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Greene, Shamans Needle PDF
Greene, Shamans Needle PDF
Medicine has played a complicit role in European imperial expansion since the very
beginnings of colonial ventures around the globe (see Comaroff and ComarorY 1992; Fanon
1978; Latour 1988:111-145; Macleod and Lewis 1988; Paul 1978). Such complicity, termed a
"medical conquest" by Kay (1987), is historically present in Latin America. There is evidence
in even the earliest Spanish efforts aimed at facilitating the containment, control, and conversion
of native populations of the New World through royal ordinances demanding the creation of
nucleated "orderly" townships, termed reducciones, in the colonies.' As with cathedrals,
hospitals were centrally located, physically and socially constructed monuments integral to
establishing a sense of Spanish colonial order and facilitating the subjugation of native
populations. In the modern era, the existence of Western-style, biomedically based health
centers and services that are often overly specialized for what "developing" countries are
permitted to afford in the global economy points to the influence Western societies hold: it is,
concomitantly, political, economic, cultural, and medical.
A recent manifestation of the continuing collusion between medicine and Western neocolo-
nial, capitalist interests is the role that medicine plays in Western development schemes for the
so-called Third World. As a whole, development is in fact often conceptualized in overtly
medicalized terms; health and sickness are employed as analogies for "developed" and
"underdeveloped" or "developing" countries respectively (Escobar 1995:30; Nandy and Vis-
vanathan 1990:146). Western biotechnologies and biomedical practice take on the same
internationally valued status in development as have science, high technology, and capitalism
more generally. During the late 1970s and early 1980s, the status of ethnomedicine in
developing countries underwent simultaneous reexamination on two fronts: in the development
of medical anthropology and in the medical sphere of "development" of the Third World. A
consideration of the former is necessary for a reconsideration of the latter.
In this article I juxtapose and integrate three distinct but interrelated lines of
analysis: (V a critique of "development" with respect to its (misconceptions of
ethnomedicines as epistemologically and practically (that is, culturally) static; (2)
an explication of how shamanic curing epitomizes such perceived stasis; and (3)
an ethnographic analysis of a specific shamanic session (originally presented by
Brown [1988]) conducted by an Aguaruna shaman whose discourse and practice,
when contextual ized and fully explored, undermine (misconceptions of stasis. The
article employs a notion of intermedicality to examine medical development,
demonstrating the important social agency executed on the part of native practi-
tioners. I discuss implications for theorizing indigenous culture and the importance
of an ethnographic approach, [development, shamanism, ethnomedicine, culture
change, medical anthropology, Amazonia]
A proliferation of publications over the past 20 years has contributed to the development of
a specifically anthropological cross-cultural approach to medicine (see Young 1982). Foster
and Anderson's Medical Anthropology in 1978 was a pioneering publication, synthesizing
modern medical anthropology as a distinct social scientific subdiscipline. Anthropological
investigation before the mid-to-late 1970s had by no means overlooked indigenous medicines.2
These early accounts of then so-called "primitive medicine," however, were almost invariably
discussed in very well-trodden anthropological categories (now cliches): ritual, religion, witch-
craft, magic, supernatural ism, and so forth (Foster and Anderson 1978: ch.1). Because of a sole
concentration on "primitive medicine" as essentially a magico-religious phenomenon based on
local traditions conceived as being culturally and historically static, these earlier investigations
effectively ruled out the possibility of finding any type of medicality present in these medicines.
Always in contrast to Western biomedicine, "primitive medicine" was considered pre- or
nonmedicine in typical socioevolutionist fashion.3 A familiar Western indulgence in asymmetric
binaries was the template to these early anthropologies of ethnomedicine:
Our first analytical task [as medical anthropologists] is to realize that the concept of a medical system,
which appears simple and straight-forward, is in fact loaded with historical assumptions. The concept is
an artifact of the division of labor in nation states with Departments and Ministries of Health, and of
legislators, physicians and other specialists who claim the legal responsibility for supervising the health
status of populations. The generic conception of a medical system is thus based on a single, historically
recent system: a bureaucratically ordered set of schools, hospitals, clinics, professional associations,
companies and regulatory agencies that train practitioners and maintain facilities to conduct biomedical
research, to prevent or cure illness and to care for or rehabilitate the chronically ill. From this perspective
This epistemological shift sanctions a new kind of anthropological analytic. Viewed from this
new ground, medical systems are always and everywhere complexes of knowledge and practice
which are media for ideological and symbolic expression (Comaroff 1982) and as such are
inseparable from socioideological interests (Young 1981), as well as from the transformational
processes of cultural change (Comaroff 1981).
Thus the reconceptualization of "primitive medicine" facilitated a dismantling of the ideology
implicit in biomedicine—that peculiarly Western mystification that reifies sickness and medi-
cine as components of an exclusively technical and thus nonsocial and noncultural ("natural")
process (Taussig 1980). As Young insists, "the proper study of African medicine is simultane-
ously the study of our knowledge about medicine. To forget this is to accept what is perhaps
the most influential ideological belief of our time, that is, that scientific inquiry gives access to
ideology-free knowledge" (1981:386).
Within this shift from "primitive medicine" to ethnomedicine are the necessary roots of a
concept that logically followed and then quickly became (and remains) a central analytical
trope in medical anthropology, virtually all discourses of medical development, and cross-cul-
tural research of healing systems: medical pluralism.4 Biomedicine was no longer conceived as
the only viable medical system. The legitimation of ethnomedicine helped pave the way for
new waves of research aimed at determining the nature of this medically plural context and
exploring possibilities for employing ethnomedicines as alternative health care resources—what
would be termed the "integration" or "collaboration" of ethnomedicine and biomedicine
(Akerele 1987; Bastien 1982, 1992a; Neumann and Lauro 1982).
Appropriate technology, that is, recognition of the limitations and disadvantages of high technology and
the importance of less complex, lower cost technology appropriate to local needs and capabilities.
Awareness of the distorting effects of an over-emphasis on curative medicine, especially on hospital-based,
specialty-oriented, technologically sophisticated care, and consequent emphasis on more balanced ap-
proaches to prevention and to lower cost, technologically simplified modes of medical care. . . .
The emergence of primary health care, emphasizing preventive, promotive and curative services
available at or very close to communities in culturally acceptable patterns, and at locally affordable costs.
[1980:383]
Ethnomedicine is viewed as a medical resource that permits the W H O and other developers to
continue expanding Western development policy making and biopolitical supervision without
any commitment to address the global economy's serious asymmetries even though these
directly affect any health effort that might provide improved biomedical resources to developing
countries. Such a commitment further mystifies the capitalistic yearnings of biomedicine; it
allows organizations such as the W H O to continue expanding political influence over medical
issues with the understanding that nothing can or will be done about the economic factors
influencing the distribution of health care resources among world regions.
Further, Akerele instructs that the W H O "is fulfilling its constitutional responsibility to act as
the directing and coordinating authority" on all efforts to link ethnomedicine into the health
care system with biomedicine in developing countries (1987:177). "The most needed field of
endeavor" in this regard, Akerele says, is to subject ethnomedicine to a thorough "evaluation"
in order to place it on a "scientific basis" (1987:1 78); scientifically competent health researchers
(those sufficiently familiar with the biomedical view) should determine what elements of
ethnomedicine are worthy of inclusion and which should be discarded. It becomes clear later
in the article that this scientific "evaluation" essentially means ethnomedicine is best used as a
resource for pharmaceutical research: "the examination of all these [ethnomedical systems]
shows that they hold great promise of a rich harvest that can benefit mankind, especially in the
field of ethno-pharmacology" (Akerele 1987:178-179, emphasis mine). Akerele does not
address the issue of how a harvest of indigenous plant knowledge and resources will benefit all
of mankind. (Will it benefit mankind or the capitalist kind of man?) Three things become clear:
(1) no mention is made of indigenous resource or intellectual property rights, nor economic (or
any other kind of) compensation of indigenous peoples, for their knowledge of medicinal plants;
(2) the W H O encourages developing nations to scientifically research and utilize such plants;
and (3) the W H O itself will keep abreast of all such research and will "stand ready to be an
active partner" (Akerele 1987:179).5
What should become clear from all of this is that the idea of collaboration between
ethnomedicine and biomedicine is for health developers a result of the realization that replacing
the former with the latter (as was assumed would happen) is economically impossible. The
inherently capitalist commitment of biomedicine restrains the proliferation of costly resources,
but does not then preclude opportunistic expansion of biomedical political influence (emanat-
ing from the West) through control, regulation, direction of and scientific research on eth-
nomedicine. Nor does it preclude opportunistic exploitation of indigenous medical knowledge
and resources (much less protect against it) through international ethnopharmaceutical re-
search—a Western biomedical-capitalist practice that has really only been brought to interna-
tional attention in the 1990s and no doubt remains unresolved (Greaves 1994; Posey 1990).
Ethnobotanical research on medicinal plants, utilizing indigenous knowledge resources and
labor in various capacities, proliferated during the 1980s and has expanded further in the 1990s.
Following earlier discourses of the W H O and others which predicted its importance in further
development, medical ethnobotany, though often academic in practice, has fallen into the
development discourse and is now simultaneously gaining renewed support from private (and
powerful) pharmaceutical interests (see Cox and Balick 1994). As one can easily gather from
recent compilations of summary literature, ethnobotanical research represents for many the key
to this development style of "collaboration" between indigenous and Western medicines:
shamans helping scientists in the "search for new drugs" (Prance et al. 1994). Due to many
recent protests from indigenous groups around the globe, the source countries of research
The nuances of contraposition in this passage are worth examining. Traditional medicine is
predicated as a static phenomenon that is "in existence" continuously over some unexplored
past of at least "hundreds of years," well before the "development" and "spread" (note the active
terms) of Western biomedicine. The conception that guides Akerele's statement is that
traditional medicine is a dormant and passive phenomenon (it is "in existence" and continuous
with the past), whereas modern medicine is an agential and active phenomenon (it "develops"
and "spreads" and transcends tradition): stasis versus progress.
With this cultural stasis counterposed to progress construction as a template to his under-
standing, Akerele invokes the need for the scientific evaluation and manipulation of eth-
nomedicine by biomedical researchers. "The proven useful traditional practices" constitute
those practices that biomedical researchers deem "scientifically" worthy as a health resource.
Here too there is an element of passivity (stasis and tradition) versus activity (change and science)
corresponding, respectively, to ethnomedicine and biomedicine. This conception imbues
biomedicine and science with a necessarily hierarchically superior cultural-symbolic position,
as the agent of change that activates (through scientizing) an otherwise stagnant (and necessarily
unscientific) ethnomedicine. In and of themselves, ethnomedicines (indigenous peoples) are
devoid of agency; only biomedical and scientific influence (Western peoples) can activate
ethnomedicine. It is this culturally constructed biomedical-scientific activation of eth-
nomedicine, this "bringing together" of the medicines, that leads to Akerele's revealing phrasing
of what collaboration in medical development means, which is, in his own words, "bringing
traditional medicine up to date" (1987: subtitle of article).8
Ethnobotanists fall prey to the same misconception. Walter Lewis, the principal investigator
of the ICBC project with the Aguaruna, is a prominent example. His own understanding of the
Jivaro ethnic groups (including the Aguaruna) posits their way of life as "culturally intact,"
implicitly denying the obvious influence of the West in Jivaro cultures, and conceives of jfvaro
medicine as a body of knowledge in stasis, stating that they "use plants now as they have for
perhaps thousands of years" (Lewis and Lewis 1994:61). But this language is typical of that used
by ethnobotanists to represent indigenous culture and medicine. I am suggesting that such
language reflects a limited understanding of the people with whom ethnobotanists "collaborate."
Development ideas about integration are caught in a morass of Western constructions that
erase ethnomedical practitioners' (and indigenous peoples') social agency—the ability to effect
social and cultural, thus medical, change—via the maintenance of this ideology that defines
stasis as the negative counterpart of progress. This ideology, in turn, bolsters the very justification
of further development and valorizes development as the sole embodiment of "progress" itself.
Although acknowledgment that ethnomedicine has not died out (as previously expected) is
widespread, ethnomedicine is rarely understood explicitly in terms of acf/ve indigenous cultural
This line of analysis posits shamanism as a cultural "reservoir." Kreimer (1988) argues for this
line of reasoning with terms like cultural survival, while Ramirez de Jara and Pinzon Castano
call it the preservation of "traditional content" through the guarding of "cultural specificity"
(1992:287). Practicing shamans come to embody this reservoir of preconquest ethnic identity,
precolonial traditions, pre-Western culture, and pre-Columbian Indianness—again, as if
timeless, mythic, prehistoric, primordial. All of these aspects of identification are in metonymic
relation to this Western-imagined cultural stasis of shamanic practice they simultaneously construct.
These researchers present themselves as explorers of a still intact native worldview by refuting
syncretic arguments and those popular laments of the (assumed) inevitable decline of the
shaman (and the "primitive" more generally).10 They are at least attempting to move away from
the idea that shamanism has been corrupted by Western influence and is therefore necessarily
doomed to extinction in the wake of Western expansion. The result, however, is a replication
of the same familiar, very Western, mythic-ideological view of indigenous cultural forms—as
static, nonagential, and closed-off systems: that ideological myth that simultaneously bolsters
the very viewthey claim to be refuting. Both sides propel their arguments, in like fashion, through
a silent quest for rediscovery of the "pristine archaic phenomenon," as Flaherty phrases it
Before delving into the presentation and analysis of Brown's transcript of one of Yankush's
healing sessions, a few preliminary remarks must be made about Jivaro shamanism. I do not
intend to make a comprehensive review of shamanism.12 Rather, my aim is to highlight a few
features of the shamanic complex extant in this area of Peru and salient in my analysis. Most of
these features are applicable to shamanism throughout northwest Amazonia.
Shamanism and sorcery are fused components of a complex that socializes sickness and
health for Amazonian Indians. The shaman is important for his ability to appropriate effectively
power from places distant from the social world (Harner 1972:119-125; Taylor
1981:672-673): 13 principally the natural world, the otherworld (spiritual and ancestral realm),
The particular healing session I examine in this section occurred on January 18, 1978, and
was recorded by Michael Brown during his fieldwork among the Aguaruna (see Brown 1986,
1988,1989).14 In addition to Yankush, the presiding shaman, two female patients (Chapaik and
Yamanuanch), their respective husbands (Katan and Shimpu) (all four distantly related to
Yankush), Yankush's wife (Tumus), and several other interested community members and
relatives were present. Also present were two anthropologists: Michael Brown and Margaret
Van Bolt. I use the ethnographic present as does Brown.
During the session, Yankush is in contact with his shamanic power and knowledge (pasuk),
but this does not preclude ongoing interaction among Yankush, the patients' husbands, and
certain other people present. Yankush is engaged in a performance for which shamans are
renowned, a multileveled discursive practice that includes talking, chanting, and singing in
various shamanic "registers," as Brown calls them:
Yankush's utterances encompass several distinctive styles or, as I shall call them, "registers": 0 ) a normal
discursive register consisting of simple declarative statements; (2) a normal shamanic register, performed
as song, which includes divinatory and metaphorical statements presented in a compressed style still
This shamanic singing or chanting in both socially intelligible and unintelligible languages is,
as Brown notes, not unlike that described by Sherzer (1983) in his discourse analysis of Cuna
healers who perform chants while curing. These registers are important because they actually
increase the efficacy of shamanic power and knowledge: "verbal control is magical control"
(Sherzer 1983:133). But this verbal and magical "control" is by no means incontestable, as the
"polyphonic" nature of Brown's transcript illustrates (1988:105).
In reading the transcript, close attention should be paid to the manner in which biomedicine
is invoked by Yankush and what relation he draws between biomedicine and the acknowledged
presence of sorcery. Brown introduces the transcript with an evocation of the scene. After a
series of informalities, Yankush "yawns in a drawn-out fashion, indicating that pasuk are entering
his body. He begins to shake the fan [of sampi leaves]. He takes off his sweater, then combs his
hair, still facing away from the participants" (1988:106):
1 Yankush: "I, I, I, I, I. With Tsunki [spirit being of aquatic realm and ultimate source of shamanistic
2 power] / am seated." He falls silent. He spits, then shakes his fan while breaking into wordless
3 song. He stands up, still facing the wall.
4 Katan, shouting: "Let's listen! He's intoxicated now, so let's listen!" Yankush sits down again, still
5 singing. His daughter brings him a small bottle of an unidentified liquid. He rubs this liquid on
6 his neck.
7 Katan: "Sing to your own body so that others won't bewitch you."
8 Utijat: "Others know you are curing. They can hurt you. Be careful.1" Yankush faces participants.
9 Katan brings in two large banana leaves. Shimpu moves the lantern to put Yankush in shadow.
10 Yankush [to Katan]: "Mother's brother, bring your wife." Both patients come forward and sit in front
11 of Yankush. They take off their dresses but remain covered with blankets below the waist. One
12 woman turns over to lie on her stomach.
13 Katan: "Take the darts out. See where the sickness is!"
14 Shimpu [indicating Yamanuanch]: "She can't eat. Her throat hurts."
15 Utijat: "Think powerfully!" Yankush looks at Chapaik, sucks on her back, and spits. He drinks from
16 a bottle [later identified as kistian ampi, "mestizo medicine"], faces toward wall, and vomits.
17 Katan: "If you can't cure her, tell me the truth. Throw it [the sorcery substance] out! . . . Look, stand
18 up to the intoxication. If you cure her, I'll always receive you well in my house. Throw it [sorcery
19 substance] away!" Yankush turns to face Yamanuanch. Shimpu and other begin to shout.
20 Various: "Show him where it hurts!" Yankush appears to suck on chest of Yamanuanch.
21 Yamanuanch: "My throat hurts too."
22 Yankush: "You'll get well." Yankush takes off his shirt, facing the wall again. He turns to look at
23 Yamanuanch.
24 Katan: "Sit well, think well!"
25 Yankush [shaking fan in direction of Yamanuanch]: "Her chest is bad [i.e., diseased]." He sucks the
26 afflicted spot and spits noisily. He turns quickly to Chapaik.
27 Various men: "Tell him where it hurts!"
28 Yankush: "You can give her an injection."
29 Katan: "Nephew, look at all the places that hurt!"
30 Yankush: "Give her an injection. She will recover. She is not sick with sorcery, but a cold in her
31 throat." He sucks on Chapaik's back, spits, then sings above Chapaik. He yawns noisily, then
32 kneels to suck on her back. He hawks noisily and spits.
33 Yankush: "You can give her an injection of wichu [unidentified; probably a corruption of the name
34 of a pharmaceutical product]. You can give her three injections. She will get well."
35 Katan: "Tomorrow I'll get the medicine."
36 Yankush: "With various injections she'll get better." Turns to Yamanuanch. "She has sickness in her
37 stomach."
38 Shimpu: "Is she going to die? If so, tell me!" Yankush leans over Yamanuanch, sucks, and spits.
39 Katan: "Why would they want to bewitch me? I always give people food when they come to visit.
40 Why bewitch my wife? I'm angry."
41 Yankush [stands singing over Yamanuanch. He drinks from the bottle of "mestizo medicine." He
42 sings over Yamanuanch for several minutes]: "If my enemies want to bewitch me, here I am.
43 They can't hurt me. f see everything. She had darts in her stomach, and I took them out."
44 Utijat: "See well in order to cure!"
45 Yankush:" Your throat is sore from vomiting. I will heal you. Your stomach hurts right there. I'll heal
46 it. When I first began curing, few people came. Now many come because I can cure. If they
47 are weak, I can heal them. If they have rheumatism, I can cure them. You will return to your
The presence of Western biomedical elements is abundantly clear in the transcript. For my
purposes, the most important elements are:
Yankush demonstrates an ability for dual diagnosis. He determines the source of sickness as
either sorcery or a natural nonsorcerous process, made explicit when he refers to his wife's
affliction (line 163). An essential part of his healing task is to determine the presence or absence
Yankush's constant reference to injections and pharmaceuticals, and the various clients'
requests for Yankush's advice on such matters reflectthe generally "high regard" of the Aguaruna
toward biomedicine, or Christian medicine (Brown 1986:174). Biomedicine is ascribed a role
of culturally symbolic import by the Aguaruna, and this points to the ways in which pharma-
ceuticals, injections, and shamanism are imbricated in the practice of a hybridized eth-
nomedicine. Brown writes:
The profound symbolism of the biomedical procedure of injecting medicines into the body as
an enactment of medical power is not restricted to the Aguaruna (or even to South America—see
Reeler 1990); nor is it a restricted notion that injection resembles a sorcery dart that becomes
lodged beneath the sick person's skin. Bastien notes that the Andeans in Bolivia make similar parallels
(1982:801,1992a: ch. 8).
Yankush prescribes pharmaceuticals and injections in a professional tone: pharmaceuticals
and injections become shamanized in his discourse. Recalling Brown's distinction between the
three shamanic "registers," we see occasions when the references to injections occur in the
sung (second or third) register (lines 36, 48-49). The fact that Yankush pays discursive attention
to injections not only in his spoken responses and recommendations to his clients but also in
his personalized shamanic singing leaves little room for doubt that Yankush is conscious of the
presence of Western medicine as more than simply a practically useful product or procedure.18
By chanting about injections {"With various injections she'll get better" [line 36]), instead of
simply prescribing them, Yankush incorporates biomedicine into his exclusive shamanic
discourse. Using verbal as magical control, he appropriates the foreign power that biomedicine
holds for the Aguaruna, channelling that power into his own shamanic repertoir of knowledge
and practice. If, as Brown says, injection instantiates the power of biomedicine, and if, as Bastien
says, the hypodermic needle is perceived as "the ultimate tool" (1992b:138) of the biomedical
profession, then Yankush has determined a means of actively tapping into the source of that
power for the express purpose of empowering his own shamanic technique.
This power is attributed to biomedicine precisely because it is a foreign medicine that does
not originate within the Aguaruna social world. As is evidenced in Yankush's sung discourse,
socially distant (that is, natural and supernatural) beings constitute the source of shamanic
power. The session begins with his calling on the progenitive power of Tsunki, the aquatic
originating source of shamanic power for the Aguaruna (lines 1-2). Later he calls on the power
of the jaguar (line 133) and the mankup (line 140). All of these beings reside at the periphery
of the Aguaruna social world, and it is for precisely that reason that they are conceived as
powerful. Shamans do retain a sense of this power and knowledge inside their bodies as Langdon
(1992) notes in her discussion of Siona shamanism. Yet, the origins of shamanic power lie in
sources not within but without: in sources "outside" of or at a distance from the particular
shaman's social world. Indeed, shamans deal in distant power: they are mediators between the
inside and outside and the social and natural continuums that construct Aguaruna life. Searching
for a means to channel curative power from the realm of the socially distant into the realm of
the socially near is the shaman's specialty.
We would do well to juxtapose Sherzer's insight (cited above) that "verbal control is magical
control" with Yankush's appropriation of biomedical power through the shamanizing of injections
in his personalized discourse. Shamanic appropriation is facilitated by hallucinogenic trance but is
enacted or activated in shamanic singing and chanting. Drawing on several distant powers of the
natural realm, Tsunki, the jaguar, and the mankup, Yankush also recognizes the power socially
ascribed to Western medicine—the medicine of social outsiders (such as mestizos, Christians, and
whites)—and activates these through a similar co-opting maneuver in his shamanic chanting.
Brown claims (in quote above) that the power of injections lies in the fact that injections
"invert traditional knowledge" about sorcery-sickness causation. This would mean that the
Aguaruna revere injection because it is a practice that is procedurally similar to sorcery (in that
While developers contend that ethnomedical practices are actively useful to the extent they
can be scientized by biomedical research and policy, I present for radical contrast the knowledge
The shaman, uwishin, is a specialist in symbolic relations with the outside.. . Shamans mediate symbolic
bonds and seek to control other groups... . Nowadays such power is derived primarily from white
spheres.... The ideological basis of prestige and value ascribed to foreignness is today epitomized by
the "white world." [1981 -.672-673]
We must realize that indigenous South American societies, including their shamans, understand
biomedicine in relation to a socially distant, at times nefarious, and powerful foreign identity
(connected to the West) that postcolonial history has made an everyday part of their social
consciousness—just as Westerners understand ethnomedicine and shamanism, particularly in
relation to a subjected indigenous South American identity.20 That identity has been continually
misconceived ideologically facilitating further imposition—further capitalist-inspired development,
including biomedical domination.
Exploring Yankush's shamanic appropriation of Western culture, however, opens up a
potentially new conception of shamanism and ethnomedicine generally, as well as the
intermedical space it shares with biomedicine. To some extent, I agree with Kreimer (1988) that
the continuing practice of shamanism can be understood as a means of indigenous "cultural
survival," but our agreement is superficial. I disagree with her conceptualization of that cultural
survival and the ideological assumptions underlying it, which posit shamanism as a passive
"reservoir" of pre-Columbian traditions (Kreimer 1988:22). I also disagree with the idea that
shamanism is a "traditional" medicine meant to passively "preserve cultural institutions"
(Neumann and Lauro 1982:1817), and an unchanged resource of "culturally intact" (Lewis and
Lewis 1994:61) plant knowledge, as so many health developers and their ethnobotanical
partners understand it to be.
Yankush demonstrates that shamanism is a creative and dynamic ethnomedical knowledge
and practice, not a static conservative one. His shamanism shows his keen acknowledgment
and understanding of the realities of his interethnic and intermedical social situation. He acts
from within that situation to renegotiate what shamanism is for the Aguaruna—an actively
produced hybrid medicine.21 Yankush's shamanic appropriation of biomedicine is itself the
process by which he asserts his shamanic ethnic social agency and affects cultural and medical
change among his community. Because of his appropriation of biomedicine Yankush was
"highly regarded" among colonists, but Brown adds that "his fame among colonists seemed to
raise rather than lower his standing among the Aguaruna" (1988:104-105). Yankush's ability
to renegotiate actively the constitution of his knowledge and practice is not a corrosive effect
but precisely what is needed to assure its "cultural survival/'
Indigenous cultural survival is too often espoused in implicit rescue terms, the constant
rediscovery oi yet another slightly different version oi the untouched, primordial, pristine—and
notes
Acknowledgments. I am grateful to the Tinker Foundation for a travel grant that supported part of this
research. The article benefited greatly from the (ever) insightful input of Kathleen Lowrey. Special thanks
should also go to Terence Turner who supported the article's original production and to Michael F. Brown
whose work makes the article possible in the first place and whose comments I considered essential before
submission. I am grateful to the editors ofMedicalAnthropology Quarterly for permission to use the extended
quote from Michael Brown's (1988) article. I would like to further thank Jean Comaroff, T. M. S. Evens, Jean
Jackson, and Janet Morford for their time spent giving extremely thoughtful and useful comments and
criticisms, and Michael Herzfeld for his editorial counsel. Le agredezco al Dr. Marcos Cueto del Instituto
de Estudios Peruanos por todo sus comentarios y especialmente su advertencia que la idea de "colabo-
racion" ya no existe solamente como un problema entre la biomedicina y la etnomedicina sino tambien
como un problema entre los acadeYnicos norteamericanos y los academicos latinomericanos. Edward
Hammond of Rural Advancement Foundation International provided helpful information about the ICBG-
Peru project. I remain grateful for all these contributions but of course I am fully accountable for the ideas
presented here.
1. The ordinances pertaining to the construction of reducciones include mandates for the construction
of European-style hospitals (Crouch etal. 1982:15; ordinance 121). For a more detailed examination of the
policies regarding reducciones and their implications in colonialism, see Fraser 1990:40-45, 75-81.
2. Representative examples of this kind of earlier "medical anthropology" are Ackerknecht 1942,
Evans-Pritchard 1937, Rivers 1924, and Turner 1967.
3. There is in fact at least one example where ethnomedicines are referred to explicitly as nonmedicine,
as when Press refers to "urban curandero" practices as "non-medical" services (1971:749).
4. For examples of the use of "medical pluralism" as an analytical trope see Bastien 1992a, Cosminsky
1983, Crandon 1986, Crandon-Malamud 1991, Frankenberg 1980, and Leslie 1980.
5. Neuman and Lauro (1982) describe expanding ethnopharmaceutical research on indigenous plant
knowledge as a primary benefit of linking biomedicine and ethnomedicine. They do not mention intellectual
property rights or compensation for indigenous peoples.
6. The Aguaruna are a group of lowland Indians of the Jivaro linguistic group. The Jivaro region stretches
across the southern fringe of the Ecuadorian and north-central Peruvian lowlands. Harner's ethnography
(1972) gives an adequate introduction to Jfvaroan cultural life.
7. The author holds a copy of the Consejo's protest letter to NIH and the principal investigator of
Washington University's research team. It is dated March 10, 1995 and contains a detailed account of the
Consejo's claims against the Washington University team, as well as a demand that the research team leave
Aguaruna-Huambisa territory. Portions of the letter have been translated and reprinted publicly by RAFI
(1995).
8. I see clear connections between this Western conception of cultural stasis and cultural progress with
the Western conception of history and myth which Turner (1988) criticizes. His argument systematically
refutes the idea that indigenous Amazonian societies operate solely under a mythic (as opposed to a
historical) social consciousness, delineating the ways in which myth and history coexist and cooperate in
Kayapo discourse. In doing so, he also refutes the ubiquitous Western idea that before contact with
Europeans indigenous peoples had no sense of history. The opposition that Turner discusses between history
and myth is conflated with these similar oppositions of stasis and progress (or change), tradition and science,
and, I would argue, ethnomedicine and biomedicine. Similarly, these oppositions, when correlated with
the opposition between Western culture and indigenous culture, serve as a justification of further Western
references cited
Achterberg, Jeanne
1985 Imagery in Healing: Shamanism and Modern Medicine. Boston: New Science Library.
Ackerknecht, Erwin H.
1942 Problems of Primitive Medicine. Bulletin of the History of Medicine xi:503-521.
Akerele, Olayiwola
1987 The Best of Both Worlds: Bringing Traditional Medicine Up to Date. Social Science and Medicine
24(2):177-181.
Ansion, Juan, ed.
1989 Pishtacos: De Verdugos a Sacaojos. Lima: Tarea.