Healthcare in the Honduran Mosquitia Faces Special Issues
By Wendy Griffin
Studies of traditional healthcare and beliefs about how diseases are caused, diagnosed and cured among the Miskito Indians of the Honduran Mosquitia have generally taken place in the context of some event of global interest has taken place in the Mosquitia. For example there are two studies of “grisi siknes”, a hysterical disease caused by problems of stress or “nervios” which many Miskito Indians on both sides of the Honduran-Nicaragua border suffered during the Contra War. Isabel Perez, an Ecuadorian anthropologist married to a Honduran university professor, in her book Entre la Vida y la Muerte (Between Life and Death), tried to give the foundations of Miskito beliefs in illness and wellness, before analyzing specifically “grisi siknes” during the Contra War period whose name come from gris-grey in Spanish, and the English word sickness. 91% of the people who live in the Honduran Mosquitia come from a minority culture like the Miskito Indians, Tawahkas, Pech, and Garífunas, and for most Spanish is not the language they use at home.
More recently as over a thousand Miskito divers have become paralyzed due to decompression illness (the bends) while lobster diving for international seafood companies , the issue of how do you treat or prevent or do education about this illness, has had to take into account that Miskitos see it as as one type of illness caused by angry mermaids or water spirits (liwa mairin) who protect the aquatic life from over exploitation, illnesses generally treated by traditional healers, called sukya, rather than hospitals, which is the subject of Laura Hobson Herilhy, an anthropologist at the University of Kansas. Miskito shamans use special songs and maracas as part of their healing practices which have been studied by Dr. Ronny Velasquez, a specialist in shamanistic songs, originally from Honduras, but taught most of his career in Venezuela where he headed the Ethnomusicology Foundation.
Danira Miralda’s book “La Guerra de Baja Intensidad y los Pueblos originarios de la Mosquitia” (The War of Low Intensity and the original peoples of the Mosquitia”) is full of references to “no hay medicina” “there is no medicine” in the Mosquitia, a rainforest area known to have at least 600 documented medicinal plants which traditional healers among the Miskitos, the Garifunas, the Pech, the Tawahkas, and the Ladinos or Spanish speakers used.
The reason for this contradiction is that the Moravian Evangelical Church threatens people, for example they might not be able to stay in the church or in the village, if they use traditional healers who know how to diagnose traditional illnesses and prescribe medicinal plant remedies. These healers, called sukya in Miskito, are associated to pre-Christian Miskito religious beliefs, and for example believe that before you pick a medicinal plant you must say the prayer or secret of the plant, called “sika” in Miskito, so that the spiritual owners of the plants will activate it and it will work. Trying to collect just the name and use of the plant does not work, according to these healers, because, you have to have the permission to take the plant and activate its medicine. These Miskito, Garifuna, and Pech Indian healers also often prepare themselves before collecting the plants, so that they are in the right state to collect plants and ask for permissions.
The Miskitos, like the Garifunas, are the result of the mix of Africans with Indians, and this belief in “sika” is similar to African medicinal beliefs about medicinal plant beliefs, such as in the Wikimedia article on Traditional African medicine. However, Native America healers in the US, and Garifuna and Pech healers in Honduras, also agree that it is not just a case of knowing a medicinal plant and for example, growing a whole field of it commercially and processing it into capsules, that there are permissions, prayers, payments, and mysteries involved, and these too are probably “censored” topics among Western medical doctors.
The issue of currently evangelical Christian missionaries and in the past Catholic missionaries telling traditional people not to use traditional healers and midwives, and medicinal plant cures, and not to learn from these people, even when no other locally available alternative, like government health clinics, were available, is probably also a “censored” topic.
I originally began to study Garifuna midwife techniques, to see if I could help understand why Miskito women had such high levels of infant and mortality, a problem reported to me by a MOPAWI Miskito employee Walstead Miller. I thought maybe if we could exchange experiences of the Miskitos and Garifunas, who live in similar eco-systems and so would have access to similar plants, we could lower the mother and infant mortality among the Miskitos. We were never able to do the seminars due to lack of funding, so I was not able to discuss with the women themselves the reason why Miskito women have such a high rate of mother and infant mortality.
In the entire Honduran Mosquitia, there is only one government hospital in Puerto Lempira, even though there are at least 120 villages large enough to have an elementary school. There are healthcare clinics in not more than three or four Miskito towns, such as Brus Laguna and Ahuas. There are almost no roads in the Mosquitia, with most people getting around by canoes, with or without outboard motors, and in the case of real emergencies paying for charter flights in and out of the Mosquitia or from the villages to the regional hospital in Puerto Lempira. There usually are not 4 doctors to serve the entire Mosquitia, and these doctors are often not graduated doctors, but rather students who are finishing a 5 year undergraduate program in medicine who are doing one year of social service, a requirement of Honduran medical schools. The total inability of the government or missionary provided health care to meet the sheer volume of needs of the Mosquitia, is one reason that local healers and midwives remain important in the Mosquitia, as they are in Africa.
One problem contributing to high maternal death rates in the Mosquitia may be that modern Miskito midwives may not be able to use the medicinal plants traditionally used by the Miskitos, either because the destruction of the rainforest has wiped them out, or because being part of the Moravian church they did not teach them to the new generation, and the new generation for the same reason may not have learned them. The young Miskito women may have gone to Spanish speaking government schools and taught to look down on traditional knowledge of Indians and Blacks and non-Christians.
There is also an added problem among Miskitos, that most of the people who are bilingual in Miskito and Spanish are men. The topic of childbirth among Miskito men is so taboo, that in a mixed meeting of teachers, the Miskito male teachers were so embarrassed to even say the word for Miskito midwives, as an example for the list of “Who are the Workers in my community”, a common topic in first grade texts, that in the end I have never heard the Miskito word for midwife spoken clearly.
If the Miskito men will not even say the word for midwife, we can imagine that the monolingual in Miskito women who go to a Western style hospital in the Mosquitia, are going to have a very hard time finding anyone who will translate for them with the doctors who are usually monolingual in Spanish, if there is some complication in the pregnancy. The Miskito midwives also simply may not know the same plants as the Garifunas, and it would be a benefit for them to be able to learn to use them, to help the other Miskito women.
The Miskito Indians, still a very traditional people in many ways and the group with the highest percentage of monolingual indigenous language speakers in Honduras, have a lot of beliefs regarding birth, and regarding the cutting of the umbilical cord, and the proper burying of the placenta, which are all acts that among the Miskitos they believe affects them their whole lives. The person who is given the ceremonial job of cutting the child’s umbilical cord at birth, calls the child “lapia” the rest of its life and there is a fictive kinship bond between them, which is true of most Honduran ethnic groups, including Black English speakers who call the midwives “goddies”, short for Godmother. The Garifunas use the Spanish word “comadrona” the big co-mother of the child, and the child usually calls their mother’s midwife, “abuela” (grandmother), even if they are of different races like mestizo children and a Garifuna midwife, like Yaya.
Another example of the sacredness of birth, Miskito mothers bury the umbilical cord under a tree, and that tree is that child’s tree their whole life, even if they move away. Adult Miskito men, even professionals in Tegucigalpa the country’s capital, will still talk about where their umbilical cords is buried, that their umbilical cord is buried in the Mosquitia, that it calls them home, that they are literally sons of the Mosquitia, because they are planted, physically planted as well as spiritually planted, in the earth in the Mosquitia.
A Maya Chorti man told me he did not believe in the necessities of total purity in the burying of the afterbirth, and so was not as careful as he could have been, and everyone told him that is the reason his children had eye problems. Garifuna midwives bury the afterbirth in a secret place, partly to avoid the danger of witchcraft against the person.
Can you imagine telling these traditional people in a US hospital, we are collecting the placentas to make replacement tissue for burns, as one US researcher is trying to get a patent to do? Or that we just throw them away as hazard waste, because of the danger that the mother might be HIV positive?
One researcher thought there were now more Mayas in the US, than any single Maya tribe in Central America. Are we being respectful to traditional people’s beliefs if they happen to give birth in a US hospital instead of at home in Central America or in Africa? Are we teaching doctors, who are overwhelmingly male, to be disrespectful to the beliefs of minority women? The theme of the Censored medical conference, also includes references to gender and gender issues, and these are some ways why the two issues are linked.
Besides the issue of midwives, the Miskito Indians believe in a wide range of illnesses caused by angry nature spirits, by upset spiritual owners of animals and trees as well as of fish or lobsters, and also by ancestor spirits called “isigni” among the Miskito Indians. There are ceremonies among the Miskitos to find out why the isigni have returned to earth, what it wants, resolve the problem, and send it home. These ceremonies are significantly different from the Garifuna ceremonies of dugu. The belief in witchcraft is also widespread in the Mosquitia. Pech Indians who have been cured or their family members have been cured of witchcraft (mal), and of diseases caused by angry nature spirits, including tree, and water spirits by Miskito traditional healers, say they are alive today and their children are alive today because these Miskito healers healed them.
Honduran rainforest Indians like the Pech, Miskitos, and the Tawahkas are also essential for their knowledge of how to cure snakebites, because if you have been bit by a lance de fer snake (barba amarilla or tamagas) in the rainforest, such as during the time of the Truxillo Railroad, a subsidiary of united Fruit in NE Honduras, the worker would not live long enough to reach a government or banana company hospital if the local Indians or Garifunas did not agree to cure you. It takes about 40 minutes for a person to die of a lance de fer snake bite, while the trip from Sico to the banana company hospital by train took all day. Although lance de fer snakes are common in the area and United Fruit had a serpenterium to study poisonous snakes in Trujillo, the Truxillo Railroad reported almost no deaths to these snakes, thanks to these traditional healers. Among most NE Honduras ethnic groups curing snake bites and making them not come back is a speciality of male healers (curanderos) rather than female healers (curanderas). Not just medicinal plants are used. There is a whole ceremony with food, drink, dances,music, prayers either at the time of the cure, after the cure to give thanks for healing, or to prevent the snake from coming back to bite the person again.
Nature spirits associated with rainforest animals can also cause illnesses, and among the Miskito and Tawahka Indians there is a whole class of illnesses, known as iumu like iumu de lagarto (illness caused by the nature spirit who owns the alligators) caused by the nature spirits who own the rainforest animals. Ceremonies with food, dance, music, prayers, for recovering health after such a type of illness have been reported among the Pech and Tawahka Indians.
Nature spirits associated with rainforest animals can also cause illnesses, and among the Miskito and Tawahka Indians there is a whole class of illnesses, known as iumu like iumu de lagarto (illness caused by the nature spirit who owns the alligators) caused by the nature spirits who own the rainforest animals. Ceremonies with food, dance, music, prayers, for recovering health after such a type of illness have been reported among the Pech and Tawahka Indians.
Among both Mesoamerican Indians like the Nahua who used to live in the Trujillo area and later moved into the Mosquitia and for Africans snake magic as well as snake bite curing was an important aspect of their culture. The Honduran Spanish name for this snake Tamagas comes from the Nahua name, which is also the origin of the name of the one the highest levels of governors in the Pipil state, who spoke Nahua. In Honduran Spanish the phrase “ el mero mero Tamagas” (the really high up or important lance de fer) refers to some high ranking person not the snake. The towns in the Trujillo area had names like CeCoatl (One Snake), when the Spanish with Cortes arrived. The SiguaCoatl, the woman snake was also a high ranking position in Nahua and Lenca societies, and in spite of the name is thought to refer to a male official or leader. The Miskito word for mermaids who cause mermaid sickness (liwa sicknes) is “liwa marin” (the worm or snake female). The idea of large snakes in the water who bite children and cause them to drown or disappear also exists among the Pech Indians. Miskito Indians have complex ideas about whether decompression illness, caused while diving for lobsters for export and thus violating the rule of not taking too much of a particular animal or fish under the protection of the mermaid, is caused by mermaids and what should be the role of sukya in healing them.
While the Pech Indians have lost most of their healing ceremonies as a result of adopting more seriously the Catholic religion since the 1960’s, they are very concerned about the possibility of losing the snakebite curing ceremonies as the Pech healers who know the ceremonies and the plants are now over 70 years old, and if the young people do not learn the plants, and the prayers, the Pech in the future and other Hondurans in their area may die of these poisonous snake bites. It can take all day to reach a government hospital from the Pech area, if the hospital even had any medicine which they often do not, and an untreated lance de fer snake bite can kill you in under an hour. Pech ceremonies included the use of the musical instruments in the Burke Museum collection at the University of Washington--the drum tempukah, the maracas or sonajas kamachá, and the flute arwa. The crafts in that collection can be seen on the Internet. There is also a photo of the Pech Carrizo flute arwa in Wikimedia Commons on the Internet.
Another part of this Pech healing ceremony is the male healer (curandero) blows through a carrizo tube (acatl in Nahua) a technique known as “soplo” and used from Honduras all the way into the Amazon. However after a two and half year off and on search, even going up into the mountains in the nuclear zone of the Rio Platano biosphere and the Sierra de Agalta National Park, the Pech can not find any Carrizo to do the soplo part of the ceremony or for making a Pech flute, of which one example was recently donated to the Burke Museum at the University of Washington. Carrizo grows only at an altitude above 1,500 feet, which is also the attitude considered appropriate for growing coffee, a major Honduran export.
