AUSTIN, Texas — There is a major disparity in income and healthcare access between Ecuador’s Indigenous community and the Spanish-speaking majority. Alternative health clinic, Jambi Huasi, strives for change by providing quality medical services while honoring Indigenous culture.
Ecuador’s Indigenous Peoples
There are slightly more than 1 million Indigenous people in Ecuador who form part of 14 different Indigenous nations. Nearly 88% of Ecuador’s Indigenous population resides in rural areas. The majority live in regions of the Andes mountains or the Amazon rainforest. While there have been improvements in recent years, Ecuador’s Indigenous population is underserved in health and education. Indigenous households in Ecuador are also 15.5% more likely to live in extreme poverty than non-Indigenous households.
In 1986, Ecuador’s Indigenous leaders founded the Confederation of Indigenous Nationalities of Ecuador (CONAIE). CONAIE works to increase collaboration between Indigenous groups and advocate for Indigenous rights, including protection of ancestral land and education incorporating Indigenous cultures and languages.
Ecuador’s 2008 constitution also strives to improve conditions for Ecuador’s Indigenous population. This constitution recognizes Indigenous languages and the need to preserve them. The constitution also includes the protection of Indigenous land and the right to practice traditional medicine. Notably, it states Ecuadorian citizens’ right to live sumak kawsay (“good living”) — an Indigenous philosophy entailing co-existing with one’s community and with nature. However, there is debate over the degree to which recent government policies actually reflect this concept.
Disparities in Indigenous Health in Ecuador
Despite these efforts, Ecuador’s Indigenous people have inferior healthcare compared to the rest of the population. One barrier to healthcare is that Ecuador’s Indigenous communities primarily live in the Amazon rainforest or the Andes mountains where hospitals are inaccessible. For Indigenous peoples in the Amazon, oil extraction near their land and water also puts them at risk for cancers, birth defects and other detrimental health consequences.
Additionally, Ecuador’s Indigenous peoples have a health system that differs from Western biomedicine. Health, for the Quechua-speaking peoples of the Andes, is based on a concept of harmony in mind, body, community and environment. This holistic health philosophy emphasizes relationships with other people and the planet over the profit and technological advancement of Western medicine. Because of this worldview, many Indigenous peoples prefer traditional medicine over Western hospitals and clinics.
Indigenous peoples of the Andes also believe in illnesses such as mal aire (bad air) or mal viento (bad wind). People associate these conditions with physical symptoms including headaches, coldness, fatigue and diarrhea. These Indigenous groups believe supernatural forces cause mal aire and mal viento, requiring a curandero’s (traditional healer) services. To diagnose these illnesses, a curandero rubs a raw egg or guinea pig (cuy) over the patient and then examines the guinea pig’s insides for abnormalities. To cure patients, a curandero performs a limpieza, or cleansing that may involve plants, guinea pigs, candles, holy water and/or cologne.
Jambi Huasi: Western and Indigenous Medicine Find Harmony
Jambi Huasi, Quechua for “House of Health,” is a private clinic in Otavalo, Ecuador. Founded by Indigenous leaders in 1983, Jambi Huasi addresses healthcare inaccessibility and the desire for traditional medicine among Otavalo’s Indigenous community. This clinic offers medical services with doctors trained in Western medicine as well as traditional medicine performed by Andean healers. Jambi Huasi’s Western medical services include obstetrician-gynecologist care, pediatrics, dentistry and therapeutic massage. Jambi Huasi also offers traditional Andean medical services, including acupuncture, treatment for mal aire, diagnosis using a guinea pig (un cuy), Andean pregnancy, birth and post-pregnancy services and energy changes.
The clinic strives to meet the financial needs of its community. In its initial years, the clinic provided free services. While Jambi Huasi now charges for consultations, when a patient cannot pay, the clinic still offers pro bono medical care.
Respecting Indigenous Culture in Healthcare
According to Jambi Huasi administrator, Señor Darwin Tamba, Jambi Huasi is the only clinic in the area that provides both Indigenous and Western medicine. Because of this, Jambi Huasi emphasizes respect for Indigenous culture. Medical staff uses the community’s native language, Quechua, to speak with patients. Staff also honor patient choices regarding medical care. Tamba estimates that about 60% of Jambi Huasi’s patients request traditional Andean medicine while 40% request Western medicine.
In an interview with The Borgen Project, Tamba said that Jambi Huasi has achieved better care in the clinic, offering alternative medical services according to the needs of the diverse population while respecting their beliefs, their way of viewing diseases, their culture and their cosmovision.
As a small clinic, Jambi Huasi has faced financial difficulties, exasperated by the COVID-19 pandemic. However, it has already overcome immense challenges in its nearly 40-year history, including acquiring its own building and educating doctors about the legality of providing traditional medicine. Tamba is optimistic that the clinic will be able to expand in the future, serving more low-income Indigenous communities throughout Ecuador.
Hope for the Future of Indigenous Health in Ecuador
Providing inclusive healthcare involves both reaching underserviced populations and providing care in a way that aligns with that population’s culture and values. By offering both Western and Indigenous medicine and listening to the Quechua community’s needs, Jambi Huasi provides greater potential for its community to embrace sumak kawsay.
– Annie Prafcke
Photo: Courtesy of Jambi Hausi