He regularly visits a botánica, usually once or twice a day,
to drink a herbal tea remedy prepared by the botánica owner. The owner claims it helps him
deal with the anxiety associated with his substance abuse problem. The tea consists of half
an ounce of sándalo (mint, Mentha sp., Lamiaceae) mixed with perejil (parsley, Petroselinum
crispum (Mill.) Fuss, Apiaceae) and one branch of ruda (rue, Ruta spp., Rutaceae). The owner
prepares the remedy in advance in bulk and stores it in the refrigerator, so that when the patient
drops in he can get immediate assistance. While explaining the use of medicinal plants, the
botánica owner stressed the importance of the spiritual component of healing. He reiterated
that whereas medicinal plants assist in alleviating a biomedical problem, healing also has a
spiritual component. It prepares the patient mentally in the healing process. Spiritual healing
can be achieved through cleansing (‘limpieza’), bathing, faith and spiritual consultations. This
supposedly ‘cuts off’ the negative energy that a patient has been accumulating. It is important
to note here that it is not the issue whether or not a spiritual component is effective, but that
this component is relevant to both traditional healthcare provider and patient. It contributes
to the realm of healing, and as such merits its place as a subject of scientific inquiry.
The needle user’s story unravels the many often complex layers of traditional medicine,
entwining physical, cultural, emotional and spiritual dimensions. The richness of the cultural
context clearly goes beyond utilitarian knowledge about plants. This multidimensionality is
not restricted to isolated rural areas, nor is it something from the past. It exists within urban
and even transnational environments, for example in New York City, and it is used today for
conditions as ‘modern’ as substance abuse and ovarian cysts.
The aspiring ethnopharmacologist might wonder if this complexity in traditional medicine is
something he or she should take on as a research task. How relevant is culture in the face of the
evaluation of the pharmacological properties of plants in the laboratory? Perhaps the question
can be rephrased as follows: should ethnopharmacologists focus only on that part of culture
that is associated with the utilitarian aspect of plants? Do we take culture into account when
we want to obtain data on local plant uses, but not when it relates to other types of knowledge
linked to plants, the kind that is psycho-social or spiritual in nature? An easy answer would be
‘I cannot do it all.’ Or ‘the funding agency I am applying for does not support these kinds
of musings’. Nevertheless, generating a rich, inclusive dataset to develop a comprehensive
plant monograph can be indispensable to understand (cultural patterns of) plant knowledge,
as opposed to a reductionist (and inevitably incomplete) approach. It also serves the added
benefit that it can help preserve the integrity of cultural heritage. The psycho-social, religious
or spiritual components of plant knowledge contain a lot of meaning for conservation of useful
plant species at the community level since unfragmented stories associated with plants have
direct cultural relevance to keep knowledge about plants (and their uses) alive. It has been
argued before that to ‘deprive a people of their language, culture and spiritual values [makes
them] lose all sense of direction and purpose’ (Posey, 1999).
As an ethnobotanist educated in and trained from a botanical perspective, I became
increasingly aware of the overarching importance of culture during fieldwork. The more I
studied medicinal plants, the more I began to understand that culture shapes everything,
including plant knowledge. After all, biomedicine is a cultural construct too, which is elegantly
demonstrated by Miner (1956) in his influential article about the Nacirema. Furthermore,
anthropology has highlighted the importance of cultural relativism, the view that beliefs,
customs and ethics vary from culture to culture and that all are equally valid; no one system is
‘better’ than another (Spiro, 1986). Spiro writes: ‘In short all science is ethnoscience. Hence,
since modern science is western science, its truth claims (and canons of proof) are no less
culturally relative than those of any other ethnoscience.’ Other scholars have gone as far
as to bring up the notion that traditional medicine needs to be evaluated within its own
cultural framework rather than approved and subdued by the rules of biological (western)
medicine (Gorn and Sugiyama, 2004). Finally, Lynn Payer’s compelling work Culture &
Medicine: Varieties of Treatment in the United States, England, West Germany and France
(Payer, 1996) shows in a compelling way how even contemporary western cultures differ,
sometimes dramatically, in the ways in which they construct scientific medicine.
The key to improving healthcare in an increasingly globalized world may lie in integrating
different cultural dimensions of healthcare, or at least in keeping an open mind about different
ways in which other cultures think about, experience and respond to health and healthcare. In
that regard, it would be useful to adopt the term ‘culturally competent healthcare’ systems
(Anderson et al., 2003), which take into account the cultural knowledge, beliefs and practices
of patients as well as physicians. Ethnopharmacology can be at the forefront of building bridges
between these different systems of healthcare by embracing culture as the indispensable link
between a plant and a medicine.
Ina Vandebroek