1. Traditional Medicine/CURANDERISMO within the Hispanic/Latino population Traditional Medicine/CURANDERISMO within the Hispanic/Latino population

7. What’s the point??? When we’re selective about the options we consider. This limits our ability to solve problems. It’s far better to open our minds to all possible solutions/options.

8. Latino and Asian Populations in the US and NC, 2000 The Latino population The Latino population 12.5% of the US population (35.3 million) 12.5% of the US population (35.3 million) 4.7% of the NC population (378,963) 4.7% of the NC population (378,963) The Asian Population The Asian Population 3.6% of the US Population (10.2 million) 3.6% of the US Population (10.2 million) 1.4% of the NC population (113,689) 1.4% of the NC population (113,689) U.S. Census Bureau, 2000 U.S. Census Bureau, 2000

9. Demographic Data - Latinos in US Majority of Latino immigrants employed in agriculture, construction, food services, landscaping, and factories Majority of Latino immigrants employed in agriculture, construction, food services, landscaping, and factories Despite high levels of employment, nearly 60% of Latinos live in families with incomes below 200% of the poverty level (US) Despite high levels of employment, nearly 60% of Latinos live in families with incomes below 200% of the poverty level (US)

11. Hispanic Cultural Views Respeto/Respect Respeto/Respect Famialismo Famialismo Non-Verbal expressions Non-Verbal expressions Time Concept Time Concept Machismo Machismo Chauvinism Chauvinism Religious Values Religious Values Marianismo Marianismo

12. Barriers to Care Language Language Cultural differences Cultural differences Lack of insurance Lack of insurance Lack of transportation Lack of transportation Knowledge of services Knowledge of services No phone No phone Hours of services offered Hours of services offered Immigration status Immigration status Residency requirement Residency requirement Public charge Public charge

13. Culturally Sensitive interview (Non Verbal Communication Styles) Hispanics tend to touch people with whom they are speaking. Hispanics tend to touch people with whom they are speaking. They tend to sit and stand closer than Anglos. They tend to sit and stand closer than Anglos. Shake hands or engage in an introductory embrace kissing on the cheek, hugging. Shake hands or engage in an introductory embrace kissing on the cheek, hugging. Interpret prolonged eye contact as disrespectful. Interpret prolonged eye contact as disrespectful.

14. Antojos are cravings in a pregant woman. It is thought by many that failure to satisfy the cravings may lead to injury to the baby, including genetic defects. Ataque de nervios are episodic, dramatic outbursts of negative emotion - usually in response to a current stressor (but often related to a significant childhood stressor). Barrevillos are obsessions. Bilis is thought to be bile flowing into the blood stream after a traumatic event, with the end result of nervousness. Caida de la mollera is the presence of a sunken fontanelle in an infant. Decaiminientos is fatigue and listlessness from a spiritual cause. Dercernsos are fainting spells.

15. Empacho is intestinal obstruction and is characterized by abdominal pain, vomiting, constipation, anorexia, or gas and bloating. Post-partum women and infants and children are most susceptible. Mal de Ojo is the "Evil Eye" that may affect infants or women. It is caused by a person with a "strong eye" (especially green or blue) looking with admiration or jealousy at another person. Mal de Ojo is avoided by touching an infant when admiring or complimenting it. Nerviosimo is "sickness of the nerves" and is common and may be treated spiritually and/or medicinally. Pasmo is paralysis or paresis of extremities or face and is treated with massage. Susto is fright resulting in "soul loss." Susto may be acute or chronic and includes a variety of vague complaints. Women are are affected more than men.

16. COMMON HOME REMEDY COMMON HOME REMEDY Tea from Herbs, Spices or Fruits Not unusual for Sick Person to use:  Prayer  Folk/Herbal Medicine All at the same time All at the same time  Prescription Drugs from Friends  Prescription Drugs from Physicians

17. Folk Remedies Everyone Should Know (+ indicates yes, with + being least and +++ being most; - indicates no, with - being least and - - - most, i.e., - - - in the safety column indicates the treatment is significantly dangerous. ? ? ? indicates the information is not known to the author.)

18. Spanish Name English Name UsesEfficacySafety Ajo GarlicHypertension, antibiotic, cough syrup, tripaida ++++ Azarcón/ Greta Lead/mercury oxides Empacho, teething- - - - Damiana Aphrodisiac, frio en la matriz, chickenpox0+ Estafiate WormwoodWorms, colic, diarrhea, cramps, bilis, empacho + purge- Eucalipto Eucalyptus (Vicks Vapor Rub) Coryza, asthma, bronchitis, tuberculosis + respiratory Sx; 0 TB + Goberna dora Chaparral Arthritis (poultice); tea for cancer, venereal disease, tuberculosis, cramps, pasmo, analgesic + as a poultice 0 as a tea - - - (internal) Gordolob o MulleinCough suppressant, asthma, coryza, tuberculosis + Cough; 0 asthma, TB, coryza + + (if right species)

19. ManzanillaChamomileNausea, flatus, colic, anxiety; eyewash + except eyewash = 0 + + (if no allergy) OréganoOreganoCoryza, expectorant, menstrual difficulties, worms 0/ + except worms = 0 + PasionaraPassion flowerAnxiety, hypertension+ + + sedative + + (if right species) RodigiosaBricklebushAdult onset diabetes, gallbladder disease? ? ? RudaRue Antispasmodic, abortifacient, empacho, insect repellent ? ? ? - - - (internal, external)

20. SalivaSagePrevent hair loss, coryza, diabetes? ? ?- - (chronic use) TiliaLinden flowerSedative, hypertension, diaphoretic + sedative, other = ? ? ? - - (chronic use) TronadoraTrumpet flower Adult onset diabetes, gastric symptoms, chickenpox ? ? ? Yerba buenaPeppermintDyspepsia, flatus, colic, susto+ + ZábilaAloe vera External - cuts, burns Internal - purgative, immune stimulant External + + + Internal +/? ? ? External + + Internal - - - Zapote blancoSapodillaInsomnia, hypertension, malaria? ? ?

21. CURANDERISMO There is a widespread belief in Mexico that when a rich person is ill, it is time to go to a doctor. When the rich person is desperately ill, it is time to seek the help of a curandero (healer). When the poor person is ill, the first alternative is to find a curandero. It is only when the poor person is desperately sick that it is time to go to a doctor. There is a widespread belief in Mexico that when a rich person is ill, it is time to go to a doctor. When the rich person is desperately ill, it is time to seek the help of a curandero (healer). When the poor person is ill, the first alternative is to find a curandero. It is only when the poor person is desperately sick that it is time to go to a doctor. Most Mexicans, especially those who live in the less developed areas, use herbal remedies and other folk treatment, such as healing massage, with such confidence as a U.S. citizen might in taking an aspirin. Most Mexicans, especially those who live in the less developed areas, use herbal remedies and other folk treatment, such as healing massage, with such confidence as a U.S. citizen might in taking an aspirin.

22. CURANDERISMO CURANDERISMO Curanderismo is the art of folk healing by a curandero. Curanderismo is the art of folk healing by a curandero. Healers can be either male or female and may even specialize in their practice. Healers can be either male or female and may even specialize in their practice.

23. Origins of Curanderismo Curanderismo in Mexico is based on Aztec, Mayan, and Spanish influences. Curanderismo in Mexico is based on Aztec, Mayan, and Spanish influences. The ancient natives believed that the delicate balance existed between health, nature, and religion. The ancient natives believed that the delicate balance existed between health, nature, and religion. Illness occurred when one of these areas were out of balance Illness occurred when one of these areas were out of balance

24. Three most common types of Curanderos Yerbero (herbalist) Yerbero (herbalist) Partera (midwife) Partera (midwife) Sobador (masseur) Sobador (masseur) The Curandero has the skill to treat a wide variety of illnesses, he is the only healer in the culture who can treat mal puesto, illnesses caused by witchcraft The Curandero has the skill to treat a wide variety of illnesses, he is the only healer in the culture who can treat mal puesto, illnesses caused by witchcraft

25. Curandero’s Treatments Curandero’s treatments may consist of Curandero’s treatments may consist of ceremonies ceremonies rituals rituals herbal remedies herbal remedies potions potions countermagic countermagic

26. CURANDER OS CURANDER OS Curandero’s work on three levels Curandero’s work on three levels the material the material the spiritual the spiritual the mental the mental He may prescribe a herbal remedy or conduct a religious ritual. Quite often a curandero is called upon to treat the physical symptoms that patients believe come from supernatural causes He may prescribe a herbal remedy or conduct a religious ritual. Quite often a curandero is called upon to treat the physical symptoms that patients believe come from supernatural causes

27. CURANDERISMO CURANDERISMO The practice of Curanderismo teaches that it is not enough to simply diagnose a physical problem but the Curandero needs to look at the heart and the soul of the person to understand the true illness. The practice of Curanderismo teaches that it is not enough to simply diagnose a physical problem but the Curandero needs to look at the heart and the soul of the person to understand the true illness. Only medicine that deals with the “whole being” can effectively create a “whole cure” Only medicine that deals with the “whole being” can effectively create a “whole cure”

28. CURANDERISMO CURANDERISMO True healing can only be effective if it has some spiritual basis. True healing can only be effective if it has some spiritual basis. The patient will need to call upon that divine energy to help guide them in their healing. The patient will need to call upon that divine energy to help guide them in their healing. The belief with modern medicine is that the body goes to the doctor, the mind to the psychiatrist, and the soul and spirit go to the church. The belief with modern medicine is that the body goes to the doctor, the mind to the psychiatrist, and the soul and spirit go to the church.

30. CURANDERISMO CURANDERISMO The Curandero treats the person on three levels The Curandero treats the person on three levels The Plática The Plática The Limpia The Limpia The Soul Retrieval The Soul Retrieval

31. CURANDERISMO CURANDERISMO THE PLATICA is the portion of the healing process in which the Curandero learns about the patient through stories and also is an important part in educating the patient and beginning the healing session. THE PLATICA is the portion of the healing process in which the Curandero learns about the patient through stories and also is an important part in educating the patient and beginning the healing session. Items used : candles, incense, pictures of saints and lot of flowers present Items used : candles, incense, pictures of saints and lot of flowers present

32. CURANDERISMO CURANDERISMO THE LIMPIA is the portion of the healing process that starts the healing of the soul, the mind, and the body. THE LIMPIA is the portion of the healing process that starts the healing of the soul, the mind, and the body. Objects used: whole raw egg. glass of water, Copal, hot charcoal, herbs (rosemary), variety of candles, feathers(Eagle) and prayer and/or chants. Objects used: whole raw egg. glass of water, Copal, hot charcoal, herbs (rosemary), variety of candles, feathers(Eagle) and prayer and/or chants.

33. CURANDERISMO CURANDERISMO THE SOUL RETRIEVAL is the process in which the Curandero attempts to find where the soul was lost. THE SOUL RETRIEVAL is the process in which the Curandero attempts to find where the soul was lost. Items used: Drums, chants, rattles and on some occasions music Items used: Drums, chants, rattles and on some occasions music

34. Other objects used in their healing sessions Other objects used in their healing sessions Herbs and spices Herbs and spices eggs and lemons eggs and lemons flowers and fruits flowers and fruits holy water and pictures of saints holy water and pictures of saints crucifixes and candles crucifixes and candles incense and oils incense and oils *Each object has a specific purpose.

35. Symptom Profiles for Common Curandero Syndromes Mal de Ojo (evil eye) Mal de Ojo (evil eye) One may interpret this behavior of the (Evil Eye) look, glance, or state of someone who is an enemy or a stranger as an attempt to inoculate someone with this illness. Headaches, crying, irritability, and restlessness are common symptoms, accompanied by stomach ailments One may interpret this behavior of the (Evil Eye) look, glance, or state of someone who is an enemy or a stranger as an attempt to inoculate someone with this illness. Headaches, crying, irritability, and restlessness are common symptoms, accompanied by stomach ailments

36. Susto (extreme fright/fear) Susto (extreme fright/fear) Susto is typically the result of a traumatic experience. In particular the symptoms of this disorder mimic those of Post Traumatic Stress Disorder. These symptoms include feeling keyed up or on edge, fatigue, restlessness, a significant change in appetite, bodily complaints, withdrawal and other symptoms of depression. Susto is typically the result of a traumatic experience. In particular the symptoms of this disorder mimic those of Post Traumatic Stress Disorder. These symptoms include feeling keyed up or on edge, fatigue, restlessness, a significant change in appetite, bodily complaints, withdrawal and other symptoms of depression.

37. Mal puesto (hexing) Mal puesto (hexing) Hexes may be placed by someone who is familiar with witchcraft. Symptoms may include a host of somatic complaints and gastrointestinal problems. Paranoia and anxiety may also be symptoms. Hexes may be placed by someone who is familiar with witchcraft. Symptoms may include a host of somatic complaints and gastrointestinal problems. Paranoia and anxiety may also be symptoms.

38. Empacho Empacho A condition in which food becomes stuck in the intestines causing a blockage. It is caused by eating the wrong kinds of foods, or mixing infant formula with milk. Symptoms include nausea, diarrhea, stomach cramps, and a lump in the abdomen. It is treated with herbal teas, abdominal massage, and a restricted diet at home or in combination with a folk healer’s care. A condition in which food becomes stuck in the intestines causing a blockage. It is caused by eating the wrong kinds of foods, or mixing infant formula with milk. Symptoms include nausea, diarrhea, stomach cramps, and a lump in the abdomen. It is treated with herbal teas, abdominal massage, and a restricted diet at home or in combination with a folk healer’s care.

39. ENVIDIA (ENVY) ENVIDIA is when someone envies you. ENVIDIA is when someone envies you. Symptoms may include feeling sick on the stomach, having a sense of dread, feeling sad but not knowing why. It can lead to a person having “bad luck”. Symptoms may include feeling sick on the stomach, having a sense of dread, feeling sad but not knowing why. It can lead to a person having “bad luck”. It is believed that if a pregnant woman has envidia the baby can be born with birth defects or be born very sick. It is believed that if a pregnant woman has envidia the baby can be born with birth defects or be born very sick.

40. Benefits of Curanderismo Curanderismo is used to treat ailments arising from physical, psychological, spiritual, or social conditions. Curanderismo is used to treat ailments arising from physical, psychological, spiritual, or social conditions. Illness is said to be caused by either natural or supernatural forces. Illness is said to be caused by either natural or supernatural forces.

41. Training & certification Curandero’s are generally trained informally. The information is passed from generation to generation. Curandero’s are generally trained informally. The information is passed from generation to generation. Often a curandero starts out as an apprentice to a more experienced curandero. Often a curandero starts out as an apprentice to a more experienced curandero.

42. HERBAL TEAS TE RUDA CON CHOCOLATE USED TO HELP SPEED UP CHILD BIRTH

43. HERBAL TEAS TE ESTAFIATE TE ESTAFIATE USED FOR STOMACH PROBLEMS/ GASTRITIS, ETC. USED FOR STOMACH PROBLEMS/ GASTRITIS, ETC.

44. HERBAL TEAS TE MANZANILLA TE MANZANILLA (CHAMOMILE) (CHAMOMILE) USED FOR BABIES WITH COLIC, CALM MINOR STOMACH PROBLEMS USED FOR BABIES WITH COLIC, CALM MINOR STOMACH PROBLEMS

45. HERBAL TEAS TE ROMERO TE ROMERO (ROSEMARY) (ROSEMARY) (BATH) (BATH) USED TO CALM CHILLS, CAUSED BY INFECTIONS USED TO CALM CHILLS, CAUSED BY INFECTIONS

46. HERBAL TEAS BATH BATH (LIMON, CEBOLLA, SAVILA Y ALCHOOL) (LIMON, CEBOLLA, SAVILA Y ALCHOOL) USED TO LOWER BODY USED TO LOWER BODY TEMPERATURE /FEVER TEMPERATURE /FEVER

47. HERBAL TEAS TE EPAZOTE TE EPAZOTE USED TO CLEAN THE STOMACH OUT AFTER CHILD BIRTH USED TO CLEAN THE STOMACH OUT AFTER CHILD BIRTH

48. HERBAL TEAS TE ARTRIZAN TE ARTRIZAN (ALSO APPLY TO INFLAMED AREA OF THE BODY) USED TO TREAT ARTHRITIS, USED TO TREAT ARTHRITIS, HELPS WITH INFLAMATION HELPS WITH INFLAMATION

49. HERBAL TEAS TE DAMIANA TE DAMIANA USED TO HELP MAKE MENSTRUAL CYCLE MORE REGULAR (STORY) USED TO HELP MAKE MENSTRUAL CYCLE MORE REGULAR (STORY)

50. HERBAL TEAS TE NEGRO TE NEGRO USED TO HELP GET PREGNANT USED TO HELP GET PREGNANT (FOR LA MATRIZ FRIA) (FOR LA MATRIZ FRIA)

51. HERBAL TEAS TE TRES MILAGROS TE TRES MILAGROS (MANZANILLA, YERBA BUENA, ANIS ESTRELLA) (MANZANILLA, YERBA BUENA, ANIS ESTRELLA) USED TO CALM THE NERVES, RELAX, USED WITH CHILDREN WHO HAVE A HARD TIME SITTING STILL USED TO CALM THE NERVES, RELAX, USED WITH CHILDREN WHO HAVE A HARD TIME SITTING STILL

52. WHAT CAN WE DO? ASK PROPER QUESTIONS WHEN GETTING PATIENT HISTORY! ASK PROPER QUESTIONS WHEN GETTING PATIENT HISTORY! ENCOURAGE PATIENTS TO TALK ABOUT REMEDIES USED IN MEXICO! ENCOURAGE PATIENTS TO TALK ABOUT REMEDIES USED IN MEXICO! DON’T THEARTEN TO TAKE MEDS AWAY IF THEY BRING IN TO SHOW YOU WHAT THEY ARE! DON’T THEARTEN TO TAKE MEDS AWAY IF THEY BRING IN TO SHOW YOU WHAT THEY ARE!

53. Health Problems What do you think caused your problem? Do you have an explanation for why it started and when it did? What does your sickness do to you; how does it work? How severe is your sickness? How long do you expect it to last? What problems has your sickness caused you? What do you fear about your sickness? What kind of treatment do you think you should receive? What are the most important results you hope to receive from this treatment?

54. ¿Questions? ¿Questions? STEVE DAVIS STEVE DAVIS 252-560-3168 252-560-3168 DIRECTOR, OUTREACH SERVICE DIRECTOR, OUTREACH SERVICE GREENE COUNTY HEALTH CARE SDAVIS@GREENECOUNTYHEALTHCARE.COM GREENE COUNTY HEALTH CARE SDAVIS@GREENECOUNTYHEALTHCARE.COM SDAVIS@GREENECOUNTYHEALTHCARE.COM