‘Health’ and ‘illness’ are very much words the meaning of which we take for granted according to our own understanding in the modern world we live in. Therefore, a key objective in the study is to understand what indigenous Andean people mean by these terms. There is evidence that until a generation or so ago, certainly in more remote parts of the sierra, these terms were glossed rather differently reflecting distinctive Andean Pre-European experience of life, the human body and its wider cosmological context. Section 4 of the questionnaire asked people about their understanding of these terms in a number of ways, to try and elicit views upon whether any of these distinctive notions still survived in any way.
Health and Illness Concepts
It became very clear early into the survey that no-one really understood these questions at all and that any subtle semantical nuances of health and illness states according to any pre-European understanding had by and large already been lost. Health was health in much the way that we see it now, and also illness. However, the daily reality of the life experience for indigenous Andeans was clearly reflected in the associations that these states evoked. Health was generally seen as Life and life is maintained by the ability and the energy to work. In response to the question: “How do you say/explain that a person is healthy?” many people responded that a healthy person had the ability and desire to work and you knew they were sick when they were unable to work.
Conversely, illness is seen as a decayed or a declined state, the word most generally employed to describe a sick person being decaida (decayed or declined) when someone has no enthusiasm for life and work. The notion that sickness is related to identity was also poorly understood, although ethnographic studies dating back to as recently as the 1980s in Bolivia and also the central highland regions of Peru make it clear that Aymara and Quechua peoples did distinguish between well and sick people in a way that suggested a relationship to identity. Wise people couldn’t be seen as sick people for example. I tried to explain this notion with a very relevant example today, where it is not uncommon to see people constructing an identity around being sick. This is quite commonly observed in social media sites for example. However, the example was still not experienced very meaningfully and again exemplified the reality of life for rural Andean people, wherein health was seen as the normal state and sickness a misfortune that impacted your ability to work and therefore sustain life. To the question “When do you lose your health?” many people replied “when you die”, reflecting the polar opposite to the notion that health is life.
The origin or causes of illness, sickness and disease were commonly viewed as both lifestyle and environmental. People who worked too hard, ate poorly or drank too much were likely to get ill; also the exposure to modern day environmental pollutants were seen as hazardous reflecting a consciousness of how life had changed in recent years with more toxic substances abounding, whereas in the recent past, people only used organic products, particularly in horticulture and agriculture.
The most common family illness is, perhaps unsurprisingly, gripe – the common cold. And, as explained earlier (The Spiritual Source of Health: of God and Wak'a), there were several people, both women and men, who claimed never ever to have been ill in their life and who had a poor understanding of what illness actually was and what caused it. One of these – a man in his seventies – presented with a slight cough at the time of the interview, but clearly did not view this as a significant health altering condition that he might have called ‘illness’ – unlike the majority of people in modern day societies for whom a cough is a clear sign of a respiratory tract infection and might elicit several days off work. And the consciousness of the passing infection through the respiratory tract is now seen everywhere in the country, in that many people now take to wearing face masks if they feel at risk of catching a cold or cough. None were ever observed in the most rural settings of the survey however.
Dr 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.