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spiritual support. Although the health-care system of
the ayahuasquero incorporates magical, religious, and
psychotherapeutic elements, it is also largely based on
pharmacology because of its reliance on numerous
biodynamic plants. In that respect it is more akin to
Western medicine than to other shamanic, quasimedical
systems of traditional healing (McKenna
1995:351).
A vegetalista often offers to the poor patients Ð
which represent the majority of the people of this
area Ð more psychological support (Luna 1986:161).
Formal psychiatric facilities in jungle cities are
relatively rare. In fact, in Peru, as SeguõÂ n (1970:175)
points out, there are about 100 psychiatrists in
practice, 90 of them in Lima, the capital. Of the total
of 2 010 psychiatric beds in the nation, 95 per cent are
in Lima. The rest of the country, which has 83,4 per
cent of the population, has only 93 psychiatric beds.
University training in underdeveloped countries, as
well in the United States, generally prepares the
doctor for a focus on organic rather than psychological
illness. For these latter illnesses, the folk healer is
probably better prepared, as his general expectations
are that a patient will suffer from socially precipitated
illnesses which have resulted from stress, conflicts,
tensions and the like. To the healer, interpersonal
referents are as important, if not more so, than organic
symptoms. To the ayahuasquero, in fact, his patient is
not merely a `bearer of organs' in Frans Alexander's
(1950:17) term, but an invisible whole. Peruvian folk
healers recognize the important role of emotional
factors in disease, and give this great prominence in
their diagnoses (Dobkin de Rios 1984:68±88).
In rural areas, the vegetalista is often the only help
available to the mestizos or riberenÄos in critical
situations. Every riverine community has a government
appointed promotor en salud or sanitario, who
diagnoses, uncomplicated ailments and prescribes
medicines he thinks may be effective. Sometimes
these technicians are of help, but it is doubtful if they
maintain any standard of hygiene or have any real
understanding of what they are doing (Dobkin de
Rios 1984:78). I have found these technicians mostly
incapable of their title, and always without medicine,
leaving the vegetalista as the only help in many
situations.
I am of the opinion that the Peruvian government is
overlooking a potential solution to the medical
problems in rural areas. I have found my informants
to be the most healthy and sober people in the villages
I visited. Rather than spend money on the training of
just any local person as sanitario, leaving them
without medicines, the government would be better
served training the local vegetalista as a promotor en
salud, who can make use of both traditional remedies
and Western medicines when available. Many private
organizations like the Peruvian Amazon Conservation,
Inc., a charitable medical and educational organization,
are taking this into consideration, but they
receive no financial support from the local or national
governments.
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