# Between their own and the western: the experience of Emberá communities in Chocó with Malaria

## TL;DR

This study explores how Emberá communities in Colombia perceive and manage malaria, highlighting their blend of traditional and Western approaches.

## Contribution

The study reveals how Emberá communities construct meanings around malaria, integrating spiritual and Western health practices.

## Key findings

- Malaria is perceived as a 'Western disease' and attributed to mosquitoes, not human transmission.
- The Jaibaná (spiritual healer) plays a key role in treating malaria by addressing spiritual causes alongside Western medicine.
- Ancestral practices are used in healthcare, but often empirically and in response to public demand.

## Abstract

To explore how the Emberá communities of Chocó, Colombia, coexist with malaria, through the recognition of the meanings they construct about the disease, its treatment, and care.

This was an ethnographic study. Between October 2022 and November 2023, 250 hours of participant observation were conducted in six Emberá indigenous communities, and 25 interviews were conducted with community members, including authorities and Jaibaná. The data were analyzed according to Constructivist Grounded Theory, using NVIVO software.

The central category «Malaria: a disease that accompanies indigenous communities» emerged, supported by three subcategories: «Disease from the West,» which moves with people, can be prevented, and is always present; «The mosquito as the master of the disease,» which is controlled through training, cleanliness and hygiene, use of mosquito nets, and organic food; and «Health Care for Indigenous People with Malaria,» which begins with the Jaibaná, who controls the spirits that hinder the process and Western treatment.

Communities perceive malaria as a Western disease and attribute its origin and transmission to mosquitoes, without recognizing humans as the main source of outbreaks. The Jaibaná plays a fundamental role in patient care, addressing spiritual conditions that complement Western treatment. Although the incorporation of ancestral practices into health care for Indigenous communities is recommended, this is done empirically and based on public demand.

Explorar cómo las comunidades Emberá del Chocó, Colombia, conviven con la malaria, a través del reconocimiento de los significados que construyen sobre la enfermedad, su tratamiento y cuidado.

Estudio con enfoque etnográfico. Entre octubre de 2022 y noviembre de 2023, se llevaron a cabo 250 horas de observación participante en seis comunidades indígenas Emberá; y 25 entrevistas a miembros de las comunidades, incluyendo autoridades y jaibanás. Los datos se analizaron según la propuesta de la Teoría Fundamentada Constructivista, utilizando el software NVIVO.

Emerge la categoría central «La malaria: enfermedad que acompaña a las comunidades indígenas», sustentada en tres subcategorías: «enfermedad proveniente de occidente» que se mueve con las personas, se puede prevenir y siempre está presente; «el mosquito como dueño de la enfermedad», el cual se controla mediante capacitación, limpieza y aseo, uso de toldillo y alimentación orgánica; y « la atención en salud del indígena con malaria» que inicia con el jaibaná quien controla a los espíritus que entorpecen la evolución y el tratamiento occidental.

Las comunidades perciben la malaria como una enfermedad occidental y atribuyen su origen y transmisión a los mosquitos, sin reconocer al ser humano como la principal fuente de brotes. El jaibaná asume un rol fundamental en el cuidado del enfermo, atendiendo afecciones espirituales que complementan el tratamiento occidental. Aunque se recomienda la incorporación de prácticas ancestrales en la atención en salud de las comunidades indígenas, esta se realiza de forma empírica y por demanda de la población.