The Case of a Tropical Disease and Its Treatment by Santanello and Rehg

Part III—The Search for an Alternative Treatment

Adrian considered purchasing the medication prescribed by Dr. Rodriguez. He wondered how much the medication would cost and how long he would have to wait for the prescription to be filled. He considered the possible side effects of the medication, how long he would have to take the pills, and how often he would need to take them each day. How was he to work outside at the plantation if sunlight reacted with the medication to cause skin rashes? Where could he store the medication to keep it cool and retain its effectiveness? And he still might not be cured after weeks of treatment! As he stood outside the clinic in Quepos, he looked down the road in the direction of the nearest pharmacy, with no idea what to do.

Then Adrian recalled that his brother knew someone who had lived in this area before it was converted to plantations. His brother’s friend, Carlos, had spent time with several groups of indigenous Costa Rican peoples in the south of the country, including the Bribri and the Guaymi. Carlos had learned how the curanderos (healers) among the Bribri and Guaymi used different plants to treat many ailments, including arthritis, infertility, and other diseases. Adrian had hope that there was a more natural and less expensive way to treat the “kissing bug” disease. Adrian decided that he would have his brother arrange a meeting with Carlos to get advice on alternative treatments for Chagas disease.

The following day Carlos met with Adrian at his house at the plantation and Adrian explained the diagnosis of Chagas disease. Adrian’s left eyelid was almost swollen shut and he still had a high fever. Carlos nodded his head, “Chagas disease is very uncommon among indigenous Central Americans—but people do become infected occasionally. What you should do is brew a tea from a plant called gavilana. Drink a cup of this tea every day until the eye is no longer swollen and there is no more fever. It may take a few weeks for the symptoms to go away, but if you keep drinking the tea you will eventually feel better.” Carlos told Adrian the story of a young girl with Chagas disease who seemed on the verge of death. “She was given gavilana tea for four weeks every day without fail, and her eye got better and all of her other symptoms disappeared. She is now a grown young woman, with her own family—and she has had no problems with her eye since then.”

Carlos continued, “I will show you how to find the gavilana. It is a relatively common plant in grasslands, bordering forests, and cleared areas near forests” (see Figure 4).

Adrian was very hopeful that this remedy would work. Then he would not have to use an expensive, unnatural medication, and if he was feeling better in a few weeks, he wouldn’t even visit Dr. Rodriguez again. If one cup of tea each day might cure him in a few weeks, maybe drinking more tea more often would cure him even sooner ….

Questions

1. What might be some general advantages and disadvantages of using ethnobotanical products to combat diseases?
2. More specifically, from Adrian’s perspective, why would use of gavilana tea be preferred to the medications prescribed by the doctor?
3. What would be some potential consequences for Adrian if he opted for this type of self-treatment?
4. Based on the information provided, what kinds of evidence did Carlos have that gavilana is effective in treating Chagas disease?
5. What kinds of evidence would be necessary to reliably demonstrate that an ethnobotanical treatment is effective in treating Chagas disease?

References

Duke, J. 1996. Dr. Duke’s Phytochemical and Ethnobotanical Databases, Tico Ethnobotanical Dictionary.

http://www.ars-grin.gov/duke/dictionary/tico/index.html. Accessed on Oct. 12, 2006.

Encyclopedia Britannica. Costa Rica: The people: Ethnic and religious groups.

http://www.britannica.com/eb/article-40879/Costa-Rica. Accessed on Oct. 12, 2006.

Etkin, N.L. 1988. Ethnopharmacology: Biobehavioral approaches in the anthropological study of indigenous medicines. Annual Review of Anthropology 17:23–42.

García–Serrano, C.R. and J.P. Del Monte. 2004. The use of tropical forest (agroecosystems and wild plant harvesting) as a source of food in the Bribri and Cabecar cultures in the Caribbean Coast of Costa Rica. Economic Botany 58:58–71.

Joly, L.G., S. Guerra, R. Séptimo, P.N. Solis, A.M.D. Correa, M.P. Gupta, S. Levy, F. Sandberg, and P. Perera. 1990. Ethnobotanical inventory of medicinal plants used by the Guaymi Indians in western Panama, Part II. Journal of Ethnopharmacology 28:191–206.

Memoria—Consulta de expertos sobre productos forestales no madereros para América Latina y el Caribe, Serie Forestal Nº 1. 1995. Santiago, Chile. FAO Corporate Document Repository.

http://www.fao.org/docrep/T2354S/t2354s0q.htm. Accessed on Oct. 12, 2006.

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