From Lemongrass to Ivermectin: Ethnomedical Management of Chagas Disease in Tropical Bolivia

ABSTRACT

Chagas disease is a neglected tropical disease; the only viable drugs are outdated and produce frequent side effects, and the overwhelming majority of cases are undiagnosed and untreated. Globally, people encounter numerous impediments to accessing biomedical treatment for Chagas disease. However, little is known about how people with Chagas disease manage their health outside the biomedical system. In this article, I discuss knowledge of ethnomedical treatments among marginalized patients in an endemic area of Bolivia. I interviewed 68 patients, 63 (93 percent) of whom had positive diagnoses for Chagas disease. Participants free listed 66 ethnomedical remedies either for Chagas disease (n = 39) or its cardiac symptoms. Participants stressed the accessibility of ethnomedical remedies in contrast to the multiple barriers to accessing biomedical treatment. Far from eroding in the face of globalization and sociopolitical marginalization, ethnomedical knowledge in the study area is dynamic and flexible, communicated through various channels.

KEYWORDS:

• Bolivia
• Chagas disease
• ethnomedicine
• neglected tropical diseases
• self-treatment

Acknowledgments

I would like to thank Dr. Susan Hou and Dr. Mark Molitch, co-founders of the Centro Medico Humberto Parra, for the opportunity to perform research at the clinic. Many thanks to the staff and volunteers at the CMHP for guidance and assistance during the research period. I am very grateful to the CMHP’s health promoters and patient groups for invaluable support, without which the research would not have been possible, and especially the people who participated in the study and shared their experiences and knowledge. Thanks as well to Roberta Baer, my faculty advisor at the University of South Florida, and my dissertation committee for encouragement and guidance in the undertaking of this project. Finally, I greatly appreciate the feedback provided by anonymous reviewers and editorial staff of Medical Anthropology, which improved this article considerably.

Funding

This research was undertaken independently, without external funding.

Additional information

Funding

This research was undertaken independently, without external funding.

Notes on contributors

Colin Forsyth

Colin Forsyth is as an epidemiologist for the Drugs for Neglected Diseases Initiative’s Chagas Treatment Access Project, which aims to expand health care for people with Chagas disease in the United States and worldwide. His position is supported by Médecins sans Frontières/Doctors without Borders, USA, and he works in close collaboration with the Center of Excellence for Chagas Disease at the Olive View-UCLA Medical Center. He has conducted anthropological and epidemiological research on Chagas disease in Bolivia and Los Angeles, California.