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Market integration and health : the impact of markets and acculturation on the self-perceived morbidity, diet, and nutritional status of the Tsimane' Amerindians of lowland Bolivia

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Title:
Market integration and health : the impact of markets and acculturation on the self-perceived morbidity, diet, and nutritional status of the Tsimane' Amerindians of lowland Bolivia
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Impact of markets and acculturation on the self-perceived morbidity, diet, and nutritional status of the Tsimane' Amerindians of lowland Bolivia
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Byron, Elizabeth
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English
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xx, 332 leaves : ill. ; 29 cm.

Subjects

Subjects / Keywords:
Acculturation ( jstor )
Adults ( jstor )
Cash ( jstor )
Diet ( jstor )
Diseases ( jstor )
Food ( jstor )
Market economies ( jstor )
Nutritional status ( jstor )
Retirement communities ( jstor )
Wealth ( jstor )
Acculturation -- Bolivia ( lcsh )
Anthropology thesis, Ph.D ( lcsh )
Chimane Indians -- Bolivia ( lcsh )
Chimane Indians -- Cultural assimilation ( lcsh )
Chimane Indians -- Nutrition ( lcsh )
Dissertations, Academic -- Anthropology -- UF ( lcsh )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

Notes

Thesis:
Thesis (Ph.D.)--University of Florida, 2003.
Bibliography:
Includes bibliographical references.
General Note:
Printout.
General Note:
Vita.
Statement of Responsibility:
by Elizabeth Byron.

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University of Florida
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University of Florida
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Copyright [name of dissertation author]. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
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MARKET INTEGRATION AND HEALTH:
THE IMPACT OF MARKETS AND ACCULTURATION ON THE SELF-PERCEIVED
MORBIDITY, DIET, AND NUTRITIONAL STATUS OF THE TSIMANE'
AMERINDIANS OF LOWLAND BOLIVIA















By

ELIZABETH M. BYRON


A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY

UNIVERSITY OF FLORIDA


2003






























Copyright 2003

by

Elizabeth M. Byron














ACKNOWLEDGMENTS

I would foremost like to acknowledge the four members of my supervising

committee and express my gratitude for their support. Anthony Oliver-Smith chaired

both my masters and doctoral committees, encouraging me as a scholar along the way.

Anita Spring had a strong influence during my early years in graduate school and training

in gender and development. I appreciate participation of Gail Kauwell and Ricardo

Godoy who provided useful comments and suggestions.

This research and dissertation would never have come to fruition without the

invitation, funding opportunity, and never-ending personal dedication of Ricardo Godoy.

I trusted his advice and guidance when I first committed to the necessary 18 months of

field work in lowland Bolivia. At the time it seemed an eternity to be so far from family

and friends. It more than paid off, and he provided me with the opportunity for a rich

field experience incomparable to any other. Ricardo contributed countless hours of time

and energy to my doctoral career and continues to be an excellent mentor.

Bill Leonard stuck with me beyond his career at the University of Florida and has

encouraged me as a mentor and friend throughout my years in graduate school. He has

shaped my research interests and contributed to my anthropological knowledge in the

classroom and the field. David Wilkie assisted in the logistical matters of our field work;

and most importantly insisted that our two research teams have sufficient time for rest

and recuperation built into the intensive schedule of data collection.








Victoria Reyes-Garcia shared in the field work with me, each of us pushing the

other toward success in the field; and inspired me as a woman and professional

anthropologist. Her comments and suggestions on early drafts are appreciated. Together

with Vincent Vadez, we built an important and lasting friendship that enabled me to

make it through the tough times in the field. I share this accomplishment with them both.

My research partner and roommate in San Antonio, biologist Lilian Apaza, was a

great complement to my social science orientation. We share unique memories of living

and working together in San Antonio that no one else can fully comprehend. Eddy Perez

was a great friend and colleague in the field.

I extend my appreciation to the students who shared the initial months in the field

with us (including Michelle Lieberman, Julian Castafieda, Luke Williams, and Mike

Gurven). I am also grateful for the time and effort of members of the cross-section

survey teams (that included Tomis Huanca, Mario Alverado, Zbe Foster, Yorema

Gutierrez, Brian Sandstrom, Susan Tanner, and Ana Yakhedts).

My translators in San Antonio, (Jorge Cuatta, Pablino Pache, and Alonzo Nate)

were my constant loyal companions and guides throughout the seemingly unending

rounds of data collection. I also owe a heartfelt thank-you to friends in San Borja,

Bolivia (including Luis Pefialosa and family, who provided a welcoming home in town;

and the park guards at the Estaci6n Biol6gica del Beni, for their logistical support and

assistance).

I am forever indebted to my friend and colleague Nanette Barkey, whose support

throughout my qualifying examinations and dissertation was constant. She contributed

immensely to the timely completion of this document through editorial comments,








organizational suggestions, and continual motivation. She inspires me as a medical

anthropologist and scholar.

H. Russell Bernard, while not a member of my committee, played a subtle, yet

significant role in guiding my career path from my early days of graduate school. He has

had a profound influence on my methodological orientation and training; and his advice

and instruction figured prominently into the successful completion of my degree.

Through coursework, methodological training, and scholarly conversations, he has had

lasting impact on my formation and career as a behavioral scientist. I owe him a great

debt of gratitude.

My years as a graduate student at the University of Florida have been enriched by

special friendships with Melissa Denmark, Pamela (Miller) Ottesen, Rachel Sandals,

John Schultz, Grace Shih, and Meghan Wilson. I began my graduate training with Debra

Rodman Ruiz: we mutually encouraged, consoled, and advised each other for over 6

years. Rich Wallace was a wonderful running partner and confidant with whom I shared

the process of writing our dissertations (both the struggles and the accomplishments). I

benefited mentally and physically from our regular runs through the streets of

Gainesville, hashing out methodological uncertainties and questions of data analysis.

Rod Clare, my friend since my years at Duke University and now an academic colleague,

provided constant support of my successes for over 10 years.

I was able to return to the Beni in 2002 and introduce my fiance, Jim Barham, to

the many Tsimane' individuals and families of San Antonio and Yaranda who enriched

my life while living along the Maniqui River. Even though he still cannot believe that I

weighed babies in a hanging scale, he continues to provide the right words of emotional








and academic support, editorial comments, and encouragement to get me through the

final stages of this dissertation. He is everything I could ask for in a mate and partner. I

look forward to sharing the experience of his doctoral field research together in Africa.

Finally, I thank my family for their constant support and unconditional love

necessary to make it through graduate school. My older sisters served as academic role

models for me since my early years in elementary school, setting standards of excellence

to follow. My parents provided unconditional emotional and logistical support wherever

my studies have taken me, even though the often-uncertain and unconventional

environments may cause them worry. They even read and commented on portions of my

dissertation draft out of their own interest, a request that has meaning to me beyond

description.















TABLE OF CONTENTS
Page

ACKNOWLEDGMENTS......................................................................1i

LIST O F TA BLES ............................................................................................................ xiv

LIST O F FIG U RES ....................................................................................................... xviii

A B STRA CT ..................................................................................................................... xix

CHAPTER

I M A RK ETS AN D H EA LTH ........................................................................................

M arkets and Indigenous H ealth ............................................................................... I
Introduction ...........................................................................................................
Structure of the D issertation ............................................................................. 3
M arkets in G eneral ................................................................................................... 5
M arket Econom ies ............................................................................................. 6
Subsistence Econom ies ..................................................................................... 8
A nalysis of N on-W estern Econom ies .............................................................. 9
Culture Change through Integration and Acculturation ...................................... 11
A cculturation .......................................................................................... 12
Econom ic Integration ............................................................................... 13
Variation in Modes of Integration and Motivations ........................................ 15
Changes in Traditional Social and Economic Institutions ..................................... 18
Linking H ealth and M arkets ................................................................................. 21
Self-Perceived H ealth Status .......................................................................... 21
M arkets and D ietary H ealth .......................................................................... 25
N utritional Consequences .............................................................................. 26
The Tsimane': A Case Study of Market Integration ............................................. 28

2 M ETH O D S ................................................................................................................. 30

Introduction ................................................................................................................ 30
Team A pproach ..................................................................................................... 31
Site Selection and Sam pling Strategy .................................................................... 32
Site Selection ................................................................................................... 32
San A ntonio ............................................................................................. 34
Y aranda ................................................................................................... 34









Panel Study Sam ple Design .......................................................................... 35
Definitions, Sam ple Size, and Attrition .......................................................... 35
Prelim inary Research and Pilot Testing ................................................................. 37
Prelim inary Research ..................................................................................... 37
Language Training ......................................................................................... 38
Pilot Testing ................................................................................................... 39
D ata Entry and Storage .................................................................................. 40
Survey M odules ..................................................................................................... 40
Baseline Surveys ............................................................................................ 40
Socio-dem ographic inform ation ............................................................ 40
Problem s with aging the population ........................................................ 41
Reproductive histories ............................................................................ 42
Panel research design .............................................................................. 43
Module 1: Economic Activity over the Last 30 Days ................................... 43
Cash and in-kind incom e survey ............................................................ 44
Credit survey .......................................................................................... 46
W ealth survey .......................................................................................... 46
V illage price survey ................................................................................ 49
M odule 2: Consum ption via W eigh D ays ...................................................... 50
M odule 3: M easures of Illness and D iet ........................................................ 51
Self-perceived illness and treatm ent utilization ...................................... 52
Dietary inform ation ................................................................................. 53
M odule 4: N utritional Status .......................................................................... 56
H eight and w eight ................................................................................... 57
Skinfolds thickness ................................................................................ 58
Clothing adjustm ents ............................................................................... 59
Other Methodological Notes: Provision of Health Services ......................... 60
Conclusion .................................................................................................................. 60

3 TSIMANE' HISTORY, ETHNOGRAPHIC BACKGROUND, AND MODES OF
SUBSISTEN CE ..................................................................................................... 61

Introduction ................................................................................................................ 61
H istorical Background .......................................................................................... 62
Sources of Inform ation about the Tsim ane'. .................................................. 62
The M ission Period and Ethnic D istinction ................................................... 64
Failed M issionization ..................................................................................... 66
Linguistic Origins .......................................................................................... 67
Bolivian Independence and Economic Development in the Beni .................. 68
Twentieth Century M issionary Influence ...................................................... 69
Catholics ................................................................................................. 69
N ew Tribes .............................................................................................. 70
Social Organization .............................................................................................. 73
Political Organization ...................................................................................... 73
Kinship System .............................................................................................. 74
Territorial Rights and H istory ....................................................................... 75
Population ........................................................................................................ 77









Tsim ane' M odes of Subsistence ............................................................................ 78
H orticulture ..................................................................................................... 78
H ousegardens ................................................................................................ 83
G athering of Forest Resources ....................................................................... 84
Fishing ................................................................................................................. 85
H unting ................................................................................................................ 86
Anim al husbandry .......................................................................................... 87
Economic Participation In The Market Economy ................................................. 87
Sale of G oods ................................................................................................ 88
Barter of G oods .............................................................................................. 90
Barter relations on the low er M aniqui River ........................................... 91
Jatata trade on the upper M aniqui River ................................................. 92
W age-Labor ................................................................................................... 94
Chapter Sum m ary ................................................................................................... 96

4 TSIMANE' ACCULTURATION AND MARKET INTEGRATION: THE CASE
STUDY OF SAN ANTONIO AND YARANDA ................................................. 97

Introduction ................................................................................................................ 97
Demographic Attributes of The Sample (Control Variables) ............................... 98
Explanatory V ariables ................................................................................... 98
Com m unity A ccess ....................................................................................... 99
H ousehold and Individual D em ographic A ttributes .......................................... 101
H ousehold com position .............................................................................. 101
A ge and sex distribution ............................................................................. 103
M easures and D iscussion of A cculturation .............................................................. 103
Educational System ........................................................................................... 104
Fluency in Spanish ............................................................................................ 106
Literacy in Spanish ............................................................................................ 107
H ighest School G rade ........................................................................................ 108
M athem atic A bility ........................................................................................... 109
Com m ents on M easures of A cculturation ......................................................... 110
Tsimane' Articulation With The Wider Economy And Society .............................. 112
San Borja and the Regional M arket ................................................................. 112
Tsim ane' as Participants in the M arket Econom y ............................................. 114
W ealth A ccum ulation ................................................................................. 115
Credit M arkets ............................................................................................ 117
A ccessing the M arket in San Borja ................................................................... 117
San Antonio ................................................................................................ 118
Yaranda ...................................................................................................... 119
M easures of Integration To The M arket ................................................................... 120
Individual-Level M easures of Integration to the M arket ......................................... 120
N ote on Statistical Analysis of M onthly Incom e .............................................. 120
Total M onthly Incom e ....................................................................................... 121
Incom e by Type ................................................................................................. 124
Cash incom e ............................................................................................... 125
In-kind incom e ........................................................................................... 127









Source of Incom e .............................................................................................. 128
Incom e earned through sales or barter ....................................................... 129
Incom e earned in w age labor ..................................................................... 130
Disposal of income earned through wage labor activities ......................... 131
Individual W ealth of M aterial A ssets ................................................................ 132
M odem w ealth ........................................................................................... 133
Traditional w ealth ...................................................................................... 134
Total w ealth ................................................................................................ 135
Household-Level M easures of M arket Integration ................................................... 135
Household-Level Incom e .................................................................................. 135
Household Groupings by Incom e Thirds .......................................................... 136
Household Income Measured through Daily Consumption .............................. 137
Household-Level W ealth ................................................................................... 140
Factor of M arket Integration and A cculturation ....................................................... 141
Chapter Conclusion .................................................................................................. 143

5 GENERAL HEALTH CONDITIONS IN THE STUDY COMMUNITIES ........... 147

Health Related Factors of Tsim ane' W ay of Life .................................................... 147
Infrastructure ............................................................................................................ 147
Pow er and W ater ............................................................................................... 147
Housing and Clim ate ......................................................................................... 149
Personal Hygiene, Behaviors, and Habits ................................................................ 150
W aste D isposal .................................................................................................. 151
U se of A lcohol, Tobacco, and Coca Leaves ..................................................... 153
A lcohol consum ption ................................................................................. 153
Tobacco use ................................................................................................ 154
Coca leaf .................................................................................................... 155
Health Services ......................................................................................................... 155
Traditional Options ........................................................................................... 156
Traditional healers ...................................................................................... 156
Hom e rem edies ........................................................................................... 156
Biom edical Options ........................................................................................... 157
Research team first-aid kits ........................................................................ 157
Perm anent biom edical options ................................................................... 158
Hospital or private doctors ......................................................................... 159
Clinic at Horeb ........................................................................................... 159
Vaccinations ............................................................................................... 160
A ccess and Utilization of Services .................................................................... 162
Reproductive Health ................................................................................................. 163
Delivery and Disposition of Pregnancies .......................................................... 163
Abortion and M iscarriage .................................................................................. 165
M enarche ....................................................................................................... 165
Selected Rates ................................................................................................... 165
Chapter Sum m ary ..................................................................................................... 167




x









6 MARKETS, ACCULTURATION, AND SELF-PERCIEVED ILLNESS .............. 168

Introduction .............................................................................................................. 168
Review of the Literature ........................................................................................... 169
Acculturation and Integration to the M arket ..................................................... 169
Factors Affecting Health Status and Use of Treatments ................................... 170
Education .................................................................................................... 170
Incom e ........................................................................................................ 173
W ealth ........................................................................................................ 175
M ethodological N otes .............................................................................................. 175
M easuring Health Status ................................................................................... 175
Lim itations to M ethods ..................................................................................... 177
Lag Tim e ........................................................................................................... 177
Child versus Adult Populations ......................................................................... 178
Hypotheses ............................................................................................................... 178
Self-Perceived H ealth Status of A dults ............................................................. 179
Self-Perceived H ealth Status of Children .......................................................... 180
D escriptive A nalysis of Tsim ane' Illness ................................................................. 181
Illness Prevalence .............................................................................................. 181
Duration and Severity of Illness ........................................................................ 182
Overall Pattern of Illnesses ............................................................................... 184
M ortality ............................................................................................................ 187
Treatm ent of Illness ........................................................................................... 187
Types of treatm ent ...................................................................................... 187
Effect of research team 's m edical kit ......................................................... 189
Hypothesis #1 Adult Self-perceived H ealth ............................................................. 189
Multiple Logistic Regression Model on Self-Reported Illness (Logit) ............. 190
Repeated Measures Tobit Analysis of Duration and Severity of Illness ........... 193
Duration of Illness ............................................................................................. 193
Severity of Illness .............................................................................................. 195
Discussion of Adult Results .............................................................................. 196
Hypothesis #2 Child Perceived Health Status .......................................................... 197
Logit M odel for Child Illness ............................................................................ 197
Tobit M odels ..................................................................................................... 199
Duration of Child Illness ............................................................................ 199
Severity of Child Illness ............................................................................. 200
Sum m ary of Child Illness .................................................................................. 201
Chapter Sum m ary and Interpretations ...................................................................... 202
Adult Education and A cculturation ................................................................... 202
Adult M arket Integration ................................................................................... 203
Child Illness ....................................................................................................... 203
Conclusion ......................................................................................................... 204

7 MARKETS, ACCULTURATION, AND DIET ...................................................... 206

Introduction .............................................................................................................. 206








Integration to the Market Economy, Acculturation, and Diet: A Review of the
Literature .............................................................................................................. 209
Several A spects of Diet ..................................................................................... 209
Source of dietary resources: Toward greater reliance on market foods ..... 210
Diversity of foods ....................................................................................... 211
N utritional content of diet .......................................................................... 212
Seasonal availability of food resources ...................................................... 214
Acculturation and changes in values and preferences for foods ................ 216
Hypotheses ........................................................................................................ 217
M ethodological Lim itations and M odifications ................................................ 218
A nalysis of Tsim ane' H ousehold D iet ..................................................................... 220
Description of G eneral Food Consum ption ...................................................... 220
Food crops .................................................................................................. 221
Forest foods ................................................................................................ 222
M eats .......................................................................................................... 223
Purchased foods (nonm eat) ........................................................................ 224
Comparison of nutritional content of traditional foods versus market
substitutes ............................................................................................. 225
V alue of m arket foods ................................................................................ 227
Hypothesis Testing ............................................................................................ 228
Source of foods .......................................................................................... 228
M ultivariate m odel ..................................................................................... 231
D ietary diversity ......................................................................................... 232
Seasonal reliance on the m arket ................................................................. 233
Discussion ................................................................................................................. 235

8 NU TRITION A L STA TU S ....................................................................................... 238

Introduction .............................................................................................................. 238
M easuring N utritional Status through Anthropom etry ............................................. 239
Reference Standards and Interpretations ........................................................... 240
Summary of Research on Nutritional Status in the Amazon ............................ 241
Socioeconomic Factors Correlates of Nutritional Status .................................. 243
Hypotheses on Market Integration and Nutritional Status ................................ 245
Analysis of the Tsim ane' N utritional Status ............................................................ 248
Child N utritional Status ............................................................................................ 251
Descriptive Analysis ......................................................................................... 251
Standardized Indices of N utritional Status ........................................................ 252
Com parison of Am erindian Children ................................................................ 254
Prevalence of Grow th Deficits .......................................................................... 255
Child Grow th and Developm ent Com pared ...................................................... 257
Linear growth ............................................................................................. 257
Growth in body w eight .............................................................................. 258
Multivariate Regression Analysis of Child Nutritional Status .......................... 260
Household-level m arket integration ........................................................... 261
M aternal m arket integration ....................................................................... 264
Discussion of Findings on Child N utritional Status .......................................... 265








A dult N utritional Status ............................................................................................ 268
D escriptive Analysis of A dult N utritional Status .............................................. 268
N utritional Status of Tsim ane' W om en ............................................................. 268
N utritional Status of Tsim ane' M en .................................................................. 270
Chronic Energy D eficiency (CED) ................................................................... 272
Genders Com pared ............................................................................................ 273
Com parison with Other Am erindians ............................................................... 274
M ultivariate Analysis of A dult N utritional Status ............................................ 274
Individual-level analysis ............................................................................ 275
H ousehold-level analysis of adult nutritional status .................................. 278
Gender analysis .......................................................................................... 280
D iscussion of Results from A dult A nalysis ...................................................... 282
Individual level ........................................................................................... 282
H ousehold level .......................................................................................... 282
Com m unity level ........................................................................................ 283
Chapter Conclusion .................................................................................................. 284

9 CON CLU SION S ...................................................................................................... 287

General D iscussion of Findings ................................................................................ 287
Self-Perceived H ealth ........................................................................................ 287
Household Diet .................................................................................................. 290
N utritional Status ............................................................................................... 292
M arket Integration .................................................................................................... 293
A cculturation ............................................................................................................ 296
Com m unity differences ............................................................................................ 298
M ethodological Contributions .................................................................................. 299
Research Design ................................................................................................ 299
Research Team Approach ................................................................................. 300
Areas of Future Research .................................................................................. 300
Policy Recom m endations .................................................................................. 302
Integration and A cculturation in M otion .................................................................. 303

APPENDIX KEY CONCEPTS TO LOGIT MODEL ................................................ 307

Logit M odel .............................................................................................................. 307
Odds and Odds Ratios .............................................................................................. 307
Interpretation of coeffi cients .................................................................................... 307
Interpretation of Odds ratios ..................................................................................... 307

LIST OF REFEREN CES ................................................................................................. 308

BIOGRAPH ICA L SKETCH ........................................................................................... 332














LIST OF TABLES


Table pae

2-1. Calendar of field work activities ......................................................................... 33

2-2. Sam ple size by quarter ......................................................................................... 37

2-3. Panel study design quarterly (3 month/12 week) research schedule .................... 43

3-1. Most frequent goods traded through sale or barter by community percent of total
number of exchanges recorded ............................................................................. 88

3-2. Average unit sale prices for top commodities over 5 quarters ............................. 89

3-3. Total days of wage labor recorded during income surveys by type of activity and
com m unity ......................................................................................................... 96

4-1. Definition and measurement of explanatory variables in panel study .................... 100

4-2. Demographic characteristics of the sample by community ..................................... 102

4-3. Summary of adult measures of acculturation .......................................................... 105

4-4. Total adult monthly income in cash or kind by quarter (income rounded to
nearest B s) .............................................................................................................. 123

4-5. Characteristics of individual monthly income, average percent of total income
earned by type ........................................................................................................ 125

4-6. Individual adult cash income by quarter (income rounded to nearest Bs.) ............. 126

4-7. Individual adult in-kind income by quarter and gender, (income rounded to
nearest B s.) ............................................................................................................. 128

4-8. Characteristics of individual monthly income, average percent of total income by
source ..................................................................................................................... 129

4-9. Individual adult monthly income from sales and barter by gender and community
(incom e rounded to nearest Bs.) ............................................................................ 130

4-10. Adult monthly income from wage labor activities by gender and community for
each quarter (incom e in B s.) .................................................................................. 131








4-11. List of material assets used in wealth survey ........................................................ 132

4-12. Average quarterly adult wealth by gender and community (Bs.) .......................... 134

4-13. Summary of household-level monthly income (Bs.) by type, gender, and
com m unity ............................................................................................................. 136

4-14. Community distribution of households in income groupings based on average
income over all quarters of measurement .............................................................. 137

4-15. Quarterly average composition of daily household consumption by source and
com m unity (B s./household) ................................................................................... 138

4-16. Comparison of average measures of consumption by source ............................... 139

4-17. Comparison of source of total consumption by community ................................. 140

4-18. Average quarterly household wealth ..................................................................... 141

4-19. Characteristics of adult factors of market integration and acculturation ............... 143

5-1. Average adult recreational consumption habits in the last week by gender and
community for all 5 quarters (n= 598) ................................................................... 153

6-1. Definitions and measurement of dependent variables for health status .................. 180

6-2. Comparison of illness prevalence rates for total sample and by community, (one
observation per person per quarter; n = 1325) ....................................................... 181

6-3. Comparison of illness prevalence rates by age category and gender (one
observation per person per quarter; n = 1325) ....................................................... 182

6-4. Summary statistics on illness duration- cumulative person days ill from all illness
during the last 7 days .............................................................................................. 183

6-5. Summary statistics on illness severity, days confined to bed due to illness during
the last 7 days ......................................................................................................... 184

6-6. Illness groupings by type ......................................................................................... 185

6-7. Most common types of illness/symptoms by categories from all illnesses
reported over 5 quarters n = 685 illness episodes .................................................. 186

6-8. Percent of all recorded illnesses treated by community and age category
(n = 685 illnesses) .................................................................................................. 188

6-9. Comparison of illness treatment type by community .............................................. 188








6-10. Odds ratios for the effect of market integration, acculturation, and control
variables on adult illness (1 = Ill; 0 Not ill) ........................................................ 191

6-11. Coefficient from tobit analysis of the effect of market integration, acculturation,
and control variables on duration of adult illness (total days ill) .......................... 194

6-12. Coefficients from tobit analysis of the effects of market integration,
acculturation, and control variables on severity of adult illness (total number of
days ill in bed ) ....................................................................................................... 196

6-13. Odds ratios for effects of parental market integration, acculturation, and control
variables on child illness (1 = Ill; 0 = Not Ill) ........................................................ 197

6-14. Coefficients from tobit analysis of the effect of market integration,
acculturation, and control variables on child illness duration (total days ill) ........ 200

6-15. Coefficients from tobit analysis of the effects of market integration, acculturation,
and control variables on child illness severity (total days ill in bed) ..................... 201

7-1. Most common foods in daily diet of Tsimane' households .................................... 222

7-2. Type and source of meats in household diet by community ................................... 224

7-3. Nutritional contribution of common foods in Tsimane' diet, conversions for IOOg
edible portions ....................................................................................................... 226

7-4. Indices of dietary analysis ....................................................................................... 228

7-5. Source of Tsimane' diet, average percentage of items in daily household diet by
com m un ity ............................................................................................................. 229

7-6. Average percent of items in daily household diet by income groups by thirds ...... 230

7-7. Regression results for effect of market integration, acculturation, and control
variables on percent of total foods from the market (MDS/DDS) ......................... 232

7-8. Dietary Diversity Score (DDS) by income thirds ................................................... 233

8-1. Definitions of anthropometric measures and indices of nutritional status .............. 248

8-2. Sample size of children by community ................................................................... 251

8-3. Anthropometric dimensions of Tsimane' children under 11 years of age .............. 252

8-4. Anthropometric data for Tsimane' children by gender and community (age less
than 11 years) ......................................................................................................... 253

8-5. Selected data on heights and weights of Amerindian children ............................... 255








8-6. Mean and prevalence of Z-scores below -2SD cutoffs for anthropometric indices
am ong Tsim ane' children by season ...................................................................... 256

8-7. Results from random effects model of the effect of household-level market
integration, parental acculturation and control variables on child nutritional
status (M odel 1; ages 0-4.99 years) ........................................................................ 262

8-8. Results from random effects model of the effect of household-level market
integration, parental acculturation and control variables on child nutritional
status (M odel 1; age 5-10.99 years) ....................................................................... 263

8-9. Results from random effects model of the effect of maternal market integration,
parental acculturation and control variables on child nutritional status (Model 2;
ages 0-4.99 years) ................................................................................................... 265

8-10. Results from random effects model of the effect of maternal market integration,
parental acculturation and control variables on child nutritional status (Model 2;
ages 5-10.99 years) ................................................................................................. 266

8-11. Summary of anthropometric data of adult females 18 years and older by
com m unity ............................................................................................................. 269

8-12. Summary of anthropometric data of adult males by community (18 years and
o lder) ...................................................................................................................... 2 7 1

8-13. Adult chronic energy deficiency (CED) by gender and community ..................... 273

8-14. Heights and weights of selected Amerindian adults ............................................. 274

8-15. Results from random effects Model 2 on type factors of individual adult market
integration and acculturation .................................................................................. 277

8-16. Results from random effects Model 4 on factors of household market integration
and adult acculturation ........................................................................................... 278

8-17. Results from random effects Model 5 household measures of market integration
and individual acculturation ................................................................................... 279

8-18. Results from random effects Model 4 on factors of household market integration
and adult acculturation for women only ................................................................ 281

8-19. Results from random effects Model 4 on factors of household market integration
and adult acculturation, m en only .......................................................................... 281

9-1. Summary of findings from analysis of effects of market integration and
acculturation on measures of Tsimane health ........................................................ 288


xvii














LIST OF FIGURES


Figure page

1-1. Relationships between market integration, acculturation, and health ................. 22

3-1. Location of the study area within map of Bolivia ............................................... 62

3-2. Seasonal calendar of productive activities. Compiled from information in
(Huanca et al.2002) and interviews with Tsimane' adults during fieldwork ..... 82

4-1. Total average monthly adult income by quarter ...................................................... 121

4-2. Total average monthly adult income by quarter and gender ................................... 122

4-3. Average monthly income earned in cash by quarter and gender ............................ 127

5-1. M onthly rainfall August 1999-October 2000 .......................................................... 150

7-1. Percent of diet from market foods by community for each quarter of study .......... 234

7-2. Percent of foods from market by income groupings in thirds ................................. 235

8-1. Comparison of height-for-age for Tsimane' vs. U.S. females (0-9 years) .............. 258

8-2. Comparison of height-for-age for Tsimane' vs. U.S. males (0-9 years) ................. 258

8-3. Comparison of weight-for-age for Tsimane' vs. U.S. females (0-9 years) ............. 259

8-4. Comparison of weight-for-age for Tsimane' vs. U.S. males (0-9 years) ................ 260


xviii














Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy

MARKET INTEGRATION AND HEALTH:
THE IMPACT OF MARKETS AND ACCULTURATION ON THE SELF-PERCEIVED
MORBIDITY, DIET, AND NUTRITIONAL STATUS OF THE TSIMANE'
AMERINDIANS OF LOWLAND BOLIVIA

By

Elizabeth M. Byron

December 2003

Chair: Anthony R. Oliver-Smith
Major Department: Anthropology

Scholars have long been interested in the effects of markets and contact on the

health of native populations. Greater integration into a market economy and exposure

and assimilation into a dominant society can result in shifts in modes of subsistence,

decision-making about resource use, and access to health-related goods and services. The

clear direction of influence is often elusive. Increased income, material wealth and

credit, predicts expanded access to goods and services that may directly and indirectly

improve household and individual health. At the same time, greater involvement in

market trade can shift economic priorities away from secure subsistence production

toward the lure of material gain and novel items. Additionally, exposure to acculturative

forces (such as formal education, language skills of the dominant society, and frequency

of contact) can result in the adoption or rejection of new values and preferences.








The Tsimane' Amerindians of lowland Bolivia have been undergoing varying

degrees of integration into the regional economy and society. The organization of their

economic and social activities has been influenced by external forces from as early as

colonial expansion. The Tsimane' people share many experiences with other native

peoples of the Amazon who have responded in myriad ways to the encroachment,

expansion, and opportunity of contact and articulation with a larger economy. The

Tsinane' provide a suitable population among which to examine the relationship

between markets and health.

Research on the health impacts of market integration and acculturation is important

because health is a standard indicator of human welfare. This dissertation examines three

components of health: illness episodes, household diet, and nutritional status. Using data

from a panel study of two Tsimane' communities, I present descriptive and multivariate

analyses of each of the three dependent measures of health as they relate to measures of

integration into the market economy and acculturation.

Tsimane' household and individual integration into the market economy did not

demonstrate strong effects on health status. The absence of statistically significant

findings is explained in part by the observation that income and education alone are

insufficient to improve health. Even with increased participation in the regional economy

and society, constraints such as poor physical infrastructure, lack of political

representation, and access to health care and knowledge remain despite increased

opportunity for earning income and attaining education.













CHAPTER 1
MARKETS AND HEALTH

Markets and Indigenous Health

Introduction

Scholars have been interested in the effects of markets on human health for many

decades (Godoy and Cardenas 2000; Gross et al. 1979; Leatherman 1994; Wirsing 1985).

The relationship between markets and health has been studied from a variety of

perspectives, yet scholars are still searching for a clear understanding of the nature of the

relationship between individual health status and participation in a market-organized

economy. Participation and integration in a market-economy are often gauged by

measures of income, wealth, savings, and use of credit institutions. Within this broader

research agenda lies a range of specific indicators of health, including frequency and type

of illness (both perceived and objective), dietary adequacy, and nutritional status.

Two contrasting perspectives have been advocated in the literature on markets and

the health of indigenous peoples. The first is that integration into a market economy

improves health through access to higher incomes, formal education, and health-care

services (Akin et al. 1985; Haddad et al. 2002; Holmes 1985; Kennedy 1994; Steckel

1995). Income and education are associated with the ability to smooth consumption,

purchase medical services, treat illness promptly, and maintain proper sanitary

conditions. Markets can also function as a safety net for fluctuating dietary intake during

seasonal shortfalls in resource availability. Increases in household income can augment

individual energy intake through improved access to food (Kennedy 1994). If so,








safeguards to dietary health would be evident in indicators of both long and short-term

nutritional status.

The second perspective is that market economies are detrimental to the health of

indigenous populations because market expansion is often accompanied by increased

disease exposure and dietary alteration (Leatherman 1994; Leonard 1989). This

perspective comes from an ecological approach that suggests traditional societies have

adapted to their environments in ways that maintains good health and nutrition (McElroy

and Townsend 1996; Wirsing 1985). While studying indigenous Andean peoples,

Leatherman (1994) found that increases in cash income were accompanied by shifts in

dietary diversity. As diversity increased, nutritional value decreased, because people

replaced foods of high nutritional value with higher-calorie food items that were lower in

nutritional content (Leatherman 1994).

Clearly, these contrasting perspectives indicate that a complex relationship exists

between health status and measures of integration to a market system. While few remain,

there are still relatively unacculturated and unintegrated groups living today. Indigenous

peoples around the world are currently undergoing varying degrees of exposure to and

integration into market economies. In many places, these people are not controlling or

determining their own relationship with the market economy and are therefore in a

disadvantageous position (Gray 1990). If researchers can identify patterns of similarity

in what is happening as economic integration and social acculturation intensify, the

findings can perhaps influence policy and programs that would mitigate any detrimental

consequences for these native cultures and livelihoods. Research on the impact of market

integration on the health of indigenous populations is important because health is a








standard and classic indicator of human welfare and robustness of the society. For these

reasons, the objective of my study was to analyze relationships among integration to the

market and indigenous perceived-morbidity, diet, and nutritional status. To achieve this

objective, I studied a sample of Tsimane' Amerindians in two communities in the

Bolivian Amazon who are experiencing varying stages of integration into a market

economy.

Structure of the Dissertation

The dissertation is organized into nine chapters that guide the reader through the

theoretical background and research questions, methods used to collect data in the field,

and findings based on analysis of the data. Chapter 1 discusses the theory behind

assumptions about market and nonmarket organized economic systems. Two related

concepts important to understanding how indigenous peoples interact with market

economies are social acculturation and economic integration. I examine how aspects of

human health are subject to alteration through these processes of socioeconomic

integration, drawing from scholarly research on the effects of markets on illness, diet, and

nutritional status.

In Chapter 2, I present the research design and methodology used to collect data in

the field. The methods reflect a variety of considerations including research objectives,

plans for data analysis, facility in applying the methods accurately in a tropical setting,

cultural appropriateness, cost, and human resource requirements. I describe the selection

of the sample population, the structure of the data collection, and each of the surveys

used in the field. Each method is accompanied by a brief discussion on possible

limitations to its use in the ecological and social context of Bolivia's Amazon region.








Chapter 3 details the ethnographic background of the Tsimane' [chee mah nee]

people, what is known of their genesis as a distinct ethnic group, and their social and

economic organization in general. This includes their traditional social and economic

institutions and a specific history of social and economic integration into the larger

Bolivian society leading up to the study period.

Chapter 4 describes the specific marketplaces and economic activities of the

Tsimane' people. I present summary statistics of measures of integration to the market,

acculturation, and demographic characteristics from my sample of two communities.

Chapter 5 discusses factors important to Tsimane' health, such as access to health

resources, infrastructure, and behaviors to illustrate the constraints to health and welfare

facing the two study communities.

While the first five chapters set up the necessary foundation for understanding the

research questions, design, and ethnographic background, the next three chapters cover

the data analysis and testing of each of the research hypotheses. Chapter 6 addresses self-

perceived morbidity among the Tsimane'. I begin with a review of the relevant literature

on markets, acculturation, and perceived health status, then describe the health of the

Tsimane' people and variations within and between the two study communities. Finally,

I test whether measures of integration to the market correlate with the frequency,

severity, and type of self-reported illness.

Chapter 7 examines the household diet of the Tsimane' people. First, I review the

literature on dietary transitions among indigenous peoples with special attention to

consumption, availability, and seasonal variation in dietary intake as participation in a

market economy and society intensifies. It is important to assess whether foods








purchased with income earned in market activities are adequate substitutes for home-

produced diets. There is evidence that when households turn more to the market, the

resulting cash income may be insufficient to meet nutritional needs. If a market diet is

not economically accessible, the nutritional state of individuals in the population may

worsen (Messer 1984).

Chapter 8 presents a review of the literature on nutritional status and analyzes

measures of market integration, acculturation, and nutritional status (adult and child).

Summaries of various measures of nutritional status inform us about body composition

and biological responses to the environment. I also compare Tsimane' nutritional status

with that of other Amazonian populations.

In the final chapter, Chapter 9, I discuss how the findings from each of the three

analytical chapters apply to a broader context of integration to the market and human

welfare. I consider explanations and interpretations of findings from this study. Given

the socioeconomic alterations taking place throughout the Amazon region, there is a need

for research that contributes to understanding whether this process of change is

detrimental or beneficial to the overall mode of subsistence and welfare of groups like the

Tsimane'. I conclude with suggestions for how future research on indigenous health,

markets, and acculturation can be informed by my study.

Markets in General

The Tsimane' are a population with varying degrees of involvement in a market

economy. Before discussing the possible effects on indigenous health, it is useful to

understand the economic and social systems that provide the impetus and pressure to

modify human behavior. I approach the analysis of markets and health using a








comparative framework of involvement in market- and nonmarket-organized economies

and examine the impacts this behavior has on health.

Economic systems are distinguished by different principles that guide behavior for

determining how scarce productive resources are used and allocated for consumption,

distribution, and accumulation. Before discussing variations in economic involvement, I

outline the principles of a market economy and contrast them with those of a traditional

nonmarket economic system. The value-laden label of "traditional" often depicts

societies as static and deficient in social and economic development, blinding the analysis

to relationships among these constructed categories (Wolf 1982); but "traditional" in my

study refers to historical patterns of behavior characteristic of native peoples in contrast

to customs introduced from exogenous cultures. By nonmarket, I mean economies in

which production and distribution are organized according to principles such as

reciprocity and redistribution. I describe these principles later in this chapter.

Market Economies

A set of general principles structures market-oriented economic behavior. The

market at its most basic definition is an institution of economic relations and exchange

behavior. Institutions in this context are principles or rules that guide behavior. The

elements of a market economy put forth by neoclassical economists include exchange

relations, scarcity, and capital accumulation. Understanding these elements provides a

foundation for the mechanisms through which integration and acculturation can affect

social institutions and behaviors and thereby influence health.

Market exchange is characterized by the transacting of goods and services whose

values, and/or prices, are determined by supply and demand (Johnson and Earle 2000).

Money in Western market systems serves as a medium of exchange whose value lies in








the transaction. "Money allows value in a fixed form to be converted to value in any

form" (Peterson 1991:13). In contrast, money in nonmarket systems has been described

as having specific uses, for example, the exchange of livestock for marriage payment. A

completely market-based economy mandates the acquisition of material livelihood

through the selling of something, namely land, labor, or a commodity (Dalton 1971).

Economic anthropologists have described market transactions as either atomized or

embedded, depending on the level of tie or relation between the actors involved in the

exchange (Granovetter 1985). The short-term profit-seeking exchanges typical of a

market system do not foster personal relationships. Compared to reciprocal exchange

institutions, this form of socioeconomic organization is impersonal and thought to

comprise self-interested participants. This stands in contrast to reciprocal institutions and

embedded exchange networks of nonmarket cultures organized for the purpose of

establishing and maintaining social ties and insurances.

Another principle associated with economic behavior in a market system is the

universal perception of scarce material resources (Dalton 1971). Perceptions of scarcity

are the organizing causes of self-maximizing behavior in a market system. With

capitalism, unlimited desires are the driving force of human nature responsible for the

development of free markets in which actors seek to maximize personal gain (Graeber

2001). The idea that material needs are insatiable has been criticized as an attempt by

neoclassical economists to naturalize a behavior and tie it back to a biological postulate

(Dalton 1971).

From a different perspective, unlimited wants can be seen as socially constructed

(Gowdy 1999). Sahlins (1972) challenged the idea of a natural component of human








behavior as having unlimited wants with insufficient means to satisfy. He wrote that "it

is not that hunters and gatherers have curbed their materialistic 'impulses,' they simply

never made an institution of them" (1997:13). Most of literature on hunter-gatherers and

small-scale horticultural societies is filtered through the Western perspective of what

defines success, productive capacity, and affluence. In the twentieth century, studies of

indigenous economies were heavily influenced by the perspective of neoclassical

economics. Formalist economic theory was built out of the analysis of capitalist market

systems where livelihoods depend on capital generation (e.g., wage labor), competition

for positions, self-maximizing behavior, and dependency. These concepts were then

applied to noncapitalist societies (Graeber 2001; Heilbroner 1985).

Accumulation of capital is another essential element of a capitalist system.

Furthermore, capitalism is understood as an expansive process (Heilbroner 1985) where

the goal of social activities is to generate more capital. By contrast, precapitalist societies

are described as amassing wealth for use, rather than for the regeneration of more wealth.

Heilbroner (1985) discusses prestige as attributable to inherent qualities or talents of an

individual. Prestige goods are inanimate objects that have the ability to increase the

owner's prestige as seen by others. With capitalism, accumulation of goods translates

into prestige for the owner.

Subsistence Economies

Small-scale subsistence economies are typically depicted as functioning according

to reciprocal institutions of exchange (Sahlins 1972). A subsistence-level economy relies

on production at the domestic unit to meet basic human needs, often biological needs

such as food and water, as well as the technologies necessary to harness or produce these

resources. In a subsistence-level economy, the producers, means of production, and








products are not separated (Gudeman 1978 in Dewey 1985). This contrasts with

commercial production where goods are primarily destined for sale or trade.

It has been postulated that before the rise of the state and the entrenchment of social

inequality, people lived for millennia in small-scale kin-based social groups, in which the

core institutions of economic life included collective or common ownership of land and

resources, generalized reciprocity in the distribution of food, and relatively egalitarian

political relations (Lee 1988). This perspective emphasizes collective rights to basic

resources in contrast to private property. It traces its roots to Lewis Henry Morgan, as a

necessary ethos based on ecological and social constraints (Lee 1988). One of the main

principles organizing subsistence economies is generalized reciprocity whereby material

resources are given to group members without expectation of immediate return.

Essentially, this institution serves as a long-term safety net during periods of resource

scarcity and is aimed at smoothing consumption (Smith 1988). Reciprocity is also a type

of leveling device, by way of cultural proscriptions against wealth accumulation and

inequality. Reciprocity can be understood as a sharing ethos whose purpose is to

establish and maintain social ties and insurances.

Analysis of Non-Western Economies

Indigenous peoples vary widely in their economic institutions and organization.

Discussions of indigenous groups who have historically occupied tropical forests refer to

certain economic and social formations of small-scale societies. Forager-horticultural is

the organizational form addressed by my research. Populations still exist, predominantly

in the tropics, that organize subsistence procurement through a combination of foraging

and small-scale cultivation. We can study them to understand better how the process of

economic and social integration impacts their welfare.








Conventionally, the study of the economic evolution of tropical populations places

them along a continuum from subsistence-level to interdependent market-organized

economies. This view is highly influenced by the historical interpretation of the rise of

capitalism in Western Europe. Firth (1968) summarized features of non-Western

economies to include the following: simple level of technology, small productive units,

the absence of an expanding market for capital, absence of entrepreneurship, and

different social conventions for control of capital goods (e.g., restrictions on wealth

accumulation). It is evident that these features are contextualized negatively or as lacking

Western market features. A dichotomous construction of capitalist and noncapitalist, or

an evolutionary bias as precapitalist, negates the hybrid formations and variants in

integrative processes (Cleary 1993). Anthropologists have played an important role in

gathering empirical data to investigate whether small-scale societies are operating under

market-defined decision-making and economic behaviors. However, there is often a

limited time-scope or lens of historical analysis when we begin to study tropical

populations. This, combined with a cultural evolutionary perspective that views societies

as "developing" toward more complex forms of organization, casts an ethnocentric

shadow over our understanding. Furthermore, there is a tendency to naturalize the

historical development of a capitalist system and impose this interpretation on the

analysis of foraging populations in an ahistorical manner (Dalton 1971; Lee and Daly

1999; Richards 1997; Wolf 1982; Wood 1999).

Scholars recognize and challenge the validity of the inclination to situate

subsistence economies within a specific historical trajectory of another world region

(Graeber 2001; Sahlins 1972). Dalton (1971) questioned whether a theory born out of a








specific form of economic system (capitalist) would be applicable to the analysis of other

economic forms. Yet, these are the theories against which economies are analyzed. It is,

perhaps, more useful to think of the range of transformations on this multidirectional path

(that occur over time and place) as economic and social institutions adapt and respond to

new stimuli.

Culture Change through Integration and Acculturation

Economic and social institutions undergo modification through contact with and

integration into other cultures. Over time, individuals and societies may alter older

patterns of behavior, adopt or create new traits, or pull back and detach from external

influences (Social Science Research Council 1954). While cultures are constantly

undergoing change, contact with external forces can increase the speed and alter the

direction of change.

Some anthropologists have criticized the tendency within the discipline to

perpetuate an isolated model of pristine foraging peoples (Eder 1988; Headland and Reid

1989). Whether any society is truly self-sufficient at the present time is debatable.

Headland and Reid (1989) suggest a more appropriate approach to understanding

foraging populations through an interdependent model in which different populations are

linked through trade and exchange. A useful analytical approach involves looking at

"various stages of culture change" (Headland and Reid 1989:44), which recognizes the

wide variation in formation of indigenous foraging groups throughout history and today.

Wolf (1972) approaches culture change as a process involving responses to economic and

political forces acting on the acculturating group. More continuous and regular contact

with individuals and institutions of different cultures exerts pressure to change existing

institutions and behaviors. This can result in a pattern of decreasing autonomy and








increasing dependency on the dominant system, an economic and sociopolitical system in

which the acculturating group has a marginal role. The disruptive process is occurring

more rapidly than in the past because of shrinking geographical, economic, and social

distances, necessitating in-depth research into possible outcomes.

Two important concepts for understanding the process of culture change are

acculturation and integration. There are several ways of applying the often-overlapping

concepts of acculturation and integration of small-scale societies. In general, we are

referring to processes that are part of larger culture change. Acculturation refers more to

broader social behaviors and customs, while integration is specific to participation and

orientation of economic behavior.

Acculturation

Early definitions of acculturation come out of anthropology with the following

classic definition provided by Redfield, Linton, and Herskovits (1936:149) as the

phenomena which results when groups of individuals having different cultures
come into continuous first-hand contact with subsequent changes in the original
culture patterns of either or both groups.

The study of this concept was advanced significantly by researchers in cross-cultural

psychology. In 1954, the Social Science Research Council (1954:974) offered a revised

definition of acculturation as

culture change that is initiated by the conjunction of two or more autonomous
cultural systems. Its dynamics can be seen as the selective adaptation of value
systems, the processes of integration and differentiation, the generation of
developmental sequences, and the operation of role determinants and personality
factors.

From these definitions, acculturation can be seen as a process through which

behavior is influenced by outside cultures. Acculturation, which is distinct yet related to

market integration, encompasses the adoption of features of an exogenous culture by the








acculturating group. Peterson (1991:6) defines acculturation as "increasing assimilation

to the national culture and loss of cultural distinctiveness." Both of the classic definitions

above imply the adoption and/or alteration of prior cultural features or values. Increased

contact may exert pressure for change in the direction of cultural assimilation. By

contrast, Wirsing (1985:305) defines "unacculturated" people as having the

characteristics of geographic isolation, an unwritten language different from the national

one, low levels of technology, and low economic specialization.

Acculturation should be conceptualized as multidimensional. It is a process that

occurs over time and place. "Acculturation can be viewed as a multilinear phenomenon,

as a set of alternatives, rather than a single dimension ending in absorption into a
"modem society" (Berry et al. 1986:305). Common measures of acculturation include

proficiency in the national language, years of contact with the modern population,

distance to the nearest trading town (Gross et al. 1979), level obtained in formal

education, participation in national politics, social relations and interactions with

members of dominant culture, religion (Berry et al. 1986), and value orientation (Dressler

1996). In measuring degrees of acculturation, not all measures are related (Trimble

2003). Berry et al. (1986) wrote "not everybody in the acculturating group will

necessarily enter into the acculturation process in the same way or to the same degree"

(1986:296). There are different stages and ways of engaging the dominant culture by the

acculturating individual or group. Factors such as purpose, length, and permanence of

contact are important to consider.

Economic Integration

Scholars often use integration synonymously with participation and involvement in

the market economy or system of exchange. Market integration differs from








acculturation in that it refers specifically to articulation with a specific economic system,

that is, the degree of involvement and dependency on the market for acquisition of

subsistence needs. Compared with acculturation, economic integration is analyzed more

through material measures of behavior. Still, an examination of the literature reveals an

often-indiscriminate use of these two terms, complicating the interpretation of research

findings.

When looking at indigenous groups in Amazonia who are undergoing rapid

economic change, it is useful to make the distinction that such societies are not

necessarily going through the process of developing markets, but rather integrating into

an existing market system. A subsistence mode of production may shift toward a mode

that facilitates or intentionally strives to extract surplus for commercial exchange. For

example, small-scale agriculturalists or forest horticulturalists can expand crop

production with the intention of exchange in the market for commercial goods and

services, or to amass capital (Heilbroner 1985). They might reorient their economic

strategy toward wealth accumulation.

In a comparative study of four ethnic groups in the Brazilian Amazon, Gross et al.

(1979:1049) defined market integration and participation as "activities that result in the

production of goods and services for exchange with non-Indians outside of the village

community." This definition goes beyond the exchange or use of cash, to include the

exchange specifically with people exogenous to the ethnicity. Gross et al. (1979) linked

the degree of market participation with environmental and historical factors such as

circumscription and encroachment of national frontiers and the process of becoming

sedentary. The term "integrated" communicates the level of involvement in the wider








political economy, interrelation with other groups, and expanding socioeconomic

networks (Johnson 1989:60). Integration into the market has been operationalized by the

number of hours spent in market activities (Eder 1988; Gross et al. 1979; Henrich 1997),

the proportion of subsistence derived from the market, indices of wealth assets (Henrich

1997), use of modem technology, distance from the village to a market town, number of

government institutions in the village, use of credit (Godoy and Cardenas 2000), and the

share of total income from market transactions.

Variation in Modes of Integration and Motivations

Tropical forest peoples have been involved in exchange relations with exogenous

actors throughout history (Bird-David 1988; Eder 1988; Headland and Reid 1989; Reed

1995). In the last century, however, indigenous forager-horticultural groups have become

increasingly economically and socially integrated into regional, national, and

international systems. These shifts in economic orientation have been associated with

religious missionization efforts (Helms 1972), contact with dominant societies (Murphy

and Steward 1968), national colonization programs (Sponsel et al. 1996), frontier

expansion (Putsche 2000; Ramos 1984; Sponsel et al. 1996), environmental degradation

(Gross et al. 1979), development projects (Gray 1990; Santos et al. 1997), and new

market opportunities (Murphy and Steward 1968). Contact with dominant cultures for

South American tropical peoples has intensified in the last two decades. This "contact"

with industrialized societies has been discussed as causing change or disruption in the

adaptation of traditional groups (Wirsing 1985:303). Often there are certain qualities of

the dominant group that can meet specific needs such a new technologies, medicine, and

products (Berry et al. 1986). Scholars have identified market participation as an

important force to transforming social structures (Gross et al. 1979). Likewise, changes








in economic institutions, how indigenous forest peoples organize production and

consumption activities to meet material needs, also accompany market participation.

Indigenous peoples in tropical forests integrate into a market system through two

primary modes: 1) sale and barter of forest products or the surplus of their subsistence

production and 2) sale of their labor. Researchers studying the effects of market

integration on indigenous societies have arrived at different conclusions. Different types

of participation in the market need to be examined to understand the variation in

consequences. For example, economic integration may include wage labor or the sale of

either agricultural or forest products. The difference between commodity and labor

integration might be significant (Godoy 2001). This variation makes it difficult to arrive

at general theories about the effects of markets on welfare (Eder 1988; Godoy 2001).

Different circumstances lead to the participation or intensification of market

activities in tropical ecologies. Integration has neither a common commencement nor is a

universal process. Understanding motivations for participation has implications for

whether scholars see the market as an institution that erodes traditional organization,

provides a substitute or safety net or social insurance, or as an opportunity to actively

expand one's productive and consumption base. There are both proximate and ultimate

causes of integration into the market system (Putsche 2000; Sponsel et al. 1996). Godoy

(2001) summarizes three approaches to explain why people become more market

integrated: natural processes, pressure from encroachment bodies, and conscious choice.

Gross et al. (1979) offered a hypothesis of market participation based on difficulty of

procuring subsistence through traditional means. Similar to Eder (1988), Gross and

colleagues saw that market involvement was related to the difficulty in meeting








subsistence needs through traditional productive activities (Gross et al. 1979). As

constraints to meeting subsistence needs increase, intensification and use of technology

follows with a resulting dependency on market derived tools and other goods. There is

also variation in how villages, households, and individuals articulate with a market

economy. Some actors/households/communities are better positioned to take advantage

of market opportunities while others turn to the market economy as a last alternative in an

eroding subsistence livelihood.

In studying how changing economic orientations affect social systems our research

team found that, even within the same village, some households or individuals will

become involved while others will not. Both individual and household data are necessary

to account for possible variation in participation. Godoy (2001) conceives of a choice to

participate in markets and individual inclinations (fixed effects) to become more

acculturated. Henrich (1997) also acknowledges individual agency in his study of the

Machiguenga in Peru. He claims that the Machiguenga people are not compelled into

market activity by structural forces, as is argued in most studies, but rather they are

actively interested in integrating.

Definitions of acculturation and integration often imply an underlying lack of

agency by members of native cultures. However, the impact of integration and

acculturation is not unidirectional. How native individuals and groups relate to these

forces varies. There may be elements of the new culture that are attractive and sought

after such as technologies and commodities. The participation of forager-horticulturalists

in the market system changes the system itself. With integration into the market

economy, there is an expansion of roles as consumers, sellers, and innovators of new








products. As buyers they create new and/or expanded demand for specific market-traded

items. As sellers, they introduce competition with traders and merchants of the similar

products. Whether or not dependency is an inevitable outcome of market participation

varies by who is controlling and determining relationships with the market (Gray 1990).

Research suggests that when indigenous people do not control their own marketing,

integration to the market will be detrimental to their social and economic livelihoods

(Gray 1990). Richards (1997) offers a situation where there might occur a positive

response to the increased demand in market process. When the commodity whose

production is intensified during economic integration is of cultural or historical

significance to the indigenous group, there might be a reinforcement of indigenous values

(Richards 1997). Unfortunately, in Amazonia, the activities through which native people

historically articulate with the market economy, such as rubber tapping, logging, and oil

exploration, have not been compatible with native social and economic institutions.

Changes in Traditional Social and Economic Institutions

The processes of market integration and acculturation indirectly impact health

through the modification of social and economic institutions. This section examines the

changes in social and economic organization that come from the incorporation and

adoption of a cash economy. First, I describe the link between market integration and

social and economic institutions. Next, I complete the connection by looking at how

these changed institutions influence health.

Several authors have proposed that markets erode traditional social insurance

institutions (Lee 1988; Murphy and Steward 1968). Reciprocal sharing of food, as

mentioned earlier, is a strategy for mediating risk and uncertainty inherent in tropical

forests. Through economic integration, the market system allegedly replaces this








traditional institution. When there is no longer a need to share, or as a substitute for this

safety net arises, generalized reciprocity declines or ceases to occur. Putsche (2000)

found that purchased items were shared less than home procured items. This has

implications for periods of vulnerability associated with seasonal availability of food

resources as well as shocks such as prolonged illness episodes or death. Lee (1988)

argued that the spread of capitalism has destroyed the communal base of many societies.

Murphy and Steward's (1968) classic comparative study of Montagnais in Canada and

Mundurucfi in Brazil highlights how market integration and acculturation culminated in

social deterioration.

There is also evidence that market integration does not erode social institutions in

all cases. The Mbuti of the Ituri Forest in Central Africa have a history of exchange

relations and resistance to dominance. They have been commercially active through

bushmeat trade without disrupting social priorities and communal hunting practices (Hart

1978). However, Hart found that Mbuti meat consumption was promised to meat trader

demands during poor hunting returns. Reed (1995) similarly concluded that among the

Guarani of Paraguay, market participation did not erode reciprocal institutions and

networks because they maintained a base in subsistence production and integrated market

commodities into traditional systems of exchange.

The degree to which the sharing ethos of a particular group is maintained,

modified, or disregarded when faced with increased integration varies. Intragroup

dependencies may not be immediately eroded, as in the Guarani case, but the situation

might eventually erode more with increased dependency on and relations with exogenous

trading partners. Eventually tropical peoples have been observed to relinquish hunting








and gathering activities, reorienting more toward the market for acquisition of food and

other commercial goods. The different stages of the process of integration may explain

the difference in research findings on the impact of market participation.

The use of money as medium of exchange can be contrasted with a barter-based

exchange system. The introduction of money alters the relations of exchange in

fundamental ways through the establishment of a foreign standard unit of value.

Increasingly, there becomes a need for cash to enact exchanges for subsistence needs.

Behrens (1992) found that cash transactions decreased participation in traditional kin-

based exchange networks and lessened the importance of women in forming and

maintaining networks. Reciprocity may still be important where there are poorly

developed credit markets (Godoy 2001). Godoy questions whether markets weaken

reciprocity, and if weakened reciprocity in fact creates a vulnerable situation for

indigenous people.

Social norms, such as proscriptions against internal sale of commodities among

subsistence-level groups, break down with increased market activity. With agricultural

intensification oriented toward cash crops, households become nucleated, seek the cash

market for labor, and often participate in intravillage sale rather than reciprocal exchange

of food (Behrens 1992). With the advent of cash cropping, there is less redistribution of

subsistence products. Cash becomes a commodity that is not shared among others or

loaned with great ease.

When social and economic institutions meet material needs come under pressures

to change, there is a risk to the welfare of the people. If the ability to produce or procure

food energy is compromised, there will be health consequences for individuals in the








group. The ecological balance of societies that acquire a large proportion of their food

from the natural environment is threatened when the population density increases as a

result of market integration.

Linking Health and Markets

Many Amazonian groups are facing increasing ecological and social pressures

brought on by accelerating contact with national market systems. The relationship

among economic integration, acculturation, and the health of subsistence-level

populations is still unclear. In my research, I attempt to clarify these relationships.

Illness prevalence, dietary intake, and nutritional status are indicators of overall health

status, an aspect of human welfare which is vulnerable to the changes I have described in

the preceding section. In this section, I explore the direct effects of market integration

and altered social and economic institutions on health. Each area is discussed in greater

detail in the corresponding analytical chapter. Figure 1-1 shows how the processes of

integration and acculturation act on one another during the process of culture change; and

alludes to some of the possible impacts on health that I explore in this dissertation.

Self-Perceived Health Status

Contact with members of an exogenous group allows for exposure to new

pathogens. More importantly, the disruption of traditional subsistence patterns as a result

of territorial encroachment and market expansion can limit indigenous peoples' capacity

to maintain their own health and well-being. Two interrelated components of human

welfare affected by these pressures are health status and health-seeking behaviors. With

greater contact and integration through economic exchange, use of medical services, and

formal education, the manner by which individuals experience illness and use treatment

modalities and societal modes of recognizing and treating diseases are altered.








Dietary Alteration


Nutritional Status

Value Systems U.-


Subsistence Activities 4



Settlement Patterns


Treatment Behaviors

'H
Self-Perceived Health


"-.Ability to participate
in markets


7


I


Integration
into the
Market Economy
A


Language
Cash Income
Schooling
Wage Labor
Years of Contact
Sale of Goods
Political
Participation Wealth
Accumulation
Religion
Credit
Distance


Figure 1-1. Relationships between market integration, acculturation, and health


Acculturation








The nature of the relationship between markets and health is unclear because of the

myriad factors that mediate both economic participation and health. From one

perspective, market integration may improve objective morbidity yet increase self-

perceived morbidity (Godoy and Cardenas 2000). Godoy and Cardenas (2000)

hypothesized that with greater integration into the market economy, people get sick less,

yet have a lower threshold for illness. This lower threshold is tied to their higher

expectations for their health (Goodland 1988) and greater identification or labeling of

illnesses as observed through more frequent reporting of minor ailments. As people

become acculturated to a different understanding of what it means to be healthy, their

standards of hygiene and perceptions of good health undergo revision. Self-reports of

illness capture perceptions of physical and emotional states relative to an understood

standard. To be sick translates into not meeting the acceptable characteristics of good

health, which often differ from one culture to another. Increased contact and familiarity

with health-care services may actually heighten perceptions of morbidity (Murray and

Chen 1992). Self-reported illness has been found to be positively related to income

(Murray et al. 1992; Murray and Chen 1992), but it is necessary to tease out whether the

relationship is caused by objective changes in morbidity. Alternatively, participation in

the market system could allow individuals to take time off from labor activities when ill,

while subsistence-based activities cannot go similarly unattended, depending on one's

social capital. Still, income opportunities lost due to time spent seeking treatment are

trade-offs that individuals and households face.

Greater economic opportunities that accompany market expansion may facilitate

access to medical services, better nutritional status, and improved education and








knowledge about illness prevention. These benefits, of course, depend on whether

individuals and households actually avail themselves of these services and information.

Access is not just an economic constraint, but also a social constraint. Receiving the

benefits of modem medical services such as vaccinations, surgical care, and

pharmaceuticals hinges on important factors such as language use, communication skills,

gender, class and racial barriers, trust, and familiarity with a health care system. New

health knowledge available only in the dominant language will not evenly reach the

members of the acculturating group.

Utilization of health services is another measure of self-perceived morbidity.

Rather than measuring perceptions of illness, this measure conveys information about

perceived efficacy of treatments, access to health care of different types, and price factors

(both monetary and in time) (Murray and Chen 1992). Greater integration into the

market system might be associated with wider availability of medical services from

which to pick. Use of traditional medicines and treatments may also indicate changes in

health status or ability to access other services.

The relationship between access to and use of medical services is complex.

Utilization of health services is a result of many factors including access, availability,

severity, perceived efficacy, and cost (Murray et al. 1992). As part of integration and

acculturation, people come into contact with a range of new options for managing illness

and disease. Whether or not this influences their treatment behaviors is important to

understand. Both access and perceived need factor into decisions about what type of

treatment to seek.








Markets and Dietary Health

Dietary alteration and changes in nutritional status resulting from economic

integration or acculturating forces has been studied in many places. The manner in which

populations are brought into contact with market systems is significant to the analysis of

their nutritional status. Studies have looked at forced human resettlement (Wilkie 1989),

ecological constraints (Carneiro 1974; Shell-Duncan and Obiero 2000), willing

participation (Henrich 1997), and colonization schemes (Ventura Santos and Coimbra

1996).

Brown and Konner (1998) argue that most humans have lived without a predictable

food source, evolving in environments prone to food shortage. Cohen (1989) writes that

changes in human diet and nutritional status have accompanied change in economic

modes of subsistence over time. As groups shift from a mode of production based on

hunting and gathering to small-scale horticulture, and onto commodity agriculture there

are associated changes in their diet. Archeological evidence has also been uncovered

linking differences in nutritional health of hunter-gatherers and agriculturalists to their

mode of production (Armelagos 1990; Cassidy 1980; Larson 1995).

As foraging groups shift subsistence practices toward the cultivation of food,

qualitative and quantitative changes occur in their diet. The composition of food

resources is altered with the domestication of plants and animals. There are also notable

differences in diet breadth between sedentary and migratory populations. The analysis of

changes in availability and distribution of food resources over the last 250 years

emphasizes a pattern of delocalization of production and distribution (Pelto and Pelto

2000). An ever-increasing proportion of the diet comes from sources outside of the

immediate community.








Seasonal fluctuation in food availability can be affected by market participation as

well. Increased integration into national economic systems of exchange and acculturation

can have the potential benefit of greater access to income and thus purchased foods

(Dennett and Connell 1988; Holmes 1985). These market foods can serve as buffers

against seasonal fluctuations. In theory, access to markets should provide an opportunity

for a more predictable stable food source capable of withstanding seasonal fluctuations

and nutritional vulnerability experienced by forager-horticulturalists. In practice

however, the mode by which individuals and households become articulated into the

market system is complex. The existence of market-traded food sources does not

guarantee access to these items, particularly for populations originating in exchange-

based economies rather than the capitalist model of commodity exchange. Too often

access is an assumed rather than demonstrated component of integration to the market

economy and serves as a foundation for an argument in favor of health benefits to

transitioning populations.

Dietary practices may be modified via acculturation or competition for resources

(Berlin 1985). Prestige and status associated with different foods may counter any

benefit of expanded education about food choices. Shifts in food taboos or avoidances

can be affected by acculturation, essentially redefining what constitutes food resources

(Aunger 1996; Berlin 1985).

Nutritional Consequences

Human nutritional status is also particularly sensitive to economic and cultural

change. Increasing contact with and participation in market economies can bring both

costs and benefits to the nutritional health of the acculturating group. Research on








economic and nutritional transition among populations in tropical forests and other

ecological regions has turned up different findings.

There is evidence that integration into the market economy does not lead to

improvements in nutritional status. The dependency on market-derived foods that may

have a lower nutritional value than home produced items can be detrimental to nutritional

status (Dewey 1981). As households intensify agricultural production for sale in the

market, there may be a decline in both quality and quantity of household consumption.

Foll~r (1995) writes that indigenous peoples are not experiencing the benefits of

integration with respect to health. The marginal status that they occupy is an obstacle to

accessing potential market benefits, and risks such as diseases associated with

consumption of processed foods and loss of micronutrients are increased.

Other scholars such as Rebecca Holmes (1985) have challenged this assumption

that traditional villages have better health, measured through nutritional status, than more

"civilized" populations. She concluded that culture change did not lead to poorer

nutritional status, but rather her findings pointed toward the access and utilization of

medical services and community stability as correlates of good health (Holmes 1985).

With increased acculturation, the inclusion of purchased food in the diet and introduction

of exogenous diseases may be offset by access to modem medical and dental treatment.

Still others acknowledge that the market effect is not uniform (Dennett and Connell

1988; Leonard and Thomas 1988). It is my intention with this dissertation to examine the

factors of market integration and acculturation through which health effects are mediated.

With my data from the Tsimane' in Bolivia, I address the different levels of involvement








in the market economy and measures of acculturation to compare the relationship to

several measures of health.

The Tsimane': A Case Study of Market Integration

Understanding how increased participation in a market economy affects the health

of tropical forest peoples requires approaching integration as a process rather than a

single event. Studies that analyze the effects of market integration need to approach it as

iterative changes, rather than as a switch from some metaphorical traditional mode,

persistent until the time of study to a sudden catapult into a market integrating phase.

The process from a traditional subsistence mode to a market-influenced mode of

livelihood requires more attention. The relationship between markets and health are best

studied through a longitudinal research design. Comparison of groups living under

similar socioeconomic and ecological conditions is useful to better understand how

changes associated with economic integration affect social and economic organization.

Even so, it is still debated as to whether market integration is a beneficial or detrimental

process for the health of indigenous societies (Godoy 2001; Richards 1997). This may, in

part, be attributed to the differences in operationalizing integration and acculturation.

Based on the literature on the relationship between markets and health I developed

research objectives and seven hypotheses to test whether, in fact, markets do positively

affect different dimensions of the health of indigenous peoples in the tropics. I present

and test each hypothesis in this dissertation using data from 18 months of intensive study

of Tsimane' Amerindians of lowland Bolivia. I studied their economic behavior, health

status, dietary intake, and nutritional status. The Tsimane' are a suitable population

among which to study relationships between health and integration and acculturation as

they are currently undergoing varying degrees of market integration. The variation both








within and between communities provides a good example for comparing the effect of

acculturation and integration into the market economy on various aspects of health.

My research among the Tsimane' contributes to the ongoing debate about the

effects of market integration on health. Vague and inconsistent conclusions about these

relationships are in part are due to the fact that different forms of integration may affect

health differently. However, markets may not have any directly generalizable impact on

the health and welfare of indigenous forest peoples. The effects may be mediated

through degree and type of integration. Any effect may be an artifact of how variables

are defined to measure market integration and acculturation. To address this issue, I

disaggregate the different activities through which indigenous peoples participate in the

market system so as to be able to test both type and degree of integration and

acculturation. In the next chapter, I explain the methods used to operationalize and

measure market integration, acculturation, and health.














CHAPTER 2
METHODS

Introduction

In this chapter I describe the research design and methods used to collect data for

the analysis of the relationships among acculturation, integration to the market economy,

health, and nutrition. The methods chosen for this research design reflect a variety of

considerations including: research objectives, plans for data analysis, facility in applying

the methods accurately in a tropical setting, cultural appropriateness, cost, and human

resource requirements. Each of the methods is presented with a discussion of the

advantages and limitations along with the justification in selecting the methods for this

study. There are many different approaches to examining issues of indigenous health and

economic integration that draw on either qualitative or quantitative methods of data

collection. A systematic and quantitative approach to measuring market integration,

acculturation and indicators of health was adopted in order to define and test hypotheses

about the relationships between integration and health.

Data presented in this dissertation represent the health and nutritional component of

a larger study of the effects of integration into the market on the use of natural resources

conducted by an international and interdisciplinary research team of which I was a

member.' Together, our research team was interested in the relationships among



'The larger study, "The Impact of Market Integration on Health, Knowledge, and Resource Use among the
Tsiniane' of Beni, Bolivia," was directed by anthropologists Ricardo Godoy and William R. Leonard, and
conservation biologist David Wilkie, and funded by National Science Foundation (SBR-9417570),
MacArthur Foundation, and Food, Health, and Conservation grants to the principal investigators. A NSF








integration into the market and various social and biological phenomena. Therefore, the

research design for measuring market integration was developed through a team and

multidisciplinary approach and all members utilized the data in doctoral dissertations,

undergraduate theses, and professional publications. Each member was responsible for

developing the survey instruments specific to their research interests. I was responsible

for the research design that included the health, dietary, and nutritional components.

Team Approach

Our interdisciplinary team of researchers collected the panel data in the Beni

department of Bolivia over 18 months between May 1999 and November 2000. The field

team was composed of two anthropology graduate students from the University of

Florida (Victoria Reyes-Garcia and myself) and two biology undergraduate students from

the Universidad Mayor de San Andr~s in La Paz (Lilian Apaza and Eddy Prez). We

divided into two sets of an anthropologist and biologist to reside in the villages of San

Antonio (Apaza and myself) and Yaranda (Reyes-Garcia and Perez). An independent

agronomist (Vincent Vadez) joined the team in Yaranda during Quarter 2 of the panel

research and continued until the end of the study. Anthropologists are beginning to

acknowledge limits to data collection such as the inability to collect data in different

locations simultaneously when they work alone in the field (Henrich 1997). Our team

approach allowed for a multi-site research design for data collection.

In each site, team members administered the same survey instruments on a three-

month or "quarterly" schedule. The quarterly research schedule was composed of a

series of four different survey modules: 1) economic activity, 2) consumption, 3) illness

Research Experience for Graduates (REG) grant provided supplemental funds for my return visit in June of
200 1.








and diet, and 4) nutrition. Each quarter the two sets of researchers began by collecting

economic measures in their respective communities. Once complete, we moved onto the

other modules in the above sequence. This sequence was designed to satisfy time order

requirements for statistical analysis. With measures of market integration and

acculturation as the independent variables, they must necessarily be measured before the

dependent measures of health status. Each of the instruments used to collect the different

types of data relevant to the health study is described within this chapter. The two sets of

researchers worked on the calendar of scheduled data collection to ensure that similar

data were collected within a comparable time frame.

Site Selection and Sampling Strategy

To explore the influence of market integration on physical health, dietary intake,

and nutritional status, our research team collected data in two ways: 1) an in-depth 15-

month panel sample frame in two Tsimane' communities, and 2) a cross-section of 58

communities with different levels of exposure to a market system. For this dissertation, I

test my specific research hypotheses on only the panel data set.

Site Selection

Site selection for the study was informed by past experiences working in the region

with the Tsimane' people (Godoy 2001; Godoy and Cardenas 2000; Godoy et al. 1997)

and a preliminary field visit by Godoy and Wilkie. They identified two ecologically

comparable Tsimane' communities through visits and meetings with the Gran Consejo

Tsimane', the political authority representing the Tsimane' ethnic group. In determining

the final research sites they considered comparability, variance in market integration, and

the willingness of community residents to have a team of researchers take up residence

for a year and a half. The principal investigators received formal permission to work in









the two selected communities of San Antonio and Yaranda from the Gran Consejo

Tsimane' in the spring of 1999. At that time, the Gran Consejo Tsimane' also agreed to

allow our team to conduct a larger cross-section study in additional Tsimane'

communities the following year. Table 2-1 shows the calendar of field activities for the

entire research project.

Table 2-1. Calendar of field work activities

Dates Quarter Reseach Activity
May 10-Aug. 9 Preliminary
1999 Research &
Pilot Testing

Aug. 10-Nov. 9
1999 1Panel Study
1999

Nov. 10-Feb. 9
1999- 2000 2
Feb. 10-May 9
2000 IPanel Study
20003

Training for Cross-Section
May 10-Aug. 9 PnlSuy Cross-Section Crs-eto
2000 4 Panel Study Study Study

Aug. 10-Nov. 9 Cross-Section
2000 Panel Study Study

June -6 Follow-Up
2001 Visit


The two communities included in the sample represent different levels of economic

integration and socio-cultural acculturation based on distance from the regional market

town of San Borja, access to modem medical services, wages labor opportunities, and

contact with the dominant national culture. Both communities are located along the

Maniqui River in the Beni department. There are considerable differences in proximity

to the regional market town of San Borja as well as exposure to acculturative influences.









San Antonio

The community of San Antonio is situated on the lower Maniqui River, 10 km to

the northeast of the town of San Borj a.2 Thirty households are scattered along both banks

of the river for a length of approximately 2.5 km. Each household has direct access to the

river within 20 meters or so from their residence. Residents clear plots in close proximity

to their houses. One side of the community (western bank) pushes up against savanna

lands used for cattle ranching and is under greater land pressure than the more populated

side (eastern bank) which boarders secondary forest. San Antonio is delimited downriver

to the northeast by the Tsimane' community of Campo Bello (30 minutes by foot) located

within the limits of the Estaci6n Biol6gica del Beni (EBB) and the mestizo3 community

of Santa Elena upriver to the south (20 minutes by foot).

Yaranda

Yaranda is nestled back from the southeastern bank of the upper Maniqui River, 47

km from San Borja. Residents of the 24 households live within five to ten minutes by

foot to the river's edge. This configuration reflects a conscious decision by residents to

move their houses closer to a central area around the schoolhouse more than two decades

ago. Yaranda is bordered by two other Tsimane' communities, Santa Maria and

Cachuela, roughly two hours walking distance. Unlike San Antonio where fields are

close to or surround the residential structures, the agricultural fields are farther away from

the residences due to Yaranda's community layout. The clustered layout of Yaranda's

households dictates frequent interactions as community members must pass around or

2 Distances were measured by GPS representing linear distance from the town center, not actual road
distance.
3 People of mixed European and Native American ancestry.








through other residences in order to reach the river, their fields, or the forest. In San

Antonio, the linear layout precludes any need to pass through neighboring households on

a regular basis to reach one's field, the river, or the forest. Yaranda is more distant from

San Borja and is overall less integrated into the regional market system. Yaranda is,

hov.ever, integrated through thejatata4 (Genoma deversa) palm trade between Tsimane'

and itinerant river traders (discussed later in detail).

Panel Study Sample Design

A longitudinal or panel study consists of repeated observations on the same person

(Deaton 1997). The cohort of individuals is referred to as the panel. Because nutritional

and health status are directly affected by seasonal consumption patterns and resource

availability, collecting data during different points in the annual cycle captures a wider

range of circumstances than with only a one-time cross-section design. Collecting panel

data also reduces error in the collection of data on household and individual income, key

factors to this analysis. In cross-sectional study designs, income is typically measured at

one point in time. A single measure excludes data necessary to analyze the seasonal

variation in resources available (Benzeval and Judge 2001). For this reason, our team

studied participants every three months (quarterly) over a fifteen-month period for a total

of five observations per indicator. By doing this, our data capture information over more

than a full annual productive cycle.

Definitions, Sample Size, and Attrition

Individuals 15 years or older were classified as adults as they are active economic

producers through trade, sale, and agriculture by this age. Economic information was

4 Throughout this dissertation words designated by italics indicate Spanish origin. Words designated by
underlining indicate a Tsimane' term.








collected only from adults. Individuals younger than 15 years were treated as children in

the sample. An adult living in the household, typically the mother, provided the

information on the children during the various surveys. Individuals, both adults and

children, are therefore the units of analysis. The total panel sample of two communities

includes 150 adults and 182 children (n = 332).

One of the challenges inherent in a longitudinal sample design is attrition of

subjects or households from the panel (Deaton 1997). Attrition can result from the

dissolution or formation of households, death, migration, or refusal to remain in the

study. Absenteeism due to extended visits to relatives in other communities, or wage-

labor migration resulted in fluctuations in the sample size or the panel and therefore the

dataset does not include complete data or observations on every individual in the panel

for all five quarters. Likewise, new households were formed through marriage, births, or

migration to the study community, or by shifts of individuals to new households within

the same community. Despite these changes, the minimum number of subjects (n = 276

in Quarter 1) in the sample during any one quarter was still 83% of the maximum sample

size (n = 332). The dataset contains records of all of these changes and they are

accounted for in the pairing of measurements with individual and household-level

variables. Table 2-2 reflects the sample of individuals captured in each of the five

quarters.

Individuals in the sample were part of households in each of the communities. Our

team defined households as a group of people sharing in production and consumption.

We relied on Tsimane' definitions of who was and who was not a member of the

household. Households were typically composed of the individuals who lived in close








proximity, cooked on the same hearth, and shared in food resources. Generally, this

included a nuclear family with perhaps a young married son or daughter and their recent

spouse. In San Antonio, we found more nuclear families than in Yaranda where

households were more often organized through larger extended kin ties.

Table 2-2. Sample size by quarter

Quarter Women Men Girls Boys Total
1 63 67 66 80 276
2 67 71 73 85 296
3 67 72 73 79 291
4 67 65 73 81 286
5 70 69 80 88 307


Preliminary Research and Pilot Testing

Preliminary Research

The U.S. based researchers (Godoy, Reyes-Garcia, and myself) developed the

preliminary survey instruments before departure to Bolivia. During weekly meetings

with Godoy in the spring of 1999 at the University of Florida, we discussed hypotheses

and generated relevant survey instruments for data collection in the field. Once in

Bolivia, our entire team further tailored these instruments to the Tsimane' culture. We

conducted preliminary research and pilot testing from May to August 1999 to identify a

sample of households to study, find out what traditional and modem health resources

were available, and learn about Tsimane' definitions of illness and health. We met with

community leaders and households in a general meeting and followed up by visiting each

potential study household to explain our team's intentions and research focus. In San

Antonio, three households on the far edge of the community refused to participate in the

study, and in Yaranda only two households declined. We respected their preferences and








did not collect data in those households. Therefore, the final sample for the panel study

included 51 households (San Antonio = 27; Yaranda = 24) in the two villages agreeing to

participate in the study. This translates into 189 individuals in San Antonio and 143 in

Yaranda.

One of the goals of this pilot phase was to compile a complete list of potential

responses and codes for the closed ended-portions of the surveys to facilitate coding and

data entry. The methods to accomplish these goals are based in large part on rapid rural

assessments of primary health care (Scrimshaw and Hurtado 1987), participant

observation, and semi-structured interviews with residents and health providers. With the

help of Alonzo Nate, a Tsimane' translator and guide, we generated plant, animal, market

product, and illness lists and translated portions of the different modules directly into the

Tsimane' language. During initial visits to both communities, I informally elicited lists

of illnesses known to the Tsimane' in both Spanish and Tsimane' and eventually

established trilingual (Tsimane', Spanish, and English) databases of response codes.

Language Training

During these initial months our team further devoted time to language study and

training in data collection with the help of Nate and existing grammars developed by

evangelical missionaries (Gill and Gill 1988; Gill and Gill n.d.; Mayer Roca and

Caymani 1999). While some Tsimane' are bilingual in Tsimane' and Spanish (24% of

the adults in panel sample; 12% of adults in the cross-section), it was necessary to

conduct interviews in their native language to reach the full range of study participants,

especially women who are more often monolingual in Tsimane'. We employed bilingual

Tsimane' men as translators in the preparation of the instruments and to assist in the

interview process through the oral translation of questions and responses. Alonzo Nate








accompanied the team members who lived and worked in Yaranda (Reyes-Garcia and

Pdrez) and Jorge Cuatta and Pablino Pache worked as the principal translators in their

home community of San Antonio with the other members (Apaza and Byron). We

studied the basics of the Tsimane' language in order to ask questions and eventually

achieved a functional conversational level. Owing to the repetitive nature of the survey

schedule and high frequency of quantitative responses, our competency level in the

Tsimane' language was sufficient for understanding the majority of the responses.

Nevertheless, the role of our translators in facilitating the logistical and substantive

support was invaluable.

Pilot Testing

In mid-June 1999, our team visited San Antonio to pilot test the different modules.

We chose San Antonio for the pilot testing because of the greater logistical ease of

movement back and forth between the community and San Borja where we were

conducting our fieldwork preparations. Each researcher took the initiative to explain her

or his research component and instruct the other team members on survey delivery, as we

would rely on two sets of researchers to collect data on a parallel schedule. As the

quarterly research schedule spans across three months, we needed to test all the modules

without burdening the participants. We divided the team and selected several households

to test and refine each method. Three undergraduate anthropology students from the

University of Florida, Julian Castafieda, Michelle Lieberman, and Luke Williams,

accompanied our team and assisted in the pilot-testing phase. Leonard came from

Northwestern University to train our team in anthropometric measurement and practice

on families in San Antonio.








In addition to refining the research instruments, our team aimed to ensure that our

ideas based on training in anthropological and biological theory and method would be

culturally appropriate and acceptable to the Tsimane' participants. For example, we

anticipated that the body measurements or income surveys might pose obstacles to

successful completion. In the field we found that the Tsimane' do not mind talking about

their income and generally, the body measurements were culturally appropriate. With the

exception of a few households in Yaranda where there seemed to be more reluctance to

the measurements by some small children, participants enjoyed the anthropometric

segment of the research as it was organized into a quasi-social event and gathering.

Data Entry and Storage

The two sets of researchers entered the majority of the data from their respective

communities while in the field using portable computers powered by solar panels affixed

to the roofs of our houses. We entered the data into Microsoft Access at quarterly

intervals. Throughout the research period, our team met periodically in San Borja to

discuss methodological issues. Each team member visited the other community with a

specific focus on her or his topics, for short periods of time to acquire a sufficient

understanding of life in both communities. Upon return to the United States, Godoy,

Reyes-Garcia, and myself merged and cleaned the data set in STATA 7.

Survey Modules

Baseline Surveys

Socio-demographic information

In the initial three-month phase of panel research (May-August 1999), our team

collected baseline demographic information on all individuals in the households

interested in participating in the panel study. This baseline included the measures of








acculturation to be used as explanatory variables. Demographic information included

names of household members, ages, birth dates, educational histories, residency, religion,

and literacy scores on language (both Tsimane' and Spanish), and numerical competency

tests for all individuals in the household. Educational attainment for the mothers and

fathers of all individuals was elicited to find out whether each parent was literate or had

attended any formal schooling. We also asked participants about their frequency of visits

to the market town, provincial capital and national capital. Throughout the study, we

recorded any births, new additions to household, or deaths and updated the demographic

database accordingly. In any panel sample design there exists the risk of participants

dropping out of the study for a numerous reasons. For this reason, we also recorded the

attrition of individuals or households from the panel sample and the reason behind their

removal.

Problems with aging the population

An essential variable in the baseline survey was the subject's age or birth date since

many of the Western reference measures of health used in this analysis are age-

dependent. However, there are rarely any written records of births in Tsimane'

communities. Establishing ages for adults was difficult particularly in the more isolated

community of Yaranda. While some individuals associate their birth dates with

particular festivals or other seasonally significant periods, they often are unable to narrow

down in which calendar month that festival falls. This methodological complication has

been noted by some researchers (Coimbra et al. 2002; Hem 1994), yet is often

overlooked. To cope with this challenge, we adjusted ages provided by parents

throughout the year. Information elicited from reproductive histories, school records, and








comparisons with neighbors and other relatives helped us piece together more accurate

estimates of ages and birth dates.

A small percentage of Tsimane' adults have Bolivian identification cards or

carnets, but we later found out that the ages and birth dates inscribed on these cards were

haphazardly assigned. One of the most highly educated Tsimane' proudly recounted his

experience working on the identification card campaign; part of his responsibility was to

"assign" ages to the participants according to his own judgment. This problem of aging

the population is a major obstacle to the analysis of the data on children and might be one

reason explaining the dearth of information on health status for these types of

populations. Nevertheless, age is not without error and this must be taken into account in

any analysis, particularly the age-dependent interpretations of anthropometric indices.

Other authors have remarked on this similar difficulty in establishing accurate ages and

the implications for interpreting measures of nutritional status (Keller 1991; Shell-

Duncan and Obungu Obiero 2000). These limitations will be discussed in further detail

during the presentation and discussion of the nutritional status data in Chapter 8.

Reproductive histories

To better understand lifetime fertility, infant mortality, and birth spacing, I

assembled reproductive histories for all women past menarche and with a male partner or

husband. Working with either a female or male translator, I met with each of the women

in both San Antonio and Yaranda to record information on their total number of

pregnancies, the outcome of each pregnancy, and present status of the child. The

instrument was based on modifications from Weiner and Lourie (1969). Tsimane'

women were comfortable discussing the pregnancies even when a pregnancy had been

terminated by abortion or miscarriage. Often an adult child would assist in putting the








woman's children in accurate sequential order and spacing during the interview. This

aided somewhat in establishing ages.

Panel research design

The panel research design is composed of four modules or segments, organized in a

specific sequence within each quarterly round of data collection according to our research

hypotheses. Each of the survey modules relevant to the analysis of health and markets

and its corresponding subsections are described in this section and depicted in Table 2-3.

I also discuss relevant methodological limitations and challenges to each subsection.

Table 2-3. Panel study design quarterly (3 month/12 week) research schedule
Module Surveys Approximate
_________Schedule
Module I Economic Activity over last 30 days
Cash and In-kind Income Survey
Credit Survey Weeks 1-3
Wealth Survey
Village-Level Prices

Module 2 Daily Consumption
Weigh Days Weeks 4-6

Module 3 Health and Diet
7-day Self-Perceived Illness Survey Weeks 6-7
24-hour Dietary Recall Surveys

Module 4 Nutritional Status
Anthropometric Measurements Weeks 8-9

Data Entry & Researcher Vacation Weeks 10-12

Module 1: Economic Activity over the Last 30 Days

This first module captured measures of integration and activity in the market

economy. The economic component incorporated three different surveys for eliciting

data at the individual-level: a) cash and in-kind income, b) credit, c) wealth, and d) a one








village-level survey on price information. We surveyed all adults to recall their

individual economic activity and wealth of material assets over the past 30 days.

Collecting data from a specific temporal segment can be problematic in a

population that uses more generalized categories of time than the researcher's. One of

the methodological issues associated with this recall error is "telescoping" or the

tendency to look farther back in time than the reference point (Sudman and Bradbum

(1974) discussed in Bernard 1995:235). We attempted to mediate this potential problem

by providing temporal reference cues. Often prompts of porojm, (long ago), were made

by the translators to help decide if the economic transaction occurred within or beyond

the timeframe for the survey. When possible, reference events were suggested to

enhance accuracy of recall (Loftus and Marburger 1983). Our team's full-time residence

in the two communities aided in this recall because we actively participated in or were

knowledgeable of local events. Community festivals, national holidays, visits from

vaccination brigades, or the research team's return from vacation, are examples we

frequently used to set the temporal reference for a prior month's period.

Cash and in-kind income survey

Individual-level income is one of the principal measures of integration into the

market economy in this study. Type of income, cash or in-kind, may factor differently

into the overall welfare of individuals and their households. Therefore, we recorded

individual-level income earned within the past 30 days disaggregated by type of income,

either in cash or in-kind. Although more time consuming, the rigor of collecting

economic data disaggregated to the individual-level allowed us to aggregate data up to

the household or village-level at a later time. Many researchers report household income

based on methods of recording income only from an adult male. The significance of








individual-level and gender-disaggregated economic data has been an important

contribution of anthropological research methods coming out of gender and development

studies (Massiah 1981; Safilios-Rothschild 1984). Income was further disaggregated by

source of income as either sale of goods, wage labor, barter, or gift/remittance to be used

in an analysis on whether the source of income affects health in different ways.

The income survey began by asking each adult what she or he had traded or sold in

the last month, prompting with inquiries about any visits to the market town or contact

with traders. We probed for products specific to each season (Bernard 1995). It was

helpful to ask about categories of items (e.g., plantains, rice, maize, or manioc), and then

ask the volume of what they sold (e.g., kilograms, units, bunches). Next, we inquired

about the unit price in order to calculate the total income from sale or value of exchange.

With large sales, the total income was often provided rather than the total quantity of sale

items. Monetary values were assigned to the in-kind trades according to the value of the

item received as payment.

The distance from the market town poses several challenges to assigning economic

values to goods bartered farther upriver (Wollenberg and Septiani Nawir 1998). In

Yaranda, the price of thejatata thatch panels, the functional currency on the upper

Maniqui River, was used to calculate monetary value. Generally, a value of one peso

Boliviano (Bs.) per panel was assigned to the exchange calculations.5

For income from wage labor, both the specific labor activity and the daily wage

earned were recorded. Labor paid in cash was directly recorded as the value received by

the wage earner. Even though males frequently work temporarily on cattle ranches, with


5 During the 18 months 6 Bs. z U.S. $1.








loggers and traders, or in San Borja, there are no regular remittances from these forms of

labor migration. Upon return, males might bring back cash or products purchased from

wages, but it was uncommon for remittances to be sent or couriered back to the

communities while away.

Our team had to account for one specific type of gift income in this survey. The

larger study incorporated a time preference game in which participants received small

sums of cash and candy through either immediate or delayed reward schedules. Income

generated directly from our study was included in monthly income but coded so its effect

could be measured.

Credit survey

As mentioned in Chapter 1, well-functioning credit markets have been shown to

influence an individual's or household's ability to maintain health and access services

(Morduch 1995). In our research design, we saw credit as potentially influential to health

and welfare. We recorded the amount, source, and reason for individual credit taken over

the past 30 days. We also noted the current debt held by each adult. The Tsimane' do

not utilize formal credit institutions such as banks. Credit types included store credit for

commercial goods in town, personal loans, credit with itinerant traders, and loans

provided by our research team for medical needs. As a service to the community, we

provided informal credit to participants for health emergencies with the condition of

repayment in cash or labor. Credit and debt to the research team was coded specifically

to identify any influence on the study.

Wealth survey

The accumulation of modem wealth items embodies two separate aspects of

economic integration into a market system. First, ownership of physical assets serves as








a proxy for modem wealth accumulation, a trend documented in shifts to capitalism and

integration into cash economies (Heilbroner 1985). Second, savings in asset

accumulation is a means of delaying consumption to future consumption needs. Savings

might provide for a smoothing of consumption in time of shocks or uncertainties

(Morduch 1995). Certain items are more likely to have cash equivalents and if necessary

be readily sold for cash in the need to buffer shocks. Small animals are examples of

assets that can be liquidated in case of minor emergencies (Godoy 2001). These stores of

wealth differentiate individuals and households by their ability to access resources during

periods of shock, such as death or illness. The functional value of certain items, such as

canoes or bicycles, may also indirectly impact one's ability to earn money and access

health services by facilitating mobility.

The quarterly survey of wealth was designed to capture both absolute wealth and

relative wealth of individuals and households during the 15-month period. During the

pilot phase we generated a list of commonly valued market and traditionally produced

assets with the help of a Tsimane' informant and the experience of the principal

investigator (Godoy). The list included both low and high value items that serve as a

measure of market integration (Gross et al. 1979; Putsche 2000). Early into the study we

appended the list to include assets typically owned by females after the realization that it

was skewed towards male wealth. We ultimately decided on a total of 22 assets. A

complete list of market and traditional assets used in the wealth survey appears in

Chapter 4.

In the wealth survey we asked about quantity and ownership of each of the 22

items. We used permission to sell a particular asset as the operational definition of








ownership. This survey also included measures of co-ownership for items belonging to

children or jointly held by the adults in the households. We collected data on the total

number of a particular asset in the household, the total number owned independently by

each individual, the total co-owned, and the number of people with whom ownership was

shared. When possible, the number of items was verified through direct observation. To

calculate individual wealth, the value of an asset was calculated by multiplying the

village price by the quantity owed by the individual plus the fraction of co-owned items.

We made the assumption that consensus at the village level in market price was accurate

for calculating monetary values of items in the income and wealth modules. Despite data

collection at the individual-level, wealth data proved to be more useful when aggregated

to the household-level and divided by household size as there were some random

responses to co-ownership or individual private property; some males if interviewed

would claim they alone owned everything.

There often exists a problem when applying the researchers' own cultural

interpretation of private property and wealth to a population where that might not be the

most appropriate concept. This is important to acknowledge and take into account in

discussing the outcomes of quantitative analysis. In San Antonio, we began to take the

data books with us to track change in wealth as well as ownership from one quarter to the

next. The precision in quantity for large volume items, such as free-running chickens, is

somewhat limited and an error margin in counting needs to be assumed. This experience

was instructive on a methodological level. Likewise, we observed the tendency to round-

off quantities of items by multiples of five or ten.6

6 These lessons contribute to the debate on the limits of "quantifying cultural issues," however attempts are
still necessary in order for research results to yield policy or broader application of the findings.








Village price survey

In order to analyze individual and household wealth, each asset needed a calculated

monetary value for the particular quarter. One means of accomplishing this is through

contingent valuation which involves asking a sample of people about what they think the

product, such as a shotgun, is worth in different contexts and then averaging the

responses (Kramer et al. 1992). Initially, our team employed this method for establishing

village-level prices for wealth items each quarter. Each quarter, we consulted males in

the communities who frequently visited the market towns or traded in high volumes on

the value of each asset on the wealth survey. Because of their greater mobility and

economic activity in the market town, we identified males as the best representatives of

price estimations. We asked, "What is this asset worth?" and "What is the price in the

community?" for each of the 22 wealth items (Safilios-Rothchild 1988). Often this

included an exercise of asking villagers what they would pay for an item, using a unit of

exchange such as kilograms of rice or bars of soap. This price included the price plus the

costs of transport out to the village.

When an asset had not been recently purchased or trade, the men often lacked a

clear knowledge of the price. During preliminary data analysis, it became apparent that

some of the items were artificially fluctuating with unusually high variability in prices

attached to nonmarketed items such as hunting dogs. To address this problem I decided

to use the average quarterly price of each wealth item in San Borja in my analysis

calculated from monthly price-data an assistant collected in town rather than the village

prices. For items not sold in San Borja, I used the an average of prices reported in the

village over all five quarters.








Module 2: Consumption via Weigh Days

Income is not limited to cash and trade, but rather a household's economy is based

on the daily consumption of forest, farm, and market resources. This consumption can be

estimated through the imputed value of farm and forest production. In order to account

for noncash income to households, each quarter, we conducted 11-hour direct

observations of household consumption, or "weigh days." Weigh days were conducted

as the second module each quarter following the economic surveys described above.

Cash and in-kind income affect consumption dictating a time order sequence of

consumption after income data. We randomly assigned each household a day for

conducting the weigh days. On the designated day a member of the team would arrive in

the morning at 7 a.m. and spend the day recording, measuring, and counting each item

that entered the physical limits of the household, the person who brought the item, and

where she or he got it until 6 p.m. This method served as a direct measure of a typical

daily household consumption in the broadest definition. During the weigh day, we

recorded the gender and age-disaggregated household composition for analysis of

consumption per capita. The total resources "consumed" by the household can be

divided by the household composition for that specific day. We used a measure of who

was present for the main meal or who slept in the residence the previous night as the

estimation for household size (Shell-Duncan and Obiero 2000).

Each item entering the household during the weigh days needed an assigned

monetary value. While there are several ways to assign value including nutritional value,

exchange value, spiritual value, and economic value, the purpose of my study was to

capture the effect of the economic aspect of income on the health and nutritional status of

the population. Using the market value presents limitations in that the value may not








represent the true value of the items to the villagers (Wollenberg and Septiani Nawir

1998). There is also a trade-off of comparability across villages. Information on

perceptions of the nonmonetary value of items such as prestige and status was garnered

throughout the field experience through daily interactions with the Tsimane' (e.g., pasta

noodles over rice for festivals; alcohol over chicha in the more integrated communities).

In a situation where villagers are not accustomed to discussing price values of items

because they are only familiar with barter using ajatata panel as currency, price proxies

are less valid (Wollenberg and Septiani Nawir1 998). To manage this, we established

imputed values (estimated monetary value not directly derived from cash exchange) for

barter and weigh day consumption items (Wollenberg and Septiani Nawir 1998). Many

of the items that entered the households during the weigh days are nonmarketed products

and intended solely for home consumption. Monetary valuation was difficult as it relies

on assumptions or personal opinions about the value. One way in which we addressed

this obstacle was through recording the time spent to acquire the resource. Using these

data, a monetary value was calculated by multiplying time spent collecting the item by

the daily wage (cf. Wollenberg and Septiani Nawir 1998 for detailed discussion of

estimating incomes in forest environments).

Module 3: Measures of Illness and Diet

I designed the health component of the study in two parts to capture both perceived

and objective measures of individual health status to be used as dependent variables in

the multivariate analysis. This third module includes recall surveys of perceived health

status and dietary intake. We conducted the illness and diet surveys during a single visit

to the household, treating both as subjective measures. In the fourth and final module of

the quarterly schedule of data collection, objective measures of nutritional status are








taken and will be discussed in the next section. Individual nutritional status is affected by

episodes of illness and dietary intake, thus it followed in the time order sequence.

Self-perceived illness and treatment utilization

Illness and disease can be studied through several methods. Recording health data

using symptoms checklists over a designated time period is one common method.

Clinical diagnosis of illness, considered a more accurate method, was not possible in this

study due to lack of trained medical personal. I decided on self-perceived illness recalls

instead of symptoms checklists because I was interested in collecting data on more

specific representations of illness and disease. Self-perceived illness recall is one of the

most common methods in developing countries (Murray and Chen 1992). Collecting

detailed data about a subject's perception of their illness episode affords me flexibility to

aggregate data into broader diagnostic categories such as respiratory or gastrointestinal

illnesses.

Self-perceived illness was measured for each adult through quarterly recalls of any

ailments, sickness episodes, or other claimed health conditions for the period seven days

prior to the interview. Interviews were conducted with all members of each household

over age 13. Parents, generally mothers, were interviewed regarding their children

younger than 13 years of age. Women were selected because they are the household

members who have the most regular contact with children and, therefore, are most

appropriate for eliciting recent health information. Therefore information about child

health was as perceived by the parent or caregiver. We asked if they had experienced any

illness or health problems in the past seven days, and if so, to describe the type of illness.

In addition to the type of illness, we recorded length of illness in days, number of days

confined to the bed, and information on patterns of seeking treatment (Ryan 1998;








Scrimshaw and Hurtado 1987). For each illness, we inquired as to whether or not a

treatment was sought for the illness, the specific treatment applied, at what point during

the episode it was sought, and the costs in cash or time incurred to the individual or

household. Attempts to illicit free-response as to the reason for preference of one

treatment type over another proved not to be as useful for quantitative analysis but

provided interesting qualitative insights. At the same time, we recorded information on

the habits of alcohol, tobacco, coca leaf, and chicha (thick corn or manioc beer)

consumption for all adults during the last seven days.

Dietary information

The study of diet and nutrition can be achieved by evaluating individual food

acquisition, expenditures, diet composition, distribution and availability of food

resources, or seasonality through a combination of observations, measurements, and

survey interviews. In selecting methods for collecting dietary data, I considered the

range of options available. Because of the labor and time required for accurate and

detailed food consumption data, researchers often select only a few sample households in

a community and study them in-depth during dry and wet seasons for anywhere from

three to ten days (Behrens 1986; Forline 1997). Data are then analyzed and extrapolated

to generalize about the larger population. Given, that the other components of our study

were being addressed at the individual-level, I needed a method that I could use with all

the households in the sample to collect data specific to those households rather than

generalizing from a smaller sample. Moreover, because we would be living in the

communities for 18 months we would be able to collect data more than just during peak

dry and wet seasons to capture greater variation in resource availability.








There are trade-offs between precision, sample size, and bias introduced by

researcher presence during meals (Pao and Cypel 1996) when planning a dietary study in

the field. I decided on twenty-four hour dietary recalls and the accompanying trade-off

of a larger sample by recall, over an intrusive observational method. I chose for our team

to conduct recalls in all sample households to get at individual-level dietary patterns.

Twenty-four hour food recalls are a good option for our field setting in that they are not

as invasive as weighed food observations, yet are more specific than food frequencies. It

is a method easy to learn and has the advantage of being respondent driven (Cassidy

1994). Limitations to the twenty-four hour recall method include the generation of

accurate but not as precise data. Moreover, some foods may systematically go

underreported, for example, foods that are eaten away from the home, in small quantities,

with less frequency, or are seen as culturally inferior (Ulijaszek and Strickland 1993).

Another limitation is knowing the quantities consumed by each individual compared to

the quantity prepared by the cook.

Initially, we began this module by visiting households we knew were present in the

community on a particular day. After the first quarter, we changed the protocol to ensure

more randomized visits. In each community, we grouped households geographically into

three or four sections. We then assigned a random order to each group for conducting the

surveys. Any absent households were revisited on a fourth day.

Twenty-four hour dietary recalls were conducted quarterly with the household

member primarily responsible for food preparation, most often the female head. She

often received recall assistance from family members present at the time of interview.

The subject was asked to recall all the foods prepared and/or consumed by members of








the household in the twenty-four hours prior to the time of interviews. Typically, we

began with the most distant meal. Portion size was difficult to establish, but was aided by

the discussion of common containers used by the Tsimane' such as the tutuma gourd

(Crescentia cujete) or plastic drinking cup. The specific foodstuffs and modes of

preparation were recorded along with the state (e.g., raw, cooked, ripe, or unripe) and

portion size to the possible accuracy allowed under these conditions.

An important limitation to both weighed and recall methods is related to the

disjuncture between methods of assessment and the actual eating practices of populations.

Food habits that favor group over individual consumption for cultural and or economic

reasons make this method difficult to execute (Cassidy 1994). When people eat from a

common pot, it is almost impossible to collect individual-level data (Cassidy 1994;

DeWalt 1983; Quandt 1996), although the method can be somewhat modified to include

direct observation. Mid-way through our field research it became evident that this

method was more easily carried out in San Antonio than in Yaranda because people eat

from individual plates more often and have better understandings of standard weights and

measures. This made it more feasible to achieve individual portions and composition of

meals. In Yaranda, there is a greater tendency to eat out of a common pot rather than

individual plates that make portion recall less accurate and individual-level data almost

impossible. Apart from intrusive observations and measures of actual portions prior to

consumption, diet data are difficult to obtain. As it was, this was culturally a strange

topic to be studying and we were often met with chuckles when we probed for greater

detail about meal composition.








Despite the above mentioned limitations, it was possible to differentiate among

market, farm, and forest derived foods. The best attempt was made to record accurate

intake data. The Tsimane' have a relatively monotonous diet in any given season, unless

there are seasonally gathered or harvested foods, or game. Therefore, our diet data are

taken more as a representation of any given day in that quarter (Cassidy 1994) and may

be better aggregated to the household-level.

Module 4: Nutritional Status

One of the most widely used methods in the assessment of nutritional status is

anthropometric measurement. Anthropometry involves measuring different dimensions

of the body to determine aspects of body composition. Several of the most common

measures include height, weight, skinfold thickness, and waist and hip circumference.

The benefits of selecting anthropometric methods for assessment of certain components

of nutritional status include low cost, ease of training, and less user interpretation

compared to survey techniques. Another benefit is that these measures are more readily

interpreted by the participants and aid the researchers in explaining and sharing results.

However, interobserver checks are necessary when using multiple personnel (Ulijaszek

and Strickland 1993; Zemel et al. 1997). One limitation built into anthropometric

measurements is a lack of specificity or the ability of a measurement to estimate causality

behind a nutritional problem (Keller 1991). For example, a child who is assessed as short

for her or his age may have experienced prolonged periods of nutritional stress, or have

two particularly short parents.

Our team obtained anthropometric measurements on each individual to monitor

physical growth and development at quarterly intervals. We also asked each woman if

she was pregnant and/or lactating at the time of measurement. Every three months we








would set aside several days to conduct anthropometric measurements in communities.

Residents were invited to the central meeting area, usually the school (San Antonio) or

researcher's house (Yaranda), where equipment was set up in stations. We trained one to

two Tsimane' residents with elementary education to assist us in the measurements when

additional hands were needed. After participating, subjects received refreshments and

cookies for their time and patience. It became a social affair for many and generally

there was a positive response, particularly in the more integrated community where

residents are more familiar with this type of measurement and outside contact due to

annual visits by public health vaccination campaigns. In Yaranda, there was slightly

more apprehension on the part of new mothers that we cannot fully explain, but appeared

to be related to less familiarity with this type of activity. One adult male in Yaranda

refused to be weighed during the course of the study based on his belief that he would

become thinner if weighed. He did, however, participate in all other modules of the

study. For those participants unable to travel to the school due to work commitments or

age, a final two to three days was dedicated to a mobile unit in which we hauled the

equipment to the households of missing subjects. The quarterly anthropometric measures

included weight, height, body fat through bioelectrical impedance, mid-arm

circumference, and skinfolds thickness. Each is discussed below.

Height and weight

Height and weight are two fundamental measures of nutritional status. We

measured the heights and weights of subjects while barefoot and without any hair clips or

headgear. Subjects were asked to remove any obvious objects from their pockets. In the

more integrated community of San Antonio there was a cement floor on which to set up

the equipment. There was no comparable surface in Yaranda, so a wood board was








placed under the scale and the anthropometer was placed on the flat packed dirt floor of

the researchers' home. Recumbent length, rather than height, was taken for children less

than two years old and unable to stand unassisted on the anthropometer's surface

(Frisancho 1990). Subjects taller than one meter were measured on the digital Tanita

TBF-551 Body Fat Monitor Scale. Children measuring less than one meter in stature

were weighed on hanging scales. In a few isolated cases, small infants were weighed

with mothers, arriving at their weight by subtracting the mother's weight, an acceptable

methodology for these circumstances (Frisancho 1990). For the most part, it was

attempted to weigh infants independent of mothers in hanging balances.

Skinfolds thickness

Caloric status and growth progress can be assessed through measures of

subcutaneous fat, lipids, triglycerides, hemoglobin, hematocrit, and serum and urinary

vitamin concentrations (Gain 1991). A good and less invasive method for assessing

variation in energy supplies and lean body mass is the measurement of skinfolds of key

locations on the human body (Jelliffe and Jelliffe 1989). A simple caliper is used to

measure the fat that pulls away from different sites on the body. Triceps and subscapular

skinfolds are the most important sites for measurement (Zemel et al. 1997), and are good

indicators of short-term nutritional status. Other areas on the body include the bicep,

supra-iliac, inner thigh, and calf skinfolds. Practical considerations such as comfort of

the subject with her/his need to remove clothing in order to reach the site factored into

our selection. Our team used Lange calipers to take measurements of skinfolds on four

sites: triceps, bicep, subscapular, and suprailiac. We also used a flexible measuring tape

to measure the upper arm circumference at the midpoint between the elbow and shoulder

for calculations of muscle.








Limits in precision or consistency also exist in the skinfold method. Estimating

body fat and composition with skinfolds measurements can be plagued by the problem of

compressibility, which increases the potential for introduced error. Skinfolds

compressibility is age and sex dependent, with variation across body site as well

(Frisancho 1990; Garn 1991). Due to changes in skin elasticity in older subjects, there is

a tendency to pinch lean matter, as well as fat, leading to overestimations of actual fat

stores. Interobserver bias in locating the skin landmarks can also affect results (Bailey

1991; Gain 1991). There was some indication of interobserver error/bias between

skinfold measurements taken in San Antonio and Yaranda, specifically in measurement

of triceps skinfold thickness.

Clothing adjustments

Layering of clothing can introduce error into anthropometric measurements,

particularly with adults where the researcher is unable to measure hip circumference

directly on the body. One way to deal with this is a standard adjustment for clothing

allowance on the measurements. During our fieldwork, participants often dressed up for

the anthropometric measurement days, which might mean women are in full dresses

making access to their waists difficult. Because we conducted data in a public rather than

clinical setting, it was impractical to expect subjects to disrobe for the measurement. It

was more feasible to take direct measurements on the skin of adult males and children

while adult females women who wore a one-piece dress had to be measured over

clothing. Clothing adjustments were made at the time of recording. We subtracted 0.5

mm from any skinfolds measure taken over clothing.








Other Methodological Notes: Provision of Health Services

As part of our commitment to provide services to the community, the two sets of

researchers in the panel study maintained a basic first-aid kit or botiquin for minor

ailments in each community. We did this in response to a request by the two

communities in the initial terms of our research. Although I was initially concerned with

the impact of the botiquin on the study, ethically we could not refuse this request. To

mediate any influence, we kept written record of the individuals, illnesses, and

medications disbursed throughout the year. The medical care we provided left a positive

impression of our study on the welfare of the communities. Additionally, we intervened

in emergency medical situations to facilitate access to medical care including assistance

with transportation and loans for treatment.

Conclusion
There are both advantages and limitations to each of the methods we used in the

field. Part of developing a good research design involves investigating the range of

options available and making decisions about what is feasible in the field given human

and economic resource constraints. In my study, three different aspects of human health

were measured and serve as the dependent variables in my analysis of market integration

and acculturation. Each area, self-perceived health status, diet, and nutritional status,

represents a slightly different element of welfare and is subject to modification with

changes in economic and social participation. Before discussing the analysis of the data

collected using the described methods, I shift the focus to provide ethnographic

background and history of the Tsimane' people in the next chapter.













CHAPTER 3
TSIMANE' HISTORY, ETHNOGRAPHIC BACKGROUND, AND MODES OF
SUBSISTENCE

Varios siglos de relacionamiento con la sociedad dominante colonial y republicana,
no parecen haber comprometido tanto la sobrevivencia de los grupos 6tnicos
amaz6nicos de Bolivia como lo hace la penetraci6n capitalista de la filtimas
d6cadas y la consecuente expansi6n del Mercado intemo (Rioja Ballividn
1996:150).

Many centuries of contact with the dominant colonial and republican society, does
not seem to have compromised the survival of the Amazonian ethnic groups of
Bolivia as has capitalist penetration in the last decades and the consequent
expansion of the internal market [translation by author, (Rioja Ballividn
1996:150)].

Introduction
The history of the Tsimane' people, like many Amazonian groups, has been

influenced by dominant political, social, and economic forces at an increasing pace since

the arrival of the Europeans to the Americas. While we know little about the specific

social and economic trajectory of the Tsimane' before 500 years ago, common themes of

domination, attempted missionization, territorial encroachment, economic integration,

and cultural assimilation emerge when examining their history since European contact.

These widespread stresses and strains do not manifest themselves in a singular way, but

rather, they are multidimensional and affect the cultural and physical survival of tropical

peoples in different ways. My dissertation examines the case of one specific ethnic group

living in the tropical forests of Bolivia to understand how increased contact,

socioeconomic expansion, and economic integration affect their health and welfare. To

analyze how more recent pressures affect individual welfare and livelihood it is helpful to








first look back at what is known about the history of this people leading up to the time of

research. This chapter presents a brief ethno-history of the Tsimane' people, and

describes their political organization and mode of subsistence. The description draws on

a review of the available literature on the Tsimane' as well as data and observations

collected during my fieldwork.


Figure 3-1. Location of the study area within map of Bolivia, courtesy of David Wilkie.

Historical Background

Sources of Information about the Tsimane'

The Tsimane' Amerindians are classified as a Tropical Forest Culture (Lathrap

1970). They inhabit the tropical forest and border savanna regions in the lowland Jos6

Ballividn province, of the Beni department of Bolivia (Figure 3-1). The two closest

regional population centers to the Tsimane' communities we studied are the towns of San








Borja (pop. -16,273) and Yucumo (pop. -3,090) (INE 2001). Historical accounts, even

though few deal directly with the Tsimane', allow for a composite understanding of their

history in relation to the colonial powers in Bolivia. One important scholar, Erland

Nordenski6ld, conducted research in Bolivia in the early part of the twentieth century in

the sub-Andean, Chaco, and Amazonian regions. No published archeological studies

look specifically at the material remains in Tsimane' occupied territories. There are

references to human transformations on the landscape of a people preceding the

Tsimane', but not directly to any large-scale society of which they may have been a part.

While conducting survey work related to oil exploration for the Bolivia California

Petroleum Company and Bolivian Shell Ltd. in 1963, George Plafker attributed features

of the forest/savannah regions between San Borja and San Ignacio occupied by the

Tsimane' to some preceding group:

In the region inhabited today by the Tsimane', especially between San Borja and
San Ignacio, there are remains of large cannels, dikes, and constructed platforms to
drain and convert vast regions into cultivated fields. The elaborate works were
made by an industrious population preceding the Tsimane' [translation by author,
(Plafker in Portugal Ortiz 1978:31)].

Working elsewhere in the Beni, archaeologist Clark Erickson (2001) continues to

investigate raised roads and canals constructed by PreColumbian populations living under

similar ecological conditions as the Tsimane'.

The Tsimane' are not unique in their geopolitical history, rather, in a broader sense,

they share similar patterns with other peoples of South America's Amazon region

(Nordenski6ld 1924; Steward 1948). Knowledge of ethnic groups in the Bolivian

lowlands prior to European conquest is varied and concentrated on several larger groups

such as the Moxos. There is little specific historical reference to or documentation of the

Tsimane' themselves, and recent publications (Chicch6n 1992; Ellis 1996; Huanca 1999;








Piland 1991; Reyes-Garcia 2001) summarize the available historical information before

adding their own contributions to our knowledge about the Tsimane'. The history of the

Tsimane', is therefore, a composite portrait painted by a small group of scholars drawing

on limited primary resources that specifically document Tsimane' history. Tsimane'

mythologies and oral histories have been recorded by anthropologists Jurgen Riester

(1993) and Tomds Huanca (1999). More recent efforts to preserve mythology (Daillant

1994; Mayer and Caymani 2000), ethnobotanical knowledge (Nate, Ista, and Reyes

2001), and hunting practices (Mayer et al. 2000) have been promoted through

collaboration with nongovernmental organizations (NGOs) working with indigenous

cultures in the Bolivian lowlands and involvement of Tsimane' investigators aided by

second-party researchers.

The Mission Period and Ethnic Distinction

Scholars accept that prior to European contact, the Beni region was inhabited by

tropical forest chiefdoms (Deneven 1966; Jones 1980). It is not explicit, however, if the

Tsimane' were included in one of these groups. Jesuit contact with indigenous groups in

the Bolivian Amazon dates back to the 1500s with the initiation of Spanish colonization

of the Americas. The arrival of the first Europeans initiated ongoing contact by way of

attempted missionization. The written history of missionization in the region in large part

focuses on the larger Moxos group with some reference to the Tsimane' (Block 1984;

Denevan 1966; Hermosa Virreira 1986; Lathrap 1970). Franciscan priest Gregorio de

Bolivar is identified as the first individual to mention Indians in the Moseten/Tsimane'

area in 1621 (Metraux 1948:486), in his description of the Spanish myth of a rich

kingdom of Moxos, known as El Dorado. The Moxos were successfully missionized








while other native groups including the Yuracare, Siriono', and Tsimane' are described as

"marginal" or "savage tribes" because of failed attempts to Christianize them.

Tsimane' ethnogenesis, or origin of a distinct ethnicity, is not entirely certain.

Denevan (1966:43) referred to the Tsimane' as one of several "marginal savanna tribes"

living in gallery forests, forest patches, and along the margins of the Moxos savanna.

Colonial writers mentioned the Tsimane' under various names: Chimanisa, Chumano,

Nawazi-Mofitji, and "closely related to Moseten" (Metraux 1948:486). The Moseten,

another ethnic group living along the Bopi, Beni, and Quiqiuve Rivers (Metraux 1948),

have been described as having links to Aymara groups and may have been subjugated by

the Incas. Today, there is some intermarriage between Moseten and Tsimane' and both

groups identify as being close relatives. The Moseten and Mojenos also reportedly see

the Tsimane' as brave hunters and workers, but at the same time as more primitive

because they lack a fixed residence throughout the year, hunt with bow and arrow, and

though uncommon, still practice polygyny to some extent (Riester 1993). As will

become evident throughout this chapter and dissertation, to characterize all Tsimane' as

migratory bow and arrow hunters denies the diversity that exists within the ethnic group

today. Nevertheless, comparisons are found in the literature between the Moseten and

Tsimane', asserting that the Moseten are more acculturated than the Tsimane'. For

example, in 1948 Metraux compared the Moseten to the Tsimane' as "thoroughly

acculturated" while the Tsimane' "still retained much of their aboriginal mode of life of

30 years ago" (Metraux 1948:487).

Further comparisons of the Tsimane' to the Moseten allude to an ethnogenesis

stemming from missionization efforts. Castillo writes that the Tsimane' "suffered their








first group fracturing in the colonial period when one part of their population, the

Mosetenes, were integrated and resettled into the Franciscan Missions" (translation by

author, Castillo 1988:5). According to this account, the Tsimane' were then

distinguished from the Moseten in that they were not successfully missionized by

colonial institutions. Still, it is difficult to document first contacts with the ancestors of

present day Tsimane' because of the generic terms used by the colonizers for all

Amazonian societies. For example, an early account (1538) by missionaries refers to the

lowland Amerindians presumed to be the Tsimane' as "chunchos" (Ellis and Arduz

1998:2). Likewise, Mission San Borja is documented as having 3000 Indians "de la

nacion churimana" in 1693 (Ellis and Arduz 1998:3).

Faied Missionization

Beginning in 1668, the Jesuits settled in the Beni region and established more than

25 towns (Reyes-Garcia 2001). Mission San Francisco de Borja was established in 1693

along the banks of the Maniqui River. The present day town of San Borja stands a few

kilometers from the site of the original mission. The Indians associated with Mission San

Borja have been referenced with various names. There is record of attempts by

missionaries to offer trinkets to pacify Movima or Churimana peoples (Chicch6n 1992).

In the 1690s, Indians in several of the missions in the upper Beni rose up against

Dominican priests, setting fire to the buildings. The revolt was led by a nonspecified

Moseten/Maniqui/Chimane native group, as a resistance against missionary dominance

(Chicch6n 1992). Despite their continuous presence in the area for over two centuries,

Jesuit efforts did not succeed in converting the Tsimane' to a sedentary society (Dalliant

1994). In 1767, the Spanish Crown expelled the Jesuits from all its territories leading

many to speculate that the Indians in the missions must have fled back to the forest at that








time (Chicch6n 1992). Hermosa Virreira (1986) provides a map of the forest tribes and

Franciscan missions in Bolivia around 1883 which places the Tsimane' in a region

without missionary presence, lending support to this assumption. Chicch6n (1992)

proposes that a lack of centralized Tsimane' leadership and an extensive resource strategy

as a pattern of subsistence contributed to their difficult or impossible missionization by

Europeans. This apparent failed missionization is significant for the social and economic

trajectory of the Tsimane' people during the nineteenth and twentieth centuries as it

enabled them to preserve a more autonomous cultural heritage.

Linguistic Origins

Tsimane' linguistic origins are often linked to the language spoken by the Moseten

people as part of an isolated Bolivian lowland language family (Chicch6n 1992).

Denevan states that along with the Moseten, the Tsimane' form an independent linguistic

group in the Beni (Denevan 1966; cited by Rioja Ballividn 1996). Their relationship to

other South American lowland linguistic groups is less clear, with possible ties to a

Macro-Pano family along with the Ge'-Pano-Carib group (Chicch6n 1992), the Tacan

family group, a Aruaco dialect (Hermosa Virreira 1986), or related to the Arawak

speaking Moxos who were gathered into missions (Lathrap 1970). Today, the Tsimane'

maintain their own language distinct from the dominant national language of Spanish.

While Spanish facilitates market interaction, it is known to varying degrees with better

comprehension among males and the political elite. Twentieth century protestant

missionaries were the first to transcribe the Tsimane' language and continue to compile

dictionaries and grammars.








Bolivian Independence and Economic Development in the Beni

In 1825, Bolivia gained its independence from Spain. The Republican era is

characterized by the extraction of natural resources from the Beni region. From 1882

forward, white migration into the Beni increased as opportunities for economic

exploitation through extractive activities grew. Resources of interest for the international

market included vanilla, quinine, cacao, and later rubber. The indigenous peoples of the

Beni were used as slave labor in the rubber industry, an abuse common throughout the

Amazon. The population increase in the Beni during the rubber boom led to greater

market demand for beef resulting in the growth of cattle ranching in the region.

In 1912, the rubber market collapsed and cattle ranching took over as the dominant

economic activity in the Beni (Jones 1980). The white elite built large ranching estates

and continued to rely on the indigenous people as a source of cheap labor. In the 1940s, a

rise in national beef prices made cattle ranching an even more lucrative and attractive

endeavor (Jones 1980). The advent of air transport into the Beni department supported

the increase in supply to meet the growing demand. During the same period, a market for

animal pelts, such as black caiman, involved native groups in roles as forest guides and

later traders. Agrarian Reform policies favoring colonization of the Bolivia's tropical

lowland departments in 1953 made large ranches in savanna lands legal property of

individuals. The ongoing expansion of the cattle industry has led to the cutting of

forestlands to make way for additional pasture (Piland 1991).

In 1975 a road linking San Borja to the departmental capital of Trinidad facilitated

colonization programs and export of goods from the Beni. Quechua and Aymara

colonists flocked to the Beni in search of a new life and to escape poor quality and








limited land resources in the highlands. They primarily engaged in rice cultivation and

some logging activities (Reyes-Garcia 2001).

In more recent times, the Beni region, specifically San Borja, has earned an

illustrious reputation through a history of involvement in the processing of coca leaf for

the cocaine industry. These activities, which flourished throughout the 1980s, did not

directly affect the Tsimane' and have reportedly ceased or at least declined significantly

today. Many of the contemporary elites running San Borja have an infamous history of

wealth acquisition. Today, logging and ranching are the dominant economic activities

with colonist-led agriculture important as well.

Twentieth Century Missionary Influence

Catholics

The 1950s have been described as a re-awakening of the missionary movement that

would profoundly affect the Tsimane' (Chicch6n 1992). During this period, Catholic

missionaries from the Redemptionist order arrived to the upper Maniqui River. They

established a mission at Cara Cara in 1953. Later the mission was moved to an offshoot

of the Maniqui River, the Rio Tsimane', and renamed Misi6n Fdtima. Several priests

passed through Fatima, with the most significant impact made by Padre Martin Baur who

arrived in1958 with the intent of teaching cattle ranching techniques to the Tsimane'

(Chicch6n 1992; Fr6sand Joly and Moreo Cuella 1999). Padre Martin lived with the

Tsiinane' in Misi6n Fdtima from 1958 to 1996 when he left for health reasons and died

the following year. While he failed in a large-scale introduction of cash crops of cacao

and coffee, he established a mission health post and school, training two Tsimane'

women as nuns in the Catholic Church. The physical structure of Misi6n Fdtima still

endures today with some activities organized by the Tsimane' living in the community,








however, there is no missionary stationed there. During our research from 1999-2000,

Tsimane' residents of the community of Misi6n FAtima are not welcoming to

anthropologists or other outsiders who might travel up the Maniqui to the Rio Chiman

where the mission stands.

New Tribes

Another twentieth century missionary force, which continues to influence the

Tsimane', is the Misi6n Evangrliga Nuevas Tribus (New Tribes Mission) based out of

San Borja. New Tribes was founded in 1940 to offer assistance to ethnic groups

marginalized from national cultures (Castro Mantilla 1997). Their international

headquarters are located in Sanford, Florida. New Tribes entered into Bolivia and was

officially recognized as a legal body in 1943. The evangelical protestant organization has

worked with eight indigenous groups in Bolivia, including the Tsimane', offering

linguistic studies, training of bilingual teachers and health promoters, establishing health

posts, donating medicines, initiating agricultural and livestock programs, and completing

their moral and spiritual mandate by translating the Bible into the Tsimane' language.

Their center of operation, Horeb, is located on the periphery of San Borja and run by two

American couples belonging to the organization. The initial strategy of New Tribes was

for missionary families to establish residence among the Tsimane' in the community of

La Cruz, translate the Bible, and work on producing religious and educational materials

in the Tsimane' language. Later, the New Tribes became a voice against the exploitive

relationships between river traders and the Tsimane'.

In 1989, New Tribes backed the organizing of the Gran Consejo Tsimane', the

officially recognized leadership body of the ethnic group whose purpose at inception was

to represent the forest interests of the Tsimane' population. The formation of the Consejo








can be analyzed from two perspectives. On the one hand, it is a form of resistance to

threats of encroachment on Tsimane' occupied territory, while at the same time, it is also

a symbol of Tsimane' acculturation into the politics of power and privilege as the close-

knit, well-educated Consejo members spend resources on maintaining their image and

legitimacy under camba (Spanish term for lowland white Bolivian culture) norms which

include public displays of material wealth. Members of the Consejo have privileged

access to resources marking a distinct socioeconomic stratification among the Tsimane'

people. In a publication by members of New Tribes, the Consejo's president is claimed

to have stated that the older members of the ethnic group are illiterate and alcoholics and

therefore unable to represent on behalf of the group to the Bolivian government (Kempf

and Kempf 1996).

Within the last half-century, religious conversion has operated as a strong mode of

cultural assimilation for many of the Tsimane', particularly through the opportunity of

bilingual education. The New Tribes mission provided many Tsimane' with an

opportunity to learn Spanish and study in mission schools. In September 2000, close to

30 Tsimane' adults (two of whom were female7) graduated with high school diplomas.

This was a significant achievement for the Tsimane' people as a whole and in large part

attributed to the initial push by New Tribes to train bilingual teachers. The majority of

Tsimane' teachers have come from the New Tribes adopted community of La Cruz.

Another fundamental influence of missionary presence has been the altering of

traditional settlement patterns (Rioja Ballivi~n 1996). The Tsimane' traditionally

practiced a high degree of seasonal migration through visits to extended family


7 One of the women is the wife of the professor in San Antonio.








settlements. The presence of the evangelical mission and the establishment of schools

encouraged settlement of households in closer proximity around newly organized

community hubs. There are still some households that prefer to be more isolated, but

tend to become marginalized as the schools and soccer fields have become the focus of

community social activity. Dalliant (1994) noted that settlements used to be organized in

a west-east, circular fashion with a chief at one end and a shaman at the other. She also

described a history of Tsimane' shamans able to communicate with the spirit-owners of

the trees, salt, animals, fish, and ancestors, but few recognized shamans exist today. One

example of Tsimane' beliefs about residences maintained today is the practice of burning

the residential structures when a death or serious illness occurs in the household. A new

home is then built to avoid evil spirits (Ellis and Arduz 1998; Pdrez Diez 1985).

Chicch6n (1992) views community formation as a reaction/response to several

factors including land restrictions, the construction of schools, and the establishment of a

corrigedor representative parallel to the national system adopted by other native groups.

It could be argued that there was no organized authority at the general group-level until

the New Tribes Missionaries came to work with the Tsimane'. The organization has

made significant contributions to the improvement of Tsimane' education while at the

same time created greater social inequality as only a small group gained skills through

acculturation and teacher training.

The influence of New Tribes on the religious orientation of the Tsimane' varies,

often depending on proximity to communities where they have had a greater presence.

Traditionally animistic (Reyes-Garcia 2001; Riester 1976), many Tsimane' self-report

being nominally Catholic or Evangelical without any active participation in the religion.








Still others attend workshops at Horeb and can be found reading the Bible translated into

Tsimane'. In the more remote study community of Yaranda a group of residents gather

on Sundays to listen to cassettes with religious messages prepared by New Tribes and

recorded in the Tsimane' language.

Social Organization

Political Organization

Nordenskitld's recounting of Tsimane' social organization in 1922 noted an

absence of chiefs or adults commanding one another. The following quote by him

describes an inability for Tsimane' to act together and improve their lot against white

incursion due to the individualistic nature of the society.

Para ellos actuar en comn es imposible porque cada uno tiene su propio camino y
no es otra raz6n por la que los chimane no puedan levantarse. Su mayor arma de
defensa es escapar; selva adentro, dejando sin amparo a los flojos blancos
(Nordenskiild quoted in Riester 1993:96).

For them, acting together is impossible because each one has their own path and
there is no other reason in that the Tsimane' could rise up in protest. Their best
defense is to escape into the jungle, leaving the slow whites without defense
[translation by author].

In 1988, Castillo described the Tsimane' as a classless society, apart from age and

gender categories carrying certain privileges and social differences. Fourteen years later,

this characterization, whether originally accurate or not, does not hold. The all-male

members of the Gran Consejo Tsimane' enjoy a privileged status of access to resources,

respect, and opportunity not afforded to the general members of the ethnic group. They

show clear signs of acculturation, adopting the Borjano emphasis on material wealth.

Tsimane' teachers and their families also enjoy a position of status based on their

educational attainment, authority in the community, and acculturation. While there does

not exist the exaggerated machismo characteristic of Bolivian camba culture, there is








some marginalization of women in decision-making. Most of the trained teachers and all

community leaders are male. Within each community there are three authority roles or

representatives of the community to the Gran Consejo and to outside groups: the

Corrigedor (chief), Presidente de Junta Escolar (President of School Union), and Alcalde

(Mayor), based on a common system used within Bolivian communities. These roles are

held exclusively by males and lack any component of systematic rotation.

The larger body of Tsimane' people does not actively participate in local or

national politics to any significant extent. During political campaigns, candidates for

local municipal offices visit the easily accessible communities such as San Antonio and

give speeches to community members. One tactic employed by campaigning politicians

is to send individuals familiar with the communities ahead, such as agronomists from

development projects, to earn the trust of the residents. The Tsimane' speak of rumored

donations of rice or other food staples by candidates and will drop their work to flock to

another community with the hope of a donation. By casual observation, it is estimated

that less than 25% of the residents of San Antonio were even registered to vote in the

elections of November 1999. However, on election day, I observed many residents of

nearby communities in line to vote in San Borja without a registration card.

Kinship System

Traditional Tsimane' marriage patterns followed a Dravidian system of cross-

cousin unions (Dalliant 1994). This is followed by marriage with one's mother's

brother's daughter or son, or father's sister's son or daughter (Chicch6n 1992; Dalliant

1994). This cultural form of prescribed marriage pattern has eroded and cannot be

consistently documented in the present time. From our study in the remote community of

Yaranda, the researchers noted the abundance of single males of marital age without








anyone appropriate to marry according to the above prescribed rules. By contrast, in the

more integrated community of San Antonio, there are several examples of exogamous

unions with non-Tsimane'. With these mixed marriages, there is a tendency for the

ethnic identity to be diluted through a preference in Spanish language acquisition and

communication for the offspring rather than the Tsimane' language.

Post marital residence patterns have been described as initially matrilocal

(Chicch6n 1992) with some polygyny and only rare cases of polyandry (Dalliant 1994).

The evangelical protestant missionaries discouraged polygyny and incorporated this

teaching into the schools. A few cases of sorrel polygyny have been documented

recently (Huanca 1999; Reyes-Garcia 2001; Rioja-Balliviin 1996). A 1996 survey

conducted by Godoy found polygyny among the Tsimane' to be around five percent.

Territorial Rights and History

La Conquista no ha cambiado en su esencia; ha cambiado en su forma y su
mrtodos, pero el contenido sigue siendo el mismo: conquistarlo para fines ajenas a
los indigenas (Riester 1993:12).

The Conquest has not changed in its essence; it has changed in its form and
method, but the content continues to be the same: conquering for interests foreign
to indigenous peoples [translated by author].

There is no individual land tenure among the Tsimane'. Land is considered to be

under communal ownership of the residents of a community. Tsimane' land tenure

interests have undergone steady assault from more powerful interests. In the past

century, despite advances made in the process of land titling, traditionally occupied

Tsimane' territories remain vulnerable. The expansion of logging activities into the Beni

region in the 1970s threatened forest resources in territories occupied by the Tsimane' as

well as other indigenous groups. As a response to logging activities, in 1978 the Bolivian

government created the Chimane Forest Reserve (Reserva Forestal de Immovilizaci6n








"Chimane") through Supreme Decree 15585. In 1986, the status was changed to Bosque

de Producci6n Permanente through Supreme Decree 21483 (Rioja et al. 1993:227),

making logging concessions possible in the territory. This essentially undermined any

notion of a protected reserve. In October 1982, the Estaci6n Biol6gica del Beni (EBB)

was created as a protected area through requests of the Bolivian National Academy of

Sciences. The EBB includes part of the Tsimane' territory along the lower Maniqui

bordering the community of San Antonio. After failing to recognize the presence of

indigenous people in the reserve, UNESCO re-assigned it as a Man in the Biosphere

designation in 1986 (Chicch6n 1992:3). The EBB gained international recognition in

1988 as the first case of national debt for nature exchange when funds were allotted for

conservation activities and administration negotiated through Conservation International

(Piland 1991).

In line with the initial purpose of the Gran Consejo Tsimane' to represent Tsimane'

territory interests, the first act of the newly formed Consejo on May 4, 1989 was to gain

recognition of Tsimane' territory. Prior to any formal leadership body, the Tsimane'

were more vulnerable to traders introducing alcohol as a means of exploiting indigenous

labor, to loggers illegally cutting down their forests, and to colonists dynamiting their

river resources. Similar land rights and encroachments are prominent issues for other

indigenous in the region as well. In 1990 indigenous peoples of the Beni demonstrated in

the Marchapor la Dignidady el Territorio. More than 700 indigenous people from

various lowland groups marched for more than 650 km for a total of 34 days up to the

national capital of La Paz. Tsimane' participation in the event was low, given that they








were granted their own territory through a Supreme Decree by the national government a

few days prior (Rioja Ballividn 1996).

Despite the national policies and protection efforts by the EBB, Tsimane' occupied

land is still at risk of encroachment. In the larger cross-section survey of 58 communities

conducted within this research, we found communities to report an average of 6.5

conflicts with outside interests over the last 12 months. These include conflicts with

ranchers, loggers, colonists, other communities, and traders. At the end of our fieldwork

in 2000, an attempt to sort out legitimate third party land claims from unverified claims

of ownership within Tsimane' was underway. The process involved plotting the claimed

land boundaries of all third parties occupying the area. This includes private settlers,

cattle ranchers, and collective colonial migrants. To some extent, the Tsimane' have

been successful in defending their territory for the last few decades of the twentieth

century by rejecting external influences and preserving their own norms and values

(Riester 1993). However, threats to their territory are increasing through migration and

settlement by highland colonists as well as encroachment by loggers and cattle ranchers.

San Antonio, which is bordered by the mestizo community of Santa Elena, is particularly

subject to encroachment as lowland mestizo and highland colonist expansion presses up

against and threatens community boundaries.

Population

Today, the majority of Tsimane' households are congregated within gallery forests

in communities or household clusters along the Maniqui River. Smaller populations of

Tsimane' also reside in the Pilon Lajas Reserve, Multiethnic Territory, and the Isiboro-

Secure National Park (Huanca 1999). As with many remote indigenous groups,

particularly in tropical forest climates, there is little accurate national-level demographic








data on this group. Recent population figures were 5,124 in 1995 (Government of

Bolivia 1995) and 7,385 in 1999 (Vice Ministry of Indigenous Affairs 1999). Their

marginal geographic location has been overlooked during census taking and formal

record keeping is not part of the institutional structures with which they come in contact.

There has also been difficulty in estimating the Tsimane' population due to movement

between settled areas. My own experience living with the Tsimane' informs me that the

problem is primarily a lack of effort on the part of national agencies to venture out to

Tsimane' communities and count, rather than the mobility patterns of the Tsimane'.

Toward the end of our fieldwork we observed the efforts by national census

representatives to include Tsimane' households for the 2000 census by labeling

residential structures in preparation for the count.

Tsimane' Modes of Subsistence

At present, the Tsimane' mode of subsistence can be categorized as forager-

horticulture. Tsimane' households rely on acquiring food resources and other necessary

subsistence items from fishing, hunting, gathering, and cultivating crops on agricultural

plots in or near their villages. Over the past 50 years there has been increasing

involvement in the market economy. Thus, added to this complex livelihood strategy are

market-acquired resources. Each of the components of the Tsimane' livelihood strategy

is described below.

Horticulture

In a study of Tsimane' agricultural methods, Piland (1991) concluded that the

Tsimane' are better classified as forest horticulturalists, than as pure foragers, because of

the proportion of their caloric intake coming from their fields. Here, I employ the

classification of forager horticulturalists to distinguish them primarily through their








economically productive activities. Lee and Daly (1999) define foraging as subsistence

based on hunting, gathering, and fishing with no domestication of plants or animals,

except the dog. This fits well into the image of hunter-gatherers surviving exclusively off

of wild resources. However, empirical study informs us that not all foraging groups fall

into this strict definition, and most in fact, participate in subsistence-level cultivation or

horticulture (Carneiro 1974). Features that distinguish horticulturalists from other social

and economic forms of organization include the following typology outlined by Johnson

(1989): geographical distribution in the humid tropics, slash and burn methods of

subsistence-level cultivation, nuclear or extended family domestic production units,

village settlement, warfare, political leaders with a resource role, and only rare cases of

communal technology. There is variation from this typology and many horticulturalists

rely on hunting, fishing, and gathering of wild foods to supplement cultivated crops,

particularly as sources of fats and protein. Essentially, the composite label of forager-

horticulturalists describes a system where people forage for wild resources to

complement cultivated products.

Traditional Tsimane' crop production includes cultivation of manioc, maize,

plantains, peanuts, cotton, sweet potatoes, pineapple, and peach palm (Lathrap 1970:58)

for home consumption. As it is difficult to preserve crops in the archaeological record in

humid climates, much of the evidence is indirect, namely large pottery linked to manioc

beer consumption and fiestas (Lathrap 1970). Consistent with other manioc-based

cultural systems in the Amazon region (Dufour 1988), the Tsimane' grow sweet varieties

mainly for consumption as fermented porridge (shocdye' in Tsimane'; chicha in

Spanish), or a processed fine flour known in Bolivia as chive. Early Jesuit explorers








noted large maize fields, grown mainly for chicha. They observed the grinding of roasted

maize on stone platters (Denevan 1966:101). The Jesuits were responsible for

introducing cattle and African crops brought from Europe (e.g., rice, sugar cane, coffee,

and citrus-tamarind, oranges, lemons) into the Beni (Dalliant 1994). Rice is one of the

most important crops today for both home consumption and sale in the market. The

Jesuits probably introduced cacao (Denevan 1966:102) to the Moxos region although

there is wild cacao found in the forests.

Swidden cultivation, also known as slash and bum agriculture or shifting

cultivation, is a method of small-scale farming practiced throughout the Amazon. The

Tsimane' open plots averaging half a hectare (Vadez et al. 2003) using steel machetes

and axes each year for planting, beginning in late-May to August during the dry season

(Figure 3-2). Once all the trees are felled, the field is left to dry out before burning can

take place in late August to early October. After burning, a field is partially cleared and

then planted. The fields may be weeded once or twice before the harvest season. After

one or two seasons of cultivation, a plot is left fallow and often fruit trees are harvested

intermittently (cf. Huanca 1999 for detailed study of traditional fallow management

practices). This method of cultivation results in a variety of plots under different stages

of use and management (Dufour 1990). The Tsimane' do not traditionally use any

herbicides or pesticides on their fields. In recent years, some households have

occasionally used backpack sprayers acquired through agricultural projects to deliver

herbicides to their crops. However, the cost of buying the chemicals and problems with

early rains deter wider adoption of the innovation.




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