We analyzed the Fulni-ô medical system and introduced its intermedical character based on secondary data published in the literature. Then we focused on the medicinal plants known to the ethnic group, describing the most important species, their therapeutic uses and the body systems attributed to them. We based this analysis on the field experience of the authors in the project Studies for the Environmental and Cultural Sustainability of the Fulni-ô Medical System: Office of Medicinal Plant Care. This traditional botanical knowledge was used to corroborate the hybrid nature of local practices for access to health. We show that intermedicality is a result not only of the meeting of the Fulni-ô medical system with Biomedicine but also of its meeting with other traditional systems. Finally, we discuss how traditional botanical knowledge may be directly related to the ethnogenesis process led by the Fulni-ô Indians in northeastern Brazil.
The present study consists of the authors’ thoughts on their participation in the project Studies for the Environmental and Cultural Sustainability of the Fulni-ô Medical System: Office of Medicinal Plant Care. This project analyzed the medical practices of the Fulni-ô Indians (Águas Belas, Pernambuco, Brazil) and used local knowledge to improve access to health through the production of remedies based on plants. The present paper consists of an interdisciplinary proposal grounded between ethnobotany and anthropology—especially medical anthropology—and based on the interpretation of the authors as ethnobiologists. However, the positions defended here are entirely the authors’ responsibility and do not represent the position of the team that participated in the project. The text is also based on a rereading of works previously published on this group [
First, we analyze local medical practices, above all the, therapeutic itinerary, which considers the different alternatives known and used by the Fulni-ô in their search for good health. Due to its multiple aspects, the Fulni-ô medical system will be analyzed using the concept of “intermedicality” that was originally used by Greene [
Fòller [
The concept of intermedicality has already been used to help understand the indigenous groups in northeastern Brazil. After investigating practices of healthcare access among the Ramkokamekrá of the state of Maranhão, Oliveira, [
We then investigate a specific part of this local medical system: the knowledge and use of medicinal plants. We describe therapeutic uses assigned to plant resources and bodily systems, and we describe the culturally most important plants based on the consensus on their use. We emphasize that this specific knowledge is also the result of different medical traditions and can be understood as “intermedical.” However, in spite of the fact that intermedicality has been defined as a “contact zone” that reproduces neocolonial discourse and Western ideology [
In addition to guaranteeing greater access to health, local knowledge on medicinal plants can be understood as an element affirming Fulni-ô identity. Fulni-ô pharmacopoeia is a component of an intermedical system and is used to discuss how this knowledge fits into and strengthens the process of “ethnogenesis” that is experienced by the indigenous ethnic groups in northeastern Brazil. We show that the process of ethnogenesis that is experienced by the Indians of northeastern Brazil also takes place at the local medical system.
Our main goal is to use empirical and secondary data to analyze the Fulni-ô medical system as a space of “intermedicality” and “ethnogenesis.” Using these concepts, we assume that local medical systems are neither static nor mere reservoirs of pre-Colombian culture. Instead, they are creative and changeable, and thus this ability to
The historical reality experienced by the indigenous ethnic groups of northeastern Brazil, which is strongly marked by an old and notable process of colonization, separates them from any attempt to apply existing generalizations about indigenous societies [
According to Oliveira [
When one thinks of the northeastern indigenous people, in addition to recognizing their historical context, one emphasizes a phase of identity reconstruction or of the constitution of new ethnic groups who represent the protagonists for these societies based on a social process with a specific dynamic. Thus, indigenous communities of the Northeast are different because they have constructed a unique phenomenon of social reconstruction known as “ethnogenesis” (Ethnogenesis has also been called “journey back,” “emergence,” and “resurgence” [
The first ethnogenesis events were unleashed by the networks of kinship existing among the indigenous groups that were not yet recognized by the state. Here, we strongly emphasize that the journeys of certain shamans and other Indians in these groups were a propulsive factor, which becomes a key aspect for the analyses proposed here. These journeys were crucial for the diffusion of politically constructed diacritical signs, such as the “tore.” This religious and sacred dance spread among groups and became a
The Fulni-ô led the ethnogenesis events in northeastern Brazil, as they were the only group in the region that still expressed itself with its own language, Yatê (one finds different spellings in the literature when referring to the native tongue of the Fulni-ô, such as Ia-tê or Yaathê. We have chosen the form that appears in Rodrigues [
According to oral tradition, the Fulni-ô, which means “those who live close to the river” (in this case the Ipanema River), is a fusion and settlement, on the part of the Portuguese crown, of five peoples who inhabited the region: Flowkassa, Tapuya, Brogadais, Carnijós, and Fulni-ô. At present, there are three villages in the Fulni-ô Indigenous Land: “Main Village,” where the great majority of the Indians live, and “Xixiaklá” and “Ouricuri,” where sacred rituals are observed (Figure
Fulni-ô Indigenous land, Águas Belas (NE Brazil). (a) “Main Village”; (b)–(d) “Ouricuri Village”.
The Ouricuri ritual is an essential political and religious institution for the Fulni-ô and is important for a better understanding of the ethnic group and the analyses presented here. According to Souza [
Fulni-ô Indigenous land, Águas Belas (NE Brazil). (a) Overall view of Fulni-ô Indigenous land; (b) road through the “Ouricuri Forest”; (c)-(d) bark extraction of medicinal plants in the “Ouricuri Forest” and its vegetation structure.
Further, in the ritual, there is a spatial separation between the sexes. The women and babies live in little colorful houses usually located at the village periphery, while men sleep in a large central shed next to a “juazeiro” tree that is considered to be sacred. The consumption of alcoholic beverages, the use of electronic devices, and sex are prohibited. In the village of Ouricuri, there is no electricity or basic sanitation and trash is collected sporadically.
Some of the empirical data were collected by 344 semi-structured interviews between November 2007 and March 2008 from a stratified-probability sample of the Fulni-ô population inhabiting the head village, including only men and women over the age of fifteen (the procedures for which are detailed in Albuquerque [
The team evaluation meetings were important for the identification of various problematic aspects, particularly regarding data recording. If a researcher is not completely acquainted with the nature of the questions for the instrument being used or is not trained regarding cultural questions, the researcher may record information in the wrong way and compromise the general interpretation of the results. This was the case for the immediate translation of some native categories. For example, informants cited plants for the treatment of “hemorrhoids.” In the local system, some people use the term to designate a type of parasitic infection. An immediate translation can generate information that is not trustworthy. Another case is that of the local category, “gastro,” which designates oral candidiasis in children (“sapinho”). The researcher, in an attempt to categorize, a priori, may translate the category as problems associated with the digestive apparatus.
Our theoretical premises can justify the choices we made in terms of our methodological procedures. We started from the idea of culture as a system of shared knowledge [
To access local knowledge about medicinal resources, we opted for interviews with the use of questionnaires consisting of open-ended questions, which allowed room for a greater breadth of answers [
Questions specific to the ethnobotanical investigation focused on knowledge about plants: how they are used and prepared and the places where these resources are collected. Thus, the questions sought to account for the following information: (1) vernacular names of plants; (2) diseases (natural or supernatural) for which the plants were mentioned; (3) parts of plants used in preparations; (4) complete methods of preparation; (5) forms of administration of the medication; (6) quantities used in the preparation of the medications.
For quantitative analysis, the citations from the interviews were examined and categorized at a later date. However, we tried as much as possible to respect the cultural specificities of the reality investigated. For example, in the case of “bálsamo,” we considered the following citations for a single ethnospecies: “bálsamo,” “baspo,” “basso,” “bássimo,” and “bássamo.” Similarly, therapeutic indications were later categorized, as was the case for “amidalite,” which brought together the following indications: “tonsillitis,” “tonsils,” “tonsils inflammation,” “inflamed tonsils,” and “tonsil pain.” To get an idea of the versatility of the Fulni-ô pharmacopoeia, its therapeutic indications (we refer to the native categories as “local therapeutic categories” or “local therapeutic indications,” which are culturally recognized diseases whether they are biological (in the sense of the biomedical tradition) or spiritual in nature) were categorized in 18 bodily systems according to the World Health Organization [
To get an initial idea about the most important plants in Fulni-ô culture, we developed an index for calculating “relative importance.” This index was constructed based on the study of various quantitative techniques used in ethnobotanical investigations [
The relative importance (RI) of each species was calculated by the following formula:
In order to discuss the relationship between the Fulni-ô medical system and other traditional systems, all of the plants mentioned in the interviews were classified as native or exotic. Plants were considered native to the local medical system when their original geographic distribution could be traced to the South America. Conversely, plants were classified as exotic to the local medical system when their presence in the area was the result of human activity, whether intentional or unintentional. Thus, the plants considered exotic did not originally occur in the Brazilian semiarid, but were introduced by man. In this sense, it can be said that the exotic plants were introduced to the Fulni-ô through the contact with other cultures.
Finally, the team was also directed to collect the medicinal plants cited by the interviewees that were available in close proximity to the interview sites, such as in backyards, vacant lots, streets, or from neighbors, at the time of the interview. This procedure allowed for their scientific identification and avoided possible errors caused when extrapolations are made concerning the botanical identification (scientific name) of the ethnospecies cited. For example,
In the present study, out of respect for the Fulni-ô traditions and acknowledging the importance of local knowledge for the structure and differentiation of the local medical system, we will not present the confidential data or the list of species that compose the pharmacopoeia of the ethnic group. Moreover, the researchers signed a confidentiality agreement, and the publication of specific information about the plants has not yet been authorized by the ethnic group. The discussions presented here stem from theoretical reflection on information already available in the literature [
Within their medical system, the Fulni-ô use the medicinal properties of 243 native or exotic ethnospecies (Figure
The Fulni-ô traditional medical system is quite broad and responds to a total of 18 bodily systems (Table
Bodily systems addressed by the Fulni-ô medical system and the wealth of plants cited. Indigenous Land of the Fulni-ô, Águas Belas (PE).
Bodily system (WHO) | Wealth of ethnospecies |
---|---|
Undefined problems or pains (AND) | 120 |
Categories without biomedical correlation (CSB) | 23 |
Diseases of the endocrine glands, of nutrition and metabolism (DGE) | 58 |
Infectious and parasitical diseases (DIP) | 64 |
Mental and behavioral disorders (DMC) | 37 |
Diseases of the skin and subcutaneous cellular tissue (DPS) | 42 |
Diseases of the blood and hematopoietic organs (DSH) | 11 |
Diseases of the osteomuscular system and connective tissue (DSO) | 32 |
Pregnancy, birth, and puerperium (GPP) | 23 |
Injuries, poisonings, and other occurrences from external causes (LEO) | 60 |
Neoplasias (NEO) | 13 |
Disorders of the sensory system (TOL) | 5 |
Disorders of the sensory system (TOU) | 14 |
Disorders of the circulatory system (TSC) | 51 |
Disorders of the digestive system (TSD) | 98 |
Disorders of the genitourinary system (TSG) | 68 |
Disorders of nervous system (TSN) | 22 |
Disorders of the respiratory system (TSR) | 91 |
Not possible to report* | 1 |
General Total** | 843 |
*The information cannot be provided, especially due to cultural norms. **Refers to the set of all of the citations and not the total species cited, as it considers plants that were indicated for more than one system.
Using the index proposed in this study, the ten most important plants were: “aroeira,” “alecrim do mato,” “mentruz,” “sambacaitá,” “erva cidreira,” “quixabeira,” “hortelã da folha miúda,” “capim santo,” “bom nome,” and “imburana de cheiro”—of which five plants are native. In this list, “alecrim do mato,” “mentruz,” “sambacaitá,” “erva cidreira,” “hortelã da folha miúda,” and “capim santo” are exotic species. These ten plants also stand out with respect to the variety of bodily systems on which they work. That is, they are quite versatile. The “aroeira,” for example, is the most versatile plant with respect to bodily systems treated (14 in all), followed by “bom nome” and “quixabeira” (12 systems each). Other medicinal resources used are clays and fat from animals, such as tortoises, snakes and lizards, which are not plant-based but still deserve being reported.
The Fulni-ô medical system was characterized by Souza [
Biomedicine is represented in the Fulni-ô reality by the Base Pole (Figure
Base pole in Fulni-ô Indigenous land, Águas Belas (NE Brazil). (a) Base pole; (b) store of medications in the Base pole.
Use of medicinal plants in Fulni-ô Indigenous land, Águas Belas (NE Brazil). (a) A healer showing some medicinal plants collected in native forests; (b) a Fulni-ô indicating the part of the “urtiga” that is used in treatments; (c) “menstruz” leaves; (d) “pereiro”, a medicinal plant collected in native forests.
The Fulni-ô medical system shows clear evidence of its intermedical nature where a differential relation between power and capitalist ideology are present. The following are examples of intermedicality in the Fulni-ô medical system: the symbolic power and dependence of industrialized medications in the community; the high consumption of these same medications, with a turnover, in only one six-month period, of 120,000 Reais; the presence of a health center in the village of Ouricuri, the location of the sacred ritual, where there is the highest incidence of diseases and the greatest demand for traditional treatments, such as prayers and medicinal plants; the high demand for biomedical treatments even during the ritual of Ouricuri, in spite of the distance from the Base Pole; the appreciation of certain procedures and biomedical treatments, such as birth in the birth center, to the detriment of traditional practices, such as the role of “midwives”; symptoms and treatments for falling ill are linked to biomedicine, although explanatory models bring together different spheres of social and biological life, such as participation in the ritual of Ouricuri, the spiritual world, work, and emotional exhaustion; finally, poor service at large biomedical institutions, such as the birth center of Águas Belas.
In addition, biomedicine is present in the practice of some of the Indigenous Health Agents who, although they are Indians, adopt the agency’s discourse. In informal conversations, certain indigenous agents favored and gave value to biomedical practices in their activities. Fóller [
Another example of intermedicality is the appropriation of biomedical categories to refer to symptoms and treatments. Various biomedical therapeutic indications and treatments were cited in the interviews, including those by local specialists. These included “colic,” “inflammation,” “antiseptic,” “depression,” “purgative,” “expectorant,” and “hypertension”. However, some biomedical terms were re-defined, as was the case for the “hemorrhoids” category that was initially understood by researchers as being “dilations of the veins of the rectum with or without flow of blood.” A better appraisal of the local meaning allowed us to observe that for the Fulni-ô, the local category “hemorrhoids” has to do with enterobiasis, a parasitic worm infection. Finally, we highlight names of certain plants used in traditional medicine that have associations with industrialized medications, such as “anador,” “dipirona,” “terramicina,” “ampicilina,” and “novalgina,” although this traditional/industrial overlap is not exclusive to the Fulni-ô experience. Albuquerque et al. [
The examples cited above show clearly the intermedical field constructed in the Fulni-ô reality through contact between the traditional medical system and biomedicine, and some of these contacts show an asymmetrical power relationship. Capitalist ideology is explicitly marked by the creation and expansion of the local economy, showing, as Fòller [
Thus, the examples cited above reinforce the concepts of Greene [
To understand how the points of conflict and confrontation in the zone between the traditional medical system and biomedicine unleashed new forces for self-affirmation by the Fulni-ô—characterized by the desire to recover knowledge and traditional uses of medicinal plants—we will analyze the process that culminated in the planning of the project Studies for the Environmental and Cultural Sustainability of the Fulni-ô Medical System: Office of Medicinal Plant Care. We will also analyze the traditional botanical knowledge of the Fulni-ô Indians. This project is interdisciplinary and participative in nature and is financed and directed by the Area of Traditional Indigenous Medicine/VIGISUS II/FUNASA and carried out by the Mixed Association Cacique Procópio Sarapó (AMCPS).
The recent journeys to the community, whether for cultural presentations or for the sale of handicrafts (especially in large urban centers), were fundamental for the process of construction of the Office Fulni-ô and for the first manifestations of ethnogenesis. Specifically, we highlight the role of José Francisco de Sá (Xycê, in the native language), the former president of the AMCPS, who traveled numerous times to Brasília (DF) looking for more profitable sales of Fulni-ô handicrafts. During one of his journeys, he was invited to participate in a course on medicinal plants, which strengthened his already existing interest in the therapeutic properties of plants. Considering the reality of the medical system, which is characterized by its precarious nature and excessive use of medications, among other conflicts, José Francisco learned about the existence of financial resources intended for research and promotion of traditional indigenous medicine. His initial project was approved by the National Health Foundation (Fundação Nacional da Saúde, FUNASA). His initial idea was to strengthen traditional practices—specifically the use of medicinal plants from the Fulni-ô pharmacopoeia—as an alternative to industrialized medications. According to Fòller [
The first advances were the construction of a bed and a nursery for the cultivation of medicinal plants at the TIF. Twelve Indians participated in a theoretical and practical course on management and associations, agricultural techniques, and the production of herbal remedies. A pharmacist offered training for the production of herbal remedies at a laboratory in Garanhuns, Pernambuco State. It was through these activities that José Francisco came into contact with plants that were still unknown to him, such as “poejo” and “transagem.” Later, when more funding became available, a laboratory for the production of herbal remedies and the Fulni-ô Office of Medicinal Plant Care was constructed with the appropriate equipment (Figure
Fulni-ô office of Medicinal Plant Care in Fulni-ô Indigenous land, Águas Belas (NE Brazil). (a) Bark of “Aroeira,” a medicinal plant; (b) equipment for the production of herbal remedies; (c) bed and a nursery for the cultivation of medicinal plants; (d) herbal remedies.
One may conclude that concrete advances have been made in recovering and giving value to traditional knowledge. Even without the production of herbal remedies at the workshop, advances were made from the recognition of the importance of local practices of healing to the Fulni-ô identity and from recognition of the unfavorable situation of this medicine in confronting the domination of the discourse and practices of biomedicine. Like other activities, traditional medicine can be understood as resistance to an attempt to homogenize and subjugate an essentially heterogeneous and subjective system.
The training of José Francisco in Brasília and the training of the 12 Indians in Garanhuns will allow for the production of herbal remedies as characterized by their scientific framework. Even the alternative of allowing a reduction in the consumption of industrialized medications is external to the culture. The forms of preparation, the locations and the tools are different from so-called traditional practice. The physical structure of the Fulni-ô Workshop for the Manipulation of Plants, with all of its equipment, is an institutionalization of medical practices (Figure
The new understanding of the process of ethnogenesis of the Fulni-ô Indians—a cultural reaffirmation based on the value of traditional medical practices—also interferes with the utilization of some resources from the local system, such as medicinal plants. The Fulni-ô pharmacopoeia, the bank of medicinal plants known and used by the ethnic group, was considerably influenced by contact with other traditional medical systems, especially beginning with the historical experience of the Indians of northeastern Brazil, and once more, with the journeys made by members of the community.
At least 102 (42%) of the 243 species that compose the Fulni-ô pharmacopoeia are exotic species. Assuming that an exotic plant was not originally part of the environment experienced by a given community, in our case, the region of the Fulni-ô Indigenous people, the incorporation of an exotic plant in the local pharmacopoeia occurs due to some contact with a different reality. In addition to detecting the presence of exotic species in the local pharmacopoeia, we also applied the index proposed. This index considers different variables jointly in order to detect the relative importance of plant resources in cultural practices of healthcare access. Thus, results showed that among the ten most cited plants, five are exotic. This information leads us to believe that in addition to being part of local knowledge, the exotic species play an important role in traditional practices due to their versatility and consensus about their use.
This massive presence of exotic plants in the bank of plants used is viewed in different ways in the literature. Some authors state that their presence in the traditional pharmacopoeia is evidence of “cultural erosion” or “acculturation,” which reflects a passive vision of culture or a vision that is incompatible with the notion of ethnogenesis. In contrast, Albuquerque’s [
As stated earlier, the lived history of the Fulni-ô influenced the construction of the current pharmacopoeia. Like all northeastern ethnic groups, they suffered various processes linked to the land, such as their sedentarization in villages, which aimed to homogenize them through catechisms and interethnic marriages [
Again, the role of travel in the enrichment of the local pharmacopoeia was fundamental, as in the case of Towê, the Fulni-ô Indian who has knowledge of many medicinal plants. Towê travels to different places, especially Brasília, to sell handicrafts and to publicize Fulni-ô culture through the Cafuia, a dance for artistic presentation. During these journeys, Towê has learned about different biomes and medicinal plants and has worked for a long time in a pharmacy with herbal remedies. As a result, of the 243 plants cited, 23 (9.4%) belong to his knowledge alone. Each trip brings something new to the Fulni-ô reality that can be incorporated into local practices if it passes through the local crucibles of the community. Journeys, thus, have the potential to enrich the local pharmacopoeia if the knowledge is shared with the community. Many studies have investigated the intracultural diffusion of knowledge [
The current Fulni-ô pharmacopoeia is the result of the incorporation of other knowledge, and thus the Fulni-ô medical system is plural—not only in offering different forms of access to health but also in being the fruit of many other medical systems. In spite of very notable traits of biomedicine found in local practices, the intermedicality of the Fulni-ô medical system is also constructed through the appropriation of other traditional systems from other cultural matrices (a phenomenon that shapes the pharmacopoeia for all the human groups in the Caatinga.) The appropriation and re-definition of these systems constructs the Fulni-ô identity at the present time and guarantees them, in spite of points of conflict and clashes of interests, various possibilities of access to cures.
The intermedicality of the Fulni-ô system strengthens local “medical security” (an allusion to the concept of “nutritional security”). As documented by Souza [
The existence of different alternatives for curing the same disease reduces the use pressure that is placed on the plants used in treatment, which contributes to the conservation of biodiversity. Albuquerque and Oliveira [
As noted earlier, the most cited therapeutic indications by the Fulni-ô were colds, general inflammations, coughs, stomach pains, tranquilizers, fevers, wounds, strokes, wound healing, expectorants, and headaches. These indications are exactly the ones treated with a greater range of species. In other words, the most frequent infirmities are treated with a wider spectrum of resources. Thus, we expect that this relationship will allow greater security in the treatment of the more frequent diseases, as many possibilities of treatment exist, which reduces the used pressure per species. However, future studies should be done to better evaluate this question.
Analysis of the Fulni-ô medical system, from the point of view of intermedicality, allows us to recognize its multiplex nature and the fruit of the hybridization of the local medical system with other traditional systems and biomedicine. Although there are well-defined spaces of action in each one of the traditions, given their proper specificity, there is an interaction with the construction of the local medical system that results in different points of articulation depending on the correlation of existing forces and the interests that are involved. We recognize that biomedicine is floating in an ideology that does not encourage heterogeneity but seeks homogenization as a means to domination. Nevertheless, its presence in the Fulni-ô reality strengthens their search for an identity and ethnicity and, with the traditional medical system as the driving force, allows for an outlet for another event of cultural reelaboration. Once more we see that the Indians are active agents in constructing their reality. The ideological appropriations presented here are not evidence of a cultural de-structuring but evidence of the incorporation of a symbolic power to renew forces, which guarantees cultural perpetuation. Oppression makes it necessary to struggle even against expressions like “resurgent,” “remaining,” or “mixed” Indians. As they themselves recognize, they are “resistant” Indians—which is the appropriate name for those who with much health, whether hybrid or not, have struggled against more than 500 years of cultural, economic, or political persecution.
Many thanks are owed to the Fulni-ô people for their support and enthusiasm for the project; to the anthropologist Luciane Ouriques Ferreira, manager of the Area of Traditional Indigenous Medicine, VIGISUS II/FUNASA Project; to José Francisco de Sá (Xyce), project coordinator and traditional knowledge holder; to Gláucio Machado (Txhleká), traditional knowledge holder; to Luiz Carlos Frederico da Silva, president of the Associação Mista Cacique Procópio Sarapó (AMCPS); to the following members of the indigenous team: Ubiram Leite Machado, Surama Correia Darcca, Tanawá Correia Darcca, Jussiara Veríssimo, Nerivaldo Alves dos Santos e João Veríssimo Machado, Almirair Cunha Pontes, and Tairam de Leite de Sá; Liliane de Cunha Souza, Project anthropologist Maria Eliane Barreto da Silva, project pharmacist; Fabíola W. Zibetti, Project lawyer; and Dr. Cláudio Fortes Garcia Lorenzo, project physician. To FACEPE and CNPq for its financial support to the authors.