Supporting the reevaluation of indigenous health systems in Amazonia.

Presentation by Didier Lacaze to the International Conference: Sacred Plants in The Americas. April 25, 2021.

1. Why speak about reevaluation or revitalization of Traditional Medicines (TM)? Because historical and current and multiple changes and transformations are among the leading causes for cultural loss and deterioration of global life systems in Amazonia. I believe that there are some things from the past that are worth recovering.

2. It has also been assumed that the reevaluation of TM could contribute to improve the general life conditions of Indigenous peoples (without excluding modern medicine and other aspects of modern life)

3. So, my first question is: Have these projects, TM and others, and the related political processes- particularly the rights for Indigenous peoples to self-determination and autonomy [to decide for themselves & self-government] achieved the results we -that is us, and the Indigenous Peoples- had hoped for?

My first medicinal plant garden at Tambopata Wildlife Reserve (Perú, 1983)

I personally doubt they have, and what I am interested in is to understand better why that is, and that from this understanding perhaps new possibilities could arise.

It is difficult to summarize 35 years of work in 25 minutes. So, I decide to tell you a story, the story of Carlos, a young man from an indigenous people in Amazonia. I hope his story provide a better understanding to the topic of this presentation and gives us a few important lessons.    

I would like to clarify that the story I am about to tell, in the first person, brings together things I have seen, witnessed and heard, and which I have put together here in a single account.

The story of Carlos

“Many years ago a gringo came to our village. He spoke in good terms about our culture, particularly our traditional medicine. He wanted to help with a project because he said that we Indigenous peoples are forgetting our traditional knowledge and practices. Since our representative organization had given its authorization for the project, and as my people kind of liked what the gringo was saying, they also agreed to the project.

I was designated to be the health promotor of the village. We were trained during several workshops. It was good to exchange our knowledge about medicinal plants with other people from different indigenous groups. We learned different ways to prepare herbal remedies to treat the most current illnesses and diseases our people suffered from. We created medicinal plants gardens in our villages. I particularly liked when we talked about the traditional knowledge of our elders and the ways their understood the causes of many illnesses and treated them. Through the project we also built an ethnobiological center with members of other villages, where even some shamans were trained by indigenous shamans from another region. Many more things happened at the center for several years to support the reevaluation of our traditional medicine and we were proud of it all.

Application of Traditional Medicine -AMETRA-2001. (Madre de Dios, Perú, 1985)

That was many years ago, and unfortunately after 10 years the project came to an end. The health promotors then went back to their occupations, the medicinal plant gardens vanished, some of us continued to practice with our families and friends. As for the ethnobiological center it became a jungle lodge where the shamans trained by the project ended up offering ayahuasca ceremonies to the tourists.

Because I was interested to know how other similar projects were doing, I travelled to other regions and made contact with other indigenous organizations. One day I attended a meeting where the European funders had come to evaluate the health-project which had been going on for one year. After several hours of discussion, Pablo, the health secretary of the Indigenous organization, raised his arm to ask a question:

“I want to ask if someone can tell what means HEALTH? Because, you see, when we have a drink with friends, we say SALUD!”. (To your health!).

“Oh…and another thing, added Pablo: “Can someone explain to me what means exactly the word PROJECT?”

Because shamanic traditions were considered on the decline, this project had proposed to select 20 young people to train with the elders as apprentices. After one year, of the 20 selected candidates only two were still actively learning.

What happened?”, asked a member the European funders”. As no one responded to the question, an old man sitting close-by asked permission to speak and said:

The problem is that the leaders of the organization selected the apprentices without asking us, the elders, what we thought about the project or if the young people selected were going to learn. If they had asked us, we would have told them that most were not, because according to our knowledge, we know who are the ones can learn and who cannot“.

After the meeting ended, I asked Johnny, one of the two survivors of the project, why he decided to take on this shamanic training. He answered: “Well, I signed up because I saw that my uncle, who is a shaman, was making a lot of money working with the tourists”.

Signs along the road…

On another occasion, I had travelled further up North to meet with the leaders of another organization I heard a conversation between Ricardo and Armando, who had just been elected has new board members of their organization. They were kind of arguing about their role in the organization. Ricardo asked his friend Armando:

– What do you think we should do, Armando? –

– Well, we have to do a project, said Ricardo. –

– But, what kind of project are we going to do? said Armando.  –

– It does not matter, Armando, let’s just do a project, any project”. 

So, that is how I began to sense that it was difficult for some of my people to understand what these health or other projects were really about.

They somehow did not always know or understood why these white folks, outsiders, wanted us to do those things. But they thought it was a good because it would bring “something” for the village, for the organization, or for themselves.

That is how I think projects slowly have become part of some sort of local economy, both for the organization to sustain itself, as for potential benefit of some individuals.   

I continued travelling and meeting with other people and organizations to find out more on this subject. I met Mary, who was of the few existing women health promotors. I asked her how she was doing with their project. She said:

You know, Carlos, that one of our commitment is to share the knowledge we have acquired during the workshops with our community”.

This is difficult, you know, because when the project supervisor comes and asks people if the promotor has come to talk to them, people tend to say: “no, he keeps it all for himself and his family”.

“But you know”, Mary said, “when we try to talk to people, they don’t want to listen to us; and some even gossip that we are learning to do witchcraft”.  

That is one of the reasons, Carlos, that the health promotors usually do not last for long. They are constantly replaced. People of the project ask us why is that, and we tell them “it is because our people want to give a chance to all to learn“.

During several years, Carlos visited many different of these indigenous health projects and wondered why the conditions of life of his people did not seem to have improved. When I asked him why he thought this was?

– “What seems to happen, Carlos said, is that you, the gringos, people from outside, may be well-intentioned, come to us with some interesting idea, and present them to our people thinking that it is a “good thing” for them. Although people often do not quite understand it all, for some reason of their own, they approve it. That is why they do not identify or appropriate a project as if it was something of their own; and that, ultimately, is a good part of the reason why once the outside financial and technical support end the project ends with it and all goes back to what it was before”.

Many years have gone by since this all started, and despite all the money invested in projects, all the good things many people have tried to do, all the rights we have been given, I feel a bit sad to see how little of all this my people enjoy today in the communities; I think our worst disease is the loss of our dignity and the increasing poverty we continue to live in.


There are many more stories I could tell you about what happened during the 35 years I worked along indigenous people on this goal for the reevaluation of TM. In the story of Carlos I tried to highlight a few pointers, which I think can help us to learn some of the lessons they might teach.

3 more questions and final reflections

  1. How can the general life conditions of indigenous peoples really improve?
  • Can this be done just by supporting spiritual traditions, and indigenous health and medicine systems?
  • How can we ensure, as much as possible, that what we give back is what people really want or need?

I think it might be worth asking ourselves how and where do those ideas and proposals to reevaluate indigenous health systems really come from? Did they come from the Indigenous people themselves, from other well-intentioned people, or a combination of both?

Sacred plants are parts of something much larger. They were and may still be for some people a way of life. A way of life that connected with all other parts of the global manifestation of Life. Our modern cultures have extracted, distilled these parts to obtain what they thought was useful for them.

So, I think if we really want to help Indigenous people, to really improve their current life conditions, we need to rethink how to reintegrate these parts into the whole of their life. What this mean from a practical point of view, is to address not just health or healthcare, not just spiritual traditions, not just sacred plants, not just indigenous rights…but Life in general, Life as a whole. This means the protection and defense of the land, the culture, education, health, social services, economy, governance, conservation of resources, and so on…

This is what we are currently trying to do, together with a group of kichwa people in the Kuraray region of the Ecuadorian Amazon. through an initiative called “SACHA TAKI: Voices and Songs of the Forest – Biocultural Heritage of the “People of Kawsak Sacha”. (

It is about ensuring that this extraordinary symphony of life which emanates from the rainforest continues to exist and sound as much from nature as from culture, because culture and nature exist as a unity. They should not be separated, they should be re-united.

Thank you.

“It is difficult to be young, and not believe that we already know everything. On the path of knowledge you have to have a lot of patience to be able to hear and listen to what nature tells and sings; and that never ends”…

It is difficult to be young, and not believe that we already know everything. On the path of knowledge one has to have a lot of patience to be able to hear and listen to what nature tells and sings; and that never ends“…