Ethnomedical interactions: health and culture in the Nicaraguan Caribbean.

Abstract

This paper looks at the contemporary and historical interactions in medica! belief and practice among six ethnic groups of Nicaragua 's Atlantic Coast - Mestizo, Creole, Miskitu, Sumu, Garifuna and Rama. The expansion of preventive medicine and primary care under the Sandinista-led government during the 1980s is presented, along with description of counter-revolutionary attacks on the health care system. Traditional uses of medicinal plants and spiritual healing are juxtaposed against and then reconciled with the sporadic introduction of Euro­ American biomedicine. The results of an 809-household, 5-community survey, are used to demonstrate the widespread utilization of the health care system built during the 1980s. The same results show that traditional practices use of herbal medicine, visits to spiritual healers, and home birth are more prevalent among certain segments of Nicaraguan Atlantic Coast society.