Ecuador is home to some of the richest biodiversity and cultural diversity in the world, attracting more than 700,000 foreign nationals in 2017 alone. But while the world knows much about the heritage of the Kichwas in the mountains or the Shuar in the Amazon, the public profile of the country downplays its very deep Black history. The coastal province of Esmeraldas is much more than a hotbed for the most savory seafood dishes Ecuador has to offer. It is also home to the Afro-Ecuadorian community and a rich variety of distinct medicinal practices, cultural traditions and ceremonial festivals, such as the Marimba now recognized by UNESCO’s Intangible Cultural Heritage of Humanity.
The Esmeraldas region originated as a series of Maroon settlements made up of people escaping from the Colombian slave trade. Fleeing the brutal conditions of the metal mines in Colombia, many people sought refuge in the forests of the Choco region on the Pacific coast; a zone that ranges from Panama all the way to the northern coast of Ecuador. Despite initial conflicts with coastal Indigenous nations (the Chachi, Awá, Epera, and Cayapas), the escaped slaves would soon develop a long, complex, and intertwining history spanning more than 400 years of cultural and communal exchange. Along with music and cuisine, Black and Indigenous communities on the coast share some of the same cosmological qualities of traditional medicine and healing.
In Esmeraldas province, there are two main regions to take note of: the ancestral North and the touristy South. The differences between the two are striking. The South of Esmeraldas can be described as a much hotter region that is characterized by a chain of beaches. It also has a close relationship with public and private capital investments in tourism and oil production. The North, however, is primarily jungle and it is comprised of a network of rivers that stretch all the way into Colombia, with rich, fertile lands dominated by gold deposits and the African Palm industry. The region, which is made up of the counties San Lorenzo and Eloy Alfaro, has also been described as “Nobody’s Land” for its recent history of wanton gold extraction at the expense of the pollution of its rivers. San Lorenzo is the northernmost point of the province, sharing a border with Colombia. It is considered a key ancestral center of the Black community in Ecuador.
Women as the Stewards of Healing
The best way to describe Esmeraldas in regards to its ancestral medicine is that it is a “hybrid community,” a place in which people seek multiple forms of healing for conditions that affect them throughout their lives. We can say it is a way to cover one’s bases. In San Lorenzo, people often seek out ancestral medicines as a first aid, only resorting to hospitals when all other remedies fail or during emergencies. Throughout my time here, most people are reactionary when seeking care, so regular visits to a doctor for physicals are only done when it is an institutional requirement (such as enrollment for school).
A noteworthy quality of Afro-Ecuadorian traditional medicine in Northern Esmeraldas is that women are often the carriers and purveyors of these practices, a striking difference from their Indigenous counterparts. Benita Angulo (colloquially known as Venus) is from San Lorenzo and is a partera (a midwife) and a comadrona (a role that functions much like a doula). She is also a licensed auxiliary nurse and worked in the Public Health Ministry for 18 years, only having recently retired. Before her career in the public sector, Venus practiced medicine for more than 30 years as an attendant for her now-deceased mother, one of the only parteras in San Lorenzo. Although she is now retired from formal employment, Benita still attends to pregnant women who seek her services; “and I give them a great price at $20,” she would often say with a smile.
“So much has changed since those times with my mother.” It is clear that the presence and reach of the state public healthcare system has really weakened the practice and maintenance of ancestral medicine. Through former president Rafael Correa’s “Citizen’s Revolution,” medical services are provided free-of-charge and people in San Lorenzo, which is one of the poorest regions of the country, often take up this option. In addition, the national government refuses to economically integrate parteras into the state healthcare system, so the parteras that would’ve otherwise charged for their services in older times now remain outpriced by a bloated healthcare system. Today, comadronas can hardly live off of their craft alone and must make ends meet by participating in more formal economies such as gold mining in the rivers (playando) and hunting for concha (black shell clams) in the mangroves.
For much of Ecuador’s history, Esmeraldas was often neglected and marginalized from the national political spotlight. Western trained doctors and nurses were rarely a presence, and when they did find themselves in the region they often collaborated with local healers and the parteras. Venus reflected fondly of a doctor from Quito, Dr. Aurelio Fuentes, whom was particularly interested in the endemic plants of the region and their curative properties. He often collaborated with local healers to better streamline the care people received and make sure they had all ends covered. For the better part of 30 years, he was the only Western-trained doctor in San Lorenzo until he retired in the 1990s. In this context of scarcity, parteras were the first line of defense for expecting mothers–and they often employed many elements of nature such as river currents, plants, and even wild weeds in the forest.
When evaluating any healthcare system, it is important to analyze how that “universal public health system” modifies itself based on each regional context to better meet the needs of the community. Under Correa, a couple new hospitals were built in Northern Esmeraldas and the increased access to Western medicine was hailed as a milestone for the Black community. The quality of that care, however, leaves much to be desired. “Modern” obstetrics and prenatal care, Venus laments, has automated the relationship between woman and healer, centralizing the experience around the time/comfort of the doctor as opposed to the well-being of the person. She had stressed to me that during her time in the public health system, she had seen lines of pregnant women waiting to give birth, some of which were even left naked at the hospital. “That’s not how we did things as parteras. We gave individual care to each woman, covered her in a blanket. It was all so personal, we bathed her in plant solutions to soothe her. It isn’t like that now… now there are assembly lines.”
Plants and Nature are the Most Effective Medicines
Walking through her small ranch of about 6 hectares, Yenny Nazareno points out which plants/weeds can be used to season food and which have medicinal applications— they were often one in the same. Chillangua (Eryngium foetidum) is a staple in Afro-Ecuadorian cuisine that is often used to season fish and meats. As a tea however, it can soothe and calm an upset stomach. Chiraran (Ocimum basilicum, or Wild Basil) is also a delicious condiment for seasoning food and it, too, can be prepared as a tea to cleanse the liver.
In addition to the plants in the forest, the rivers are an important factor in healing and childbirth. Both Venus and Yenny indicated that, in combination with massages to the stomach, the flow of the river could be used to help a woman give birth as the currents would orient the baby in her body.
While pills and pharmaceuticals dominate women’s pregnancy in other areas of Ecuador, plant preparations still make up the first line of defense in San Lorenzo. In medicinal preparations called tragos, different plants, fruits, and spices can be mixed together with sugar cane alcohol for a variety of applications. Nacedera is a plant that grows in the forests of northern Esmeraldas; it is often used as a tea to treat inflammation in pregnant women. After giving birth, it can also be prepared as a beberizo1, often mixed with sulfur, brown sugar, and fermented sugar cane to help women shrink their bellies and prevent wrinkling. Unfortunately, due to the wide and concentrated use of pesticides in the monoculture of the northern forests of Esmeraldas, many of the wild plants/weeds that were used for generations to cure sickness are now disappearing.
In addition to plants, song and prayer can be effective tools in healing a person, especially in cases where a disease is more spiritual. Like most places in the world, Afro-Ecuadorian culture in Esmeraldas carries its own history of ethno-diseases such as El Ojo (The Eye), Mal Aire (Bad Air), and El Espanto (The Fright). In addition to plant preparations and baths, different kinds of prayers and songs are invoked to complete the healing process for these ailments. Songs and lullabies are mostly used to lull sick children into a state of tranquility and rest so they won’t have to think about their conditions. “There is an intangible magic when it comes to these cantos (songs),” Yenny told me, affirming the psychological and vibrational effects these practices have on the healing process. It is already well-established that sleep heals our bodies tremendously, and so invoking rest on children to stimulate this healing is a very powerful process in traditional medicine.
Developments in Medicinal Science in the Afro-Ecuadorian Community
Marco Vernaza is what one might call a maverick in the realm of health in San Lorenzo. He is part of a small group of medicinal workers, many of which are also Western trained, whom aim to restore some of the traditional values of healing that once existed in the region. Like Venus, he is also formally educated (he has a degree in Nutrition), but he is informed by his experiences and culture. His aunt, whom he followed closely during his childhood, was a curandera (female traditional healer) who primarily used plant medicines to treat patients in San Lorenzo. This stayed with him throughout his life and his career.
Today, he treats patients using the principles he learned at university and the ones that he grew up with in San Lorenzo. Interestingly, he is currently experimenting with the usage of tinctures as treatment for chronic illness using plants in the area (including some of the plants mentioned previously). He told me that tinctures and the alcohol used to extract the molecules from each plant are concentrated doses that, at small frequencies, can provide tremendous benefits to his patients. He has treated people with diabetes and chronic pain, and is currently treating a woman suffering from cancer who has grown tired of chemotherapy. When asked about what drove her to this decision, he replied: “it really has to do with the quality of how you want your life or your death.”
Alcohol as a catalyst for treatment is not something new either. In addition to the beberizo mentioned earlier, there are a variety of other alcohol preparations that help people medicinally. The gloriado, for example, is a staple ancestral drink here in San Lorenzo made with a variety of plants, sulfur, aguardiente (sugar cane alcohol) and different spices. For stomach problems, it works like a charm (it has my testimony) and certain preparations can help with fertility problems. There are some people that even come from the cities to seek the perfect gloriado to help them conceive a child.
The Ecuadorian State: Gatekeepers of Medical Diversity
The constitution of Ecuador has a fairly progressive stance in regards to the practice and recognition of the territory’s traditional medicines. Despite these symbolic inclusions to the state, however, traditional practitioners cannot legally prescribe or diagnose sickness. Under “Acuerdo 037,” a law passed in 2016, ancestral medicines are legally grouped together with “alternative medicines” and subject to the same legal penalties/conditions. “This was a low blow, another form of killing a medicine,” Marco stressed to me upon explaining the law. The second-class status of traditional medicines was echoed by Venus as well, “parteras are not even allowed to enter the emergency room of their patients. They are restricting our very movements as healers.”
Although recognized by some as a Leftist country, Ecuador goes only so far as to recognize ancestral knowledge. No concrete effort has been made to integrate that knowledge and the people whom practice it with the state’s health initiatives. In other parts of the country, mainly the Sierra (the region of the Andes Mountains), local pressure has obligated more resources to partially include Indigenous midwives in the wider health network or at the very least create spaces for them. The medical revolution is far from sight, however;in Esmeraldas, all efforts to institutionally protect both Indigenous and Black medicine have been met with corruption by state and local actors. Yenny recounted that the few efforts funded by NGO’s and grants to create spaces for Black curanderas and parteras failed due to San Lorenzo’s particularly corrupt political climate.
Diversity in the Evolution of Medicine
Latin America isn’t a place where communities search for only one form of healing. It has historically been a melting pot of ancestral knowledge stemming from Indigenous communities and the Africans brought over through slavery. These “hybrid communities” are made up of people who seek multiple sources of healing to cover their bases. In San Lorenzo, folks often go to their local curandera or curandero (male traditional healer) and a Western-trained medical doctor at the state hospital in the same week—and it never creates any sense of contradiction. This complex relationship is not lost on the people either, as Marco explained: “the act of healing is never an absolute practice. We as healers basically practice art and therefore can never promise results.” Every patient that Marco sees he also treats as a case for investigation and experimentation to optimize which combinations of tinctures and plant remedies work best for some conditions over others.
And even with all of his knowledge and insistence in the practice of botanical and ancestral medical interventions, Marco never refuted the merits of Western medicine: “it is very useful for emergencies.” His philosophy stresses casting a wider net into our health so that we may live more fully and holistically. “We all have unique cosmic distinctions… Every person is different and requires their health care be catered to their individual needs.” In addition, he argues, everyone should have the right to access these treatments at fair prices, free, or at the very least with support from their state medical system. Calling them “Medicinas Libres” (Free Medicines), Marco stresses that treatments for chronic conditions should be accessible so that “people can learn and apply ancestral medicine at home and in their communities for as little cost as possible.”
The Future of Wellness?
We are currently in the third year of the International Decade for People of African Descent, a recognition that indicates and highlights another branch of collective contributions to our human patrimony. One of the more insidious legacies of colonialism was the minimization and extermination of Indigenous and African trajectories of science, medicine, and engineering. It did not just attack practitioners but also created a system that would siphon off space and resources so that only certain kinds of medicine would evolve and flourish at the expense of others.
As exemplified in San Lorenzo, there will always be individuals whom are ecstatic about developing medicines that cater to the needs of their communities. It is telling how even in the “plurinational state” of Ecuador, which revolutionized the state’s relationship with its citizens, the institutional and legal impediments that stifle the development of traditional healing must be reconciled. Now more than ever in the 21st century, we are at risk of losing entire lineages of knowledge and healing, languages, and music, and every piece that we lose is a piece of human patrimony lost forever. The context in Ecuador, as well as for the rest of the world, begs the important question: how will we structure our state’s institutions to integrate other forms of medicine so that we can build a dynamic and flourishing diversity of wellness? As Marco candidly observed: “each form of medicine is just a piece of the same cake. The art of healing is figuring out the pieces that work best in our lives.”
1 Beberizo is a mixture of the nacedera plant with other condiments for treating pregnant women and women whom have just given birth.