Ecuador’s Integration of Traditional Medicine and Modern Healthcare System

Authored by Laurel Whidden, Global and Public Health Sciences '26

Art by Amber Briscoe '25

In the Subcentro de Salud de Cotundo: Sachawayasa, Ecuador

My heart pounded inside my chest as I stepped closer to the door. Blood pumped through my veins rapidly. I wondered if it was due to anxiety, or just a pure burning passion. I was greeted by a small Ecuadorian man in a blue vest, he gave me a kind smile as he opened the gates to the hospital. He was Franklin Tanguila, a “Técnico de Atención Primaria.” I was in Sachawayasa, Ecuador, a small, ambitious community outside of Tena. I inhaled the thick Amazonian air, smelling rich, sweet soil and vegetation. I walked through the doors. It was a quaint, clean little community health center. An obstetrician stepped out of a small office, “Laurel?” she said with a hefty Spanish accent, “Hola buenos dias. Por favor, entra.” I accompanied her into the office. As my nerves persisted, I had self-doubt; I felt inexperienced and undeserving to be invited into this health center. I took another breath of the humid air and focused. With my humble Spanish skills, I spoke:

(Translated to English)

“Hello, my name is Laurel, and I am a student at Cornell University studying Global and Public Health Sciences. Thank you for welcoming me into your community and finding a time to talk. I am interested in learning about the traditions and culture of your community. Could I ask you a few questions about the healthcare system here and the impacts of the health center on the community’s culture with indigenous medicine?”

The obstetrician, Anita Alban Peña, was also welcoming. She told me she was delighted to speak with me about various medical topics in the healthcare system and what she personally does in her day-to-day job. I could feel the beating of my heart and blood start to quiet. I held onto my small notebook, grasped a wooden pencil in my other hand, and peered down at the questions that I had formulated a couple of hours prior to this moment. Dra. Peña and I had a delightful conversation. She was compassionate and eager to share her knowledge. I was filled with an appetite for curiosity.

The healthcare system in Ecuador is integrated with many forms of traditional practices and culture. The indigenous Kichwa locals have some of the most beautiful medicinal ways of healing that I have witnessed. To begin, the primary healthcare technician, Dr. Tanguila, has a surplus of knowledge regarding traditional medicine. He is widely referred to as a “yachay” or a “curandero”, which is a Kichwa term for those whose specialty is botany along with the effects that plants have on the body. Tanguila is the leader of a team that established and maintains the medicinal “chakra”.

A chakra is an ancestral agricultural system of the Kichwa Indigenous Peoples in the Ecuadorian Andean region. Chakras are biodiverse agroforestry systems that mimic the forest’s natural composition [1]. This specific chakra provides traditional medicine for the community. Dr. Tanguila stated that the health professionals in Ecuador typically gravitate towards natural medicine to treat illnesses before prescribing modern medicine.

Holistically, Ecuadorian doctors understand that physical, mental, and cultural health are equally vital to a patient’s well-being. Midwives, otherwise known as “doulas” or “parteras” are also significant in Ecuador. Midwifery is the practice of assisting women through childbirth using natural procedures [3]. Midwives in Ecuador are trained specifically on ancestral and traditional maternal practices of the Kichwa culture; therefore, they are highly sought after.

As an obstetrician, Dra. Peña was passionate when discussing the intersections between traditional customs and modern healthcare practices surrounding maternal health. It is an ancestral belief that women should give birth naturally in the chakras, however, it contributes to a higher maternal mortality rate. She specified while it is not mandatory for women to give birth in hospitals, doctors try to mitigate additional risks during childbirth. As last recorded in 2017, the maternal mortality rate in Ecuador was 68.81 deaths per 100,000 live births [4].

Another key cultural intersection within the Ecuadorian healthcare system is the ancestral “shaman” system. Shamans help the Sachawayasa community cure their spiritual illnesses and get relief from the energies of the natural world [5]. Some individuals exclusively rely on the shaman to heal their body, refusing to receive any other healthcare alternative.

Dra. Peña insisted that no doctor will ever turn away low-income patients and emphasized the fact that everyone in the community will receive quality care. As virtuous as this sounds, there are still issues with the integration of the healthcare system and the indigenous community. Peña expressed that there are many cases when the community believes so much in natural medicine, they do not wish to take any modern medicine, even when their health condition is serious. To combat this issue, a trained health professional alongside a “curandero” will travel to an individual’s household. The two professionals will work together to convince a patient to receive a specific medicine, and the “curandero” is used as a gateway for this convincing.

Overall, the integration of culture, traditional medicine, and Western medicine into the healthcare system of Ecuador is a culmination of unique healthcare practices to heal the population. This curative assimilation is effective and respected by an extensive range of Ecuadorian citizens.

“Thank you for listening to what I have to say. I am so grateful to have been welcomed into such a unique, lively, and ambitious community of people. I have learned so much.”

Works Cited

1. Coq-Huelva D, Higuchi A, Alfalla-Luque R, Burgos-Morán R, Arias-Gutiérrez R. Co Evolution and Bio-Social Construction: The Kichwa Agroforestry Systems (Chakras) in the Ecuadorian Amazonia. Sustainability. 2017; 9(10):1920. https://doi.org/10.3390/su9101920

2. Ulbricht C, Isaac R, Milkin T, Poole EA, Rusie E, Grimes Serrano JM, Weissner W, Windsor RC, Woods J. An evidence-based systematic review of stevia by the Natural Standard Research Collaboration. Cardiovasc Hematol Agents Med Chem. 2010 Apr;8(2):113-27. doi: 10.2174/187152510791170960. PMID: 20370653.

3. Torri, Maria Costanza. “Perceptions and Uses of Plants for Reproductive Health among Traditional Midwives in Ecuador: Moving towards Intercultural Pharmacological Practices.” Midwifery 29, no. 7 (2013): 809–17. https://doi.org/10.1016/j.midw.2012.06.018.

4. Data Warehouse. UNICEF DATA. (2021, March 29). Retrieved March 29, 2023, from https://data.unicef.org/resources/data_explorer/unicef_f/?ag=UNICEF&df=GLOBAL_D ATAFLOW&ver=1.0&dq=ECU.MNCH_MMR. &startPeriod=2014&endPeriod=2017.

5. Corr, Rachel. “Shamans in the Colonial Frontier Zone: Spirit Mastery in Eighteenth Century Coastal Ecuador.” Ethnohistory 70, no. 1 (January 1, 2023): 45

6. 64. https://doi.org/10.1215/00141801-10117264.