Below is a brief history of North Peru ProjectS (NPP) and a

description of what has BEEN done thus far to expand

the knowledge and apply the use of traditional medicinal

plants in Peru. 


Complementary Medicine and Public Health in Peru

Starting in 1979, Peru has become a major innovator in third-world public health. In an effort to link primary healthcare to traditional medicine, Peru organized two World Health Organization (WHO) conferences addressing the clinical benefits of using Traditional Medicine in widespread healthcare in developing countries. These efforts eventually resulted in the founding of Peru's Instituto de Medicina Tradicional (Institute of Traditional Medicine - INMETRA) within the Ministerio de Salud  (Ministry of Health - MINS) in 1991. 

In the late 1990s, EsSalud (Peru's Social Security System) elaborated INMETRA's work and developed the Programa Nacional de Medicina Complementaria (National Program of Complementary Medicine - PNMC). With the help of WHO and the Pan American Health Organization (PAHO), EsSalud opened three Centros de Medicina Complementaria (Centers for Complementary Medicine - CAMECs) to serve public sector employees and pensioners. These centers were originally located in Peru's major urban centers (Lima, Arequipa, and Trujillo); as of 2014 there were 26 CAMECs in the country. 

One of the major treatment modalities applied in these CAMECs involves phytotherapy, or the use of plant-derived medicines in treatment. In addition to addressing the botany, phytochemistry, and pharmacology of 76 Peruvian medicinal plants, the program manual for phytotherapy outlines illness categories treatable by these plants, as well as advocating quality control and sustainable agricultural standards for suppliers. In 2009, a pilot program began prescribing 20 of the 76 medicinal plants to patients through natural pharmacies located in CAMECs in Lima, Arequipa, and Trujillo. It is this program that is a principal focus of NPP. 


NIH-MHIRT and NPP

Summer2008 - MHIRT students working in the lab under the guidance of Dr. Fredy Pérez (right).  Photo by John Effio. 

Summer2008 - MHIRT students working in the lab under the guidance of Dr. Fredy Pérez (right).  Photo by John Effio. 

Since 2002, most of the work performed by NPP has been funded by the National Institutes of Health (NIH) on grants from the Minority Health & Health Disparities International Research Program (MHIRT).  Over the years, project directors Drs. Douglas Sharon and Rainer Bussmann have developed and published a database of 512 medicinal plants and 974 mixtures of these plants that are used in traditional North Peruvian ethnomedicine while addressing toxicity and microbiology.  They have also conducted studies demonstrating the value of herbal commerce as a major economic resource in Peru showing that in general Peruvians use these plant species and mixtures as frequently as Western pharmaceuticals. However, the supply of these plants is showing signs of serious reduction due to over-harvesting and lack of conservation efforts

establishing native plant gardens

EsSalud-CAMEC, Trujillo - A native medicinal plant garden grows in the center of EsSalud's complementary medicine clinic. MHIRT-Peru and Ashley Glenn of the Missouri Botanical (MOBOT) aided the clinic in planting this garden where patients can learn about medicinal plants they wish to grow in gardens in their own homes. 

EsSalud-CAMEC, Trujillo - A native medicinal plant garden grows in the center of EsSalud's complementary medicine clinic. MHIRT-Peru and Ashley Glenn of the Missouri Botanical (MOBOT) aided the clinic in planting this garden where patients can learn about medicinal plants they wish to grow in gardens in their own homes. 

To remedy the loss of traditional bioresources, in 2009, leaders of a comunidad campesina (peasant community) near the highland city of Huamachuco sought  MHIRT-Peru's assistance in developing a garden that showcased the importance of native plant conservation. As a result, several NPP students volunteered to aid Ashley Glenn, director of the Sacred Seeds Community Garden Program at the Missouri Botanical Garden to work with yerbateras (female herbalists) on land donated by the Huamachuco community. In the next year, one of the former MHIRT-Peru students (Gabriel Chait) continued to work on the garden on a Fulbright Scholarship in cooperation with the US Peace Corps. Although this project was successful in demonstrating the importance of conservation, unfortunately it was largely washed away by heavy rains in 2011. However, some community members are still planting private gardens containing endangered native plants.   

Following the example of the Huamachuco community garden, MOBOT and MHIRT-Peru developed a similar project near Trujillo at the archaeological site museum of Chan Chan, the largest pre-Columbian urban center in the Americas. Four Linfield College students, under the guidance of MOBOT, ethnobotanist Carolina Tellez and anthropologist Dr. Tom Love, worked with INC Chan Chan staff and local schools in 2010 and 2014 to establish a native plant garden demonstrating Peru's wide variety of native medicinal plants.


Native Plants at EsSalud CAMEC-Trujillo

In 2012, Dr. Love returned to Trujillo with fellow Linfield botanist and colleague, Dr. John Syring, to advise students conducting a medical anthropology study involving EsSalud's CAMEC in Trujillo. Working with CAMEC Director Dr. Luis Fernandez, students assessed EsSalud patient attitudes and knowledge regarding traditional Peruvian herbal therapy. Similar to what Drs. Bussmann and Sharon found in earlier studies, the EsSalud patients displayed a great deal of knowledge about medicinal plants, applying them frequently in everyday use.

Also in 2012, as noted above, Ashley Glenn and Linfield College students consulted with CAMEC personnel and volunteers working on a community garden and education programs adjacent to the clinic's natural pharmacy.

Because of the success of both the medical anthropology study and the community garden, CAMEC´s medical director Dr. Luis Fernández extended an open invitation to NPP to evaluate the Center's plant therapy services, including efforts to develop a sustainable supply chain of medicinal plants from current Huamachuco growers.     

North Peru Projects' closest affiliation is with Dr. Fernández and the EsSalud CAMEC in Trujillo: 

 

A summary of two decades of work in Ecuador and Peru in a global context provided by Bussmann (2013)

All photography by Katelyn Henson