Discoveries at Lassance, Quebrada de Tarapacá, and Cuzco fill in some of the early history of Chagas’ disease in the Andes, but there remains a large void. Archaeologists, physical anthropologists, parasitologists, and paleopathologists have contributed to our knowledge of Chagas’ disease, and further interdisciplinary research is relevant to understanding Chagas’ disease.
Inca Expansion and the Spread of Chagas’ Disease
Medical anthropologists can interpret how sociocultural factors contribute to the parasitic cycle of Chagas’ disease. Inca civilization illustrates this. Often compared to the Romans, Incas are famous for their conquests, empire building, architecture, and treatment of diseases (see Lumbreras 1974, Rowe 1946, and Zuidema 1964). These achievements influenced the transmission of T. cruzi and the treatment of its syndromes. The Inca empire extended from Chile to Ecuador, and from the Pacific Ocean into the Amazon. An extensive road network was established between colonies. During the empire’s height in the fifteenth century several hundred ethnic groups and thousands of communities exchanged resources, ranging from parrots of the Amazon in Ecuador, Peru, and Bolivia to salt from the high Atacama desert in Argentina and Chile.
When Incas expanded their empire from Cuzco to Bolivia, Chile, and Ecuador, T. infestans rapidly spread to communities across the Andes, providing an example of biotic exchange following “civilizing” forces. T. infestans became a commensal species (such as mice), living in close proximity to humans. Houses provided proximity to animals and humans and a protected habitat from the cold. Unknowingly, Incas transported vinchucas in llama caravans throughout the empire.
During the expansionist fifteenth century in Incaic America, Pacha Kuteq Inca Yupanki, the ninth king, conquered the Chanka, a powerful neighboring kingdom, and his son, Tupac Inca Yupanki, extended the empire from the Mapuche line in central Chile to Quito, Ecuador, as well as westward to the coast and eastward to the Amazon. The Inca empire was named Tawantinsuyo for four triangulated sections that were formed with the bases of the triangle at Cuzco, the apexes extending to the four directions: two long-sided isosceles triangles pointing north and south, and short-sided triangles pointing east and west.
The Inca present a unique example of how a mountain civilization was able to incorporate many ecological zones and cultures within a continent. During the Incario there was a massive exchange of people, cultures, resources, animals, plants, insects, and parasites. Only within the last twenty years has there been a comparable ethnic and biotic exchange within the Andes.
The Andes are characterized by their verticalityas one travels up a mountain, the width of the ecological band decreases. Climbing an Andean mountain, one finds tropical leafy plants, monkeys, and parrots in the lower valleys; corn, vegetables, and fruits on the lower slopes, potatoes, oca, and barley on the central slopes; alpacas, llamas, and bunch grass on the higher slopes; and mossy and furry plants on the tundra near the summit. Andean communities live, farm, and herd in these zones. They then exchange resources with others, often relatives, from communities at another level. For example, highland Aymara herders raise alpacas and llamas at 15,000 feet whose meat they exchange to Quechua farmers at lower levels who raise potatoes, and to other farmers at still lower levels who grow corn.
The Incas moved mitmakuna, colonists, from each of the several hundred ethnic groups to different regions of the Andes as well as to different elevations. These colonists expanded the groups’ access to products throughout the Andes. The Incas profited politically by being able to better control each group, now weakened at home by the exportation of members and by the settlement within the ethnic group of Inca administrators. The ethnic groups were not entirely unhappy, however, because mitmakuna opened up the possibility of exchanging resources with many different regions. The Incas demanded portions of all produce for the state, to be stored in warehouses and used in times of famine and war. An elaborate system of roads, runners (chasquis), quipus (knotted cords used to keep records), warehouses, and military posts linked the communities with the capital, Cuzco, and each other.
Chagas’ disease increased with this exchange of people and resources that had previously been restricted to smaller levels of the region. The Incas brought herbalists and ritualists to Cuzco from the Lake Titicaca region for medicinal purposes. Especially recognized, the Kallawayas, now located in Province Bautista Saavedra, Charazani, Bolivia, carried the chair of the Inca king and practiced herbal medicine in Cuzco and other parts of the Incario (Bastien 1987a, Oblitas Poblete 1968, 1969, 1978). (Kallawaya treatments for Chagas’ disease are discussed in the next chapter.)
Inca Housing and Settlement
Architecture and housing affected the infestation of vinchucas in Cuzco. Inca rulers divided Cuzco into two parts, called upper and lower Cuzco; each was further divided into clans of pure-blood Incas, half-breed people, and foreigners (see Zuidema 1964). The clans were matrilineal, with matrilateral cross-cousin marriages between the clans. Clustered gatherings of houses and their inhabitants provided T. infestans (harboring T. cruzi) ample opportunities to hide and feed.
The imperial city of Cuzco provided many havens for insects. Imperial houses and temples were built of tightly fit dressed stone. Mortar and plaster were little used, providing openings at cornices and foundations for vinchucas to enter. Roofs consisted of wood primarily that preferred sites for T. infestans to nest. Houses in the suburbs were constructed of field stone, clay, or adobe. They were rectangular with gabled and thatched roofs. The rooms were built around a courtyard where animals were kept. The proximity of animals to sleeping quarters facilitates the transmission of T. cruzi from infected animals to humans through the bite of vinchucas.
Spanish Conquest and Vinchucas
The sequel to the Inca empire was the Spanish conquest in 1532, partially facilitated by civil war and diseases. As Tupac Yupanki lay dying in Quito about 1527, he was informed of white-skinned people with hair on their faces and shining clothes riding on big animals, they having appeared around Panama. Tupac Yupanki established a dual government. One ruler, Atawallpa, wanted total control, attacked the other, and imprisoned him after five years of civil war. Francisco Pizarro met Atawallpa on the plains of Cajamarca in 1532, slaughtered thousands of Incas, held Atawallpa ransom for gold payments from Cuzco, and then beheaded him after receiving the shipment of gold.
It is not certain to what extent Chagas’ disease debilitated the Incas, but from the evidence of this disease among Inca mummies one can assume that at least some Incas suffered from chronic Chagas’ disease. Chronic Chagas’ disease is considered by some to be the greatest hindrance to development in Latin America today.
After the Spanish conquest of the Incas, Andeans were weakened with diseases of Old World origin (see Dobyns 1963). Smallpox, measles, malaria, yellow fever, bubonic plague, and undoubtedly several other diseases were unknown in the pre-Columbian New World (Ashburn 1947; Crosby 1976). Andeans were especially stricken by smallpox, which was accompanied by respiratory ailments, possibly measles and tuberculosis. These diseases are considered virgin-soil epidemics because Andeans had no previous contact with them and were immunologically almost defenseless.
An epidemic of the 1520s in Peru was caused by either measles or smallpox. Smallpox is the prime suspect. It was a major blow to the Inca empire because it killed Wayna Capac, the Inca emperor, and as many as one-half of the population (Crosby 1972:52). “When Wayna Capac died,” wrote Cieza de León (1959), “the mourning was such that the lamentation and shrieks rose to the skies, causing the birds to fall to the ground. The news traveled far and wide, and nowhere did it not evoke great sorrow.” Conquistador Pedro Pizarro (1921) recorded that had “Wayna Capac been alive when we Spaniards entered this land, it would have been impossible for us to win it, for he was much beloved by all his vassals.” Andeans of the Inca empire told Pedro Pizarro that they had no acquaintance with smallpox in pre-Columbian times (see Crosby 1972:62, note 38). Smallpox is only one of the epidemics
that decimated Andean populations. The pre-Columbian population for the central Andes has been estimated at 6 million inhabitants; by 1650 the population had decreased to 1.5 million (see Dobyns 1966:397-98).
Conquest also brought drastic social changes, one being that Andeans were expected to exchange resources, silver, and gold with Spain. Many of the ties across the Andes were diminished as others were created from the mountains to the coast and across the Atlantic. During colonial and post-colonial times, large cities were established along the Pacific and Atlantic coasts of South America. Trade routes were established between coastal ports and interior cities. A major route was established between the oceans from Lima, through Cuzco, across the central Andes to La Paz, to the mines of Potosi and Sucre, and down across Argentina to Buenos Aires. Infected vinchucas, animals, and humans traveled this and other routes until all the countries of Latin America had Chagas’ disease.
Vinchucas had become a nuisance in Chile in the 1800s. The following is a translation of Rodolfo Amando Phillippi’s Viaje al Desierto de Atacama hecho por orden del Gobierno de Chile en el verano 1853:
Fleas and lice are not found in Atacama, and the natives assure me that these animals die whenever they are introduced by chance. Instead of these, the houses abound with vinchucas. It is a species of flying bug with very large legs; its length is 11 lineas, but it is very slender, of dark color. They rarely fly, and during the day they principally hide in the thatch of the roof where they descend at night to feed themselves on human blood. Their bite does not cause pain, but sensitive people develop boils that become inflamed for several days, accompanied by a species of fever. If a vinchuca is squashed, it leaves a very black mark that never can be removed. One morning, I counted in my bed forty-one vinchucas between large and small. They appear to belong to various distinct species, and there are some rare ones in the middle of the desert (Amando Phillippi 1860:54).
This account indicates that vinchucas continued to infest houses in the nineteenth century. The author also makes the point that vinchucas colonize areas not frequented much by other insects; he also emphasizes the insects’ abundance.
Conclusion
An important factor in the spread of Chagas’ disease was the political economy of colonization, accompanied by impoverishment of people, destruction of land, and attempts to replace Andean culture with European and American culture. It is no wonder that Andeans still refer to foreigners as “vinchucas.”
Andean Indians celebrated the quincentennial of Columbus’s discovery of America with sorrow because of their perceived destruction of the New World. Some Bolivians designed a flag for the occasion. Written on this flag, which symbolizes a pan-Andean nativistic movement, is the word “Pachacutej” (“reversed time”) and “500 years.” An Aymara leader explained its significance: “For five hundred years we have suffered diseases, poverty, and destruction of land which started with the Conquest. Now, we have to travel five hundred years back to return to what has been taken away by others.” Bolivians of all classes are working towards restoring the values, beliefs, and practices inherent in Andean culture. One finding of this book is the importance of renewing certain Andean traditional patterns to help prevent Chagas’ disease. These patterns involve environmental factors that impinge upon housing, herding, and farming, and that in turn are related to parasites, insects, mammals, and humans. Restoration of cultural values can help Bolivians get rid of the “vinchucas.”
CHAPTER THREE
Jampiris and Yachajs: Andean Ethnomedicine
Kallawaya herbalists have dealt with the symptoms of Chagas’ disease for many years. Kallawaya herbalists and diviners practiced as early as the Wankaris and Incas, with a healing tradition that dates back to A.D. 500. Even today, these diviners and traveling herbalists are recognized for their curing techniques in Argentina, Bolivia, Chile, and Peru (see Bastien 1987a). Kallawayas live in the Province of Bautista Saavedra in northwestern Bolivia near the Peruvian border. Approximately 120 herbalists (jampiris) and sixty diviners (yachajs) continue to practice the rituals and herbal healing that have been passed down by their ancestors for over a thousand years.
Andeans have effectively adapted to Chagas’ disease for thousands of years, illustrating that traditional medical systems can work independently of biomedical systems, and perhaps even more efficiently and economically, and that it is not necessary that Andeans understand Chagas’ disease in terms of Western biomedicine. Conversely, Americans rarely understand how Kallawaya medicine operates. Medical systems are peculiar to different cultures, as they function within environmental and sociocultural parameters. Kallawaya curanderos, for instance, provide valuable lessons about the relationship of disease to environment. They symbolically express that Chagas’ disease spreads through deforestation, impoverishment, and urbanization bringing T. cruzi, vinchucas, animals, and humans into proximity. Chagas’ disease results from this disorder and must be washed away in the river. These ancient medicine men drive home the lesson of an uncared-for earth.
Misfortune Ritual: Dispelling Chagas’ Disease
The following “misfortune ritual” of a Kallawaya warmiyachaj (woman diviner) illustrates how ailments of Chagas’ disease can be seen to reflect the forces of nature. It is derived from contemporary research of rituals among the Kallawayas from 1963 to the present (see Bastien 1978, 1987a, 1992). Pseudonyms are used and the account is narrated in the first person. The patient’s name is Tika, “flower” in Quechua. Tika tells about her ailments:
Chuyma usu [heart disease], I asked for a yachajs [soothsayer] to read the coca leaves and the bowels of a cuy [guinea pig] to see why my ajayu [spiritual fluid] and vira [fat: material energy] do not flow back and forth between the earth. Why my chuyma [heart] gets bigger and bigger…
The yachaj spoke with Pachamama [Mother Earth], who said that my chuyma contains fluids that must flow down the river like my yawar [blood] used to flow. Yawar, ajayu, and vira have stopped. I must call a Jampiri [herbalist] and a Warmi Yachajs to perform a sajjra mesa [misfortune ritual] to the mayu [river].
Figure 10.
Kallawaya jampiri or herbal curer. Approximately 120 Kallawaya herbalists live in the Department of Bautista Saavedra, Bolivia. They travel throughout Andean countries treating people with Chagas’ disease and other illnesses. They practice a thousand-year-old tradition and use over one thousand plants. (Photograph by Joseph W. Bastien)
Tuta Korota, a warmiyachaj, was called to perform a sajjra mesa. The first part of the ritual was performed in the cooking room of Tika’s house to dispel the misfortune with the wind; the second part was performed near the river to wash the misfortune away. A woman performs sickness rituals to the wind and river due to her structural position in a society in which she marries and moves away from her matrilineage but in which her daughters marry and return to their mother’s land. She links the generations in marriage in a movement away and yet continuous. According to age-old traditions, women are linked with misfortunes, both causing as well as removing them. So, too, rivers wash away misfortunes but also restore. Rivers form the boundaries of the land. The configuration of Cuzco as the body of a puma was defined by rivers flowing through the capital of the Incas (Rowe 1967). Rivers are also seen to traverse the heavens and netherworld. The Milky Way is believed to connect the stars across the sky. Concomitantly, it is believed that underneath the ground are rivers along which the dead travel on their return to the earth (Bastien 1978).
Tuta Korota arrived at Tika’s house on a Friday night, shortly before midnight. Tika described it:
Tuta Korota sat in the eastern corner facing west, I sat with my mother and sisters around her. We placed cloth, potatoes, oca, and coca leaves in a bundle, tawichu, a woman like us. Tuta Korota was a wizard of the wind also. She purified us with incense and asked permission of the wind [Wayra] to perform the ritual by throwing aqha [chichal corn beer] into the air so that Wayra could carry it “to where Wayra blows.”
Wayra had supposedly b
rought chuyma usu to Tika, and, in retaliation, Tuta Korota poured another cup of chicha for the community wind. She passed this cup over Tika’s and her matrilineal relatives’ heads and went into the courtyard to throw it into the wind. This toast was to ensure that the wind of those who cursed Tika would be destroyed.
Wayra has two aspects: it serves as a metaphorical vehicle for cursing people, and it also brings the rain clouds to wash away sicknessto remove the chijekuna (invisible troublesome substances) within Tika and to dispose of them within the river. The wind’s two climatic properties parallel the river’s two relationships to the mountain as both erosive and cyclical. As Andean etiology parallels telluric forces of nature, so too Andean ethnomedicine symbolically serves these forces (see Bastien 1978, 1985, 1987a, 1992). Tika continued:
Tuta Korota laid a wayllasa [ritual cloth] between us. She laid a rat at the head of wayllasa and sorted out twenty wads of dark llama wool. Mamay [my mother] brought coca leaves from Cabildo [shrine of patio] and Capilla [Chapel]. Tuta Korota put slivers of llama fat on the coca, saying, “Here’s some food for the rats and mice.” Tuta Korota also served daisies, seeds, herb clumps, and moss. The wads were wrapped to the rat’s back and two wads were given to each of us. Tuta Korota rubbed me with the wads, demanding, “Chijekuna purijchej! Chijekuna purijchej! Chijekuna purijchej!” [Be gone!]…
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