Visiting an Indigenous Medical Centre

Our guide told us that the medical centre, in the city centre of Manaus was established to bridge the differences between traditional indigenous and western medicines. He said that shamans tended to practice medicine without any western training because they use traditional medication for both cure and prevention. Our guide said that the use of traditional medicine was becoming important because western medicine seems to be too generic to be helpful to the indigenous communities.[i]

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Our guide

Our guide explained to us that the centre exists to train shamans to dialogue with and navigate between traditional and western medical practices. This was important because our guide said that shamans believe in the coexistence of both spirit and the body not just the body as a separate entity in relation to the spirit. Our guide was from the Tukano, one of the indigenous tribes in the Northwest region of Brazil. He categorised the traditional healers in this spiritual tradition with the following characteristics:

  1. The Shaman knows what is happening before it happens and is able to treat the patient without the need to see them.
  2. The Baye (payé) treats through consultation where he needs to have the ailment explained to him before he can treat the patient.
  3. The Baje (kumo) is a senior person who organises the religious ceremonies[ii]

Our guide told us that his centre is currently trying to convince the government of the benefits of tradition medicines. However, he informed us that the government has attempted to research the efficacy of traditional medicine but crucially without involving the actual indigenous communities whence it came.[iii]

Our guide then gave an example of a developing collaboration between the two medical traditions that is being trialled in the centre. He told us that a snake had bitten his cousin’s leg. Western (Brazilian) doctors wanted to amputate, as the bite had begun to threaten the integrity (function) of her leg but with a mix of traditional and western medicines, her leg was eventually saved. He also reported that she is now well and is studying to be a nurse (he said that her experience had inspired her choice of profession).

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Meeting a payé

Epistemicide

Leading on from this particular form of ‘epistemicide’ (a term coined in a previous conversation by LABINS lead researcher and scholar, Claudio Sampaio), in another conversation with the LABINS researcher Marcelo Calegare, we discussed how in his work he is working with indigenous people to help “preserve” their knowledge from western ‘epistemicide’.

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Traditional medicines

I was interested by his take on Stuart Hall when he described his process of negotiating relationships within the community, where Hall’s use of ‘articulation’[iv] is implicitly applied to problematise[v] the process of negotiating (power dynamics between research and subject). Marcelo also seemed to resonate with the idea of a quasi auto critical ethnographical methodological approach where one’s worldview (as researcher) is acknowledged from the start and where there is no pretence of objectivity. Marcelo’s methodological approach seemed particularly apposite for our ethnic communities in the UK, who very much seem to occupy the same position of the indigenous communities, still being inherently seen as “savages” not to be listened to.

How to resist Epistemicide?

Marcelo liked the idea of helping his indigenous communities set up their own schools, where they could preserve their knowledge but negotiate (with) western knowledge simultaneously. I told him about our supplementary schools research over here in the UK where we are trying to do just that.[vi] We also discussed how the Cartesian worldview of mind-body-spirit separation is hurting the environment and how we needed to listen to indigenous environmental knowledge especially around the husbandry of the land and its associated practices of health and wellbeing management. Upon reflection, I was fascinated by the emergent links that we uncovered between the macro and micro necrotic structures of whiteness, where its separation of mind, body and soul leads to processes of dehumanisation, exploitation, which in turn underpin the modern world system of capitalism that in its advanced stages, is leading to our current environmental catastrophes.[vii] For me, it is becoming increasingly urgent that we examine how these pathological structures of whiteness[viii] are leading to global death at both macro environmental levels and at micro localised levels in terms of decimated land and its displaced peoples being treated as outcasts (on their own land) with the obvious detrimental effects to their health and wellbeing.

Another of Marcelo’s research projects about the link between food, organic produce and health also echoed my community partners’ (Caribbean and African Health Network, CAHN)[ix] interests in culturally appropriate public health announcements about diet. CAHN is researching the notion of an African and African Caribbean sensitive “healthy plate” (using foods and food groups eaten by predominantly African and African Caribbean communities) and the phytonutrient content of such food for preventative health care.[x]

Health and Spirituality

Our guide explained how the spirit of the Tukano peoples is transported by a snake boat called the ‘cobra canoa’ from the Rio de Janeiro to the Rio Negre, whereupon the spirit enters the ‘body of people’ (community). The spirit is responsible for the identity and the genus of the community and this spiritual transference is mediated by the kumo.

I was surprised to discover just how effective the indigenous medical centre was as a meeting place for a dialogue between indigenous and western medicines. This rather resembles the work Faye Bruce, a Senior Lecturer and Doctoral Researcher at Manchester Metropolitan University who is leading research and enterprise with the African and African Caribbean faith communities in Manchester. We are working with the Greater Manchester (GM) devolved authority to recognise the concept of holistic health that comprises the mind, body and spirit.[xi] Crucially, we are trying to educate statutory health provision that health is not just about the body but about the complex interaction between the mind, spirit and the body.[xii] In Manchester, we are also training our faith leaders to be better able to navigate the health system to more effectively integrate the spiritual dimensions of health with the physical (from mainstream health services).[xiii] I thought that the Manchester parallels with the initiatives in the indigenous medical centre in Manaus were startling!

Endnotes

[i] See https://critracemmu.wordpress.com/an-ethnographic-appreciative-inquiry-to-establish-the-development-of-health-and-wellbeing-hubs-within-caribbean-and-african-faith-organisations/ And also see notes 9 to 12.

[ii] See S. Hugh-Jones, ‘Religious Specialists’ on Povos indigenas no Brasil,[website] February, 2003. Viewed on March 14th, 2018, https://pib.socioambiental.org/en/povo/tukano/1509  Also see N. Thomas & C. Humphrey (Eds.). Shamanism, History and the State. University of Michigan Press, Michigan, 1996 p.233 for a full and comparative description of the different types of shamans and their societal functions across different continents. The literature seems to point to two types of shamanic practice within the Tukano tradition where Stephen Hugh-Jones in Thomas & Humphery (eds.). (1996: p. 33) writes:

Though all forms of shamanism combine knowledge with inspiration, in VS [Vertical Shamanism] the dominant component is esoteric knowledge transmitted within a small elite, while in HS [Horizontal Shamanism] the emphasis is more democratic, depends less on “saying” than on “doing” and involves the more classic shamanistic features of trance and possession

It would appear that our guide in describing the prophetic powers of the ‘shaman’ was referring to the VS kumo. The kumo is often an older man who has no direct contact with patient (when healing) but holds all the esoteric knowledge to commune with the spirit world to enquire of the healing process without the need for imbibing hallucinogens (sometimes known as ‘yagé’ or ‘fish yagé’). The kumo also has the esoteric knowledge to expertly lead all the religious ceremonies from their shamanic traditions. The ‘baje’, on the other hand, corresponds to the HS payé, who is a younger man who seems to use more of the external paraphernalia associated with shamanism (i.e. the hallucinogens, rattles, manipulating the body of the patient etc.) to perform his healing duties.

[iii] To me this resembles a colonial attitude of Eurocentric anthropological investigation that subjugates the indigenous people, their culture and knowledge to a position of inferiority under the western gaze. However, see S. B. Kayne (ed.). Traditional Medicine: A global perspective. London: Pharmaceutical Press, 2010, p. 331 for great international comparative analyses of the role and efficacy of traditional medicines from across the world’s continents.

[iv] See S. Hall, ‘On postmodernism and articulation: an interview with Stuart Hall’ . (L. Grossberg, Ed.) Journal of Communication Inquiry, volume 10(2), 1986,  pp 45 – 61

[v] See M. Montero, ‘Methods for liberation: Critical consciousness in action’. In M. Montero, & C. Sonn (Eds.). Psychology of liberation: Theory and applications (pp. 73 – 93). New York, NY: Springer, 2009.

[vi] See O.D. Clennon, ‘Making Education a Priority (MEaP)’ August 14, 2016, https://critracemmu.wordpress.com/making-education-a-priority-meap/

[vii] See H. Winant, ‘The Dark Matter: Race and Racism in the Twenty-First Century’. In T.D. Gupta, C.E. James, C. Andersen, G-E. Galabuzi and R.C.A. Maaka (eds.). Race and Racialisation: Essential Readings. Canadian Scholars, Toronto, 2018, pp. 52 – 63 for an expanded breakdown of this process.

[viii] See O.D. Clennon, ‘The Black Face of Eurocentrism: Uncovering Globalisation’. In O. D. Clennon (ed.). International Perspectives of Multiculturalism: The Ethical Challenges. Nova Science Publishers, New York, 2016, pp. 91 – 128 for an exploration of the psychopathological structures of the Hegelian whiteness/blackness dialectic that are in turn transformed into market relationships.

[ix] See https://critracemmu.wordpress.com/caribbean-and-african-health-network-in-greater-manchester-cahn-gm/?frame-nonce=3cb2aeb89e

[x] See https://estheroludipe.com/about/ Dr Esther Oludipe is one of our community partners. She is involved in both the education enterprise Making Education a Priority (MEaP) and the Caribbean and African Health Network (CAHN) as well as the Chair of her own community enterprise, Highway Hope.

[xi] See https://critracemmu.wordpress.com/cahn-gm-greater-manchester-combined-authority-partnership/?frame-nonce=3cb2aeb89e

[xii] See https://critracemmu.wordpress.com/cahn-gm-public-consultations/?frame-nonce=3cb2aeb89e

[xiii] See https://critracemmu.files.wordpress.com/2018/02/clp-leaflet1.pdf

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