North Peru ProjectS is centered around providing opportunities for students to contribute to human knowledge with their research. From biochemistry to medical anthropology, this project's main goal is to make a difference THROUGH THE APPLICATION OF academic research. 


Backgound


Dr. Tom Love discusses a possible field work site and medicinal plant supply chain with community leaders in Huamachuco, Peru.

Dr. Tom Love discusses a possible field work site and medicinal plant supply chain with community leaders in Huamachuco, Peru.

Since 2002, on grants from the US National Institutes of Health (Minority Health & Health Disparities International Research, MHIRT), North Peru Projects has been involved in ethnobotanical, biochemical, and ethnographic research in the field and laboratory. Publications include:

  • A database of 510 medicinal plants and 974 remedies of mixtures. (1-2)

  • Demonstration that herbal commerce in Peru is a major economic resource, which, although used alongside modern pharmaceutical products, is showing signs of diminished popular knowledge of application. (3-4)

  • Laboratory research:

    • Minimum inhibition concentrations and toxicity screening (5)

    • Bioassays to determine antibacterial activity (6)

    • Phytochemical analyses (7)

    • Herbal treatments for acne (8), malaria (9), kidney problems, and urinary infections.(10)

  • Studies seeking to identify Ulluchu, a ceremonial plant of the pre-Hispanic Moche culture as well as surveying colonial sources of medicinal plants in Northern Peru and Southern Ecuador. (11-12)

  • An ethnography of peasant herbalists documenting aspects of the market supply chain which showed that suppliers are not adequately remunerated and revealed threats posed by lack of conservation measures and overharvesting.(13)

  • A critique of the scientific reductionism of laboratory research used in attempting to verify traditional remedies.(14)

  • An ethnography on the work of the Peruvian National Commission Against Biopiracy.(15)

  • Anthropological studies of traditional curanderos and their curing altars (mesas).(16)

The Summer 2014 Research Team after presenting their research to biology, biochemistry, pre-medical, and pharmacology students at the National University of Trujillo (UNT).

The Summer 2014 Research Team after presenting their research to biology, biochemistry, pre-medical, and pharmacology students at the National University of Trujillo (UNT).

It is worth noting that during the time we have been working in the Trujillo region there have been changes in attitudes and perceptions regarding Traditional Medicine. (17) In Trujillo, Lima and Arequipa, Peru´s social security administration (EsSalud) inaugurated its National Program for Complementary Medicine, including a pilot program prescribing medicinal plants validated by WHO/PAHO. This initiative began in 1999 with the three centers mentioned above and has now grown to 26.(18)

In Trujillo, MHIRT and the Missouri Botanical Garden (MOBOT) Sacred Seeds program started an herbal garden and educational outreach program at the site museum of the pre-Hispanic Chimú city of Chan Chan. And University of Trujillo (UNT) botanists compiled a volume of 704 medicinal plants, including taxonomy, ecogeography, and ethnobotany. (19)

In Huamachuco – a highland city east of Trujillo – a program of ethnobotany and conservation is slowly emerging through collaboration between  local peasant communities, MOBOT’s Sacred Seeds program, MHIRT, and the Peace Corps. Future work will involve developing a supply chain between Huamachuco and EsSalud´s Complementary Medicine Center (CAMEC) in Trujillo with scientific validation by MOBOT, UNT, and the University at Buffalo (SUNY).

An updated overview of our work placed in global context is provided by Dr. Rainer Bussmann in Journal of Ethnobiology and Ethnobotany 2013. (20)


Footnotes

[1] Bussmann and Sharon (2006b, 2007b, 2009c, 2015)

[2] Bussmann, Glenn, Meyer, Kuhlman, and Townesmith (2010)

[3] Bussmann, Sharon, Vandebroek, Jones, and Revene (2007)

[4] Bussmann, Sharon, and Lopez (2007); Bussmann, Sharon, and Garcia (2009); Fajardo and Sours (2012); Gauksheim et al (2013)

[5] Bussmann, Malca et al. (2010)

[6] Bussmann, Sharon et al. (2008); Bussmann, Glenn et al. (2009a); Bussmann, Glenn et al. (2010)

[7] Bussmann, Glenn et al. (2009b); Perez, Rodriguez et. al. (2012)

[8] Bussmann, Sharon et al. (2008)

[9] Bussmann and Glenn (2010)

[10] Bussmann and Glenn (2011)

[11] Bussmann and Sharon (2009b)

[12] Bussmann and Sharon (2009a)

[13] Revene, Bussmann, and Sharon (2008)

[14] Carrillo (2012)

[15] Smallwood (2010)

[16] Sharon (2009); Sharon and Gálvez (2009); Sharon, Glass-Coffin, and Bussmann (2009);  Glass-Coffin, Sharon, and Uceda (2004)

[17] Sánchez Garrafas, eds. (2009); Vergara and Vásquez, eds. (2009)

[18] Fernández (2009); Villar and Villavicencio (2001)

[19] Mostacero, Castillo, Mejía, Gamarra, Charcape, and Ramírez (2011)

[20]  Bussmann (2013)

In 2020, we will be hosting the last MHIRT-sponsored work in Peru. The following is an overview of all research conducted since 2002.

NIH-MHRT-SDSU PERU PROGRAM

Overview 2002-2018 

Dr. Douglas Sharon

   Building on the 30-year research experience of the main US mentor for the Peru program, Dr. Douglas Sharon, and starting in 2002, SDSU’s NIH-MHRT (National Institutes of Health-Minority Health & Health Disparities Research Training) site in Peru has been conducting ethnobotanical, biochemical, and medical anthropology research in Trujillo. Guided by US and Peruvian mentors, MHRT students work in teams on complementary research designs developed in the US under the guidance of Dr. Sharon. Initially working with practitioners (curanderos) of Traditional Medicine (TM), in 2007 we published a database of 512 medicinal plants (expanded 2nd edition, 2015) and planted a medicinal plant garden at the archaeological site museum in cooperation with the Ministry of Culture (for a list of project publications see our website: northperuprojects.org). In 2007, we also began biochemistry research with Clínica Anticona and Universidad Privada Antenor Orrego.  

   Beginning in 2012, work began with Peru’s social-security administered public health program (EsSalud) at their Center for Complementary Medicine (CAMEC) and the University of Trujillo (UNT). In addition to including ongoing biochemistry at UNT, the work has involved evaluating the Center’s phytotherapy program where we noted a need to include the cultural context of medicinal plant use. In addition, ongoing ethnobotanical work with local healers and herbalists and medical anthropology surveys to determine knowledge and use of medicinal plants in communities around Trujillo were pursued in order to facilitate outreach efforts by our local partners at the University of Trujillo and EsSalud.  In this context, these two public entities began a collaborative effort to conduct research on medicinal plants not yet available in the Center’s Natural Pharmacy. Another positive local development has been an initiative taken by the Ministry of Culture-Trujillo to persuade MC-Lima to designate local TM as “cultural patrimony of the nation.”

   To date, our community studies are showing that, in spite of increased use of modern medicine, the beliefs and practices of TM and its associated world view are still very strong at grass-roots level. Also, we are finding environmental destruction (overharvesting of medicinal plants, de-forestation, mining) in the communities that provide medicinal plants. Recent work by our team is documenting how curanderos in rural areas are counteracting poor health linked to environmental destruction by reinforcing local holistic health models based on the relationship between plants, sacred spaces, and people. We feel that information on this cultural context needs to accompany the findings from the lab as well as concerted conservation efforts. The following is a brief summary of our findings to date.

Ethnobotany

   Initially working with local herbalists and practitioners of TM, we published a database of approximately 500 medicinal plants that has been recently updated. These data indicate a heavy orientation to psychotherapeutic application.

            Medicinal Plant Use in the North-Coastal Area of Peru

43% of all plants are used for “magical” & “nervous system” disorders

18% used for respiratory problems

16% for kidney & urinary tract ailments

10% for cardiac & circulatory disorders

9 % for rheumatic & arthritic conditions

4 % for female reproductive system problems

65% of all remedies were mixtures

   Our research has an educational applied component. The experience gained with a medicinal plant garden we planted in 2010 at the archeological site museum for the nearby pre-Hispanic city of Chan Chan, as well as results from two community studies and the previous three clinic surveys in Trujillo are being used to develop an inventory and database of the most frequently used herbal remedies applied in alleviating day-to-day ailments.

   Given that “traceability” is a major problem in using plants from local markets, many of which grow in the sierra, another criterion for selection includes the recommendation that these plants can be cultivated in the soil and climate of the Trujillo Valley. Crucial to this assessment was the re-planting of the Chan Chan garden. The original plants—many of which had not regenerated—were obtained in local markets where vendors are unable to specify the origins of what they sell. Advancing the latter work and a study of market suppliers and sustainability, we also are documenting the efforts of a homeopathic herbalist and owner of one of the three clinics in Trujillo where previous studies were conducted. On his farm in the Andean foothills east of Trujillo, he is gradually adapting plants from other eco-zones to coastal conditions with the aim of becoming a major supplier for local markets.

   There is also a sustainability goal for this undertaking. As noted above, Trujillo’s social security-administered Center for Complementary Medicine (CAMEC) has a phytotherapy treatment modality via their certified Natural Pharmacy. Currently, only 20 of the plants researched by EsSalud are obtainable on a large scale from natural plant product suppliers and no plant-mixture remedies or cultural variables are included in their program. Potentially, the gardens and possible off-shoots could eventually become a supplier for CAMEC-Trujillo by demonstrating the viability of the medicinal plant market to local farmers. In addition, a seed bank element could provide a much-needed conservation function as demand increases over time.

Laboratory Science

   By analyzing TM remedies using laboratory sciences (microbiology, toxiciology, and phytochemistry), we  helped personnel and patients at the EsSalud Center discover how connected TM practices are to remedies used in allopathic medicine.. We also learned that the Western search for a “magic bullet” by limiting research to individual plant extracts appears to be an ineffective research paradigm since synergistic effects are found when plant mixtures are studied. As reported above in the section on ethnobotany, 65% of the herbal remedies in our studies were mixtures. Taking our lead from TM, plant-water extracts were included in our research.

Sample Laboratory Results

Microbiology: 81% of ethanol extracts from 141 plants used in TM to treat infectious disease showed antibacterial activity against S. aureus, while 36% showed activity against E. coli.

Toxicology:  76% of ethanol extracts from 341 plants used in TM showed high toxicity against brine-shrimp; while 24% of water extracts from the same plants were toxic to the brine shrimp.

Phytochemistry:  Data supporting the presence of a new compound with antibacterial activity was found in an ethanol extract of the mix of Salix chilensis Molina and Prunus serotina Ehrhart-subsp. capuli (Cav.) McVaugh that was not present in the separate ethanol extracts made from each plant.

Medical Anthropology

   Supplementing ethnobotanical work with local healers and herbalists, medical anthropology surveys were conducted to determine knowledge and use of medicinal plants in city clinics and communities around Trujillo. These studies expanded the outreach efforts of our local partners at the National University of Trujillo and EsSalud-CAMEC. In this context, these two public entities began a collaborative effort to conduct phytochemical research on medicinal plants not yet available in the Center’s Natural Pharmacy. Initially this research included cultural information from the field, a trend that we hope will continue.

   Studies of three clinics (public, private, and herbal-homeopathic) in the city of Trujillo demonstrated that, although modern pharmaceuticals were used by patients more frequently than medicinal plants in a private Western clinic, the use of medicinal plants was still relatively high. On the other hand, in an herbal-homeopathic clinic, the situation was reversed, i.e., a slightly higher use of medicinal plants as compared to pharmaceutical products. Studies at the public EsSalud-Complementary Medicine clinic which were applied in a more informed manner than in the other clinics also showed a higher use of medicinal plants in comparison to the use of pharmaceutical products.

   Regarding medical preference, comparison of two communities (Moche & Alto Moche) studied to date revealed an almost equal split between preference for medicinal plants and medicine from a doctor or pharmacy. This is similar to the findings from the three clinic studies discussed above. Many participants indicated that--even though they prefer one type of medicine--cost, severity of illness, and availability are key decision-making factors. However, belief in culturally-bound illnesses (“fright,”“shame,” and “evil eye”) was about 90% or higher for both communities and everyone explained that these are not illnesses that can be treated by a medical doctor. We feel that these strongly held culturally-bound beliefs demonstrate the unique coexistence of physical and psychosocial illnesses in Peru.

  Medical anthropology surveys comparing medical plant knowledge and use in Huanchaco and its peri-urban sector, Huanchaquito confirmed our two main hypotheses:(1) knowledge of herbal lore was similar to what was discovered in three clinics in Trujillo and Moche/Alto Moche  2) In Huanchaquito, medicinal plant lore knowledge and usage was higher than was the case in Huanchaco’s urban core as a result of maintaining traditional ethno-medical beliefs and practices. Five sub-hypotheses dealing with medical preference in relation to age, education. residence, traditional medical beliefs, and age related to traditional beliefs were also tested.

  Although reported use of modern pharmaceuticals was very high in both communities, i.e., 95% of respondents in Huanchaquito, 96% in Huanchaco, use of medicinal plants was even higher, i.e., 98% in Huanchaquito and, surprisingly, 99% in Huanchaco. However, when looked at more closely in the light of such variables as cost, medical preference, trust of practitioners, et cetera, these numbers were considerably lower by about one half

  Of our five sub-hypotheses, none were supported in Huanchaco while in Huanchaquito only the first , “subjects’ ages affect medical preference” was confirmed.

  Qther findings that were similar to what we found in earlier studies included the worrisome fact that there is clear loss of medicinal plant knowledge from one generation to the next. Also, belief in culturally-bound illnesses was over 80% in both communities.