Development of Andean Health Beliefs Models

Phase One of MEDICINE has used bibliographical, archaeological and ethnohistorical sources to begin to define ethnic Andean cosmological beliefs related to states of health, illness and healing. These data have been used to construct a three-dimensional theoretical model of these belief systems, working from a superordinate conceptual level of core belief domains (Figure 1), through to specific expressions of actual beliefs by present day Andean peoples (Figures 2 and 3).

Identification and Discussion of Core Concepts

The model demonstrates the essential dualistic state of the 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 of identified here are:

  • Alive (being born)
  • Wholeness/integrity
  • Lineage/ethnicity
  • Balance/equilibrium

These have their corresponding negative states.

State (of being) Manifested as Ritual Outcome
Positive Alive (being born) Birth Naming Identity/
Negative Dead Death: social breach/disconnection Funerary/ancestry Ancestral identity/
Positive Wholeness/Integrity Individual within family, community Community performance & ritual participation: feasts, sacrifice etc Order/Health
Negative Incompleteness Sin Ritual cleansing, sacrifice, correction/confession Order/Health
Positive Lineage/ethnicity Origin/ancestor Mythic/remembrance Identity/
Negative Alien Displaced/rootless/social disconnection Adoption by or reconnection to community, lineage, customs, traditions, Restoration of Identity/
Positive Balance/equilibrium Health Community rituals, feasts, sacrifice Order/Health
Negative Imbalance/
Illness ‘Completion’ therapy; divination, ritual cleansing, sacrifice Order/Health
Table 1: Core Conceptual Domains of Andean Health Beliefs

A state of being is ‘manifested’, as with, for example, ‘Alive’, which is manifested as being born; or ‘Wholeness/integrity’ which is manifested as an individual within the family and community context. There are two key outcome states: Identity/legitimacy and (mainly) Order/health. The above are circular, in that the outcome is linked back into the original state. The function of ritual is to negotiate between ‘State’ and ‘Outcome’ to restore balance/health in individuals/groups and/or to affirm connectedness with the Whole through identity/legitimacy.

Positive states have rituals that affirm and maintain the states, whereas negative states require rituals that address the deficits of that state to restore balance/health/identity.

Death is an ambivalent state and not necessarily ‘negative’ as such. In many traditional and particularly non-European societies, including with the Quechua, it is a transitional, intermediary state between two phases of manifestation of life, wherein the dead person becomes an ancestral identity, possessing the potential to generate rebirth (pacarina) (Salomon and Urioste 1991; Bastien, 1981). Under Christian influence the concept of death changed to a ‘final’ state (MacCormack 1991; Griffiths 1996). However, it is questionable whether the ‘Alien’ state can actually be redressed, which might, for example, require people alien or disconnected from community to be adopted by or reconciled with community, perhaps through formal ritual. This state could potentially be the most dangerous, in that its unaddressed outcome is one of ‘non-identity’ or ‘non-being’.

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 people Transgression of taboos Intoxications
Souls Sexual transgressions Parasitosis
Goblins Shaman/yachak Extreme poverty Infections
Rainbow Eating disorders: malnutrition Hereditary
Fumes Psychological disorders: excessive emotions, emotional pain, madness, bad temper, insomnia Illnesses of ‘white’ people: cancer, sores
Physical or intellectual excess of work
Table 2: Causes of illness in traditional Andean Ecuadorian medicine.
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.
Human Natural Spiritual Ancestral
Diseases of the earth or the countryside Diseases caused by God White persons’ illnesses
Soul loss; soul fright; evil eye; fright; caught by the hills, (bad)wind, hurricane, river, waterfall, lake, stone Illness sent by God as a test or as divine punishment: arthritis, tendonitis, mialgias, colds, bone pain, aftermath of wounds, smallpox, measles Cancer, measles, tuberculosis
Rheumatism, cold, cholic and diarrhea through cold
Table 3: Andean conception of the interaction of four worlds