World Archaeology

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Health beliefs, healing practices and medico-

ritual frameworks in the Ecuadorian Andes: the
continuity of an ancient tradition

Elizabeth Currie, John Schofield, Fernando Ortega Perez & Diego Quiroga

To cite this article: Elizabeth Currie, John Schofield, Fernando Ortega Perez & Diego Quiroga
(2018): Health beliefs, healing practices and medico-ritual frameworks in the Ecuadorian Andes: the
continuity of an ancient tradition, World Archaeology, DOI: 10.1080/00438243.2018.1474799

To link to this article: https://doi.org/10.1080/00438243.2018.1474799

Published online: 28 Jun 2018.

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WORLD ARCHAEOLOGY
https://doi.org/10.1080/00438243.2018.1474799

ARTICLE

Health beliefs, healing practices and medico-ritual frameworks in

the Ecuadorian Andes: the continuity of an ancient tradition
Elizabeth Curriea,b,c, John Schofielda, Fernando Ortega Perezc and Diego Quirogac
a
Department of Archaeology, King’s Manor, University of York, York, UK; bDepartment of Health Sciences, University of
York, York, UK; cSchool of Public Health, College of Health Sciences, Universidad San Francisco de Quito, Quito,
Ecuador

ABSTRACT KEYWORDS
This paper introduces the European Commission-funded project ‘MEDICINE: Andean medicine;
Indigenous Concepts of Health and Healing in Andean Populations’, which ethnomedicine; health
takes a time-depth perspective to its subject, and uses a framework of beliefs; health models;
healing rituals; traditional
interdisciplinary methods which integrates archaeological-historical, ethno-
medicine
graphic and modern health sciences approaches. The long-term study objec-
tive is ultimately to offer novel perspectives and methods in the global
agenda to develop policies sensitive to indigenous, refugee and migrant
people’s social, economic and health needs, as well as culturally sensitive
approaches to the conservation of their ‘intangible cultural heritage’. This
paper focuses on the project’s first phase, the critical examination of archae-
ological and ethnohistorical evidence and accounts from contemporary indi-
genous practitioners of Andean Traditional Medicine. These sources then
shape the development of health beliefs and practices models which have
informed the development of questionnaires for the second ‘survey’ phase of
three indigenous Andean populations in the Central Sierra region of Ecuador.

Introduction
Understanding how cultures construct their beliefs is critical to the understanding and interpreta-
tion of that culture’s experience and practice of what we now call ‘medicine’. Without such an
understanding of these different concepts, perspectives and beliefs, we are left with a partial or
erroneous view of how health, illness and therapies were understood and practised in the past. In
modern biomedicine, health beliefs and medical practices are always distinct from religious-ritual
concepts and practices, possibly excluding some aspects of Complementary and Alternative
Medicine (CAM) which are still widely distrusted by the modern biomedical and clinical establish-
ment. Yet in many traditional cultures around the world, the two are innately part of the same
phenomenon. This was, and in many cases still is, the case for indigenous Andean cultures in
South America.
Traditional Andean understandings of the nature and functioning of the cosmos and belief
systems encompassing the human body, of health, illness and healing have been under sustained
assault since the arrival of Renaissance European and Christian philosophical and metaphysical
paradigms in the sixteenth century. Throughout the 500-year process of evangelization,

CONTACT John Schofield john.schofield@york.ac.uk Department of Archaeology, King’s Manor, University of York,
Exhibition Square, York YO1 7EP, UK
© 2018 Informa UK Limited, trading as Taylor & Francis Group
2 E. CURRIE ET AL.

encompassing the persecution of indigenous Andean religion and of traditional religious specia-
lists (which encompasses ‘medical’ and healing practices), what survives of these belief systems
and practices now? How do we reconstruct the core basis of beliefs that shaped notions of the Pre-
Columbian universe and reach an understanding of concepts of self, body image, health and
illness so different from our own?

The study
Cultural and health belief systems and related rituals or behaviours sustain a people’s sense of
identity, well-being and integrity. This study explores how Andean people’s experience of their
world and their health beliefs within it is fundamentally shaped by their ontology: their inherent
beliefs about the nature of being and identity in relation to the wider cosmos. The Andean
example is indicative of a wider issue, and one increasingly relevant in a shrinking world of
transience and mobility: that people holding such beliefs move (often without choice) into new
and unfamiliar cultural settings where such beliefs are neither recognized nor understood. By
recognizing the issue, and documenting it through a single example, policy-makers and practi-
tioners may begin to recognize pathways to good and sensitive practice.
The first phase of the research sought to identify core Pre-Columbian and early historical ethnic
Andean concepts and beliefs about the human body in its wider cosmological setting, and how
health and illness are understood within this within indigenous populations of the Sierra region of
present-day Ecuador (Figure 1(a,b)).
Three sources of data have been used for this:

(1) Archaeological: (i) archaeological material culture (principally pottery and decorative motifs)
demonstrating Pre-Columbian beliefs and practices; (ii) bio archaeological data from human
remains of people with medical or surgical interventions; (iii) ethnobotanical data from plant
remains; (iv) ‘circumstantial’ data from the interment of supposed healers or ritual specialists
(shamans);
(2) Early colonial period Spanish documents which detail, through their own words, the beliefs,
rites and practices of many of the indigenous religious specialists who found themselves
prosecuted before the Jesuit ecclesiastical courts;
(3) Ethnographic studies of the beliefs and practices of more recent historical or contemporary
Amerindian peoples.

Based upon health beliefs and practice-based models constructed from the study’s first phase,
the second phase of the work determines what survives of pre-European Amerindian systems of
knowledge and medicine in indigenous Andean cultures now, through a survey of three Kichwa-
speaking indigenous Andean populations in the Ecuadorian Central Sierra.
Current practices of Andean Traditional Medicine (TM) have evolved within historical contexts
into new forms which can tell us about the nature of Pre-Columbian and historical indigenous
belief systems and demonstrate how these beliefs and associated rituals and practices have
adapted and survived in social climates of persecution and repression. In the longer term it will
also demonstrate the continuing role, relevance and use of TM in present-day communities and
the role of indigenous healers within this. Through the identification of what constitutes ‘authentic
TM’ in traditional Andean populations today, a further study objective is to develop culturally
sensitive policies to recognize and, if appropriate, protect Andean Kichwa peoples’ intangible
 WORLD ARCHAEOLOGY 3

Figure 1. (a) South America with inset showing Ecuador. (b) Ecuador, with the Study region.

cultural heritage, as defined in the 2003 UN Convention for the Safeguarding of Intangible Cultural
Heritage (Riordan and Schofield 2015).

Archaeological and ethnohistorical evidence

In recent years, new research into Andean ontology and cosmology has led to new theoretical
approaches to existing and new archaeological data (e.g. Bray [2015]; Eeckhout and Owens [2015];
Rosenfeld and Bautista [2017]; Shimada and Fitzsimmons [2015]; Staller [2008]; Weismantel
[2015a]). Complementing an extensive literature on the corpus of early colonial period ethnohis-
torical documentation (e.g. Brosseder 2014; Duviols 2008; Griffiths 1996; Mills 1997; Salomon and
4 E. CURRIE ET AL.

Figure 1. (Continued)

Urioste 1991), these data and approaches have significantly advanced our understanding of Pre-
Columbian belief systems, which allow us to interpret the nature of the world that Pre-Columbian
peoples experienced, their likely understanding of life and death, states of wellness and illness, the
medical practices employed by them and the way these were a reflection of the cosmological
whole.

Pre-Columbian beliefs about the world and health

The so-called central Andean ‘health axis’ (Camino 1992) and associated medico-ritual practices are
of longue-duree, stretching from Ecuador in the north to Bolivia in the south, and employed
healing knowledge centred principally on the administration of medicinal and psychoactive plants
(Bussmann and Sharon 2006a; Cavender and Albán 2009; Cordy-Collins 1982; Glass-Coffin 2010;
Torres 1996). In the archaeological record in Andean South America, there is a demonstrable
 WORLD ARCHAEOLOGY 5

relationship between shamanistic cosmologies and practices, and healing traditions and healing
scenes from earliest times (e.g. Kaulicke [2015]).
Healers (curanderas/os) are sometimes depicted in pottery vessels or ceramic figurines, occa-
sionally representing ‘otherworldly’ forms such as owls (see Bussmann and Sharon [2006a];
Figure 2). In Ecuador, representations of shamanistic themes in ceramics are found from the
earliest pottery producing Valdivia culture (c.3800–1500 BCE; Staller [2001]; Stahl [1985]); else-
where (particularly in monumental sculpture) from the Early Horizon Chavín Culture of Peru
(c.1200–400 BCE; Conklin and Quilter 2008; Cordy-Collins 1977) and sporadically from then on,
with most deriving from the highly naturalistic ceramic tradition of the Moche culture on the
North Coast of Peru (c.100 CE – 800 CE), where the finding of such ceramic vessels and figurines
interpreted as healers is rather more common (Glass-Coffin, Sharon, and Uceda 2004).
In recent years there has been much new research into the history and contemporary use
of psychoactive and medicinal plants in Ecuador, Peru and Bolivia (Armijos, Cota, and
González 2014; Cavender and Albán 2009; Bussmann and Sharon 2006b, 2009a, 2014;
Mathez-Stiefel and Vandebroek 2012), which has broadened our understanding of the
integral role that the native herbal still plays in traditional cultures in the region today. An
extensive survey of the ancestral knowledge and use of medicinal plants in Sierra regions of
Ecuador is currently in progress, which will further contribute importantly to our under-
standing of the key role still played by Traditional Medicine throughout the region (F. Ortega,
personal communication 2017).

Figure 2. Curanderas advertising the range of conditions treated. Historical centre of Quito, Ecuador.
6 E. CURRIE ET AL.

Indigenous Andean concepts of health and the practice of traditional medicine is embedded in
a Pre-Columbian ontology which views spirit and matter as an undivided whole, where Cartesian
dualities of mind and body were never recognized, and health itself was a composite whole
(Urtioste 1981). Recent surveys carried out for the project ‘MEDICINE’ of three contemporary
indigenous Andean communities confirm that this is still the case for over 90% of the respondents
interviewed. Harmony or balance were (and are) of critical importance: for the balance between
the spiritual and physical dimensions of human existence; and for the health and physical well-
being of both the community and the individual as a part of that. Such balance was achieved
through the maintenance of harmonious reciprocal relations between people and the spirits who
were resident in the natural phenomena around them. Through the enactment of ritual perfor-
mances and the offering of libations and sacrifices to the sacred entities embodied by mountains,
springs, waterfalls, stones and rocks (the Andean wak’as), imbalances in the wider world, and in
community life and the health of an individual sufferer could be restored. An individual person
was (and still is) never seen as separate from the community of which they are a part, or of the
wider landscape and environment to which the community belonged. Individual health and many
experiences of illness were (and are still) widely interpreted as being an expression of psycholo-
gical or socio-economic imbalances within the structure of the community, or the individual
sufferer’s relationship to their family or community (Bastien 1981; Greenway 2003).

Wak’as: the embodiment of the Andean sacred

Critical to our understanding of the functioning of the pre-Columbian world is the role played by
the sacred Andean (non-human) being known as Wak’a (also ‘huaca’). Whilst at its most basic
simply meaning: ‘a sacred thing’ (Bray 2015), it is a difficult concept for people from a European
ontological background to understand. Wak’as can be both of human manufacture or natural,
portable as well as natural loci in the landscape, or natural phenomena, but with the power to
transform into human-looking beings or animals, and back again (Bray 2015; Brosseder 2104; de la
Vega 2005; Mills 1997; Salomon and Urioste 1991). They were pivotal in every aspect of Andean life
and are still important in many indigenous communities today throughout Sierra regions of both
Ecuador and Peru (see Figure 5).
Chase (2015) explains that: ‘Human life bent around and pivoted on wak’as both in perception
and in effective historical fact’ (Chase, in Bray [2015]: location 1962). Wak’as were served by
community religious specialists and according to several early colonial period ethnohistorical
accounts, there were many categories of such specialists in the Andes at the time of the arrival
of the Spanish, who included healing within their repertoire of powers (e.g. Brosseder [2014];
MacCormack [1991]). Religious specialists acted as intermediaries between the wak’a and the
community, and through serving this entity and interpreting its oracular pronouncements, the
health of the community and individuals could be maintained. In turn, the wak’a would demand
feeding with ritual items such as coca, chicha (maize beer), guinea pigs, llama fat or other
offerings.

Concepts of the human body in the Andes

In recent years there has been increased attention to how peoples in pre-modern (including
prehistoric) societies conceptualize the human body. In archaeological terms this has greatly
enhanced our capacity to interpret mortuary behaviours and from these understand the
 WORLD ARCHAEOLOGY 7

significance accorded to concepts of ‘personhood’ or ‘individual’ and the human body itself (e.g.
Classen [1993]; Thomas [2000]; Weismantel [2015b]). Bastien (1987) and Classen (1993) point out
that the relationship between Andean cosmology and the human body was complex, with the
human body seen to mirror the physical cosmos. In addition to breaking down the human body
into its constituent physical components, Andean peoples, and Inca physicians in particular,
subdivided it into physical, cosmological and metaphysical parts. In an analysis of medicines
used in Quechua ‘soul-calling’ rituals in the southern Peruvian Andes, Greenway (1998) discusses
how the identity of patients is encapsulated within different items in sacrificial bundles called
despachos and examines the differences between Andean and Western concepts of ‘embodiment’.
In the treatment of illness, symbolic healing is achieved through the manipulation of medicines,
altering the experience of the lived reality of the patient. Symbolic healing rituals still comprise
much of Andean ethnomedicine today (see Continuity of Indigenous Religious Practice and Beliefs
below).

Health and medical practice in the Pre-Columbian world

Whatever the practice of esoteric rituals and interpretation of their function in treating a broad
spectrum of illnesses, or the application or ingestion of herbal remedies, more skilled surgical
interventions are also evidenced in the Pre-Columbian world. The human skeletal aspect of the
archaeological record testifies amply to the expertise of Pre-Columbian doctors and surgeons, with
a very sophisticated understanding of the human body and the different pathologies affecting it.
However that human body in its wider cosmological context was visualized or understood, there is
evidence for a wide range of sophisticated medical interventions including bone setting, craniot-
omy and trephination demonstrating a clear anatomical knowledge (Andrushko and Verano 2008;
Elferink 2015; Marino and Gonzales-Portillo 2000; Mendoza 2003). However, it is clear that the
Spanish completely misunderstood or underestimated indigenous skills, and that, following the
rapid demise of the Inca Empire in the later sixteenth century, such early medical wisdoms and
skilled interventions were wholly lost. Although the skilled herbal knowledge of indigenous
specialists was occasionally more tolerated, or encouraged (Griffiths 1996), there was still an innate
distrust of it throughout the colonial period, particularly the ritual context within which it was
used, and the potential occult powers of the specialists who employed it.

Archaeological evidence for Pre-Columbian medicine

What, then, are we looking for in the archaeological record to demonstrate medical practices,
outside of a conventional ‘modern’ clinical context or GP surgery with attendant equipment? What
might constitute such a context in a Pre-Columbian setting? The answer is there is relatively little
that is clear and unequivocal, that does not require ‘insider’ knowledge of Pre-Columbian ontol-
ogies and cosmologies in order to interpret what is seen in the material record (Weismantel
2015a). Archaeological evidence of medical practices may derive from erratically surviving material
culture, such as pottery and related decorative motifs, but is ‘mute’ and cannot be easily ‘read’.
Complex analytical systems such as attribute analysis are sometimes employed to construct
databases with which to interpret these kind of mute data, but are still subjective and determined
by the researcher.
In contrast, bio-archaeological and osteo-archaeological data appear to be more ‘objective’ and
robust than qualitative analytical techniques, but the actual system of belief these represent must
8 E. CURRIE ET AL.

still interpreted. For example, trepanning was a not uncommon procedure in Pre-Columbian Peru,
with over 80% survival rates as seen in skeletal records in some contexts (Andrushko and Verano
2008); however, why was this procedure performed? The phyto-archaeological record in South
America amply confirms the use of a range of plant species which are commonly associated with
healing, with inducing altered states of consciousness or even in the manipulation of blood
pressure for human sacrifice (Burger 2011; Bussmann and Sharon 2006b, 2009b; Van Limpt, n.d.;
Stahl 1985; Torres 1996; Torres and Repke, 2006), but in archaeological contexts we do not know
how these were administered.
There is not the scope here to undertake an extensive review of the range of archaeological
finds in Pre-Columbian Andean cultures that attest to medical practices and approaches to the
treatment of illnesses. These finds are reviewed in works such as Mendoza (2003) for example,
while, as noted above, other authors have amply described and discussed practical medical and
surgical procedures such as trephining and craniotomy. Here we propose looking briefly at
‘circumstantial’ evidence in the form of archaeological finds of the graves of supposed healers
and shamans, together with the sorts of ritual paraphernalia such as found in present-day sha-
man’s altars or mesas (Bussmann and Sharon 2006b; Glass-Coffin, Sharon, and Uceda 2004).
As previously stated, it is well known that shamanistic belief systems which involve magico-
ritual practices and settings were prevalent in Pre-Columbian times, and indeed still are in many
traditional indigenous South American contexts, and were intimately involved in the diagnosis and
treatment of illnesses. Therefore, when making interpretations from circumstantial archaeological
data, it is of foremost importance to understand the prevailing ontologies which underpin ideas of
health, illness and medical practices in the Andean region and what we might be looking for in the
archaeological record that would demonstrate them (Insoll 2011; VanPool 2009). For one thing we
should understand that Pre-Columbian notions of life and death were not the same as those of
people from our own modern industrialized societies (Millaire 2004; Shimada and Fitzsimmons
2015), something noted by researchers into other pre-modern/prehistoric societies such as the
Neolithic in Britain (Thomas 2000). Similarly, ritual healers and specialists might have served a
complex of interrelated roles including that of priest/priestess, ruler, as well as diviner, in addition
to healer. Brosseder (2014) notes the complex and confusing array of titles accorded to the many
different types of healer or specialist recorded by Spanish chroniclers at the time of the Spanish
Conquest of Peru.
If we are looking for archaeological examples of shamanistic personages and practices on the
understanding that they would have been the people primarily responsible for performing health
interventions, then the evidence becomes more compelling. This evidence extends from the
earliest cultural contexts in the Andean region, and can be argued to be present from the Late
Archaic/Formative Period circa second–third millennium BCE of Peru (Kaulicke 2015) in the burials
of individuals who can be convincingly interpreted as ritual practitioners, or ‘shamans’, and which
become progressively more common in later periods such as the Moche c.100–800 CE (Rengifo
Chunga and Castillo Butters 2015). Although it cannot be proven that burials of individuals with
ritual dress, ornamentation and paraphernalia were indeed healers, it is believed highly likely that
they were, given the kinds of representations of such personages in ceramic decorative scenes
(Cordy-Collins 1977; Glass-Coffin, Sharon, and Uceda 2004) and in the persistence of key traits such
as the use of ritual objects organized into shamanic ‘mesas’ which are still commonly employed in
diagnostic and healing rituals today (see ‘Continuity of Indigenous Religious Practice and Beliefs’
below). As already noted, the evidence is one of interpretation. It is posited here therefore, that it is
not an unfair assumption that graves containing the remains of personages with unusual or clearly
 WORLD ARCHAEOLOGY 9

ritual ornamentation and equipment are indeed likely to have been of individuals involved in
activities which included healing.
The north coast of Peru is particularly rich in monumental archaeological sites with attendant
burials that include many examples which have been interpreted to be of curanderos or shamans.
Rengifo Chunga and Castillo Butters (2015) discuss the evidence from the complex of burials in
Context M-U 1221 found at the Late Moche site of San Jose de Moro on the Peruvian north coast,
which the authors interpret to be of ‘witch doctors’ or shamans, owing to the highly manipulated and
complex interments of the human remains as well as the presence of ritual objects which are believed
to have been employed as part of an aforementioned mesa. Several hundred miles further north, at the
Late Integration period archaeological site of Lopez Viejo, Manabí, coastal Ecuador (c.1220 CE), what
originally appeared to be an atypical (for Manteno cultural contexts) and disorganized mix of multiple
human interments, of both primary, secondary, cremated and non-cremated remains, can, in the light
of what we now understand of Andean burial practices, be re-interpreted as potentially being the
interment of a young female ritual specialist, with guardians or attendants (upper pit fills) and ritual
objects that included the ivory figurine of a harpy-eagle headed shaman in a state of altered
consciousness and a stylized anthropomorphic ceramic figurine of a naked eagle-masked female.
This fully articulated, partially cremated individual lay atop a complex of the remains of up to 30
individuals ranging from neonates to adults, male and female (Currie 2001).
Finds of this nature, whilst potentially being those of community specialists involved with ritual
healing practices, still tell us relatively little of the actual beliefs and practices performed by them upon
their patients, however. For this we must turn to the ethnohistorical and modern ethnographic records.

Andean health and medical practices from the ethnohistorical context

Researchers into Andean religion and healing practices are able to use both the writings of several key
historical figures active during the early colonial periods (e.g. Acosta (1590) [1987]; Avendaño [1904];
Betanzos (1557) [1996]; Cobo [1964]; de la Vega [2005]; Molina [1989]; Sarmiento de Gamboa [1988]),
as well as ecclesiastical records surviving from the sixteenth to the eighteenth centuries, during the
several Jesuit campaigns to eradicate Andean religion and related practices of healing, divination and
the interpretation of dreams, omens and signs. The trial records from these waves of persecution
(‘Extirpación de las Idolatrías’) offer us much detail in terms of what Andean religious specialists and
healers believed and practised (Duviols 2008; Griffiths 1996). However, the information is generally
seen as being flawed in several key ways, both by the use of coercion by Spanish ecclesiastical
prosecutors to gain ‘acceptable’ evidence, and in the general use of interpreters, as many of the
Quechua-speaking defendants were unable to speak Spanish. Importantly too, the intellectual frame-
work adopted by the courts was informed by sixteenth- and seventeenth-century European notions
about witchcraft and sorcery, and therefore all evidence reported is filtered through this bias. Last, and
importantly, the famous Huarochiri manuscript – the late sixteenth century written accounts of
surviving pre-Columbian Andean oral traditions and mythology is another unique source of insights
into autochthonous Andean beliefs about health and illness (Salomon and Urioste 1991; Urioste 1981).
A particularly curious and distinctive (if short-lived) early post-Conquest ethnic Andean phe-
nomenon which pivoted upon autochthonous beliefs about health and illness, was the Taqi Onkoy
millenarian movement, a brief uprising led by indigenous religious specialists in the 1560s in an
effort to revive the power of their wak’as and force a separation between Andean and Spanish
worlds. The ‘chanting sickness’ as it was known declared, ‘You make us sick’ and claimed that the
very religious tenets and practices of Christianity were responsible for the catastrophic plagues of
10 E. CURRIE ET AL.

disease which were then decimating indigenous populations (Currie and Ortega Perez 2017). In
the wake of this persecution, there has been a tendency to regard what was left of Andean
‘religious’ beliefs and practices as being merely: ‘a jumbled assemblage of cultural remnants and
twisted traditions of mixed Andean and European provenance resulting from the vacuum left by
uprooted indigenous cults and the infusion of European ideas about witches, Satanism, black
magic, and the like’ (Mills 1997, 104). Other researchers, however, merely regard it as part of a
normal process of continuity and change (e.g. Millones [1981]). But what constituted something
that could be interpreted as a continuing South American shamanistic healing tradition, or a more
general level of folkloric beliefs and practices that had cross fertilized with such exotic influences
as the European or African supernatural, ‘witchcraft’ and ‘sorcery’ traditions, is questionable. In the
study of four different trial records dating to throughout the eighteenth century in what was then
the Kingdom of Quito, Salomon (1983) finds practices of ‘sorcery’ and healing (as well as harming)
to be alive and well in the regions peripheral to the country’s population centres, with local
shamans exploiting their skills and the respect accorded them to gain prestige and influence in the
regional power dynamics. Creoles of Spanish descent were clearly also using the skills of local
shamans in healing and harming their families and enemies.

Continuity of indigenous religious practice and beliefs

Although it is the case that indigenous Andeans have assimilated Christianised concepts of the
universe and related theology and many are faithful adherents to Christianity in one form or another
(Catholicism, Evangelisms and so on), they clearly also pursue parallel beliefs which still conform to
Pre-Columbian ontologies. People may revere Christian divine beings, persons and saints and observe
Christian rites and sacraments at the same time as they acknowledge local wak’as, or practising
yachaks (shamans) revere the spirits from the Andean landscape which inform and guide their
practices. In a similar way, indigenous peoples may avail themselves of conventional modern medicine
and therapies when able to, as well as understanding certain kinds of illnesses within the traditional
framework which include concepts such as espanto (fear/shock); malaire (bad winds, negative influ-
ences from the environment); envidio (envy and related personality afflictions); and a range of other
maladies of a specifically Andean nature.1 Some illnesses are seen as ‘modern’ or ‘white people’s
illnesses’, such as cancer, ulcers or sores, requiring treatment with Western medicine. Others, many of
which might conform to psychosomatic kinds of disorders as defined by conventional modern
biomedicine frameworks (Bussmann, Glenn, and Sharon 2010), are interpreted wholly within the
traditional Andean framework of beliefs discussed later in this article. These two systems of belief
are not mutually exclusive however and the continuity of traditional Pre-Columbian beliefs and
practices, modified to include Christian motifs, is perhaps most clearly seen in the persistence of the
use of ritual altars or ‘mesas’ employed by ritual healers or shamans, down to the present time. ‘While
the incantations used by healers during their curing sessions include Christian components (e.g. the
invocation of Christ, the Virgin Mary and any number of saints), references to Andean cosmology (e.g.
to the apus or the spirits of the mountains) are also common’ (Bussmann and Sharon 2006a).

Contemporary practice of traditional medicine: the case of Don Rubelio, Salasaka Yachak
Although it cannot be said with any degree of clarity that contemporary practice of Andean
medicine is exactly equivalent with what was practised in the Pre-Columbian past, it is clear that it
largely conforms to this tradition, although certainly including exotic influences in terms of beliefs
 WORLD ARCHAEOLOGY 11

Figure 3. ‘Magical’ plants (including Brugmansia species) at the indigenous market, Cuenca, Ecuador.

and practices which may be harder to identify. Traditional medicine, encompassing divination and
healing, continue to be practised widely in many indigenous communities in the Ecuadorian Andes.
In every local market place, or along certain streets in old city centres, traditional curanderas (healers)
may be found practising limpiezas (cleansings), diagnosing a diversity of afflictions (such as those
listed above) using such divinatory methods as live guinea pigs, eggs, candles and masticated
tobacco juice, brandishing bunches of magical herbs (Figure 3). The majority of indigenous com-
munities have their different specialists, in Ecuador called ‘yachakuna’ (plural of the Kichwa term of
Yachak meaning ‘wise’, he/she who knows) who practise a range of traditional healing techniques. A
good example of this is Yachak Don Rubelio Masaquiza Jiménez of the Huasalata community in the
Salasaka indigenous township of Tungurahua province of Ecuador (Figure 4).
The ‘sacra’ or equipment used by present-day yachaks varies according to the particular specialist,
but many tend to use personal items which aid them in accessing spiritual realities beyond the
mundane world of present-day ‘reality’. These commonly include certain kinds of rounded stones,
bones of different animals, including skulls or horns, unusual natural objects and occasionally artefacts
of human manufacture (Don Rubelio has a whip), which, when assembled together, form what is called
a mesa (ritual table or ‘altar’). VanPool (2009) discusses the inadequacy of archaeological methodol-
ogies for the identification of shamanic ‘sacra’ in the archaeological record, and it is true that in the
case of present-day shamans, many use the kind of material culture – often ‘natural’ objects’ – that
would never be able to be identified in archaeological contexts outside of a specific and clear ritual
setting (such as a temple). We know that objects such as iron pyrite or obsidian mirrors were used for
the ritual specialist to ‘see’ into the Otherworld and conduct divinations (e.g. Stothert 2013) and also
snuff tubes for the inhalation of hallucinogenic substances to attain altered states of consciousness
(Stothert and Cevallos 2001), but items such as those employed by Don Rubelio would likely pass
unidentified in excavations, interpreted as domestic debris.
Don Rubelio practises from his home in the community of Huasalata, Salasaka, in a small building
adjacent to the family house. He also takes his patients to the regional wak’a site of Taita Punta Rumi
– a large rock overlooking the river valley – for the performance of ritual diagnosis and healing
ceremonies (Figure 5). The rock itself has a long history of association with ritual practices and was
engraved with crosses sometime in the 1940s by Christian evangelists who sought to exorcize it of its
12 E. CURRIE ET AL.

Figure 4. Don Rubelio Masaquiza Jimenez with his personal ‘sacra’ used in healing rituals.

perceived evil. The rock is experienced by many local people as having a special spiritual energy that
is claimed can be seen emanating from it as a flame in the night. Although many yachaks follow in
the family tradition – it is not uncommon for a grandparent to tutor a grandchild – Don Rubelio was
‘auto-initiated’ into his profession following a dream wherein the spirit of the wak’a (in the form of a
woman) visited him and told him to serve her, an experience common to many ‘shamans’ transcul-
turally (Ripinsky-Naxon 1993). His personal sacra and use of them are largely drawn from this
experience, although it is true that as a member of the community he would also have been heavily
exposed to the use of these sorts of items since childhood.
Don Rubelio’s practice consists of an initial diagnosis of his patient using lit candles, which is
followed by cleansings of ‘mal’ or imbalances of bodily energy using a combination of his special
stones and bunches of herbs. Throughout the diagnosis and treatment he works using the
regional strong liquor ‘puntas’ (sugar cane spirit), which he ‘blows’ from his mouth both through
 WORLD ARCHAEOLOGY 13

Figure 5. Don Rubelio Masaquiza Jimenez performing a healing ceremony at Taita Punta Rumi, regional Wak’a
near Huasalata, Salasaka, Tungurahua, Ecuador (Currie 2017).

the candle flames, and through the herbs, onto the face and body of the patient. In this way
everything is ‘purified’ and negative energy exorcized by the perceived cleansing quality of the
liquor (www.andeanmedicine.net).
Throughout the Sierra regions of Ecuador, yachaks perform similar rituals, although they frequently
employ different methods of diagnosis and healing, using the Andean cuy (guinea pig) or a hen’s egg.
Certain individuals may acquire powerful reputations and become widely known and respected, to the
extent that many people of all ethnic backgrounds (including the country’s Mestizo majority, and, too,
of White Caucasian backgrounds) will travel long distances to be treated by them.

Development of Andean health beliefs models

Phase One of MEDICINE has used bibliographical, archaeological and ethnohistorical sources to
define ethnic Andean cosmological beliefs related to states of health, illness and healing. These
14 E. CURRIE ET AL.

Table 1. Andean health beliefs.

Positive/
Negative State (of being) Manifested as Ritual Outcome
Positive Alive (being born) Birth Naming Identity/
Legitimacy
Negative Dead Death: social breach/ Funerary/ancestry Ancestral
disconnection identity/
legitimacy
Positive Wholeness/Integrity Individual within family, Community performance &; ritual participation: Order/Health
community feasts, sacrifice etc.
Negative Incompleteness Sin Ritual cleansing, sacrifice, correction/confession Order/Health
Positive Lineage/ethnicity Origin/ancestor Mythic/remembrance Identity/
legitimacy
Negative Alien Displaced/rootless/social Adoption by or reconnection to community, Restoration of
disconnection lineage, customs, traditions, Identity/
legitimacy
Positive Balance/equilibrium Health Community rituals, feasts, sacrifice Order/Health
Negative Imbalance/ Illness ‘Completion’ therapy; divination, ritual cleansing, Order/Health
Incompleteness sacrifice

Table 2. Causes of illness in traditional Ecuadorian Andean medicine.

CAUSES OF ILLNESS IN TRADITIONAL ANDEAN ECUADORIAN MEDICINE
SUPERNATURAL CAUSES NATURAL CAUSES
Divine Inhuman Human Imbalance or Disequilibrium Natural in the strict sense
Gods Ghosts Witches Natural forces/being human Traumas
Saints Spirits Ancestors Hot/cold Accidents
Demons Ordinary Transgression of taboos Intoxications
people
Souls Sexual transgressions Parasitosis
Goblins Shaman/yachak Extreme poverty Infections
Rainbow Eating disorders: malnutrition Hereditary
Fumes Psychological disorders: excessive emotions, emotional pain, Illnesses of ‘white’ people:
madness, bad temper, insomnia cancer, sores
Physical or intellectual excess of work
SOURCE: Ortega, Fernando. Ciencia Médica Andina. Primera Parte: Las Culturas Médicas Tradicionales. Pag. 127–152 En: Ciencia
Andina 2- Sabiduría y Rescate. CEDECO- ABYA-YALA. Quito. 1990.

data have been used to construct theoretical models of these belief systems, two of which are
presented here. Table 1 presents a ‘superordinate’ conceptual level of core belief domains and
Table 2 demonstrates specific expressions of actual beliefs by present day Andean peoples.

Identification and discussion of core concepts

The model represented in Table 1 demonstrates the essential dualistic state of the Andean cosmos
in that there are two horizontal dimensions, being positive and negative experiences of the same
state of being. Dimensions are at both individual and communal level, which are intrinsically
interlinked into the economic and social order, and to the wider environment.
The core positive states identified here are:

▪ Alive (being born)

▪ Wholeness/integrity
 WORLD ARCHAEOLOGY 15

▪ Lineage/ethnicity
▪ Balance/equilibrium

These have their corresponding negative states.

Perceived ‘State’ (of being) is ‘Manifested’ as a particular individual/social condition. This is

either affirmed/reinforced through, or addressed and remediated by ritual action, leading to a
sought outcome, which is either ‘Identity/legitimacy, or Order/health’.
Table 2 demonstrates traditional beliefs about the causes of illness in indigenous Kichwa
Ecuadorian medicine, wherein the principal division is between illnesses of supernatural origin
and those with natural causes. The advent of westernized biomedical diagnostic concepts can
be seen with the inclusion of the category ‘white persons’ illnesses’. As discussed earlier, we
do not know exactly how many of these classifications of illness come from Pre-Columbian
times, and how many have evolved through ‘cross-fertilization’ with European and African
ideas of the supernatural, particularly the concept of ’mal’ (evil). Both have clearly played an
important role given the intensive admixture of races and cultures in the melting pot of
society following the conquest of the region by Spain in 1532, and much has been influenced
by European interpretations of Andean religion through medieval and Renaissance beliefs
about demonology and witches (see above). Whatever their origin however, Table 2 is a
summary representation of the model of illness in the Andean world that exists today, and
the framework for the diagnosis and therapies employed by contemporary indigenous healers
such as Don Rubelio.
These (and additional) models will be ‘verified’ through the survey phase of the study and more
refined multi-dimensional models will be developed with the long term objective to offer a novel
perspective and methods in the global agenda to develop policies sensitive to indigenous people’s
social, economic and health needs.

Conclusion
The health beliefs models developed here and presented above summarize the important first
phase of the study ‘MEDICINE’, based upon analysis of the archaeological, ethnohistorical and
ethnographic sources. These have since informed the development of the questionnaires of the
second survey phase, which have sought to verify the continuity of these beliefs and practices in
three contemporary indigenous Andean populations. A better understanding of what present day
indigenous peoples believe in terms of health and illness is critical to the provision of inter-cultural
health care which can inform the policy issues relevant to indigenous peoples’ traditional cultures.
This will more equitably address and remedy the current tendency to impose modern systems of
biomedicine which take no account of how these peoples still live their lives and perceive and
practice their traditions as a part of this. In the Andes, these traditions have in the main evolved (or
perhaps, better said, devolved) from complex Pre-Columbian systems of belief of which continuing
research is gradually improving our understanding.
In addition, a better understanding and mapping of these beliefs and practices will allow policy
to better address and plan for the protection of these traditions as ‘intangible cultural heritage’ as
recommended by the 2003 UNESCO Convention for the Safeguarding of Intangible Cultural
Heritage.
16 E. CURRIE ET AL.

Note
1. (http://www.andeanmedicine.net/blog/mountains-moons-and-rainbows-1512933603).

Acknowledgments
This project ‘MEDICINE. Indigenous concepts of health and healing in Andean populations. The relevance of
traditional MEDICINE in a changing world’ is funded through the European Commission Horizon 2020
Research and Innovation programme. Grateful thanks are expressed to the Comunidade de Huasalata,
Salasaka, Tungurahua, Ecuador, including Jorge Caisabanda and his family for their hospitality and help
during fieldwork visits. Particular thanks are also expressed to Don Rubelio Masaquiza Jiménez of Huasalata
for his permission to include personal information and photographs to the benefit of this paper.

Funding
The grant is held as a Marie Sklodowska-Curie Actions Global Fellow award to the University of York
department of Archaeology dated 2016 (commenced 1st November). The Marie-Curie Awards are part of
the Horizon 2020 research and Innovation scheme. Details of the award are: Grant agreement 705225 Marie
Skłodowska-Curie Global Fellowship (H2020-MSCA-IF-2015) MEDICINE: Indigenous concepts of health and
healing in Andean populations: understanding the relevance of traditional MEDICINE in a changing world.

Notes on contributors
Elizabeth Currie is a Marie Sklodowska-Curie Experienced Researcher and Global Fellow at the Department of
Archaeology, and Senior Visiting Research Fellow at the Department of Health Sciences, University of York,
United Kingdom. Elizabeth has regularly worked across disciplinary and methodological boundaries through-
out her rich and varied career which has consisted of two principal trajectories: that of South American
archaeology and anthropology, and health sciences and health workforce research. In recent years she
developed her lifelong interests in ethnographic and ethnohistorical study of Latin America, during which
period she lived and worked with indigenous Andean communities in Ecuador, researching Andean tradi-
tional culture and medicine.

John Schofield is Head of the Department of Archaeology at the University of York where he is also Director of
Studies in Cultural Heritage Management. John is a Fellow of the Society of Antiquaries of London, a Member
of the Chartered Institute for Archaeologists and a Docent in Cultural Heritage, Landscape and Contemporary
Archaeology at the University of Turku (Finland). He is also Senior Research Fellow at Flinders University,
Adelaide. He has published extensively in the fields of cultural heritage, archaeology of the recent and
contemporary pasts, and the archaeology of conflict.
Fernando Ortega Perez has directed the National Institute of Nutritional and Social Medicine Research
(Instituto Nacional de Investigaciones Nutricionales y Medico Sociales) throughout the 1980s and was
manager of USAID health programmes for Ecuador. He was also Dean of the School of Public Health. He
has carried out many research programmes and evaluations in Anthropology, Demography, Epidemiology,
Public Health, Nutrition, Parasitology, Traditional Medicine and Intercultural Health. Fernando has a keen
professional interest in Ancestral and Traditional Knowledge, Genetic Remedies, Health and Environment;
Tropical Diseases and Human Parasitology; Environmental Conservation and Climate Change, Global
Traditional Medicine and Research Ethics.

Diego Quiroga is Dean of Academic Affairs and Professor of Anthropology as well as Vice President of
Research at San Francisco de Quito University. He has a PhD in Anthropology from the University of Illinois,
Urbana, USA. He both lectures and leads research primarily on medical anthropology, human ecology and
race and ethnicity. He is the USFQ representative for the ‘Alliance’, an association of several national and
international organizations responsible for the USAID Project Conservation of the Galapagos Marine Reserve.
 WORLD ARCHAEOLOGY 17

Diego is Co-director of the Galapagos Academic Institute of Arts and Sciences (GAIAS) and has done research
on topics that range from Biodiversity Vulnerability, to Religion and Traditional Medicine.

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