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THE ROLE OF MEDICINAL PLANTS IN RURAL PARAGUAYAN LIVELIHOODS
By
NORMAN BREUER MORENO
A THESIS PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF ARTS
UNIVERSITY OF FLORIDA
2000
THE ROLE OF MEDICINAL PLANTS IN RURAL PARAGUAYAN LIVELIHOODS
By
NORMAN BREUER MORENO
A THESIS PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF ARTS
UNIVERSITY OF FLORIDA
2000
Copyright 2000
by
Norman Breuer Moreno
For Bea
ACKNOWLEDGMENTS
This work would not have been possible without the collaboration of many
people. I would like to acknowledge first and foremost all members of my impromptu
research teams. These mothers, farmers, young women, and elderly persons of rural
Paraguay took me into their homes and freely shared their knowledge of medicinal plants,
farming systems and many other aspects of their lives and livelihoods. Special thanks go
to my "comadre" Clemencia Escobar, who was more like a mother than a simple
facilitator to me. Others whose names I cannot overlook were my informants at Aguaity,
Eusebio Ayala. These were Juan Velhzquez and his niece Norma, and my "marketing
expert," Ndlida Noguera de L6pez and Rey Morales. My invaluable informants and
collaborators at Ru Pyah6 also deserve special thanks. Among them were Dofia
Prudencia Escobar, and her husband Leonor, who shared their home and food with me as
well as their knowledge and insight. Thanks to Erna Torres, Dofia Isabel Torres, Don
BAez and Don Karaito, all of whom were great enthusiasts in teaching me everything
from how to make cane syrup and cure yerba mate, to the secrets of living a long and
healthy life. No farmer was more hardworking than Eustaquio Otazo. Both he and his
bright 16 year-old daughter Celia helped me translate local measures and figures into a
comprehensible format. I am surely forgetting many of the wonderful people at Eusebio
Ayala and RIu Pyah6, and so, in order to make up for the inadequacy of my memory I
acknowledge everyone who assisted me in every way with my research. I owe them all
an enormous debt of gratitude.
Many dedicated Paraguayan researchers have spent years studying different
aspects of the things that make us Paraguayan. Many of them were very open and willing
to share both their knowledge and insights on the matter I was researching. I thank Dr.
Ricardo Moreno Azorero, of the Institute of Research in Health Sciences, Universidad
National de Asunci6n (UNA), Dr. Isabel Basualdo, of the Institute of Botany of the
Department of Chemistry, UNA, Dr. Elisa Ferreira, of the Human Ecology career of the
School of Agrarian Sciences, UNA, and Maria Iris Centuri6n, Professor of Agricultural
Economics at the School of Agrarian Sciences at Caazapk, UNA. I would also like to
thank Genoveva Ocampos for her comments and the useful data in her book as well as
other publications by BASE ECTA, the Sociological Institute she heads. I am thankful to
Emestina, the senior secretary at the institute who helped me with a smile.
I would also like to thank the Paraguayan researchers whom I did not have a
chance to meet but whose printed works were invaluable as references to me. Among
them are, TomAs Palau Viladesau, Ram6n Fogel, Dr. Dionisio GonzAlez Torres, Maria
Castillo de Favitsky, Dr. Michael Michalowsky, Drs. N6lida Soria, Mirta Ortiz, and
Maria FAtima Mereles, as well as Celeste Acevedo, who have all dedicated years of their
lives to the scientific study of the wonderful Paraguayan floral pharmacopoeia. A few
others whom I must recognize are Gustavo GonzAlez, Carlos Pastore, Carlos Rubbiani
and Bartomeu MeliA.
I cannot exclude from my acknowledgements my great grandfather, Fulgencio R.
Moreno. His love and understanding of what it means to be Paraguayan were transmitted
to me through my mother, Sacha. I am grateful to them both for providing me with a
noble cultural identity. I thank my father, Norman J. Breuer, doctor and healer, for
instilling scientific curiosity and the meaning of the word holistic in me. Much of the
spiritual, philosophical, historical and intellectual aspects of this work and my life are his
credit. I also owe a debt of gratitude to my brother Jos6 and my sister Michelle. Special
thanks go to my sister Ver6nica and her husband Agustin for their logistical, intellectual
and emotional support. I would not be here studying nor would this thesis have ever been
completed without the daily love and support from my wife Bea, who aside from
inspiring me to do my best, also painstakingly proofed and fixed the many details of
putting my rough ideas into meaningful, readable form. She always asks the right
questions. She always helps without being asked, and with a smile. If there were more
smiles like hers, our job as development specialists would be easier, as the world would
be a better, kinder place. My children Norman, Astrid and Erik, were constantly a source
of joy, pride and hope.
Finally, I would like to thank those at the University of Florida who have touched
my work or my life during these past two years. They include my friends Matt
Langholtz, who loves Paraguay and is deep, Ronaldo Weigand, my dialectical challenger,
and Manuel Avila, who kept me informed of current events in Paraguay. I am grateful to
Kevin Gaskin for his incisive questions and comments. I thank the Natural Resource Use
in Latin America Discussion Group that arose from Dr. Nigel Smith's seminar for quality
discussion and much needed relaxation. The walking, talking development encyclopedia
of this group, Robert Miller, exposed me to more new thought than I could have
imagined during those memorable sessions. They prove that the age of the polymath is
not yet over. Thanks go to Marilia Coutinho and Rebecca McNair for support and
encouragement.
Dr. Hugh Popenoe's experience and insight are very much appreciated. His mind
is open and his scope broad, all this without dulling the sharpness of rigorous scientific
thought. Last but not least, thanks go to Dr. Peter E. Hildebrand, a true mentor in the
classical sense. His door was and is always open for all and me. He somehow combines
a love for teaching and a fervent dedication to making things better for the world's
subsistence farmers with the demands of two university positions, running a family and
supporting computer-illiterate, non-traditional students like myself. I join "campesinos"
everywhere in thanking him warmly for dedicating his life to understanding and helping
the last, and searching for ways to put them first.
TABLE OF CONTENTS
Page
ACKNOWLEDGEMENTS........................................................................iii
ABSTRACT................................................................... .............. xiv
LIST OF TABLES..............................................................................xi
LIST OF FIGURES............................................................................ ... xiii
CHAPTERS
1 EXPLANATION OF THE RESEARCH, QUESTIONS, AND
OBJECTIVES............................................................. ..................
Prologue........ ............................................................................... 1
Introduction................................................................................. 3
The Problem....................................................................................5
Related Research................................................ ............................... 6
Research Questions........ .................... ................... ............. ................ 8
Objectives..................... ..... ............................................................. 9
Research Design................................................................................9..
The Farming System at Eusebio Ayala.................................................. 10
The Farming System at Nu Pyahi ............. .......................................... 13
Methods and Analysis .................. .................. .....................................17
Farming Systems Research for Development and Natural
Resource Management.................... ....... ..... ....................... ...... 17
Field Work Methodology..................................................................... 19
Interviews............................................................................. 19
Analysis ...................................................................................... 20
Significance ................ ...................................... ..............................21
2 CONDITIONS IN PARAGUAY AND AT THE STUDY SITES......................23
Socioeconomic Conditions in Paraguay............ ....................................... 23
Conditions at the Study Sites................................................................. 32
Aguaity, Eusebio Ayala.................................................................... 32
14u Pyahi ..........................................................................................33
3 MEDICINAL PLANTS, CONSERVATION, AND
DEVELOPMENT.................................................................................... 35
Introduction. ......................................................................... 35
Traditional Medicine, Healthcare, and the Environment.................................37
Recognition of Medicinal Plants as an Important Natural
Resource and Healthcare Issue............................................................ 38
Regulatory Agencies and Conventions...................................................38
Projects that Involve Medicinal Plants and Conservation
around the World..........................................................39
The Sri Lanka Conservation of Medicinal Plants Project..........................39
Extractive Reserves in the Brazilian Amazon........................................40
The Belize Ethnobotany Project........................................................41
AMETRA 2000.............................................................................. 41
Community Development through Medicinal Plant Projects............................42
Healthcare, Medicinal Plants, and Conservation in Paraguay...........................44
Threats to Medicinal Plants..................................................................45
Deforestation............................................................................... ...45
Loss of Indigenous Knowledge...........................................................46
Urban Sprawl...............................................................................47
Community Development in Paraguay.....................................................48
Summary.............................................................................................49
4 MEDICINAL PLANT USE IN PARAGUAY: IMPORTANCE,
HISTORY, AND NUTRITIONAL ASPECTS.............................................51
The Natural Life..............................................................................51
Introduction.....................................................................................54
Modem Paraguay..............................................................................55
Medicinal Plants in Spain...................................................................57
Plant Exchange During the Conquest and Early Colony.................................58
The Jesuit Period..............................................................................59
The Post-Jesuit Period.........................................................................60
The 19th Century ..............................................................................60
The Post-War Years.........................................................................61
Institutional Research in Paraguay..........................................................62
Cycles of Knowledge and Use of Medicinals in the World
and Paraguay...................................................................................67
Western-Trained Physicians' Attitudes.....................................................69
Homegardens, Healthcare, and Nutraceuticals.............................................71
Sum m ary..................................................................................... .. 74
5 FARMING SYSTEMS CHARACTERISTICS AT THE STUDY
SITES: INPUTS FOR THE ETHNOGRAPHIC LINEAR PROGRAM ............ 75
Introduction ............................................... ....... ....................... 75
Economic Analysis Using Ethnographic Linear Programs..............................76
Inputs............................................................................................. 77
Details of Resources and Constraints...................................................77
General Activities.....................................................................................78
Principal Crops Grown (Cropping Activities)......................................79
Resources.......................................................................................86
Land.......................................................................................................86
Labor............................................................................................87
The Intercrop Numbers...................................................................92
Constraints...................................................................................94
Cash Needs.................................................................................. .... 94
Credit............................ .. ....... ................................... ...............97
Conclusion.......................................................................................97
6 OUTPUTS FROM THE ETHNOGRAPHIC LINEAR PROGRAM...................99
Introduction....................................................................................99
Land and Discretionary Cash...............................................................102
Remittances and Food Security...........................................................102
Price Threshold at Which Medicinal Plants Replace Cotton............................103
Being Better Off...............................................................................104
Likely Adopters............................................................................105
Conclusion...................................................................................108
7 SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS.................... 111
Summary................................................................................... .. 111
Conclusions.......................... .................................................112
Strategy............ ........................................... ............................. .. .114
Distance, Access, and Crop Diversity......................................................118
Being Better Off...............................................................................119
Target Group for Medicinal Plant Cultivation Projects................................ 121
Recommendations............................................................................123
Saving Financial Resources by Identifying Target Groups..................... 124
Need for Production Research..........................................................124
Need for Nutraceutical Research....................................................... 125
Keeping Production in the Hands of Small Farmers.............................. 127
High Labor Inputs.............................................................128
Cooperative effort.............................................................. 129
Marketing.......................................................................131
Global Markets..................................................................132
Potential Pitfalls of Globalization ............................................133
Healthcare as an Objective................................................................135
Economic Justification for Medicinal Plant Projects................................137
APPENDICES
A SURVEY RESULTS.......................................... ................... 140
B LIST OF MEDICINAL PLANTS..........................................153
C FARMING SYSTEMS DATA................................................. 156
D BASELINE ETHNOGRAPHIC LINEAR PROGRAM......................162
E EARLY PUBLICATIONS ON GUARANI PLANTS
AND MEDICINE.................................................................167
REFERENCES.................. .................................. .......................171
BIOGRAPHICAL SKETCH.................................................................. 179
LIST OF TABLES
TABLES
1. Paraguay Macroeconomic Data.....................................................27
2. Poverty in Paraguay..................................................................28
3. Paraguay Health Indicators...........................................................44
4. Mineral and Vitamin Contents of Dorstenia brasiliensis..........................66
5. Doctors Surveyed by Field of Specialization ..................................... 69
6. Doctors Surveyed by Country of Specialization.................................70
7. "I believe that medicinal plants have therapeutical value"........................70
8. "I am interested in alternative medicine, especially medicinal plants............70
9. "I recommend the use of medicinal plants aside from prescription drugs.......70
10. "I take medicinal plants myself with mate, terer6 or as tea......................70
11. Reported Yields and Farmgate Sales Prices for Certain Crops at the
Study Sites ..............................................................................85
12. Water for 45 Homes at the Study Sites................................ ........88
13. Summary of Labor Generally Available per Year at the Sites..................89
14. Reported Labor Requirements for Crops by Quarters per ha/Year..............91
15. Reported Person-days Required for the Intercrop per ha/Year.................93
16. Labor Required by Quarter for Intercropping Peanuts, Melons, Squash
and Coconuts per ha per Year .......................................................93
17. Yearly Cash Requirements for Specific Needs by Farm Families
at Eusebio Ayala and l~u Pyahi ......................................................96
18. Model Calibration Using Lower Yields...........................................102
19. Size of Arable Land and its Effect on Discretionary Cash.....................102
20. Amount of Remittances from Family Members and their Effect
on End-Year (Discretionary) Cash...............................................103
21. Point at which Medicinal Plants Replace Cotton when Cotton Price
is Fixed at Gs. 2000/kg (Early 1980s Scenario)................................ 104
22. Point at which Medicinal Plants Replace Cotton when Medicinal
Plant Price is Fixed at Gs. 50,000/bag (1999 Scenario)...........................104
23. Response of the System to Healthcare Expenditure Shocks in Different
Quarters of the Year Expressed as Variations in End-Year Cash............. 105
24. Scenarios Tested in Determining the Effect of Household Composition
on the Likelihood of Adoption of the Cultivation of Medicinal Plants......... 106
25. Consumption of Medicinal Plants for Two Different
Socioeconomic Groups............................................................. 117
26. Medicinal Plant Species Grown or Gathered at the Study Sites................119
LIST OF FIGURES
1. Map of Paraguay Showing the Research Sites................... .......... .. 16
2. Farmers' Anticipated Yields for Planning.................................... ......... 101
3. Actions Produce Benefits..................................................... ....... 136
4. The Production Function and Marginal Product of Healthcare..................... 139
Abstract of Thesis Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Master of Arts
THE ROLE OF MEDICINAL PLANTS IN RURAL PARAGUAYAN LIVELIHOODS
By
Norman Breuer Moreno
August 2000
Chairman: Peter E. Hildebrand
Major Department: Center for Latin American Studies
Changing global markets imposed new conditions on Paraguayan "campesinos"
or small farmers when the price of cotton crashed in the late 1980s. Many had been
effectively inserted into the market economy due to cash available from cotton sales
during the 1970s and 80s. One of the strategies adopted to cope with these changes was a
return to more traditional farming systems. Diversification, however, has been slow to
come about, leaving many with no reliable source of alternate income. A complete return
to a pure subsistence economy would be unreal because the cotton boom created a need
for consumer items and a reversal of this trend is highly unlikely. Finding a substitute for
cotton, as a cash provider, would ameliorate cash needs faced by resource-limited
farmers. It is, however, unreasonable to think that any one crop will be able to provide
the type of income and cash flow that cotton did in its heyday. The addition of several
livelihood activities, tailored to individual regions and household compositions, then
becomes a more real and attainable and sustainable solution to the problem.
Guiding questions in the research were whether the knowledge of the use,
gathering, and cultivation of medicinal plants is a strategy for combining household
security with market demands; what the effect of distance from the market is on growing
a greater number of crops including medicinal plants; if households are better off if they
combine market and non-market strategies; and finally, which household types at which
locations are more likely to adopt the technology of cultivating medicinal plants as a cash
crop.
The history of medicinal plant use is traced from pre-Colombian times to the
present in an effort to place the demand for these botanical products in context.
Medicinal plants are shown to be important for healthcare, nutrition, biodiversity
conservation, human diversity, economic and community development, and cultural
identity among other benefits.
Ethnographic Linear Programs (ELP) are models used to analyze complex small
farms and livelihood systems. Resources and constraints are set in a matrix using a
standard spreadsheet. Labor is disaggregated by gender, season, and age. The testing of
different alternatives is possible because the model closely simulates a small family farm.
This is achieved through the gathering of ethnographic farming systems data.
Results from the ELP included household types to target in medicinal plants
production projects, the price at which medicinals replace cotton, the effect of
remittances from family members on the system, and the effect of arable land used on the
amount of medicinal plants grown and sold. Combining subsistence and market practices
makes the farming system more feasible. Growing medicinals may benefit resource-
limited farmers.
CHAPTER 1
EXPLANATION OF THE RESEARCH,
QUESTIONS, AND OBJECTIVES
Prologue
Clemencia Escobar, a cheerful 51-year-old woman sat next to me as we drove to
Nu Pyahi. She was born there and had a happy and healthy childhood When her father
died, she was turned over to her godparents, as her mother had to cope with ten other
children. I had known Clemencia for quite some time, but little did I suspect that she
would play such a pivotal role in myfieldwork. Clemencia now lives in Asunci6n and is
the single parent of two young adolescents, whom she tries to bring as often as possible
on her yearly sojourns back to the hamlet of her youth, so that they do not lose contact
with their roots. I asked Clemencia, as we drove past dry looking pastures thinly
populated by scrawny looking zebu cattle, to describe Nu Pyahz. She immediately fell
into a long comparison of what it was like back then, and what it is like nowadays.
Before, people used to plant different maizes, like Tupi Pytd, and Chipd (red
flint and yellow dent corn). There was alfalfa enough left over to feed the
animals. Then people planted mostly cotton and very few food crops. They
could not keep many animals. Nowadays, the animals don't even grow ifyou
don't give them injections. Before, people had six or seven milking cows.
Now they have just one or none at all. Before, people used to plant rice and
separate the grain from the hull in a mortar. Now, rice and pasta are bought
because no one plants rice any more. Before, life was easier. People were
not in need. Everybody had 20-30pigs, of which two or three were always
fat. They gave meat and lard. Things that were common then are harder to
find now such as manioc starch, 'typyraty' and farifia' (manioc starch). We
used to make these things and it only took a half an hour to an hour. Before,
people had 12 to14 children. Now they have only five or six. People don't
work like they used to. If we got sick, someone would quickly concoct a
CHAPTER 1
EXPLANATION OF THE RESEARCH,
QUESTIONS, AND OBJECTIVES
Prologue
Clemencia Escobar, a cheerful 51-year-old woman sat next to me as we drove to
Nu Pyahi. She was born there and had a happy and healthy childhood When her father
died, she was turned over to her godparents, as her mother had to cope with ten other
children. I had known Clemencia for quite some time, but little did I suspect that she
would play such a pivotal role in myfieldwork. Clemencia now lives in Asunci6n and is
the single parent of two young adolescents, whom she tries to bring as often as possible
on her yearly sojourns back to the hamlet of her youth, so that they do not lose contact
with their roots. I asked Clemencia, as we drove past dry looking pastures thinly
populated by scrawny looking zebu cattle, to describe Nu Pyahz. She immediately fell
into a long comparison of what it was like back then, and what it is like nowadays.
Before, people used to plant different maizes, like Tupi Pytd, and Chipd (red
flint and yellow dent corn). There was alfalfa enough left over to feed the
animals. Then people planted mostly cotton and very few food crops. They
could not keep many animals. Nowadays, the animals don't even grow ifyou
don't give them injections. Before, people had six or seven milking cows.
Now they have just one or none at all. Before, people used to plant rice and
separate the grain from the hull in a mortar. Now, rice and pasta are bought
because no one plants rice any more. Before, life was easier. People were
not in need. Everybody had 20-30pigs, of which two or three were always
fat. They gave meat and lard. Things that were common then are harder to
find now such as manioc starch, 'typyraty' and farifia' (manioc starch). We
used to make these things and it only took a half an hour to an hour. Before,
people had 12 to14 children. Now they have only five or six. People don't
work like they used to. If we got sick, someone would quickly concoct a
remedy from backyard orforest plants, but we rarely got sick! Before, my
niece Estella'sfather had 30 goats. Then, he ate the few that were left
because recently people had been stealing them. He gave up. Before, those
things never happened in the countryside, because nobody was in need.
People became used to the easy life with cotton. Before the cotton, people
used to make their own yarn and blankets from wool. Afterwards, people
would end up losing or owing money with five or six hectares of cotton. In
my time they would plant 'pety hu' (black tobacco) and twist it for sale. You
would never walk into a person's house andfind them without manioc or
maize. You walked 20-30 minutes to make it to your 'chacra' (crop field).
The youngsters used to plant to help the parents, and then they would go to
the city or somewhere else to produce cash. Most chacras are now fallow
and they require much more work for cleaning. Most wives work at the
chacra. Few are able to stay at home. They plant and harvest, and do post-
harvest cleaning. People work from before sunrise until 10:00 AM and then
from 3:00 or 4:00 until dark (because the heat is unbearable). Before dawn
they are already hoeing. People in the countryside are happier. You can
stop working one whole week, and you still have something to eat... it is
different in the city. Iffriends come that you want to be with in the country,
you can leave the work in the fieldfor two or three days, there is no problem.
This is not possible in the city. Many people use pesticides, mostly on cotton.
Before, you did not see as much leukemia disease. Now the 'Hospital de
Clinicas' (Teaching Hospital of the Medical School in Asunci6n), is full of
children with leukemia. People say that leukemia and 'pzrpura'
(hemorrhagic disease) may be from stockpiling cotton in the house where
children play. Before everyone made their own 'yerba' (Paraguayan tea).
Now they buy it. I don't even see people making 'petit grain any more. We
used to eat rord (corn bran), locro (hominy), mbeyui (manioc starch cakes),
locrillo (cracked hominy cereal), bori bori (cornball soup), chipd guazzi
(corn soufflee, chipd ku 6 (creamed corn). Nowadays it's guiso (stew),
tortilla (fried dough), andfried manioc with meat, often purchased jerky.
(1999)
All this she related to me in good Spanish, a language she learned as a young adult
in the capital, Asunci6n. Her bilingualism so common in Paraguay was going to
permit me to grasp the shades and nuances of my interviews, many of which would be
conducted in Guarani, the native and official language of at least half the
Paraguayan population. Clemencia's before and after pattern of storytelling reinforced
in my mind the before and after of the cotton boom in Paraguay. While there are several
1 An essential oil distilled from the leaves of the sour orange citrus and used in the perfume industry.
other factors responsiblefor the current situation in which rural people find themselves,
one of the greatest to have affected them was the cotton boom, their dependence on cash,
and subsequent loss of this valuable source of income.
Introduction
This thesis is about Paraguayan farmers, common folk whose culture and lifestyle
deserve at least as much attention, study and preservation as the most remote forest tribe.
In Sir Ghillean Prance's words:
I believe ethnobotany includes the knowledge of local folk cultures
as well as indigenous tribes. For example, I have learned a great
deal from the caboclo of Amazonia who have taken up many
indigenous beliefs and many plant uses. I hope that in our
discussions we refer not only indigenous peoples, but include
peasants, campesinos, caboclos, riberefios, mestizos or whatever
they are called in different parts of the world. (1994)
It is about their insertion into the market economy and subsequent re-learning of
old ways in order to adjust to the failure of cotton as a cash provider. It is about the many
things that people do to adjust and survive. It describes one of the cultural characteristics
that is most remarkable about Paraguayans of all ages and social conditions the daily
consumption of medicinal plants. These plants provide healthcare, nutrients, refreshment
and savings on bus fare and visits to doctors. Much knowledge, contrary to the general
assumption, is in the realm of ordinary country folk. There is of course, much to learn
from remote tribes and their shamans in many parts of the world. However, medicinal
plant knowledge in this work refers to that which is in the realm of small farmers often
mothers and grandmothers.
Increasing population density, along with the continued and even increased -
consumption of these plants, coupled with mass anthropogenic landscape alterations will
lead to the extinction of certain species in the near future (Basualdo 1995, Lambert et al.
1997). By using a Farming Systems Research and Extension approach, I hope to identify
families who can successfully raise medicinal plants as a cash crop. This activity could
also help recover some of the plant species, which are in greatest danger of extinction.
The loss of habitat and biodiversity are beyond the scope of this research and are a
greater policy issue than can be addressed in this thesis. I wish only to offer a grain of
sand in conservation at the species level, while at the same time suggesting a technology
that may improve the livelihoods of certain households in rural Paraguay.
Chapter 1 will deal with the problem at hand, the research questions, objectives
and the design of my research, as well as some of the characteristics of Farming Systems
Research and Extension (FSR/E) and its value for this type of work. Paraguay, a little
known and poorly understood country is described in some detail in Chapter 2, along
with the study sites where I worked to gather information. Chapter 3 explores the links
between medicinal plants, healthcare, development and conservation. The importance of
these linkages in Paraguay is described in Chapter 4, as medicinal plant use is traced from
pre-Columbian times to the present. A new concept "the nutraceutical" value of
botanicals is brought out in this section. In Chapter 5, a linear program model of a
Paraguayan farm is constructed in an attempt to identify recommendation domains for the
cultivation of medicinal plants. The 6th Chapter shows several outputs from this
mathematical model. Finally, Chapter 7 offers a summary, conclusions and
recommendations.
The Problem
Small-scale farmers known as "campesinos" in Paraguay were drawn closer and
closer to the consumer or market economy during the 20 years in which a system of
solecropping of cotton was in place (1970-1990.) During this time, the relatively high
and stable price of cotton allowed mills and middlemen to advance money to campesinos
based on the amount of land they would be planting in cotton. Perhaps for the first time,
consumer products were readily available to small-scale farmers. At first, items sold
included the standard flashlights, radios and watches. These were followed by clothing,
at exorbitant prices, furniture and finally, as subsistence crops were left more and more
by the wayside processed foods.
For generations campesino families had the benefit of a traditional diet consisting
of manioc, corn, squash, beans, peanuts, coconuts and meat from chickens and pigs,
sheep, goats, and beef. After the cotton economy, these same families found themselves
buying canned meat, crackers from Argentina, canned sardines from Brazil, rice and
noodles. Indeed, in many areas of the country, corn and bean based meals were
sometimes totally replaced by a generic stew known as rice or noodle "guiso." Farmers
found themselves needing cash to purchase more and more items at the market, and
producing less and less food crops on their own land.
The transition to democracy in 1989 unfortunately coincided with the drastic
decline of cotton prices. Some 250,000 campesino families found themselves in the
position of having to relearn many forgotten subsistence crop practices.
Almost a decade later, many households are living at the interface between the
consumer and market economies. Extremely aggressive advertisement campaigns for
soft drinks and clothing as well as tastes acquired during the cotton "boom" draw people
toward the consumer side. A renewed awareness of the importance of food security,
government campaigns for a return to diversified agriculture, and the simple lack of cash
steer people back toward the perceived safety of the subsistence economy.
One of the factors, which may help keep campesinos from being further absorbed
into the economy, is the traditional knowledge of the cultivation, collection and use of
medicinal plants. Strikingly, nearly 80% of the population consumes medicinal plants on
a daily basis (Moreno Azorero 1987, Favitski 1997). These botanical elements are used in
treating a wide range of injuries and illnesses, thereby partially alleviating the need for
cash to buy expensive manufactured pharmaceuticals. Analysis of this one aspect of a
complex livelihood system may contribute to the understanding of peasant strategies for
balancing food security and market demands, and also recognition of women's roles in
this process.
Latin American research in conservation and development has tended to focus on
the Amazon region, perhaps justifiably so, at least in light of worldwide pressure. New
light could be shed on Paraguay from data generated by this study. One valuable aspect
expected to emerge from this work is an increased awareness and interest for researchers
regarding Paraguay, which could prove highly positive for a country in dire need of
effective policies and programs on conservation and development.
Related Research
Medicinal plants are among the most misunderstood of all natural resources
(Lambert et al., 1997). Since the recognition of their importance for healthcare and
conservation in the late-1980s, much research has been done into this area of botanicals.
Information on the subject comes from several different, yet equally important and
usually interrelated facets. The issue of medicinal plant policies and priorities has been
addressed by Akerele (1991), de Alwis (1991), and Farnsworth (1991). The Food and
Agriculture Organization (FAO) of the United Nations (UN) in its continuous series on
non-wood forest products devoted an entire report to "Medicinal plants for forest
conservation and healthcare." Balick, as well as many multilateral development
agencies, national government ministries and NGOs, as reported in working papers,
including those of The World Wide Fund for Nature (WWF), The International Union for
the Conservation of Nature (IUCN) and Conservation International (CI) have grappled
with the complex policy issues involved with the conservation of medicinals (Sheldon et
al., 1996). Plotkin (1991), Shultes (1991), Balick (1994), Prance (1994), and others have
explored the ethnobotanical and traditional knowledge of medicinal plants. Principe
(1991), Anderson (1990), and Lynch (1995) explored valuation of non-timber forest
products (NTFPs). This last author followed Lambert et al. (1997) of the World Bank in
emphasizing the gender aspects of the medicinal plant realm.
One of the least researched and most urgently needed areas of study is the
agronomy and ecology for the propagation of medicinal plants. Some work has been
done in this area by Palvetich (1991), Heywood (1991), and government agencies of the
People's Republic of China and India. More recently, publications have been produced at
the Centro Agron6mico Tropical de Investigaci6n y Ensefianza (CATIE) including one
by Montiel et al. (1998). Much of this last research mentioned is related to the INBI02
project between the Merck Corporation and the Costa Rican government. The specific
area of folkloric and scientific writings on Paraguayan medicinal plants is addressed in
greater detail in Chapter 4 of this work.
Much recent research on Paraguayan peasantry has focused on "campesino"
struggles, organization and search for land and power (Fogel 1989, Ocampos 1994, Palau
1998.) Other studies have focused on the cotton boom in Paraguay (Campos, 1986).
On-farm trials and the structure of the Ministry of Agriculture of Paraguay was
studied by Poey in 1986. He described its program objectives and attitudes of its
personnel and how these reach small farmers. An annual country report by the World
Bank in 1992 specifically raises doubts as to whether the traditional weakness of this
public entity, that is, the Ministry of Agriculture, will be up to the task of influencing the
course of events through technical or policy-based interventions.
Research Questions
This study was originally guided by four research questions. During the research
and writing phases other questions and hypotheses arose. Many were explored and most
remain unanswered. Therefore, efforts have been directed to the issues that the research
was originally designed to answer. These were: 1) Is traditional knowledge of the
cultivation, collection and use of medicinal plants a strategy for balancing food and
health security, and market demands? 2) Are households better off if they combine
market and non-market strategies because they can better maintain food and health
security? 3) Is greater distance and/or less access to the market place associated with a
greater diversity of crops grown, including medicinal plants used in lieu of commercial
2 INBIO: a private non-profit organization established in 1989 in Costa Rica. It established an agreement
with the Merck Corporation in 1991. In it, Merck payed INBIO US$ 1 million for a laboratory and will
share 50% of the royalties derived from any of the extracts of plant and insect specimens.
pharmaceutical products? 4) Can medicinal plants be grown as an alternative cash crop,
and by what type of households, located where?
Objectives
The main objective of this thesis was to explore the feasibility of producing
medicinal plants as a cash crop for certain resource-limited farm families. This refers to
one of the many activities that may be undertaken by Paraguayan households to partially
alleviate the need for cash that arose when the price of cotton became unattractive.
Secondary objectives included the gathering of as much current farming systems
data as possible so that an accurate model could be used to predict the outcome of the
introduction of this new technology. Extensive literature review demonstrating both the
international importance of medicinal plants and the historical, cultural, and healthcare
needs for these elements in Paraguay was undertaken with a specific objective in mind.
That is, to demonstrate that cash income is just one of the many benefits to be obtained
by cultivating this crop. An enormous amount of secondary good can be achieved
because medicinal plants have such manifold positive characteristics. The material
covered is expected to further aid and backup policy makers as they look for supporting
materials for the implementation of medicinal plant cultivation projects in Paraguay.
Research Design
This study focused on two communities. The first was Aguaity, Eusebio Ayala, a
community in which an important conservation, development and sustainable production
program was undertaken between 1983 and 1993. These farmers were compared to
farmers in a more remote region, IRu Pyahf, in the Department of Caazapa. This is an
older established "compaiiia" or outlying district of San Juan Nepomuceno. There were
pharmaceutical products? 4) Can medicinal plants be grown as an alternative cash crop,
and by what type of households, located where?
Objectives
The main objective of this thesis was to explore the feasibility of producing
medicinal plants as a cash crop for certain resource-limited farm families. This refers to
one of the many activities that may be undertaken by Paraguayan households to partially
alleviate the need for cash that arose when the price of cotton became unattractive.
Secondary objectives included the gathering of as much current farming systems
data as possible so that an accurate model could be used to predict the outcome of the
introduction of this new technology. Extensive literature review demonstrating both the
international importance of medicinal plants and the historical, cultural, and healthcare
needs for these elements in Paraguay was undertaken with a specific objective in mind.
That is, to demonstrate that cash income is just one of the many benefits to be obtained
by cultivating this crop. An enormous amount of secondary good can be achieved
because medicinal plants have such manifold positive characteristics. The material
covered is expected to further aid and backup policy makers as they look for supporting
materials for the implementation of medicinal plant cultivation projects in Paraguay.
Research Design
This study focused on two communities. The first was Aguaity, Eusebio Ayala, a
community in which an important conservation, development and sustainable production
program was undertaken between 1983 and 1993. These farmers were compared to
farmers in a more remote region, IRu Pyahf, in the Department of Caazapa. This is an
older established "compaiiia" or outlying district of San Juan Nepomuceno. There were
no projects of community development or any other sort underway there at the time of
my visit.
At Eusebio Ayala, a community-based organization had sought to improve the
livelihoods of community members through agroforestry, sustainable agriculture and
community projects during the late 1980s and early 1990s. This was called the Centro de
Promoci6n de Campesinos de la Cordillera (CPCC), or Center for the Development of La
Cordillera Small-Scale Farmers. This grassroots level undertaking received funding from
the Inter-American Foundation, the German technical agency GTZ, and Helvetas until it
ended in 1993 (Fretes et al., 1993).
R1u Pyahi, on the other hand, has received no funding from international
development agencies. It is a well-established, old community located in an area that
may have been frontier 50 or more years ago, but which is now quite settled. It was
chosen for several reasons. Among these were the facts that my facilitator and translator,
Clemencia Escobar was a native of that hamlet. Its distance from Asunci6n (250 km)
was also an important factor to be contrasted with the other site, which is much closer to
the capital. This village had less access to the main market. The research took the form
of surveys with open-ended questions. Households were chosen at random for drop-in
visits.
The Farming System at Eusebio Ayala
"La Cordillera," where Eusebio Ayala is located, is one of the earliest colonized
regions of Paraguay. Most soils are exhausted from up to 400 years of continuous use.
This prolonged utilization, along with the hilly topography of the region explains in great
measure the state of extreme deterioration of all natural resources today, which has been
compounded by several decades of the solecropping of cotton. Another contributing
factor to the poor overall situation has been the fact that La Cordillera is and has always
been a traditional provider of firewood, lumber and charcoal for the capital city of
Asunci6n. This region is almost completely deforested, with only around 1.7% of the
total area covered with native continuous forest in 1991. What little is left today is
seriously deteriorated as is the brush and secondary growth woody vegetation that covers
a large portion of the department (Fretes et al., 1993).
One of the unique features of this area is that, in some low-lying areas of grazing
land, and in almost all farm plots, there is a medium to high population of the mbocaya
palm (Acrocomia total). It produces small round nuts (about the size of a ping pong ball)
that are collected from the ground and sold to local industries where their pulp and kernel
are pressed to make soap, cooking oil, and cattle feed. The demand for these nuts has
been declining in recent years.
La Cordillera is blessed as is most of the Eastern Region of Paraguay with a
great abundance of streams, rivers, springs etc., which are underutilized and poorly taken
care of (if at all) at present. Irrigation is a very rare practice and with the exception of
two or three very experimental farmers one can say that it is nonexistent.
Another characteristic of this region is its division into very small plots or
"minifundios," a great number of which are less than one hectare in size, and have poor
to very poor soil (Palau, 1998). This situation provoked massive migration away from
the area either to new forested regions to the North and East, or to the ever increasing
poverty belts around Asunci6n, and in many cases Buenos Aires, Argentina, where
people have migrated in search of a better livelihood.
The population of La Cordillera department was 194,011 in 1982 and 206,097 in
1992 (official census data). Aguaity, a "compania" where I worked has a population of
around 600. The population has remained relatively stable due to the high rates of
outmigration. In the population breakdown one can see that the great majority of the
population is made up of the elderly, women and children, as young men of working age
have mostly migrated elsewhere.
According to the 1992 Agrarian Census, there are 22,362 "fincas" or farms in La
Cordillera (1981: 20,842), of which 60 % are less than five ha in size. The process of
"minifundizaci6n" or the breaking up into smaller and smaller farms, has many
contributing factors among which are the growth of larger ranching units, the expansion
of suburban Asunci6n towards the farming areas for recreation or week-end farms, and
population growth. There are also more complex background historical causes for this
process, which are beyond the scope of this thesis to discuss.
On the positive side, the proximity of La Cordillera to the main consumer market
of the country, Asunci6n, has turned it into one of the largest and most natural providers
of food and produce to the capital. It is also, and has always been, the principal provider
of building materials (bricks, roofing tiles, etc.) and firewood. This last item has led the
Servicio Forestal Nacional (SFN) to calculate that more than 900 ha of forests are needed
annually just to provide Asunci6n and the building materials industry with enough
firewood yearly (Fretes et al., 1993). This represents a great advantage for this region if
and when it can begin to produce firewood sustainably. Another advantage for the region
is the fact of its proximity to the capital for providing fresh produce with a relatively low
cost for trucking. Soils in La Cordillera Department are sandy or sandy loam oxisols
resulting from the decomposition of the hilly area's bedrock, which is sandstone. These
sandy soils are the most common in the higher areas and on hillsides. The lower areas
used almost exclusively as grazing, are silty sand to a depth of 25 cm, with an underlying
stratum of black impermeable clay. It is this clay that is used as raw material for the
many brick and tile factories in the area. Land that is devoted exclusively to agricultural
use has suffered most since cultivation methods exclude trees and other cover vegetation
leaving the soil bare and exposed to the elements for a period of several months a year.
The common practice of burning stubble after the harvest compounds this situation.
A trend towards more perennial crops has been noticed in recent years, which
allow better soil conservation, especially on slopes. This change in attitude has been
heavily influenced by the CCCP, whose basic objective was to reintegrate trees onto the
farm and avoid the total disappearance of what little natural forest remained. Several sites
in La Cordillera Department were added to the project through the coordination of the
CPCC, an organization that, aside from land use, was aiming at a holistic approach to
improving the lives and livelihoods of small-scale farmers in the region. The project had
different rates of success in different areas. Community, or rather communal projects,
obtained the poorest results. The aspect of reforestation and diversification of crops,
however, proved to be groundbreaking and an awakening to other small farmers on the
all-important issue of erosion control through intelligent land utilization.
The Farming System at iFu Pyahu
Nu Pyahi, in the CaazapA Department, is a small hamlet of some 70 homes. It has
a population of around 450 people. It is politically a "compafiia" or outlying district of
San Juan Nepomuceno. San Juan itself is a small town, yet large enough to provide a
limited market for the selling and purchase of goods. Its mean annual rainfall is around
200 mm higher than at La Cordillera, around 1500 mm. Soils are typical oxisols, and
spodosols derived from sandstone. The valleys as in Eusebio Ayala are of a
sedimentary silty sand layer in the A horizon with an underlying stratum of impermeable
black clay at around 25 cm of depth. These are generally used for grazing.
Although there are quite a few young people, most of the ones interviewed during
recent research for this thesis tended to be older. Literacy is fairly high and the local
school runs up to the 9th grade. Agriculture and extractive activities principally timber
and "yerba mate" (Ilexparaguariensis) have been activities in this area for as long as
anyone can remember. Timber nowadays is reserved for emergencies and on-farm use.
Farm plots are much larger than the ones in La Cordillera. The original parcels were 18
ha each. Some owners still own farms of this size; others have divided it up to the next
generation. However, few farmers managed to cultivate more than three ha in any
particular season.
Technical assistance was more frequent in the past than it is today. The
interviewees seemed in general very self-reliant and knowledgeable about their farming
practices. With regard to the lack of agricultural extension mentioned above, Dofia Erna
Torres (aged 60) had this to say about extension:
We got money from the bank when we were just married, and with
just one harvest often ha of soybeans we began to do well. Back
then an Ingeniero (agronomist) would come right out into the field
to see how things were going. Now, there is only a t6cnico
(practical technician), and he is not from the Ministry, he is private.
Those who work at the bank now stay at their desks and don't want
to come around here. They used to come on horseback! (1999)
Agricultural production in both areas involves a range of traditional crops along
with some recently introduced ones. While Eusebio Ayala farmers tend to have more
fruit trees, and less subsistence crops, those in Ru Pyah6 have more subsistence crops
along with complementary agricultural and homemade crafts. These include elaboration
of crude processed yerba mate, blanket weaving, and home-manufactured "eira hfi" (cane
syrup), as well as "torcido," or chewing tobacco ropes and other activities. At both sites
a few farmers had a general store in the front of the house. These were usually for self-
consumption and to bring in some cash.
The selection of these two sites allowed me to operationalize the variable of
distance from the market. Distance from the capital with its wide range of available
institutions, including hospitals and schools and markets is the independent variable. The
extent to which farmers in general and women in particular rely on medicinal plants as a
first treatment for illness, and the diversity of the kinds and uses of these plants, as well
as the variety of food crops, are dependent variables. Household compositions were
variable at both sites, as they are anywhere. Household composition as a variable to be
tested as a factor affecting the likelihood of adoption of the cultivation of medicinal
plants was studied at both sites.
Paraguay
Figure 1. Map of Paraguay Showing the Research Sites
Methods and Analysis
Theoretical Methodology
Farming Systems Research for Development and Natural Resource Management
Farming Systems Research and Extension (FSRE) is a multidisciplinary approach
to understanding and attempting to solve the problems of resource-limited farmers. The
main idea being that the research and solution of problems comes from farmers
themselves. They participate actively in every step of the process. This approach grew
out of the realization that the Green Revolution was not reaching everyone. With its
emphasis on High Yielding Varieties (HYV), costly inputs and ideal conditions at
research stations, wealthier farmers were being made richer and the poorer were being
left by the wayside (Conway, 1998). As one way of dealing with this, FSRE was
developed on the late 1970s and early 1980s, with methods that focused on the needs of
the small-scale farmers and developed research and extension methods that responded to
the social and environmental and especially the great diversity within small farming
communities.
A key to this process is the formation of multidisciplinary teams to conduct
surveys or "Sondeos" (Hildebrand, 1986). These are rapid surveys that prove extremely
useful when time and money are limiting factors for researchers. On-farm visits are
conducted with the farmers to understand their farming systems. The objective is not to
isolate and analyze each individual part, but rather to understand how the system works.
Methods and Analysis
Theoretical Methodology
Farming Systems Research for Development and Natural Resource Management
Farming Systems Research and Extension (FSRE) is a multidisciplinary approach
to understanding and attempting to solve the problems of resource-limited farmers. The
main idea being that the research and solution of problems comes from farmers
themselves. They participate actively in every step of the process. This approach grew
out of the realization that the Green Revolution was not reaching everyone. With its
emphasis on High Yielding Varieties (HYV), costly inputs and ideal conditions at
research stations, wealthier farmers were being made richer and the poorer were being
left by the wayside (Conway, 1998). As one way of dealing with this, FSRE was
developed on the late 1970s and early 1980s, with methods that focused on the needs of
the small-scale farmers and developed research and extension methods that responded to
the social and environmental and especially the great diversity within small farming
communities.
A key to this process is the formation of multidisciplinary teams to conduct
surveys or "Sondeos" (Hildebrand, 1986). These are rapid surveys that prove extremely
useful when time and money are limiting factors for researchers. On-farm visits are
conducted with the farmers to understand their farming systems. The objective is not to
isolate and analyze each individual part, but rather to understand how the system works.
This system is particular to each region, indeed to each household or farm. A small-scale
farm is a household first, then a business (Hildebrand, 1986). With the farmer's help, on-
farm trials are designed to search for specific solutions for that particular site. The final
objective is increasing the farmers' productivity and thus, well being. Often, this is
achieved through a new technology, usually site specific and with great potential for
diffusion and adoption.
Modeling farm systems obligates the researcher to go out into the field and gather
ethnographic as well as production data in situ. The model is later formulated, and in
order to validate it, he or she may go back to the field and try it out on those same
farmers. By honing and fine-tuning the model, one can come to a very approximate
simulation of reality. This accuracy allows us to predict the result of new technologies on
farming systems.
Too often general life zones, typical family, average farm, and large areas are
covered by a program without taking into account the great human diversity present in
any given area. It is often argued that the models are not valid because they fail to take
into account macro-economic effects. Their relevance for this thesis, however, resides in
their use as a tool to help answer the questions that guided the research. Whether
campesinos are better or worse off than city folk remains largely subjective and cannot be
answered by a model. Nevertheless, constraints, resources (especially food availability),
can tell us a great deal about why so often peasants say they are better off than urban
people. There is an apparent greater flexibility to survive in spite of externalities and the
political-economical macro context of any given moment. This does not mean that the
macroeconomic context, markets, credit, transportation, and healthcare do not affect the
resource-limited farmer. Nor should the study of their systems and at the farmgate. It
merely refers to a position that may be considered powerful in some ways. In the words
of Gonzidez de Olarte: "Compared with the urban population and rural wage laborers, the
peasantry as a whole seems better able to neutralize the effects of an unfavorable
macroeconomic context (1992)."
An ethnographic linear program3 was constructed in Chapter 5 of this thesis. The
model used data collected through personal interviews conducted at both sites during July
and August, 1999. The objective of this model was to simulate a real farm, within the
macroeconomic context, and thus permit the identification of recommendation domains
for the cultivation of medicinal plants. This novel activity may help certain types of
small-scale farmers diversify their production, and thus their cash income, without
compromising household food security.
Fieldwork Methodology
Interviews: The work began by randomly sampling households expected to have
a variety of family compositions. At least ten families were interviewed between both
sites (five at each), to obtain information on farming systems. Another 45 families were
surveyed at each of the two sites seeking data on medicinal plant use.
The principal male and/or female member of each family was surveyed using
questionnaires (whenever possible) with specific questions about who cares for the home
garden and the "chacra" or field. Additional questions included data on how many hours
each activity requires, how plants are used when illness strikes, how often they are used,
how they are used in combination with purchased-drugs, along with questions about time
3 ELP: A mathematical model simulating a complex small farm based on data obtained through
ethnographic research.
resource-limited farmer. Nor should the study of their systems and at the farmgate. It
merely refers to a position that may be considered powerful in some ways. In the words
of Gonzidez de Olarte: "Compared with the urban population and rural wage laborers, the
peasantry as a whole seems better able to neutralize the effects of an unfavorable
macroeconomic context (1992)."
An ethnographic linear program3 was constructed in Chapter 5 of this thesis. The
model used data collected through personal interviews conducted at both sites during July
and August, 1999. The objective of this model was to simulate a real farm, within the
macroeconomic context, and thus permit the identification of recommendation domains
for the cultivation of medicinal plants. This novel activity may help certain types of
small-scale farmers diversify their production, and thus their cash income, without
compromising household food security.
Fieldwork Methodology
Interviews: The work began by randomly sampling households expected to have
a variety of family compositions. At least ten families were interviewed between both
sites (five at each), to obtain information on farming systems. Another 45 families were
surveyed at each of the two sites seeking data on medicinal plant use.
The principal male and/or female member of each family was surveyed using
questionnaires (whenever possible) with specific questions about who cares for the home
garden and the "chacra" or field. Additional questions included data on how many hours
each activity requires, how plants are used when illness strikes, how often they are used,
how they are used in combination with purchased-drugs, along with questions about time
3 ELP: A mathematical model simulating a complex small farm based on data obtained through
ethnographic research.
allocation. Tables recorded crops raised, time spent on field activities and the flow of
cash. Nearly 100% of the interviews were conducted in the Guarani language (except for
a few at Eusebio Ayala, where some farmers were comfortable with Spanish). Having a
mixed gender team, which was perceived as more serious and less intimidating,
facilitated rapport with women. I presented myself as a student. My personal
background (Paraguayan) and knowledge of the language (basic Guarani) and customs
allowed me to reach a sufficient degree of familiarity with the farmers within a relatively
short period.
An attempt was made to identify non-users of medicinal plants at these same sites,
their answers to a separate set of questions were undertaken in search of a control group.
Only one person out of 45 interviewed did not "usually" take medicinal plant infusions.
Analysis
The results of the fieldwork were analyzed in two manners: qualitatively and
quantitatively. In the qualitative analysis, community members of different ages, sex,
and social standing reported people's roles as producers and collectors of medicinal
plants through narratives. These data focused on identifying the illnesses which occur
most frequently in the household, including injuries and the "first-aid" response to these
afflictions. The role of the "medico flana," or traditional herbal healer was not explored,
except for the fact of how much he charged and how often he was visited. The objective
was to find out about household healthcare.
Quantitatively, at least six households were analyzed using linear programming as
it applies to economic analysis of small farms and livelihoods systems. This process
consists of two phases. The descriptive phase in which the farm is described and that
description is validated. This is followed by an analytical phase in which a number of
different tests can be run using the model for prediction purposes. In this manner, several
families in different stages of their life cycles, at both sites, were studied in search of
diversity rather than attempting to identify a "typical" household (Hildebrand, 1986).
The main activities and constraints were identified and quantified during family
interviews. A model was created in which men's and women's contributions to the
family economy are disaggregated and quantified, especially with regard to the home
medicinal plant garden and its use. Household (or livelihood) Security is defined as being
able to produce or obtain enough food to feed the household, and to produce or gather the
plants necessary for primary healthcare. This is an important household objective in
areas where there is no health facility nearby, nor speedy modes of transportation
(ambulances) for reaching better equipped health centers located more distantly.
In order to construct the ethnographic linear program model, farmers were asked
questions about food sources, medicinal plant sources, cash production and handling, and
constraints on land, labor, cash, and infrastructure. In order to analyze one particular
aspect of a system, in this case the medicinal plant home garden, the entire system, and
its variability must be understood (Hildebrand, 1986). This type of study complements
broad economic feasibility studies that are usually undertaken by multilateral agencies
before implementing projects.
Significance
This study will contribute to the understanding of "household" (food and health)
or livelihood security issues, by gathering data through surveys and interviews. These
will be used to build a linear program that simulates small complex farms and can be
used for prediction purposes. The role of medicinal plant home gardens, and women's
roles as well as conservation at the species level will also be explored. It will also
generate information on the post-project status of farmers at the CPCC site and the
current status of farmers at the 1lu Pyah6 site.
In the following chapter, I will give an overview of Paraguay in general taking into
account that it is a little known country. Socioeconomic and political conditions will be
recounted in an effort to keep externalities and the macroeconomic picture in the back of
our minds while describing the before and after of farmers with relation to the cotton
boom. While this latter phenomenon was certainly the series of events that affected them
most directly, many other things were going on in the country at the time over which they
had no control at all, but which also affected them.
CHAPTER 2
CONDITIONS IN PARAGUAY AND AT THE STUDY SITES
Socioeconomic Conditions in Paraguay
Paraguay is a landlocked country in the heart of South America, with an area of 406,752
sq. km. It is bisected North-South by the Tropic of Capricorn, and has a continental sub-
topical and tropical humid climate. Two great rivers drain the country: the Paraguay and
the Parand. The Paraguay River divides the country into two very different regions. The
Occidental or Chaco region, comprising 62% of the land-mass, a relatively dry thinly
populated area, and the Oriental or Eastern region, comprising 38% of the country's land,
which is much more populated as well as more adequate for farming. On the Parana
River, two large hydroelectric dams' one shared with Brazil and another with Argentina
- provide the country with a great availability of electrical energy. Unfortunately, the
distribution grids are not up to par with the dams, and electricity does not yet reach all
Paraguayans and is expensive for those who have the benefit of its use. The massive
amount of money brought into the country during the construction of these dams two to
three billion dollars by some estimates forever changed the bucolic leisurely paced
lifestyle of Paraguay. The construction of the Itaipii dam occupied a huge labor force.
Most of these workers had migrated toward the construction site from farming areas.
Completion of the dam and the subsequent release of its workers coincided with a drastic
reduction in the price of cotton (Palau, 1998).
SItaip6, with Brazil, and Yacyreta, with Argentina, both on the Parand River.
CHAPTER 2
CONDITIONS IN PARAGUAY AND AT THE STUDY SITES
Socioeconomic Conditions in Paraguay
Paraguay is a landlocked country in the heart of South America, with an area of 406,752
sq. km. It is bisected North-South by the Tropic of Capricorn, and has a continental sub-
topical and tropical humid climate. Two great rivers drain the country: the Paraguay and
the Parand. The Paraguay River divides the country into two very different regions. The
Occidental or Chaco region, comprising 62% of the land-mass, a relatively dry thinly
populated area, and the Oriental or Eastern region, comprising 38% of the country's land,
which is much more populated as well as more adequate for farming. On the Parana
River, two large hydroelectric dams' one shared with Brazil and another with Argentina
- provide the country with a great availability of electrical energy. Unfortunately, the
distribution grids are not up to par with the dams, and electricity does not yet reach all
Paraguayans and is expensive for those who have the benefit of its use. The massive
amount of money brought into the country during the construction of these dams two to
three billion dollars by some estimates forever changed the bucolic leisurely paced
lifestyle of Paraguay. The construction of the Itaipii dam occupied a huge labor force.
Most of these workers had migrated toward the construction site from farming areas.
Completion of the dam and the subsequent release of its workers coincided with a drastic
reduction in the price of cotton (Palau, 1998).
SItaip6, with Brazil, and Yacyreta, with Argentina, both on the Parand River.
According to the 1992 census, the population of Paraguay was 4,152,588. The
current population is estimated to be 5,050,000. The population growth rate of 3.2% is
the highest in South America. If this trend continues, the population will double in 22
years. The spatial distribution of the population is 50.3% urban and 49.7% in rural areas.
According to this tendency, by the year 2010, Paraguay will be an urban country.
Nevertheless, the rural population will grow by 570,000 persons or 100,000 families.
With 37% actively engaged in agriculture, rural Paraguay will continue to be important
and strategic in any process of economic growth (Palau, 1998). As in many developing
nations, there is a great preponderance of young people with 67% being under 30 years of
age and 41% being less than 15 years old.
The landlocked geographic location of the country imposes some difficult
conditions as it isolates the country from the great economic and cultural trends current in
the principal developed centers of the world. This obstacle has continuously checked
development since it is a severe limitation of opportunity for participation in international
affairs, especially trade. However, isolation has been a major factor in the continued and
widespread use of medicinal plants from pre-Columbian times to the present (Basualdo,
1995).
In addition to the disparate structure of land tenure 77% of land is in large
holdings in the hands of just three percent of the population Paraguay lacks valuable
mineral resources, resulting in an economy that depends fundamentally upon agriculture
and cattle raising. The country's predominant structure of agriculture and cattle raising
has contributed to a limited industrial development. Other causes of this
underdevelopment are the lack of mineral resources mentioned above, a limited market
and competition from its industrial powerhouse neighbors Brazil and Argentina. The
relatively limited manufacturing sector is unable to absorb labor, which is fundamentally
unskilled and continuously growing due to the migratory phenomenon from rural areas to
the cities (Palau, 1998).
Agricultural expansion occurred in conjunction with the building of the Itaipui
dam and the much criticized agrarian reform by which the government distributed land to
thousands of peasant families. This increment in agricultural production resulted in
amazing growth during the 1970s of approximately 10% per annum. This surge slacked
for several reasons in the mid 80s: first of all, at the conclusion of the construction of the
Itaipui dam. Thousands of workers were left without jobs, as new building projects were
unable to absorb the new abundance of semi-skilled labor. Second, the agrarian reform
was derailed as a result of the economic difficulties of the 80s. To this date, the State
does not have public lands needed for settlements. Almost all land apt for agriculture is
in private hands, and the little land the State does possess is mostly marginal and suited
for cattle raising. This exhausted availability of public lands and, above all, the February
3, 1989 politico-military coup, which dismantled the repressive structure of the previous
regime, stimulated a process of spontaneous occupations of private property, generating
movements of "landless" peasants. The government that was pressured on the one hand
by large business interests, both national and foreign, to protect private property, and on
the other hand by small farmers who are increasingly organized to claim their rights, has
come to a stalemate on land reform claiming that resources are unavailable for continuing
the program (World Bank, 1992).
An unfortunate policy established that unproductive "latifundios" or large estates
would be subject to agrarian reform. This piece of legislation, although funded on the
high ideals of the social function of land, proved disastrous for the environment and the
economy. Almost all land occupations occurred and indeed are still occurring on
privately owned forestland. Many owners principally cattle ranchers sought to
change the status of their land from unproductive "latifundios" to productive lands by
clearing and burning forests and converting them to artificial pastures. The combined
result of this situation along with the natural expansion of agriculture caused a massive
and progressive deforestation. According to the Food and Agriculture Organization of
the United Nations, Paraguay's eastern region has only 3% of the primary forest area it
had in 1950 (FAO, 1997). Illegal logging for the Brazilian market has contributed heavily
to this ecological catastrophe.
Another phenomenon that came with the expansion of agriculture in the 1970s
and 80s was the introduction of mechanized crops, such as soybeans, wheat, maize and
sorghum. These crops, along with the small-scale cultivation of cotton, are the pillars of
the Paraguayan economy. Eighty percent of production is exported. The terms of trade
however, have not been favorable during the last decade, as the two principal export
items cotton and soybeans underwent a decrease in real export value of around 45%
(Central Bank of Paraguay Report, 1997).
Table 1. Paraguay Macroeconomic Data
Indicator 1990 1991 1992
GNP* 3.1 2.5 1.8
Inflation** 44.0 12.0 18.0
Exports* 1.3 1.3 1.2
Imports* 1.4 1.7 1.7
Balance of trade* -0.1 -0.4 -0.5
Foreign Debt* 1.7 1.8 1.2
* Billions of dollars
** Percentage
1990-1995
1993 1994 1995
4.1 3.1 4.2
20.4 18.3 18.0
1.1 1.8 1.1
1.5 2.8 2.5
-0.4 -1.0 -1.4
1.2 1.4 1.3
Source: Palau, 1998
There are some 250,000 families of small farmers. Considering the average
family size of six, 1.5 million people make their living directly from small-scale farming.
The proportion of land cultivated among "minifundiarios" or small farming units is
nearly 70%. Units from 20 to 100 ha cultivate 42% of their land and those 100 ha or
more in size use an average of 12% of their land.
Land tenure is an issue in Paraguay as in other parts of the developing world.
Many small-scale farmers lack formal title to land, denying them access to credit.
However, between 1992 and 1993, the Institute of Rural Welfare granted almost 10,000
property titles (Gutidrrez, 1995). Unfortunately, it is all too easy to obtain land in a new
settlement and then sell the "rights" to newer settlers when the lack of hardwood species
makes it more viable to move on to a new plot. This pattern was begun in Eastern
Paraguay by Brazilian immigrants (Palau, 1998). Productivity of land and labor is very
low and, as a consequence, profits are limited generating dissatisfaction, which leads to
great social pressure (Guti6rrez, 1998). The need to provide peasants with social services,
which are high in cost and quantity, constrains efforts for land reform.
The deficient spatial structure of the production units as far as not being able to
satisfy the growing populations' needs for education, health and better dwellings is a
causal factor in the migration phenomenon from rural to urban areas. This tendency may
be irreversible and progressive over time. Neither the economy or city infrastructure is
properly prepared to deal with this. Conditions no longer exist to "export" poverty
(Palau, 1998).
The distribution of the active population per economic sector is 51.7% primary
(agriculture, forestry, fishing, and mining) in 1972, but only 35.0% in 1992. The
secondary sector (industry) has remained relatively unchanged, at 18.7% in 1972 and
19.7% in 1992. The service sector grew from 29.6% in 1972 to 40% in 1992.
Table 2. Poverty in Paraguay in 1992 (in number of inhabitants)
Characteristics Metropolitan area Rural area
Indigence 26,000 657,000
Basic poverty 156,300 588,000
Total poverty 182,300 1,245,600
Total 1992* Population 1,224,579 2,253,116
% of poor 15 55
The 1992 estimated population was 5.05 million. It is not known if absolute poverty has
augmented proportionally. Source: Palau, 1998
Average years of schooling for the population is 4.9 years: 6.2 in urban areas and
3.5 in rural areas. The situation of women peasants is particularly critical, as they
average only 3.4 years of schooling. Another breakdown shows that 65.4% of the
population has a primary school education, 22% a high school education and a mere 3.4%
reach the university level.
The rate of school retention, according to the last period considered (1988-1993)
is only 54%. Of 157,000 children enrolled, only about half finish primary school in
urban areas and 41% in rural areas. It is evident that there is a marked difference
between the educational opportunities in the capital and other cities and rural areas, as
well as in the quality of education (Ocampos, 1994).
While average life expectancy is 67.2 years (World Bank 1992, WHO 2000), the
infant mortality rate is above average for the region. The major causes for mortality,
especially in children are pneumonia, anemia and diarrhea. The lack of potable water,
which reaches only 31.5% of homes and the lack of modem sewage systems, which reach
only 7.7% of homes, contributes to generate these results.
Health services are severely limited in rural areas. Problems include: a lack of
adequate health centers, in number and in quality, concentration of medical personnel in
the capital and principal urban centers of the country, leaving rural areas deserted, the
high cost of drugs, and the high cost of medical personnel. One of the most significant
causes of the infant mortality rate is that 60% of births occur without medical or
paramedic assistance and away from assistance centers.
There is a need for nutritional education, which could induce improved
agricultural practices, through which the small-scale farmer and his/her family could eat
more nutritiously. The role of medicinal plant consumption as providers of vitamins and
minerals is becoming more evident as they are viewed in a new light as nutraceuticals5
(Ferreira, pers. comm., 1999). Health education would allow the adoption of preventive
means to reduce work-related injuries, especially intoxication with pesticides.
Environmental education could lead to the implementation of conservationist practices,
leading to improve general welfare. In turn, better-protected habitats, coupled with
studies on sustainable extraction levels, could provide a permanent source of medicinal
plants for all Paraguayans.
An aspect worthy of noting at the household level is that due to wars in the past
and political upheaval, women have often assumed the role of heads of families. This
was true of 21.8% of homes included in the 1992 census. Furthermore, 40.26% of
women aged 10 or older live with men without being married or widowed, separated or
divorced (Ocampos, 1994).
Rural poverty can be analyzed in the light of internal and external structural
causes. The principal cause is the difficulty in accessing land of sufficient quantity and
quality. Additional causes include financial needs, such as credit assistance required for
the purchase of tools, seeds and support for the family while it awaits the harvest.
Adequate roads and centers for storage of production are needed, as well as assistance in
matters of commerce. To the strictly economic factors referred to previously, specific
social deficiencies must be added. As Michael Lipton has put it, "There is a limit to
which technology can cure social pathologies (cited in Conway, 1999)."
5 Nutraceuticals are plants that provide pharmaceutical as well as nutritional factors and are often called
dietary supplements or functional foods.
Collective effort is uncommon in Paraguay. The imposition of authority is the
better-known system. Centers for discussion and debate, such as public libraries and
town halls do not exist, therefore, the value of cooperation or of cooperative societies,
despite the efforts undertaken in this area, are largely ignored. This is perhaps a partial
explanation for the limited presence of the cooperative sector (Fretes et al., 1993).
Finally, the restricted social security system, the non-existence of agricultural and
employment insurance and the lack of other expressions of social solidarity contribute
negatively to the overall poverty picture. Aside from the levels of unemployment or
extreme poverty characteristics of the population in the rural sector, in which the majority
are unsalaried family workers, in the urban sector only 76% of the economically active
population is employed and 18.5% is underemployed. Only 5.0% are fully unemployed
(Gutierrez, 1998).
Many factors hinder the possibility of providing more productive activities that
occupy labor, these include: little available capital, the high cost of capital, rigid labor
loss, a huge bureaucracy, administrative corruption, a limited market and a justice
administration now under revision which does not allay fears of insecurity.
Paraguay's porous borders offer contraband as a viable alternative for making a living
(World Bank, 1992).
As a result of the above, unemployed labor opts for two choices: emigration (in
Argentina alone, 39.2% of immigrants are Paraguayans), and the "informal sector,"
which according to estimates comprises about 40% of the work force. This indicates a
need for maintaining people in rural jobs, especially small-scale farming, unless
something can be done to curb population growth.
Paraguay fortunately has not experienced serious ethnic or social discrimination
and has no major obstacles that prevent social mobility. Socially, it is a democratic
society. In present-day life, however, certain structures of inequality are created,
particularly arising from a progressive differentiation of opportunity, which need to be
overturned to avoid unwanted consequences in the future. The rural sector, subject to the
whims of the market, adverse climate, difficulties in obtaining credit and land, and being
geographically dispersed are harder to reach with social services, may be the most
challenging sector to integrate into the country's economy. Youth, which accounts for a
large segment of the population require conditions for entry into the labor market,
education, health and leisure. This sector presents great challenges for social integration.
Conditions at the Study Sites
Paraguay's eastern region is better suited climatically for agriculture. This region
contains an extensive plains region, hilly areas with fertile valleys and low plateaus. The
soils vary from sandy oxisols and some clayey ultisols called "high red camp" in South
Eastern Paraguay, to many areas near the Paraguay River that are low-lying and swampy.
The climate of the eastern region is considered continental sub-tropical.
Aguaity, Eusebio Ayala
This site is located some 80 km southeast ofAsunci6n. The first 64 km are on
paved road No. 2, and the remaining 16-km are dirt roads. Average annual rainfall is
1,400 mm. There is an average of 75 annual rainfall days during the year and these are
fairly well distributed. The Thornthwaite humidity rate for the area is between 20 and
40. That is, average annual rainfall is above average annual potential evapotranspiration.
Therefore, it is classified as humid. The absolute minimum temperature is -1IC and the
Paraguay fortunately has not experienced serious ethnic or social discrimination
and has no major obstacles that prevent social mobility. Socially, it is a democratic
society. In present-day life, however, certain structures of inequality are created,
particularly arising from a progressive differentiation of opportunity, which need to be
overturned to avoid unwanted consequences in the future. The rural sector, subject to the
whims of the market, adverse climate, difficulties in obtaining credit and land, and being
geographically dispersed are harder to reach with social services, may be the most
challenging sector to integrate into the country's economy. Youth, which accounts for a
large segment of the population require conditions for entry into the labor market,
education, health and leisure. This sector presents great challenges for social integration.
Conditions at the Study Sites
Paraguay's eastern region is better suited climatically for agriculture. This region
contains an extensive plains region, hilly areas with fertile valleys and low plateaus. The
soils vary from sandy oxisols and some clayey ultisols called "high red camp" in South
Eastern Paraguay, to many areas near the Paraguay River that are low-lying and swampy.
The climate of the eastern region is considered continental sub-tropical.
Aguaity, Eusebio Ayala
This site is located some 80 km southeast ofAsunci6n. The first 64 km are on
paved road No. 2, and the remaining 16-km are dirt roads. Average annual rainfall is
1,400 mm. There is an average of 75 annual rainfall days during the year and these are
fairly well distributed. The Thornthwaite humidity rate for the area is between 20 and
40. That is, average annual rainfall is above average annual potential evapotranspiration.
Therefore, it is classified as humid. The absolute minimum temperature is -1IC and the
absolute maximum temperature is 410 C. "Winter" in Paraguay lasts from late May
through September. During cold spells, temperatures vary between 4 and 100C and they
can drop as low as -1IC. These spells occur very infrequently and last for only a few
days at a time. They are interspersed with warm spells during which temperatures can
reach 32 degrees Co during the daytime (Grassi and Yorki, 1988).
Topographically, it can be characterized as a hilly area with both steep inclines
and softer rolling hills. Agriculture conducted continuously on these slopes and the
sandy texture of the oxisol soils is responsible in part for the high degree of deterioration
found today, along with the mistaken practice of cotton monoculture. The area's oxisols
are derived from sandstone. This sandstone crops up above the surface, especially on
hillsides. The area is almost totally deforested except for some highly degraded patches,
some riparian forest and a few plantations.
Around 600 people populated the study site. Most of these had small farm plots
(minifundios) and many had off-farm income.
Nu Pyahu
This site is located 250 km east-southeast of Asunci6n. The first 180 km are on
paved roads, and the remaining 70 km are on dirt roads. Since the study was conducted
during the drier "winter" months, the roads were in fairly good condition. However,
many people I talked with told me that these roads were impassable during the rainier
season. Mean annual rainfall is 1,600 mm. There is an average of 92 annual rainfall days
during the year and these are fairly well distributed. The Thornthwaite humidity rate for
the area is 50. It is thus also classified as humid. The absolute minimum temperature is -
5 C and the absolute maximum temperature is 400C. "Winter" conditions are similar to
those described above for Eusebio Ayala, except that the occasional frosts are harder
(Yorki and Grassi, 1988).
Soils in Ru Pyahui are mostly oxisols, with some ultisols and patchy spodosols.
Since the farm sizes are larger, they have been allowed a normal fallow period until fairly
recently. These oxisols as in Aguayty, are sandy loams with slightly higher clay content
on the top of hills. Topographically, it is an area of rolling hills and extended plains. Nu
Pyahi itself lies nestled between large cattle ranches that use the native Andropogon sp.
and Paspalum sp. grasses for grazing. These are mostly cow-calf operations of low
productivity and are not included in this study. The area has little forest. However, many
farmers have a patch of between one and five ha of forest on their land. This is logged
for personal use and incidental needs.
There are between 70 and 75 houses in Ru Pyahi. Five of these are apparently
abandoned. The total population was around 450, although an exact number was
impossible to establish. Most of the inhabitants were farmers and their average farm size
was 12 ha (non-minifundio). Some had seasonal off-farm income.
In Chapter 3, the relationships between medicinal plants, healthcare and the
environment will be explored. These issues will be discussed in both the global and the
Paraguayan national context.
CHAPTER 3
MEDICINAL PLANTS, CONSERVATION, AND DEVELOPMENT
Introduction
Increased demand for medicinal plants has led to the extinction of a number of
medicinal plant species. A recent World Bank study Medicinal Plants: Rescuing a global
heritage, finds that community conservation practices including the use of protected
areas, community awareness and training, plant research, and documenting the
knowledge of traditional uses are critical to the long-term use of these important plants
(Lambert et al., 1997). "Ex-situ" conservation, has been identified by the World Bank as
the main hope for maintaining supplies of today's levels of botanicals needed for use in
healthcare by the estimated four billion people who rely on them (Lambert et al. 1997,
Farnsworth 1991).
Ideally, all medicinal plants species should be conserved as evolving
populations in nature. However, these species should also be
conserved ex/situ (i.e. outside their habitat) as well. The primary
purpose of this is as an insurance policy. But it also has the
advantage that it is usually easier to supply plant material for
propagation, for reintroduction, for agronomic improvement, for
research, and for education purposes from ex-situ collections than
from in-situ reserves. The disadvantage of ex-situ conservation is
that the sample of the species conserved ex-situ may represent a
narrower range of genetic variation than that which occurs in the
wild. Species conserved ex-situ can also suffer genetic erosion and
depend on continued human care. For this reason ex-situ
conservation must not replace, but should complement in-situ
conservation. Most of all, ex-situ conservation should not be used
as a reason for failing to safeguard representative samples of the
medicinal plants and their habitats in nature. Priority for ex-situ
conservation should be given to species whose habitats may have
CHAPTER 3
MEDICINAL PLANTS, CONSERVATION, AND DEVELOPMENT
Introduction
Increased demand for medicinal plants has led to the extinction of a number of
medicinal plant species. A recent World Bank study Medicinal Plants: Rescuing a global
heritage, finds that community conservation practices including the use of protected
areas, community awareness and training, plant research, and documenting the
knowledge of traditional uses are critical to the long-term use of these important plants
(Lambert et al., 1997). "Ex-situ" conservation, has been identified by the World Bank as
the main hope for maintaining supplies of today's levels of botanicals needed for use in
healthcare by the estimated four billion people who rely on them (Lambert et al. 1997,
Farnsworth 1991).
Ideally, all medicinal plants species should be conserved as evolving
populations in nature. However, these species should also be
conserved ex/situ (i.e. outside their habitat) as well. The primary
purpose of this is as an insurance policy. But it also has the
advantage that it is usually easier to supply plant material for
propagation, for reintroduction, for agronomic improvement, for
research, and for education purposes from ex-situ collections than
from in-situ reserves. The disadvantage of ex-situ conservation is
that the sample of the species conserved ex-situ may represent a
narrower range of genetic variation than that which occurs in the
wild. Species conserved ex-situ can also suffer genetic erosion and
depend on continued human care. For this reason ex-situ
conservation must not replace, but should complement in-situ
conservation. Most of all, ex-situ conservation should not be used
as a reason for failing to safeguard representative samples of the
medicinal plants and their habitats in nature. Priority for ex-situ
conservation should be given to species whose habitats may have
been destroyed or cannot be safeguarded. It should also be used to
bulk up populations of depleted or even locally extinct plants for
restocking in nature. In some countries it may be appropriate to
conserve all medicinal plants ex-situ, in others, where for example
some medicinal plants are common weedy species, this may not be
necessary. With medicinal plants it is particularly important to
conserve a broad genetic base to permit improvement in the
cultivated material. When collecting the plant material for ex-situ
collection care should be taken not to put the survival of the wild
population at risk (as a general rule, no more than 20% of the
available seed of a population should be taken). (Sheldon, 1997)
In Paraguay, as in other developing nations, approximately 80% of primary and last
recourse healthcare needs are met with medicinal plants (Moreno Azorero 1987,
Farnsworth 1991). The interesting fact about the Paraguayan case is that nearly the same
percentage of the population consumes these raw medicinals and nutraceuticals on a daily
basis (Moreno Azorero 1987, Favitski 1997, Basualdo pers. comm. 1999). Not
surprisingly, and in keeping with research in other parts of the world, a large proportion
of the plants are gathered from the wild (although some are grown in home gardens and
flower pots or intercropped in fields). This chapter will review some important current
international trends relating to medicinal plant issues worldwide. Special emphasis is
placed on how awareness of the relationship between medicinal plants and the
environment can work positively towards conservation and development. It is expected
that some basic groundwork can be laid, upon which policy makers may draw when need
arises for changes in current management practices. After describing different global
aspects of medicinal plants, the Paraguayan situation is described regarding each one of
the points addressed.
Traditional Medicine, Healthcare, and the Environment
Plants for healthcare are harvested in many parts of the world, especially in
developing countries. In some cases, over harvesting of the Non-Timber Forest Products
(NTFPs) leads to loss of biodiversity at the species level. In other areas, ecosystem
degradation due to logging, clearing for pastures, urban sprawl, drainage of wetlands and
other anthropogenic alterations, cause the loss of habitat where medicinal plants can grow
and where they are easily accessible by common people.
In any nation in which traditional healthcare systems are used, the link between
local communities and the landscapes where they live is inextricable. The option to train
long term professionals in traditional healthcare often hinges as much on the probability
of there being enough health care plants available in the mediate future, as on the
acceptance or not of these practices by the scientific communities of each country. Often,
women are the primary healthcare providers and the reservoirs of knowledge of
traditional use (Lambert et al., 1997). Changing gender role patterns in the developing
countries may lead to an interruption in the chain of passing down of knowledge, which
is often (though not always) from mother to daughter.
Many societies are going through the recovery of traditional knowledge in health
care after the botanical know-how was forgotten or even suppressed in many countries.
This knowledge, the "interrupted tradition of natural medicine" may be recovered
through the study of ethnobotany, in this case called "salvage ethnobotany" (Sheldon et
al., 1997).
Recognition of Medicinal Plants as an Important Natural Resource and
Healthcare Issue
A pivotal conference that pushed the issue of medicinal plants and conservation
onto the world stage was organized by The World Health Organization (WHO), the
International Union for the Conservation of Nature (IUCN), and the World Wild Fund for
Nature (WWF), held at Chang Mai, Thailand, in 1988. Among other things, the
document recognized that medicinal plants are essential in primary healthcare, both in
self-medication and national health services; that they are being lost at an alarming rate;
and that this could have dire consequences. The document drew the attention of member
states to the vital importance of plants to healthcare; the increasing and unacceptable loss
of these plants due to habitat destruction and unsustainable harvest practices; the fact that
plant resources of one country are often of critical importance to other countries; the
significant economic value of medicinal plants used today, and the great potential of the
plant kingdom to provide new drugs; the continuing disruption and loss of indigenous
cultures which often hold the key to finding new medicinal plants that may benefit the
global community; and the urgent need for international cooperation and coordination to
establish programs for conservation of medicinal plants to ensure that adequate quantities
are available for future generations (Akerele, 1991).
Regulatory Agencies and Conventions
The Convention on International Trade of Endangered Species of Wild Flora and
Fauna (CITES) is a treaty that has been in effect since 1975 to curb markets for
endangered species. A drawback of this system is that often, by the time a plant makes it
to the list, its population is already severely decimated and its survival as a species is
Recognition of Medicinal Plants as an Important Natural Resource and
Healthcare Issue
A pivotal conference that pushed the issue of medicinal plants and conservation
onto the world stage was organized by The World Health Organization (WHO), the
International Union for the Conservation of Nature (IUCN), and the World Wild Fund for
Nature (WWF), held at Chang Mai, Thailand, in 1988. Among other things, the
document recognized that medicinal plants are essential in primary healthcare, both in
self-medication and national health services; that they are being lost at an alarming rate;
and that this could have dire consequences. The document drew the attention of member
states to the vital importance of plants to healthcare; the increasing and unacceptable loss
of these plants due to habitat destruction and unsustainable harvest practices; the fact that
plant resources of one country are often of critical importance to other countries; the
significant economic value of medicinal plants used today, and the great potential of the
plant kingdom to provide new drugs; the continuing disruption and loss of indigenous
cultures which often hold the key to finding new medicinal plants that may benefit the
global community; and the urgent need for international cooperation and coordination to
establish programs for conservation of medicinal plants to ensure that adequate quantities
are available for future generations (Akerele, 1991).
Regulatory Agencies and Conventions
The Convention on International Trade of Endangered Species of Wild Flora and
Fauna (CITES) is a treaty that has been in effect since 1975 to curb markets for
endangered species. A drawback of this system is that often, by the time a plant makes it
to the list, its population is already severely decimated and its survival as a species is
greatly at risk. A further commission was created called the Species Survival
Commission (SSC) of the IUCN. In February of 1994, it presented a document "Criteria
and Requirements for Sustainable Use of Wild Species" to the General Assembly of the
IUCN. The assembly concluded that the guidelines were too difficult to apply and that
they were too broad in their scope as well as needing further clarification. As a result, the
SSC began looking at case studies searching for possible indicators rather than broad
general outlines. In May 1994 the SSC recommended that a Medicinal Plant Specialist
Group be formed. The group's main focus is the ethical considerations related to
prospecting for new drugs, and the creation of a conservation action plan with both
taxonomic and geographic focus.
While CITES attempts to control the conservation of medicinal plants at the
species level, this is often difficult due to the problems associated with identifying a
particular plant or cultivar, especially in ground or powdered form. The SSC and World
Bank have taken the initiative of addressing both ecosystems and species level
conservation.
Projects that Involve Medicinal Plants and Conservation around the World
The Sri Lanka Conservation of Medicinal Plants Project
On December 17th, 1997 the World Bank announced the approval of a U$ 4.57
million grant from the Global Environment Facility. The project was aimed at medicinal
plant conservation and sustainable use, based on high levels of use in Sri Lanka, and the
fact that many species are endemic. This project is the first of its kind approved by the
World Bank. Though the Bank had supported the enhancement of technical skills and
greatly at risk. A further commission was created called the Species Survival
Commission (SSC) of the IUCN. In February of 1994, it presented a document "Criteria
and Requirements for Sustainable Use of Wild Species" to the General Assembly of the
IUCN. The assembly concluded that the guidelines were too difficult to apply and that
they were too broad in their scope as well as needing further clarification. As a result, the
SSC began looking at case studies searching for possible indicators rather than broad
general outlines. In May 1994 the SSC recommended that a Medicinal Plant Specialist
Group be formed. The group's main focus is the ethical considerations related to
prospecting for new drugs, and the creation of a conservation action plan with both
taxonomic and geographic focus.
While CITES attempts to control the conservation of medicinal plants at the
species level, this is often difficult due to the problems associated with identifying a
particular plant or cultivar, especially in ground or powdered form. The SSC and World
Bank have taken the initiative of addressing both ecosystems and species level
conservation.
Projects that Involve Medicinal Plants and Conservation around the World
The Sri Lanka Conservation of Medicinal Plants Project
On December 17th, 1997 the World Bank announced the approval of a U$ 4.57
million grant from the Global Environment Facility. The project was aimed at medicinal
plant conservation and sustainable use, based on high levels of use in Sri Lanka, and the
fact that many species are endemic. This project is the first of its kind approved by the
World Bank. Though the Bank had supported the enhancement of technical skills and
institutional development in Sri Lanka through the Forest Sector Development Project
and the Environmental Action Plan, this project focuses on the long-term viability of Sri
Lanka's medicinal plants by:
1) Establishing five protected areas Medicinal Plant Conservation Areas (MPCAs) to
conserve species of medicinal plants found in the wild. MCPAs act as focal points for
cultivation, research, raising awareness for the importance of conservation and
documentation of traditional knowledge of the plants and their uses; 2) Increasing nursery
capacity to research the suitability of cultivation of select species; 3) Collecting and
organizing existing information on plant species and their uses; and 4) Promoting the
appropriate legal and regulatory framework through draft regulations to ensure the
protection of Intellectual Property Rights.
Considering that the total medicinal plant collection of Sri Lanka
meets only 40% of the domestic demands the remaining 60% is
imported- there is great incentive for Sri Lanka's rural poor to over
harvest the fragile and limited supplies in the wild without much
awareness of the sustainability of the species. (Nadim Khouri and
Malcolm Jansen, 1997)
Besides the very comprehensive and well-funded Sri Lanka project, other efforts are
underway in several tropical countries aimed at the conservation of medicinal plants.
These include several schemes and different relationships between government, non-
governmental organizations and local communities. A few that deserve highlighting are
the following.
Extractive Reserves in the Brazilian Amazon
This is a new type of land-management system that arose in the Brazilian Amazon
when the rubber tappers protest movement culminated in the assassination of Chico
Mendes in 1989. Since then, many extractive reserves were modeled after the original
Chico Mendes reserve in the state of Acre, Brazil. Based largely on the extraction of two
species ofNTFPs by rubber tappers who act as stewards of the forest. The early models
were based exclusively on rubber (Hevea brasiliensis) and Brazil nut (Bertholletia
excelsa), some have recently decided to diversify the list of products that can be extracted
to include medicinal plants.
The Belize Ethnobotany Project
This project began in 1988 in the tiny Central American country. It is a
collaborative effort between The New York Botanical Garden Institute of Botany, the Ix
Chel Tropical Research Foundation in the Cayo District, the Belize Center for
Environmental Studies, and many other governmental and non-governmental
organizations. A 2,400 ha parcel of forest received the status of"ethno-biomedical forest
reserve" in 1993. Within this reserve and from other areas of Belize, plants are classified
and "rescued" by transplanting to safe areas on private farms. Although recent political
and economic changes have caused setbacks in the original program, local healers and
scientists continue to do research including the supplying of bulk samples for testing for
the National Cancer Institute (NCA-USA), (Sheldon et al., 1997).
AMETRA 2000
"Aplicaci6n de Medicina Tradicional" (Application of Traditional Medicine) is an
on-going project in the Madre de Dios region of the Peruvian Amazon. It is a
community-based project that revolved originally around one plant, the oj6 tree (Ficus
insipida) a powerful anti-helminthic. More than 100 species of medicinal plants are
currently under cultivation at the site. Although the principal objective of the project is
Mendes in 1989. Since then, many extractive reserves were modeled after the original
Chico Mendes reserve in the state of Acre, Brazil. Based largely on the extraction of two
species ofNTFPs by rubber tappers who act as stewards of the forest. The early models
were based exclusively on rubber (Hevea brasiliensis) and Brazil nut (Bertholletia
excelsa), some have recently decided to diversify the list of products that can be extracted
to include medicinal plants.
The Belize Ethnobotany Project
This project began in 1988 in the tiny Central American country. It is a
collaborative effort between The New York Botanical Garden Institute of Botany, the Ix
Chel Tropical Research Foundation in the Cayo District, the Belize Center for
Environmental Studies, and many other governmental and non-governmental
organizations. A 2,400 ha parcel of forest received the status of"ethno-biomedical forest
reserve" in 1993. Within this reserve and from other areas of Belize, plants are classified
and "rescued" by transplanting to safe areas on private farms. Although recent political
and economic changes have caused setbacks in the original program, local healers and
scientists continue to do research including the supplying of bulk samples for testing for
the National Cancer Institute (NCA-USA), (Sheldon et al., 1997).
AMETRA 2000
"Aplicaci6n de Medicina Tradicional" (Application of Traditional Medicine) is an
on-going project in the Madre de Dios region of the Peruvian Amazon. It is a
community-based project that revolved originally around one plant, the oj6 tree (Ficus
insipida) a powerful anti-helminthic. More than 100 species of medicinal plants are
currently under cultivation at the site. Although the principal objective of the project is
healthcare for the local population, supply of wild plants is an important issue. The oj6
tree is a dwindling species in the wild, and the project is focusing on forest stewardship
by the local people as a way of maintaining a harvestable stand over time.
Community Development through Medicinal Plant Projects
The success of community level production projects and commercialization
schemes are documented in several countries. A brief description of three successful
projects is given here in search of a model, which could prove suitable for Paraguay. The
marketing of raw, but clean and well-presented medicinal plants may be more suited to
small rural projects instead of high tech industrialization, which by its very nature, may
be big business for large companies. These two approaches are not necessarily exclusive,
and the proper identification of communities for projects and the right project for certain
communities are crucial to the their success or failure. Projects may be grouped
according to their main objective. Some seek grass-roots community development above
all. Others consider cash income, environmental services or sustainable development as
fundamental. Still others are basically conservation oriented. Those who focus on
healthcare as a primary goal are apparently fewest in number. Those projects that can
balance all of these objectives have the greatest possibility for long-term success, as
conservation and development are two sides of the same issue and cannot be separated.
In the Sri Lanka Medicinal plant project mentioned previously, awareness for the
preservation of medicinal plants will be increased through training and education
activities. The MCPAs will ensure that benefits of the project are felt in those rural
communities. A dispensary staffed with an Ayurvedic physician and information center
will provide appropriate medicines and information to the surrounding communities.
In the Brazilian "Cerrado," medicinal plants have been used as the basis for
community development, health, the environment and sustainable development. The
"Centro Comunitario de Plantas Medicinais: Comunidade do Cedro" is a project
currently underway in the Municipality of Mineiros in the State of Goias. This is a
community where the social network and identity dating back to the slave days had been
waning for decades.
One of the cash generating activities was the small-scale manufacture of
medicines derived from local plants. A committee formed especially for this purpose
sought local knowledge through interviews with some of the elder locals. A small plot of
land was later obtained to function as an introduction and reproduction garden. At the
same time, workshops were held on the plants of the cerrado ecosystem and on their
handling.
The positive results of this project have made it into a role model for other
communities from surrounding areas as far away as the State of Minas Gerais. The
community received low cost, good quality, and low toxicity medicines. Aside from this,
the project opened up a physical space that was beneficial in providing appropriate
conditions for the handling of the plants and at the same time strengthening internal
social organization. The "re-learning" of such traditional practices as "mutirdo" (joint
work) greatly improved attendance at community meetings (Ioris, 1999). Currently, the
project is seeking a more systematic agronomic assistance for its producers. It is
interesting to note that at the time of implementation, the organizers were not able to find
one agronomist in the entire region who possessed knowledge of the agronomic aspects
of cultivating medicinal plants. As in many other projects of this type, conservation of
natural habitats is a by-product or secondary objective.
Healthcare, Medicinal Plants, and Conservation in Paraguay
In Paraguay, health services are severely limited in rural areas. Problems include
a lack of adequate health centers; concentration of medical personnel in the cities; the
high cost of drugs, and the high cost of medical personnel. Social indicators for the
health sector only partially reflect this situation.
Table 3. Paraguay Health Indicators
Crude birth rate (per 1,000) 35
Crude death rate (per 1,000) 7
Infant mortality rate (per 1,000 live births) 42
Population per physician 1,800
Population per hospital 700
Access to safe water (percentage of population)
Urban 46
Rural 10
Calorie intake 2,873
Per capital protein intake (g/day) 81.0
Source: World Bank, 1992
Medicinal plants are healthcare inputs. Although there are probably less endemic
medicinal plant species than in the Sri Lanka case mentioned above, many are in fact
unique to this meeting of tropical and sub-tropical zones. Massive loss of habitats and
high rates of consumption are other reasons to support a medicinal plant project. While
population density is nowhere near Sri Lanka's, the growth rate of 3.2% per annum in
Paraguay is the highest in the Southern Cone of South America (World Bank, 1992). The
opportunity to use the medicinal plant issue as a driving force for conservation and
development is present and should not be overlooked. Their importance for cultural
identity in Paraguay is on a par with that of the Guarani language. Prance has insisted
upon this aspect of medicinal plant study:
We also need to bear in mind the vital role of conservation of
culture, as well as biodiversity. To my mind, biodiversity gets too
much attention compared with cultural conservation. We should be
asking ourselves: how can our work in ethnobotany help to maintain
cultural identity? (1994)
Threats to Medicinal Plants
Deforestation
The loss of forests, especially rainforests, is particularly worrisome on this subject
as they contain by far the highest biodiversity per unit area in the world. It is a
widespread, though unproven tenet, that many of these may be potentially useful
medicinal plants. An annual worldwide loss of an area five times the size of the
Netherlands serves to help visualize just how rapidly species and ecosystems are being
lost.
Paraguay is not immune to the ravages of deforestation. Most "campesinos" or
small-scale farmers live in the Eastern Region. In this area, from the 1950s, when
measurements began being taken through aerial photography until the mid 1990s, it is
estimated that 90% of the original forest was lost. Much of this was due to logging, the
expansion of the agricultural frontier, and misguided government policies, which
high rates of consumption are other reasons to support a medicinal plant project. While
population density is nowhere near Sri Lanka's, the growth rate of 3.2% per annum in
Paraguay is the highest in the Southern Cone of South America (World Bank, 1992). The
opportunity to use the medicinal plant issue as a driving force for conservation and
development is present and should not be overlooked. Their importance for cultural
identity in Paraguay is on a par with that of the Guarani language. Prance has insisted
upon this aspect of medicinal plant study:
We also need to bear in mind the vital role of conservation of
culture, as well as biodiversity. To my mind, biodiversity gets too
much attention compared with cultural conservation. We should be
asking ourselves: how can our work in ethnobotany help to maintain
cultural identity? (1994)
Threats to Medicinal Plants
Deforestation
The loss of forests, especially rainforests, is particularly worrisome on this subject
as they contain by far the highest biodiversity per unit area in the world. It is a
widespread, though unproven tenet, that many of these may be potentially useful
medicinal plants. An annual worldwide loss of an area five times the size of the
Netherlands serves to help visualize just how rapidly species and ecosystems are being
lost.
Paraguay is not immune to the ravages of deforestation. Most "campesinos" or
small-scale farmers live in the Eastern Region. In this area, from the 1950s, when
measurements began being taken through aerial photography until the mid 1990s, it is
estimated that 90% of the original forest was lost. Much of this was due to logging, the
expansion of the agricultural frontier, and misguided government policies, which
encouraged landholders to improve their land to avoid its being subject to expropriation
for land reform. As in many other countries of Latin America, this led to the falling of
great tracts of forest (200-500 ha at a time) for the establishing of monoculture cattle
grazing ranches.
The western or Chaco region was less developed until recently. A handful of
Anglo-Argentine tannin companies, along with a few Paraguayan large landholders
practiced extensive cattle production for the canned meat industry (Liebig's Extract of
Meat Co., and other large British firms), on the natural flood plain near the Paraguay and
Pilcomayo rivers. This area is populated by the palma or karanda'y (Copericia alba). It
is only within the past ten years that Brazilian ranchers have moved into the Alto
Paraguay region and begun large-scale clearing (using bulldozers and anchor chain) of
sub-humid and semi-arid forests. While Mennonite immigrants had been clearing the
central Chaco since the 1930s, their plots were usually small and family run. The
Brazilian-owned ranches on the other hand, are commercial operations. The rate of these
new land clearances could have potentially devastating impacts for the conservation of
little-known Chaco indigenous medicinal plants. Both types of clearance i.e. aggregate
family size clearings, and large commercial clearings have a devastating impact on the
environment.
Loss of Indigenous Knowledge
The Northern Chaco is home to the last group of hunter-gatherers that have not
yet come into contact with "white man." They are the Totobiesiogode. It is estimated that
there are only two or three groups of between 25-50 persons each in these clans. Their
knowledge of medicinal plants of that region, especially the powerful steroid abortificants
is being lost at the same rate as the massive deforestation of their ancestral lands (Arenas
and Moreno, 1977). The preservation of this knowledge for all generations to come and
especially for the Totobiegosode and other small tribes, depends largely upon the
recognition of indigenous rights and the setting aside of large tracts of their ancestral
lands in perpetuity.
Urban Sprawl
In countries where deforestation has long ago ceased to be the main factor to the
loss of habitat for medicinal species, such as China, a new menace confronts small farm
plots and home gardens as well as forests and fields. This new threat is urban sprawl.
Much of the best land around Beijing and other major cities is becoming urbanized. This
process can also be seen in the Central Valley of California some of the most fertile
agricultural lands in the world and in Malaysia and Indonesia, where much prime peri-
urban farm and forestland has been lost to the construction of golf courses. The need to
feed the population has led to massive (and quite successful, from the production point of
view) drainage, flooding schemes for rice cultivation in countries that have been
recovering from generations of war, such as Myanmar, Vietnam, Laos and Cambodia.
These infrastructure works, so necessary for local food security, often overshadow the
perceived lesser need for health security from natural medicines. As lands go to rice,
habitat is lost for many of the species formerly in normal use by the general population.
Several factors along the time line of Paraguayan history have saved it from the
blight of the megalopolis. Asunci6n, the capital boasts a population of only 650,000 in
the city proper, and around 1.2 million in the metropolitan area. Only four other cities
have populations of more than 100,000. There is no such thing as suburbia. Therefore,
the threat of loss of ecosystems due to urban sprawl in Paraguay is not urgent. The rate
of migration to the cities, however, is steadily rising. Just fifteen years ago, the rural
population of Paraguay was nearly 70%. The 1992 census undertaken just before the
elections showed that only 49% live in the countryside. This could pose another kind of
threat since many newcomers to the city do not have secure jobs. While they continue to
wish to drink their daily medicinal herbs, they are unlikely to be able to pay for them.
This may place great pressure on fields and riparian habitats surrounding the greater
Asunci6n, which according to some sources, have already been stripped of much of their
former wealth of medicinal plant biodiversity. It is essential therefore that conservation
projects contemplate suburban and peri-urban areas along with rural areas. Studies into
the rate and direction of conversion to urban land uses are needed.
Community Development in Paraguay
In the "Centro de Promoci6n de Campesinos de la Cordillera" (CCCP) project
mentioned earlier, one of the crops under consideration to be promoted was medicinal
plants as an understory crop for nurseries and home gardens.
One aspect of this now defunct project, which deserves highlighting, was the
"campesino-indigena" (small-scale farmer-indigenous) meeting that was organized in
1990. During this three-day workshop, native indigenous groups from eastern Paraguay
were invited to the Cordillera. The objective of this meeting was to help resource-limited
farmers recover or re-learn the names and uses of many plants of different habitats, which
have been forgotten during the many years of cotton monoculture. The meeting proved
highly successful (Fretes et al., 1993). Some of the knowledge of Guarani cosmogony
was transmitted to the local farmers during this event. Among other benefits were a new
found appreciation on their part for native species and the role that each one plays in
contributing to a more healthy, sustainable environment.
Summary
Traditional medicine, healthcare and the environment have been linked together
by many of the world's most important multi-lateral organizations, NGOs, multi-national
corporations and national governments. Paraguay must construct its system based on its
own unique components and the peculiar interconnections among them. The recognition
of the tremendous importance of medicinal plants in maintaining the health status of the
population is the logical first step. Recognizing that plants needed for this natural
medical care system are being lost at an alarming rate due to habitat destruction should
lead to policies that tend to protect biodiversity in the general sense, and especially
regarding the botanical pharmacopoeia so important to Paraguayan cultural identity and
healthcare. The very real threats of deforestation, over harvesting, and to a lesser extent,
urban sprawl, should be dealt with within this context.
Ownership of medicinal plant intellectual rights, is a crucial issue especially when
native and remote tribes are the source for medicinal plant knowledge. However, since
plants and remedies used by "campesinos" are in the public domain, the issue is less
important in the context of this thesis. The government of Paraguay needs to set up rules
to regulate the value and benefit-sharing potential of the enormous library of knowledge
that is the Paraguayan culture of medicinal plants. The policy to be created must be
uniquely Paraguayan. Reference points such as the World Trade Organization (WTO),
Trade Related Aspects of Intellectual Property Rights (TRIPs), The Convention on
Biodiversity (CBD), the National Biodiversity Institute of Costa Rica (INBIO) and other
relative agreements and projects should be taken into consideration when creating or
enforcing policy.
Finally, all of the above will have the highest, most sustainable rate of success for
the highest number of people if applied to community development projects. Grassroots,
small-scale, organic production of medicinal plants both native and introduced in
agroforestry and home garden projects is one way of achieving this. Experience from
around the world indicates that through this means, the issues of biodiversity
conservation and development may be resolved with the least cost and highest return for
all stakeholders involved.
CHAPTER 4
MEDICINAL PLANT USE IN PARAGUAY: IMPORTANCE,
HISTORY, AND NUTRITIONAL ASPECTS
The Natural Life
Dofia Zenona Gonzdlez sat in a comfortable yard chair just outside her small private
rancho. She was enjoying the sun's heating rays on this brisk July, Paraguayan
morning. I had been talking at length with her son Juan (55), on many aspects of
farming in and around Aguaity, Eusebio Ayala. As we walked into his home garden so
he could show me his medicinal plants he mentioned almost as an afterthought that
his mother, who lived near their home garden in a small house of her own, was 102
years old, and still had use of all her faculties. Apparently, my nod of acknowledgment
was one of disbelief. Juan immediately took out his wallet and proudly displayed his
father's birth certificate. The folded, sepia-colored, hand-written paper stated the year
of his birth, 1888. "He passed away in 1978, he lived a long healthy life, but my mother
is even healthier! Come, let's go see her." Frail and well wrapped against the chill,
Dofia Zenona smiled an almost toothless smile when I asked her what had kept her
going for so long.
I eat kamby (milk), so'o cu'i (ground meat), eira kesi (homemade
cheese with honey), ryguasu rupi a (eggs), rord kamby (corn bran
with milk), mbeyup6 armir6 (flat manioc starch cakes) and dulce de
mam6n con leche (papaya preserves with milk).
CHAPTER 4
MEDICINAL PLANT USE IN PARAGUAY: IMPORTANCE,
HISTORY, AND NUTRITIONAL ASPECTS
The Natural Life
Dofia Zenona Gonzdlez sat in a comfortable yard chair just outside her small private
rancho. She was enjoying the sun's heating rays on this brisk July, Paraguayan
morning. I had been talking at length with her son Juan (55), on many aspects of
farming in and around Aguaity, Eusebio Ayala. As we walked into his home garden so
he could show me his medicinal plants he mentioned almost as an afterthought that
his mother, who lived near their home garden in a small house of her own, was 102
years old, and still had use of all her faculties. Apparently, my nod of acknowledgment
was one of disbelief. Juan immediately took out his wallet and proudly displayed his
father's birth certificate. The folded, sepia-colored, hand-written paper stated the year
of his birth, 1888. "He passed away in 1978, he lived a long healthy life, but my mother
is even healthier! Come, let's go see her." Frail and well wrapped against the chill,
Dofia Zenona smiled an almost toothless smile when I asked her what had kept her
going for so long.
I eat kamby (milk), so'o cu'i (ground meat), eira kesi (homemade
cheese with honey), ryguasu rupi a (eggs), rord kamby (corn bran
with milk), mbeyup6 armir6 (flat manioc starch cakes) and dulce de
mam6n con leche (papaya preserves with milk).
She specified that she never or rarely ate sugar and flour. Unknowingly, she was
telling me that she consumed a diet of unprocessed or little processed foods. She had
never heard of modern medical trends towards high fiber, less sugary and less floury
foods. Nevertheless, her wise traditional ways were or so it seemed to me the very
essence of what health specialists preach today.
Oh, and one more thing. I never forget my herbs. I have consumed
verbena and vira vird guasfi all my life every other day. This is what
keeps me young. The only supplement I buy is vitamin B 12 and
that only started a few years ago.
The following week it was time to head for my comparative study site, Nu Pyah6,
200 km to the Southeast. As we arrived in the dusty, treeless hamlet, it was apparent that
we were not going directly to the home where we would be staying. Dofia Clemencia
Escobar (51), and her son Fransisco (14), my travel companions, had a birthday party to
attend. There were several cars and pick-up trucks arranged in haphazard fashion in front
of an unpainted plank, thatch-roofed house. Dofia Isabel Torres was receiving an honor
that for a long time had been reserved for her husband, who had passed away the
previous year. In honor of her 83rd birthday, her daughter and son in law had slaughtered
a young heifer. Although no invitations had been sent, they knew that many would come
as Dofia Isabel had touched many lives en route to this birthday. As I had done with
Dofia Zenona, I asked this woman what she had eaten and drunk to live so long.
I always ate tupi cu i (cracked corn), my mother grew taya 6
(Equinodoruspaniculatus) and I always ate home cooked food, like
typyraty (a sub-product of manioc starch processing). When I was
first married, we lived in the disierto (desert: by this she referred to
the isolated area where her husband had taken her to settle for the
first 13 years of married life). I never ate much beef, but I did eat
meat. I especially ate a lot of"paloma barrero" (dove from a salt
lick). In fact, all the meat we ate during that time was from a salt
lick. My husband would bring home dove, deer, armadillo and even
tapir, back then. It was so easy to find. As for medicinal plants, I
have always taken verbena every day before breakfast. I often take
rue as well.
All this she related to me in a comprehensible level of"yopari." This is the mixed
language more Guarani than Spanish that so many speak in Paraguay.
The fact that I was concentrating on medicinal plants brought an intriguing
question to mind. Of the three plants these two elderly women claim to have aided them
in obtaining their longevity, two were of European origin. When did the syncretism with
Guarani culture begin? Could this knowledge have been passed down exclusively by
word of mouth? Furthermore, I found more and more species of Paraguayan plants that
people normally consume. I wondered, how, with less than 2% of the population being
indigenous (and having been that way for a long, long time), and with more than 2/3 of
the original population wiped out in the genocidal war of 1865-70, names, recipes and
uses of so many plants seemed to be known and understood by so many of the common
country-folks I interviewed. There must have been some sort of systematization along
the line. I needed to take a closer look at how ancient knowledge had reached so many
and indeed, remains so popular and well respected even by many physicians in
modern day Paraguay. Regarding the maintenance of knowledge, Sheldon, Balick, and
Laird (1997) have written:
In some cultures, the knowledge of how to use plants medicinally is
shared by all members of a community, whereas in others it is
guarded by a carefully trained few. As a result, there are many
different ways ethnomedical information is transmitted from one
generation to the next. The cumulative body of knowledge can be
concentrated in healers who are respected and central members of
the community. It may also be stored in the detailed oral traditions
of a people or in elaborate medicinal volumes such as the Ayurvedic
texts of the Indian sub-continent. In other cultures, the knowledge
of the medicinal uses of plants is a thinly spread residue of folk
medicine, weakened by colonialism or other fragmentation.
Introduction
The unique situation of political and geographical isolation that Paraguay
underwent throughout much of its history is one of the main influences on the persistence
and extent of medicinal plant use. The cycle of use, starting with only wild, then
cultivated medicinals, over to western manufactured pharmaceuticals, and a slow trend
back toward more natural remedies (interrupted natural medicine) in many other parts of
the world is in contrast to Paraguay's case. Here there was no interruption, but rather,
traditional and modem pharmaceuticals exist side by side, with traditional healing taking
the higher spot in the rural areas. It is possible that a better understanding of some of the
reasons why the use of home-grown or gathered botanical elements for mostly
preventative, but also therapeutic medicine is so widespread in moder-day Paraguay,
may have policy implications that will benefit the health security of small-scale farmers.
There are two basic and quite distinct types of medicine practiced worldwide.
The most common form known to westerners of the developed countries is allopathic
medicine. This is the treatment of ailmentspost-facto, or once the symptoms
characteristic of a disease manifest themselves. The other type of medicine is a group of
medical practices known as natural or alternative medicine. While Paraguayan
Traditional Medicine is often called natural or alternative, it does not exactly fit into these
narrow categories. One type of natural medicine, in which minute quantities of medicines
(usually but not always natural or herbal) are taken a priori, on a daily or weekly
basis, before disease strikes, is usually called homeopathy. Although homeopathy has
become more popular in modern western developed societies, sometimes as a fad, in the
tropical and subtropical developing world, a form of health maintenance and preventative
medicine, which is not strictly scientific (European) homeopathy, uses homeopathic
(minute and frequent) doses of natural products for preventative medicines. This is the
essence of Paraguayan Natural Medicine. Therapeutic plant medicine also exists.
Modern Paraguay
In modern Paraguay, vendors of medicinal plants can be found on many street
corners of any one of the major cities and towns. The vast majority of the population
consumes yerba mate (Ilexparaguariensis), known as Jesuit tea or Paraguayan tea on a
daily basis. This tea is drunk differently from the more commonly known coffee and
"English tea." Instead of being prepared separately and then served in cups, Jesuit tea is
consumed as a hot infusion called mate, or a "cold" infusion called terer6. Hot mate is
usually drunk by pouring hot water onto the ground leaves of the mate plant in a gourd
and sucking it through a metal straw with a perforated end (for straining), known as a
"bombilla." This is usually consumed first thing in the morning and in late afternoon
(especially in "winter" time). Similarly, terer6, the cold version of the same thing, is
consumed at mid-morning and mid-afternoon by pouring cold or cool water onto the tea,
usually contained in a special cow's horn or "guampa" and sucked through the same
straw described above. Aside from the massive consumption of yerba mate (Ilex
paraguariensis) itself, the method and frequency of drinking of these infusions lends
itself very well to the additional intake of other herbs, roots, barks, etc. Mate and terer6
drinking provide an excellent vehicle for introducing medicines into the human organism.
One simply takes the prescribed (very often self-prescribed) medicinal plant parts,
pounds them using a mortar and pestle or other less conventional means (brick and curb,
bottle and table), and adds them to the water to be used in drinking the infusion. The
herbs are sometimes placed in the mate or "guampa" instead of the water but this is much
less common than placing it in the water itself. The word cold is placed in quotation
marks above to make a point. The infusion of refreshing leaves and roots used in the
water for terer6 drinking is known as "poha roynsa" or cold medicine (not medicine for
colds) in the Guarani language. With the advent of modern technology (ice making) and
the fusion of Spanish with Guarani to form the bastard or pidgin "Yoparw" (literally:
everything mixed together), terer6 began to be drunk with ice distorting the real meaning
of the term "pohi roynsA." Originally meaning medicine that is refreshing to the stomach
or depurative, it became cold (a reference to temperature) water medicine.
In cities, these medicinal plant parts are bought in bundles from local vendors. In
the countryside, however, these plants are grown in the homegarden and gathered from
fields and forests. Gathering forest plants was traditionally men's work. They were the
ones who went off into the forest to hunt, clear land or undertake other activities. The
growing and gathering of plants around the homestead is usually associated with women
and children. Gathering is usually carried out during women's daily walks to haul
firewood and drinking water. Women are the primary marketers of medicinal-plant
materials. Mothers and grandmothers use herbal products in the home as well as sell
them in the rural markets. Such materials make home healthcare affordable and provide
much needed income. Sustainability of supply can be greatly assisted if women were
included in the process of developing conservation and cultivation (Lambert et al., 1997).
This thesis focuses on the possibilities of cultivation rather than gathering.
Medicinal Plants in Spain
The influence of Europe on medicinal plant cultivation in the New World cannot
be overlooked. Iberian conquistadors and missionaries spread out across the central and
southern parts of the Americas brought with them the plants from their native Spain and
Portugal. These prospered when conditions were right and many cases became voluntary
weeds. In other cases, adaptation to new climatic conditions was not possible and
substitutes were sought out and found in the Americas. In Spain, most houses had a
homegarden until the early 1800s. From 1492 until the 19th century, there was little
addition of plants to the Spanish collection itself other than the significant number of
plants sent to Europe from the New World. The major source of the Spanish
pharmacopoeia itself was made up of a mixture of native Mediterranean plants common
to southern Europe, the Middle East and northern Africa. Spices brought from the East
Indies during the middle ages using the overland caravan routes through central Asia and
plants brought up from the East Coast of Africa and other areas and introduced into Spain
by the Arabs during their 800 year stay on the peninsula. Another source were spices and
medicinals brought from the East Indies by the Dutch and Portuguese just a few years
before the "discovery" of America. We find many of these plants in common daily use in
Paraguay today. The difference between the presence of these plants in Paraguay and
elsewhere, is that in Paraguay they are used daily not as spices, but as medicines. In
Europe the frequency of the keeping of medicinal plants at home began a sharp decline in
the early 1800s, with the advent of better hygiene and manufactured pharmaceuticals.
Today, as in most other areas of the world, there is a renewed interest and "revival" of
traditional herb and medicinal knowledge.
Plant Exchange During the Conquest and Early Colony
The Spanish had shown an interest in learning about autochthonous medical
science and using local fauna for this purpose. By royal decree (c6dula) of January 11th,
1579, Phillip II ordered the coming to America of General Protomedics and ordered the
study of the plants and natural waters that might have medical application. He also
ordered seeds and herbs of any healing plant of high local prestige to be sent to Spain.
Those practiced in the use of medicinal plants could obtain the title and diploma of
"Herbolario" (herbalist) to practice their specialty. Dr. Francisco Fernandez' magnificent
ten volume book on the plants of Mexico was lost to a fire at El Escorial Palace in 1617
(Martin and Valverde, 1995).
At the same time conquistadors and explorers were bringing plants with them
from the Old World, many of which became quickly acclimatized. Thus was born a
confusion that pervades many of the early works written by the unskilled observer. In
Paraguay, as well as southern Brazil, Misiones, Argentina, and Santa Cruz, Bolivia and
the countries of the River Plate estuary, natural history and indigenous knowledge on
plants and diseases were gathered and studied by naturalists and missionaries, principal
among these were the Jesuits. Many members of this order were trained in medicine or
other sciences. They wrote catalogs, recipe books and manuals some finely illustrated
- which were copied and widely distributed. In America, studies of nature and
especially medicinal plants were undertaken principally in four main areas: Peru, Mexico,
Brazil and the River Plate. Great contributors were also travelers, naturalists and early
scientists.
The Jesuit Period
The Jesuit State or Province that existed from the 17th through the 18th centuries
in lower Paraguay is considered by some as one of the greatest social experiments in
history (inspired in part by More's Utopia). During this time distance from home,
coupled with scientific rigor brought over from Europe, allowed for the classification and
description of one of the greatest known pharmacopoeias in the world (Martin and
Valverde, 1995).
During the 17th century, novice priests were waived the required three years of
Latin so that they could devote themselves full-time to the learning of the Guarani
language. A corps of orderlies (nurses) was organized early on with the specific task of
learning all they could about the local plants, their properties and uses. Many of these
nurses and later physicians had been trained in Europe, and had battlefield experience.
While ignorant of the Linnean system of classification, nevertheless were able to use
Theophrastian and Dioscoredean systems to describe and work with plants. In many
cases, they found South American substitutes for European ingredients in recipes for
poultices and infusions. Several modem authors have addressed this issue. "With regard
to the loss of autochthonous knowledge supported by the tradition of use, it may be lost
or kept definitively according to our participation to rescue it through the most scientific
annotation possible (Pulido, 1993)." The Jesuits did just this in Paraguay. They wrote
and published at least 30 books on Guarani medicinal plants during the 17"t and 18th
centuries. This has facilitated the passing down of indigenous knowledge through the
generations by more than word of mouth. A list of publications is cited in Appendix E.
The Post-Jesuit Period
After Paraguayan independence (1811), just as Europe and North America were
adopting manufactured medicines at a frenetic pace, Paraguay was totally isolated from
the outside world. This was a political strategy designed to avoid annexation by
neighboring Brazil and Argentina, and an ultimately greater menace: British interference
in internal and continental affairs (Cardozo, 1977). This isolation was a strong force in
the maintenance of native knowledge on the use, cultivation and gathering of medicinal
plants.
The 19th Century
Geographic and self-imposed isolation effectively blocked out the arrival of
modern medicines and medical techniques in the first three quarters of the nineteenth
century. In fact, the great French botanist Bonpland -Von Humboldt's travelling
companion was imprisoned and then kept under house arrest by the dictator J.G.
Rodriguez de Francia, to prevent the entry of outside influences and protect national
natural knowledge from reaching the outside world, among other reasons (Boccia, 1999).
Paraguay fought a war considered by some historians to be "the bloodiest war in history"
(Chiavenatto, 1979). During the Triple-Alliance War (1865-70), the population of
Paraguay was decimated. Reduced to one third of its former population (from 900.000 to
270.000), most survivors were women, children and the elderly. This drastic fall in
population density may be part of the explanation of how medicinal plant use was
continued into the present century. The fact that many of the survivors were women (1:7
male/female ratio) suggests that knowledge of the use and growing and gathering were in
the domain of women. Due to this destructive war, and additionally the Chaco war with
Bolivia (1932-35), Paraguay had one of the lowest population densities in Latin America
well into the late 1950s (World Bank, 1992). Slash and burn shifting cultivation was a
sustainable practice until this time, and the availability of medicinal plants from forests,
wetlands and fields was seemingly unlimited.
The Post-War Years
Another great scientist and promoter of Guarani traditional systems of thought
and knowledge of plants was Dr. Mois6s Bertoni. This Swiss-Tyrolean naturalist, after
having worked and published in his native country, came to Paraguay in the 1890s. He
set up a home and scientific research station in the remote Alto Parani Region of Eastern
Paraguay. There he delved into many aspects of science, especially agriculture, and
published a number of works including "Agenda y Mentor Agricola," in 1926, and two
volumes of"La Civilizaci6n Guarani," in 1928. These books were printed on a press that
he had installed at his home in Puerto Bertoni on the Parani river. Bertoni was later
called upon by successive governments in the 20th century to organize the agricultural
school and Botanical Gardens of Asunci6n. Throughout Bertoni's works an insistence on
the idea that the Guarani Indians had good methods of plant use and agricultural
knowledge is prevalent. His approach was way ahead of its time, even though he is
considered to have been over enthusiastic in attributing a highly developed civilization
status to the Guarani. On medicinal plant cultivation he wrote:
The Great World War raised a great interest on this continent for the
cultivation of medicinal plants. South American pharmacies found
it almost impossible to import what was usually needed. Therefore,
cultivation was considered. For a time, it appeared it would be good
business and another possible cash crop for our agriculture. Time
was lost and the great opportunity passed. As usually happens, as
soon as the danger was over, all haste was forgotten. Nevertheless,
the lesson stands. Many believed, very soundly, that the sad
occasion of war may return, and even if it should not, it will not
have been in vain to have attempted to substitute many imported
medicines with those that can be grown here. (1926, emphasis
added)
Some or all of these scientists may have provided a link between past Paraguayan
medicinal plant knowledge and the present. It must be recalled that even in the United
States, until the early 20th century, Botany was considered to be a fundamental discipline
of therapeutic medicine. As much of 80% of medicines were derived from plants at that
time. Even today, three quarters of all medicines available are derived originally from -
even though they may now be synthesized plants (Akerele, 1991).
Institutional Research in Paraguay
The National University of Asunci6n was founded on March 31st, 1890. The
majority of the new professionals went on to specialize in Europe and became eminent
scientists in their fields (Baez, 1939). Even though pharmacognosis was never part of the
medical school curriculum, many modern day Paraguayan physicians accept the use of
medicinal plants, or at least are not vehemently opposed to it, as occurs in some other
countries.
Today, the Institute of Research in Health Sciences functions with an
unfortunately low budget at the Faculty of Medicine in Asunci6n. The head of this
institute, Dr. Ricardo Moreno Azorero has for many years taken an active interest in
medicinal plants. He is a well-known indigenist, and has contributed heavily to modem
scientific writings on medicinal plants, especially those of the Chaco Indigenous groups
(Moreno Azorero 1977, 1986 and pers. comm. 1999).
As far as medicinal plants go, the most active areas of the university are the
departments of Pharmacy and Botany, both of the Faculty of Chemistry of the
Universidad Nacional de Asunci6n. Dr. Maria del Carmen Ibarrola and her group are
currently researching the anti-depressive potential ofKyllinga brevifolia Rottb. This is a
plant of the gramineae family extensively used in Paraguay in folk medicine. The group
at the department of Pharmacology has confirmed the effects of the rhizome of this plant
as an anti-depressive and stress reducer (Ibarrola, 1999 cited in ABC Color). At the same
time, Dr. Isabel Basualdo and her colleagues at the department of Botany at the same
Faculty are doing serious work on their own and with the Botanical Gardens of Geneva in
the very important field of plant inventory and systematics. These findings are regularly
published in the journal of the department of Botany "Rojasiana." Such works as
"Medicinal Plants in Paraguay: underground organs" by Basualdo have appeared in
Economic Botany (1995).
An inter-institutional project between the Botanical Garden of Paraguay, the
Municipality of Asunci6n, Alter-Vida, an NGO, and the Botanical Garden of Geneva
(CJBG) has published "Paraguayan Ethnobotany, Ethno-Botanically and Socio-
Economically Formalized Inventory of Medicinal Plants Traded in the Markets of
Asunci6n" (Didier et al., 1999). The emphasis on research regarding medicinal plants is
obviously not located at the School of Medicine, but rather in the Faculty of Chemistry.
It will be interesting to see in the future if collaborative research will be undertaken
between the Faculties of Chemistry (Departments of Pharmacy and Botany), Medicine
(Institute of Research in Health Sciences), and Agronomy (Horticulture and Human
Ecology).
The school of Human Ecology, of the Faculty of Agricultural Sciences, has had
several students research medicinal plant use near their rural workstation at Piribebuy.
The contribution of Maria Castillo de Favitsky in her 1997 thesis is enormous. In it she
gives solid evidence of what so many had wrote about previously as intuitive knowledge.
That is, medicinal plant infusions are not only medicinal but also nutritious. Here in the
United States "nutraceutical," a term that describes any natural dietary supplement that is
both therapeutic and nutritional is very much in vogue. Medicinal plants contain
proteins, fats, carbohydrates, mineral salts and vitamins. A typical plant contains around
40 active substances in the vegetative stage and 60 in the flavoring stage (Ratera, 1996).
This point has been suspected and known for a long time in Paraguay. Gonzilez Torres
1986, Ratera 1996, Burgstaller 1987, and the Japanese Technical Cooperation Agency
(JICA) 1988, among others mentioned it.
It is this nutraceutical portion of the medicinal plant consumption, i.e.considering
them as foods, that is most intriguing. Paraguayans eat many greasy, hard to digest
foods. Perhaps medicinal plants are an aid in liver function for digestion (Ocampos, pers.
comm., 1999). The Japanese finding of the enzyme ardosa reductase in many medicinal
plants supports this notion. This enzyme contributes greatly to proper liver function
(JICA, 1988). Dr. Timothy Johns, of McGill University in Canada has worked for twenty
years with the Maasai. He describes what he calls the "Maasai Paradox," this is similar
to the French Paradox of southwestern France (and possibly the "Rural Paraguayan
Paradox"). Among both these peoples, enormous amounts of animal fats are eaten.
Among the Maasai, they account for 80 % of the diet. Their staple is lard soup. Both the
southeastern French and the Maasai of Tanzania and Kenya have normal serum
cholesterol level. In the French case, it is known that flavinoids contained in red wine
somehow keep cholesterol levels low. Among the Maasai, gums, sticks, barks and leaves
are constantly chewed throughout the day. Dr. Johns' theory is that over the millenia
man has selected plant products to eat for their anti-oxidant properties.
"Plant Materials Consumed as Normal Dietary Constituents may provide sources
of nutraceuticals or dietary supplements with potential for commercial development.
Low incidence of atherosclerosis and hiperlipidemia among African pastoral populations
consuming whole milk as their main staple, and 60% or more of their calories as animal-
derived, run counter to epidemiological evidence from other milk consuming populations.
Anti-oxidant and lipid-binding properties of roots and barks that are added to high-fat
soups and of gums and other plant masticants help explain this paradox. In addition as
part of a participatory research program with Maasai communities in Ngorogoro district,
Tanzania, we have documented species that are added to boiled milk to form a product
called 'Orkiwa.' This product may improve milk properties by altering lipid composition
or cholestrogenic properties of the milk. Elaboration of dietary supplements from plant
products that can be harvested sustainably by local people can contribute to economic
development within these communities (Johns, 1999)."
Elaborate experiments designed to deprive one group of medicinals while others
consume them to see if those deprived suffered from more nutritional deficiencies are
unthinkable under modern ethical standards (Hiebsch, pers. comm., 2000). Dr. Elisa
Ferreira, professor of family nutrition at the School of Human Ecology in Asunci6n has
reported that there is very little undernourishment in Paraguay. In fact, the only place in
the country where extreme malnutrition can be observed is in the poverty belts around
Asunci6n and Ciudad del Este (Ferreira, pers. comm., 1999). Perhaps the tens of
thousands of people who have migrated to the city recently do not have access to the
medicinal plants they used to consume in the countryside. This possibility merits further
research.
In her study, Favitsky (1997) found that 100% of those surveyed in 11 districts of
Piribebuy consumed medicinal plants on a daily basis. Among her conclusions were that
drinking terer6 or mate is a cultural habit and not a vice. Nutrition enters very little in
people's choice of plants to consume. And some of the main reasons they are consumed
are that they grow all over, are accessible, are flavorful, and people have faith in the fact
that they help one maintain themselves healthy. The knowledge of those surveyed on the
possible nutritional value of botanicals was very low (Favitsky, 1997).
Table 4. Mineral and Vitamin Contents of Dorstenia brasiliensis
Vitamin or Amount Contained Human Percent of
Mineral per 100 g Requirements* Daily Requirement
Provided
Vitamin C 2.9 mg 55 mg 2.5
Thiamine (Vit. B1) 0.0724 mg 1.17 mg 0.2
Riboflavine 0.865 1.67 mg 2
(Vit.B2)
Calcium 144 840 mg 28.8
Magnesium 44.2 275 mg 13
Iron 17.3 6.5 mg 96.1
Sodium 11.9 1,116 mg 1.07
Potassium 296 900 mg 32.89
Source: Favitsky, 1997, analized at School of Chemistry, Universidad Nacional de Asunci6n, San
Lorenzo, Paraguay, 1997. These data correspond to ground powder of the whole plant of Dorstenia
brasiliensis. Dilution in water might diminish or modify their virtues (Favitsky, 1997). *Comparison to:
U.S. male (25-50 years of age)
Cycles of Knowledge and Use of Medicinals in the World and Paraguay
A newly founded Institute that may exemplify a return to medicinal plant use in
many parts of the world is the Institute for Traditional Medicine in Dar-es-Salaam,
Tanzania (Ngowi, pers. comm., 1999). Western-trained doctors increasingly attend
symposia on alternative medicine held at western medical facilities. The simultaneous use
within hospitals of modern pharmaceuticals and medicinal plants is a norm in Thailand.
Ghana is extremely advanced in this type of complementary use of both systems. Another
example is the Rukararwe tree-planting project under the Bweranyangi West Ankole
Diocese Bushenyi, Uganda. This is a church-sponsored project aimed at rescuing and
disseminating traditional medicinal plant knowledge for the treatment of illnesses
(Mugisha, pers. comm., 1999).
In 1998 many articles began to appear in North American medical journals. The
New England Journal of Medicine (NEJM) wrote a scathing editorial against the use of
dietary supplements. In contrast, in November the Journal of the American Medical
Association (JAMA) printed a special issue covering alternative medicine. It contained
six articles covering original research, review articles and editorials on herbal topics.
Seven of the nine other American Medical Association (AMA) Journals published at least
16 articles on herbs the same week. In all, AMA published at least 22 articles dealing
with herbs. In response to a call for papers, the JAMA received over 200 manuscripts
and additional manuscripts were submitted to the other Archives journals owned by
JAMA. In all, over 80 articles and editorials were published in the 10 JAMA journals
including 18 randomized trials and systematic reviews covering over 30 topics, with
authors from over 16 countries (Fontanarrosa and Lundberg 1998, cited by Blumenthal
1999). Despite the opposition of the also influential NEJM, it appears that medicinal
plants for use in modern medicine are becoming more mainstream, even in the USA.
In general, around the world, widespread cultivation and gathering of medicinal
plants declined as population density increased and land became scarcer. The knowledge
and use of these plants was further left by the wayside with the appearance of European
colonial powers pushing their products on indigenous populations and prohibiting or
limiting use of local medicines. In many cases, this was due to incompatibility with
European religious beliefs (Christians often considered local medicine to be "black"
magic or witchcraft). Many drugs no longer in use in the first world were dumped on
"third world" countries by unscrupulous multi-national pharmaceutical conglomerates,
even to the point of recommending drugs for uses for which they had been strictly banned
in the developed world (De Assis Pacheco, 1983). With high and rising costs of modern
medicine all over the world, efforts are undertaken to rescue forgotten knowledge of
medicinal plant cultivation and use. Finally, large multinational pharmaceutical
conglomerates take over this native knowledge rarely paying royalties to do so and
manufacture pill or liquid modern forms of traditional medicines which are then marketed
around the world, even to the countries from which the plants originated. An example is
the sweetener and diabetes medicine Stevia rebaudiana B., native to Paraguay, and
currently being produced in Southeast Asia, and the Peoples Republic of China for the
Japanese market where it is a multi-million dollar industry. No benefits from these sales
have ever reached a Paraguayan community. Intelectual property rights (IPR) have
already been touched upon above.
Western-Trained Physicians' Attitudes
In order to help confirm a suspected trend in physicians' attitudes toward
medicinal plants for this thesis, an informal survey was conducted among Paraguayan
physicians between the months of September and October of 1999. The objective of the
surveys was to find out about Western-trained doctors' attitudes towards medicinal
plants. A short questionnaire was designed and sent to Paraguay. Thirty-one doctors
answered the survey out of 54 that were sent (a 57.4% response). Thirteen specialties and
10 different countries of post-doctoral specialization were represented. This was
assumed to be a representative cross sample of the current Paraguayan medical
community. A deeper study of this phenomenon may be useful to the health status of
Paraguayans.
The composition of the doctors surveyed was the following:
Table 5. Doctors Surveyed by Field of Specialization*
Psychiatrist 4
Gynecologist/OB 4
Internal medicine 4
Gastroenterologist 1
Endocrinologist/Diabetes 3
Pediatrician 2
Anesthesiologist_ 2
Urologist_ 1
Osteopath 2
Hematologist 1
General Surgeon 5
Pneumologist 1
Allergist 1
Table 6. Doctors Surveyed by Country of Specialization
USA 6
Denmark 1
France 2
South Africa 3
Brazil 4
Netherlands 1
UK 2
Mexico 2
Paraguay 7
Argentina 3
Table 7. "I believe that medicinal plants have therapeutic value"*
Answer No. of Doctors Percentage of Sample
Agree 24 77%
Disagree 4 13%
Indifferent 3 10%
Table 8. "I am interested in alternative medicine, especially medicinal plants"*
Answer No. of Doctors Percentage of Sample
Agree 19 58%
Disagree 5 16%
Indifferent 7 26%
Table 9. "I recommend the use of medicinal plants aside from prescription drugs"*
Answer No. of Doctors Percentage of Sample
Agree 14 45%
Disagree 8 26%
Indifferent 9 29%
Table 10. "I take medicinal plants myself with mate, terer6 or as tea"*
Answer No. of Doctors Percentage of Sample
Agree 15 48%
Disagree 12 39%
Indifferent 4 13%
*Source for all tables: E-survey conducted by Norman Breuer with Paraguayan
physicians in September-October, 1999. N=31
The relative open-mindedness of modern western-trained physicians towards
medicinal plant use may be a result of the conditions mentioned above. This attitude
could prove useful for a range of Paraguayan needs including healthcare, development,
conservation, and cultural identity. If well-trained doctors faithful to the scientific method
are receptive to something as primitive, or avant-garde as botanical remedies, it is logical
to assume that this frame of mind is very prevalent among the lay population.
Homegardens, Healthcare, and Nutraceuticals
The nutraceutical component of homegardens can be seen when looking at some
common systems in other parts of the world. Fruit trees such as guava, rambutan, mango,
and mangosteen and other food-producing trees such as Moringa oleifera and Sesbania
grandiflora dominate the Asian homegarden. A substantial proportion of food
requirements (as high as 40%) is provided by the Javanese homegardens. It also
produces more net income than the rest of the farm (Nair, 1993). Sommers (1978, cited
in Nair, 1993) surveyed 40 householdswith homegardens in the Phillipines and found
that they supplied all the households with the recommended daily requirements for
vitamin A, vitamin C, iron, and calcium. Moreover, half of the households obtained a
sizeable part of their thiamine, riboflavin, and niacin requirements from the homegarden
outputs and resources. This well-rounded diet may be thought of in terms of preventative
or homeopathic medicine arrived at empirically over the ages.
Obviously, many important elements required for health security at the small farm
level come from plants grown around the homestead. In fact, it has been noted that: "the
knowledge and use of medicinal plants for medicinal purposes dates from the very
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