Cultural significance of medicinal plant families and species among Quechua farmers in Apillapampa, Bolivia.

ETHNOPHARMACOLOGICAL RELEVANCE: Medicinal plant use was investigated in Apillapampa, a community of subsistence farmers located in the semi-arid Bolivian Andes. AIM OF THE STUDY: The main objectives were to identify the culturally most significant medicinal plant families and species in Apillapampa. MATERIALS AND METHODS: A total of 341 medicinal plant species was inventoried during guided fieldtrips and transect sampling. Data on medicinal uses were obtained from fifteen local Quechua participants, eight of them being traditional healers. RESULTS: Contingency table and binomial analyses of medicinal plants used versus the total number of inventoried species per family showed that Solanaceae is significantly overused in traditional medicine, whereas Poaceae is underused. Also plants with a shrubby habitat are significantly overrepresented in the medicinal plant inventory, which most likely relates to their year-round availability to people as compared to most annual plants that disappear in the dry season. Our ranking of medicinal species according to cultural importance is based upon the Quality Use Agreement Value (QUAV) index we developed. This index takes into account (1) the average number of medicinal uses reported for each plant species by participants; (2) the perceived quality of those medicinal uses; and (3) participant consensus. CONCLUSIONS: According to the results, the QUAV index provides an easily derived and valid appraisal of a medicinal plant's cultural significance.

Comparison of health conditions treated with traditional and biomedical health care in a Quechua community in rural Bolivia.

BACKGROUND: The objective of the present study was to reveal patterns in the treatment of health conditions in a Quechua-speaking community in the Bolivian Andes based on plant use data from traditional healers and patient data from a primary health care (PHC) service, and to demonstrate similarities and differences between the type of illnesses treated with traditional and biomedical health care, respectively. METHODS: A secondary analysis of plant use data from semi-structured interviews with eight healers was conducted and diagnostic data was collected from 324 patients in the community PHC service. Health conditions were ranked according to: (A) the percentage of patients in the PHC service diagnosed with these conditions; and (B) the citation frequency of plant use reports to treat these conditions by healers. Healers were also queried about the payment modalities they offer to their patients. RESULTS: Plant use reports from healers yielded 1166 responses about 181 medicinal plant species, which are used to treat 67 different health conditions, ranging from general symptoms (e.g. fever and body pain), to more specific ailments, such as arthritis, biliary colic and pneumonia. The results show that treatment offered by traditional medicine overlaps with biomedical health care in the case of respiratory infections, wounds and bruises, fever and biliary colic/cholecystitis. Furthermore, traditional health care appears to be complementary to biomedical health care for chronic illnesses, especially arthritis, and for folk illnesses that are particularly relevant within the local cultural context. Payment from patients to healers included flexible, outcome contingent and non-monetary options. CONCLUSION: Traditional medicine in the study area is adaptive because it corresponds well with local patterns of morbidity, health care needs in relation to chronic illnesses, cultural perceptions of health conditions and socio-economic aspects of health care. The quantitative analysis of plant use reports and patient data represents a novel approach to compare the contribution of traditional and biomedical health care to treatment of particular health conditions.

Use of medicinal plants and pharmaceuticals by indigenous communities in the Bolivian Andes and Amazon.

OBJECTIVE: To investigate, by means of household surveys, the use of medicinal plants and pharmaceuticals in Apillapampa, a large Andean community of Quechua peasants, and in six small communities of Yuracaré-Trinitario "slash-and-burn" cultivators of the National Park Isiboro-Secure (the NPIS) in the Bolivian Amazon. METHODS: A total of 12% of households in Apillapampa and nearly all households in the NPIS were interviewed about their use of medicinal plants and pharmaceuticals for treating illnesses. Informants were also asked to name any medicinal plants they knew. FINDINGS: In spite of the presence of a primary health care service (PHC) with medical doctor in Apillapampa, an equal number of informants used medicinal plants and pharmaceuticals. In the NPIS, the prevalent use of medicinal plants or pharmaceuticals in any community depended on the distance of the community from the nearest village and from a PHC with medical doctor (r = 0.85 and r = -0.96; both P = 0.05. The NPIS communities' knowledge of plants expressed as the average number of medicinal plants mentioned correlated positively and negatively with distance from the nearest village and use of pharmaceuticals, respectively (r= 0.95, P < 0.005 and r = -0.90, P < 0.05, respectively). CONCLUSION: The cultural importance of traditional medicine and the physical isolation of communities, both in general and from PHCs, are factors that influence the use of and knowledge about medicinal plants.