Traditional medicines, conception and development in the Americas

The WHO Strategy on Traditional Medicine 2014-2023 defines traditional medicine as “the sum total of knowledge, skills and practices based on the theories, beliefs and experiences specific to different cultures, whether explicable or not, used to maintain health and prevent, diagnose, ameliorate or treat physical or mental illness.”

Its definition in the different countries of the Americas has varied over time according to internal social, political, economic and cultural conditions, as well as the progress made in the formulation of public health policies with an intercultural approach. 

Thus, in the last century we found definitions that considered traditional medicine as a set of preventive, diagnostic, therapeutic and evaluative practices (Ecuador, Peru and Dominican Republic); a set of medical practices with a ritual, mystical and magical basis or magical-religious practices (Costa Rica and Mexico); a “mestizo” medical practice of the Andean Region with a strong religious influence (Bolivian Society of Traditional Medicine SOBOMETRA); alternative medical practices for healing human illnesses and diseases (Chile); nosological concepts, some with indigenous roots and others of Spanish and/or black African origin, which include a range of therapies used in the past by the people to solve health problems (Nicaragua); or as the application and wisdom of the indigenous population of a nation, based on their own cosmovision, to solve the most common health problems (Guatemala) (1).

Moving on to definitions in the current century, most of which are included in the policies and regulatory frameworks of countries:

Guatemala: traditional medicine is understood as a system with knowledge, traditions, practices, beliefs and its own agents and methods of diagnosis and treatment (2). 

Colombia: as the knowledge, practices, rituals, concepts and processes of integral health that indigenous peoples have ancestrally practiced as a model of collective life, framed within the cosmovision of each people (Agreement 326 of 2005 of the CNSSS) (3). 

Mexico: as a set of health care systems originating in the Mesoamerican and North American cultural regions, rooted in the indigenous cosmovision (intimate conception-interpretation of the world) and in the profound knowledge of health and illness that the different indigenous peoples of our country have accumulated, organised and updated throughout their history (National Policy of Traditional Indigenous Mexican Medicine) (4).

Nicaragua: as the sum of all the knowledge, skills and practices based on the theories, beliefs and indigenous experiences of different cultures, with or without explanation, used to maintain health and to prevent, diagnose or treat physical and mental illnesses (Ley de Medicina Tradicional Ancestral, Nicaragua) (5).

Bolivia: as a set of concepts, knowledge, wisdom and millennia-old ancestral practices based on the use of material and spiritual resources for the prevention and cure of diseases, respecting the harmonious relationship of individuals, families and communities with nature and the cosmos, as part of the national health system (Law of Ancestral Traditional Medicine, Bolivia) (6).

Peru: as a set of diverse health practices, approaches, knowledge and beliefs that include plant, animal and/or mineral-based medicines, spiritual therapies, manual techniques and exercises used individually or in combination to maintain well-being, in addition to the prevention, diagnosis and treatment of diseases (Peru) (7).

Traditional medicine is recognised as a health system composed of a complex set of knowledge, wisdom, traditions, practices and beliefs, structured by its own health agents (known as traditional doctors, ancestral doctors or “sabedores ancestrales”, traditional medicine specialists, traditional healers, bone healers or “sobanderos”, depending on the country in which they practice), or “sobanderos”, depending on the country and the speciality they practise), who have their own methods of diagnosis, treatment, care, maintenance and prevention, and whose therapeutic resources include, among others, medicinal plants, animals, minerals, rituals, diets and songs.

This concept then encompasses the diversity of traditions, medical practices and concepts of health and illness among the Indigenous, Afro-descendant, Roma and other ethnic populations of the region, which over time and through cultural encounters have syncretised or not various elements of other medicines, but which remain anchored in their ancestral history, their world view.

References.

1. The research project “Traditional Health Systems in Latin America and the Caribbean: Información de Base” is part of the Health of Indigenous Peoples of the Americas Initiative of the Pan American Health Organization (PAHO). 13|Traditional Health Systems in Latin America and the Caribbean: Información de Base. November 1999. Washington, D.C. Pan American Health Organization.
2. Ministry of Public Health and Social Assistance, Guatemala. National Program of Traditional and Alternative Popular Medicine. p. 13.
3. Article Seven. Adequacy of the Mandatory Health Plan of the Subsidized Regime for Indigenous Peoples of Agreement 326 of 2005 of the National Council of Social Security in Health. Whereby some guidelines are adopted for the organization and operation of the Subsidized Regime for Indigenous Peoples. Ministry of Social Protection, Colombia.

https://www.minsalud.gov.co/Normatividad_Nuevo/ACUERDO%20326%20DE%202005.pdf

4. National Policy on Traditional Indigenous Mexican Medicine. Ministry of Health. General Directorate of Health Planning and Development. Directorate of Traditional Medicine and Intercultural Development. First Edition 2007, Update 2022.
5. Ancestral Traditional Medicine Law. Law No. 759, Approved on March 29, 2011, Published in La Gaceta No. 123 of July 04, 2011. Nicaragua. 

https://www.ilo.org/dyn/natlex/docs/ELECTRONIC/92483/107761/F-269157595/NIC92483.pdf

6. Bolivian Ancestral Traditional Medicine Law. Law No. 459, of December 19, 2013, Plurinational Legislative Assembly, https://bolivia.vlex.com/vid/ley-459-553811138
7. Dionisio Astuhuamán Doris Irene; Portocarrero Gutiérrez Julio; Salaverry García Oswaldo. Intercultural dialogue in health: technical document. [Internet] 2014. Ministry of Health, National Institute of Health, 41 p. Available at: https://repositorio.ins.gob.pe///handle/20.500.14196/549

Glossary of terms related to traditional medicines in the region of the Americas

https://mtci.bvsalud.org/en/traditional-medicine-in-the-americas/traditional-medicines-conception-and-development-in-the-americas/glossary-of-terms-related-to-traditional-medicines-in-the-region-of-the-americas-2/ 
Link in VHL TCIM:    https://mtci.bvsalud.org/en/traditional-medicine-in-the-americas/traditional-medicines-conception-and-development-in-the-americas/traditional-wisdom-and-knowledge-cosmovision/