Ambio 2016, 45(Suppl. 3):S263–S275 DOI 10.1007/s13280-016-0826-1 Gendered medicinal plant knowledge contributions to adaptive capacity and health sovereignty in Amazonia Isabel Dı́az-Reviriego, Álvaro Fernández-Llamazares, Matthieu Salpeteur, Patricia L. Howard, Victoria Reyes-Garcı́a Abstract Local medical systems are key elements of actors and groups living in small-scale populations social-ecological systems as they provide culturally (Kleinman 1978, 1980). Local medical systems are critical appropriate and locally accessible health care options, to the resilience and adaptive capacity of many indigenous especially for populations with scarce access to peoples and rural communities with scarce access to bio- biomedicine. The adaptive capacity of local medical medicine. ‘Resilience’ refers to ‘‘the capacity of a social- systems generally rests on two pillars: species diversity ecological system to absorb recurrent disturbances so as to and a robust local knowledge system, both threatened by retain essential structures, processes and feedbacks’’ local and global environmental change. We first present a (Adger et al. 2005, p. 1036), whereas ‘adaptive capacity’ conceptual framework to guide the assessment of refers to ‘‘the preconditions necessary to enable adaptation, knowledge diversity and redundancy in local medicinal including social and physical elements, and the ability to knowledge systems through a gender lens. Then, we apply mobilize these elements’’ (Nelson et al. 2007, p. 397). this conceptual framework to our research on the local Local medical systems contribute to resilience and adaptive medicinal plant knowledge of the Tsimane’ Amerindians. capacity because they provide culturally appropriate, Our results suggest that Tsimane’ medicinal plant locally accessible, and affordable health care options knowledge is gendered and that the frequency of reported (Kassam et al. 2010; Santoro et al. 2015). ailments and the redundancy of knowledge used to treat Local medical systems generally rely on two main pil- them are positively associated. We discuss the implications lars: plant species diversity and local knowledge. Species of knowledge diversity and redundancy for local diversity is related to the locally available spectrum of knowledge systems’ adaptive capacity, resilience, and chemical components used for medicinal purposes, where health sovereignty. the higher the diversity of available plant species, the greater the potential range of illnesses that can be treated. Keywords Gendered knowledge  Knowledge diversity  Species diversity also relates positively to functional Knowledge redundancy  Local knowledge systems  redundancy, that is, the fact that more than one species can Local medical systems  Tsimane’ be used to treat a given illness. Redundancy is thus a key attribute of resilient local medical systems, given that, if a particular species becomes locally unavailable, others may INTRODUCTION substitute (Alburquerque and Oliveira 2007; Santoro et al. 2015). The second pillar of local medical systems is a Local medical systems involve the knowledge, beliefs, and complex and dynamic local knowledge system. Local behaviors relating to health and illness, local natural knowledge systems are generally threatened and eroding resources attributed with medicinal properties, and social but, at the same time, many are also dynamic and adaptive (Reyes-Garcı́a 2015). People’s ability to generate, trans- form, accommodate, transmit, and apply local knowledge Electronic supplementary material The online version of this article (doi:10.1007/s13280-016-0826-1) contains supplementary in an integrative way is critical to the resilience of such material, which is available to authorized users. systems (Ellen et al. 2005; Mathez-Stiefel et al. 2012), and Ó The Author(s) 2016. This article is published with open access at Springerlink.com www.kva.se/en 123 S264 Ambio 2016, 45(Suppl. 3):S263–S275 the erosion of medicinal plant knowledge may compromise argue that recognizing the gendered nature of knowledge a community’s adaptive capacity and resilience more and understanding its dynamics provides insights into local generally. In this paper, we focus on this second pillar of vulnerability and adaptation to GEC. Since the challenges local medical systems. and vulnerabilities posed by GEC are not gender neutral Local knowledge is unevenly distributed (Bruschi et al. (Denton 2002; Jost et al. 2016), specific attention must be 2011; Guimbo et al. 2011), which means that it is diverse. given to the impacts on women’s knowledge and access to Knowledge diversity partly arises from specialization, plant resources. which is related to social relations and identities. For The aim of this paper is twofold. We propose a con- example, shamans, herbalists, and midwives may hold ceptual framework and initially test a new concept that can different corpora of medicinal knowledge and their be applied to assessing the degree to which local medicinal knowledge also differs from lay knowledge. Knowledge knowledge systems may be adaptive and resilient to GEC also varies according to differential access to ecosystems and to other forms of social change that are affecting local and landscapes (e.g., forests) and therefore to different medical systems and hence community resilience. The species and the knowledge about these species, interests in concept proposed, ‘functional knowledge redundancy,’ medicinal plants and healing, and to the health concerns of considers the importance of knowledge diversity within the people treated (e.g., elderly, infants). Furthermore, local medical systems. We argue that gendered knowledge there is a gender division of labor and responsibilities diversity in particular may increase functional knowledge around care giving and healing that also generally leads to redundancy, and hence adaptive capacity and resilience in different behaviors and knowledge (e.g., Rocheleau et al. local medicinal knowledge systems. We partially test how 1996; Pfeiffer and Butz 2005). Indeed, differences in the this framework operates in a particular empirical situation knowledge held by women and men, or gendered knowl- using the case of medicinal plant knowledge among lay edge, are considered to be one of the most significant Tsimane’ of Bolivian Amazonia. sources of intra-cultural knowledge variation (Howard 2003). Gender also intersects with other social divisions (Banerjee and Bell 2007), so that, for example, lay women CONCEPTUAL FRAMEWORK belonging to different clan groups may hold distinct knowledge not only compared with men, but also with Knowledge diversity in knowledge systems other women (see Boster et al. 1986). One of the arguments that we make here is that attention Researchers have long documented the fact that knowledge to gendered knowledge is required if we are to understand is unequally distributed within communities and that how global environmental change (GEC) is affecting local knowledge distribution is patterned. For example, Boster medicinal knowledge systems and the resilience of local (1985, 1986) showed that, among the Aguaruna medical systems more generally. Local medical systems Amerindians of Peru, the distribution of knowledge about are particularly vulnerable to the impacts of GEC as plant names follows a single, culturally shared model changes in the vegetation and floristic composition of where knowledge is learned by different people to varying ecosystems directly influences the availability and use of degrees. Knowledge distribution in Aguaruna society medicinal plants (Hanazaki et al. 2013). Social change can reflects Aguaruna social structure, which determines the also lead to changes in local medicinal knowledge systems, importance of particular plants to particular people within for example, through outmigration, formal education, and it, where the variation between informants can be the increasing use of formal medicine (Byg et al. 2010; explained by factors that reflect differential knowledge: Giovannini et al. 2011), all of which are also likely to age, sex roles, and opportunities to learn (Boster 1985). involve men and women differently. Knowledge diversity in local medical systems may arise Previous research analyzing the effects of GEC on local as a result of a division of labor, or specialization, in dif- medical systems has focused on the challenges and vul- ferent healing roles (e.g., shamans, healers, midwives, lay nerabilities facing such systems and attributes that may people) (see e.g., Lambert 2012) that potentially affect the contribute to their resilience. However, such research has performance of local medicinal knowledge systems. For tended to focus on the knowledge and practices of male example, in local medical systems, shamans and lay people specialists (i.e., shamans, healers) or experts (Kothari 2003; play different roles (or functions) associated with different Gold and Clapp 2011). As a consequence, women’s fields of action. Shamans may be responsible for treating medicinal knowledge and access to different medicinal spiritual illnesses and hold the related knowledge, while lay resources is often neglected, despite the fact that lay people may deal with mild afflictions. women treat many common health concerns at household Despite the fact that researchers have been aware of level (Wayland 2001; Finerman and Sackett 2003). We knowledge variation for many decades, they have rarely Ó The Author(s) 2016. This article is published with open access at Springerlink.com 123 www.kva.se/en Ambio 2016, 45(Suppl. 3):S263–S275 S265 discussed the implications of knowledge diversity, or the same ailment. Such redundancy arises when different plant differences in the knowledge held by different people, for species are known by different groups of people to treat the the continuity of knowledge systems. Only recently have same illness. Functional knowledge redundancy arises some researchers begun to argue that differentiated from any or all of those factors that account for intra- knowledge may be an asset for adaptation to changing community knowledge diversity discussed above. The social and ecological conditions. Ruelle and Kassam concept of functional knowledge redundancy serves to (2011), for example, studied plant knowledge among assess the overall capacity of a community (which, as per Standing Rock Nation elders in the United States. They Boster 1985; Boster et al. 1986, is essentially the sum of found that elders hold knowledge about different plants and knowledge held by all sub-population groups) to use dif- also different knowledge about the same plants. Differ- ferent medicinal plants to treat health afflictions within a ences in knowledge are partly linked to variations in spe- local medical system. cies use, spatial distribution, and harvesting strategies. The Overall, in local medical systems, knowledge diversity authors conclude that such knowledge diversity allows the may affect the system’s performance. Functional knowl- system to store more potential options for coping with edge redundancy may affect local medical system adaptive change, which may improve the adaptive capacity of capacity by providing more options to treat ailments within knowledge systems and therefore communities’ resilience. a community. Knowledge diversity in local medical sys- tems is likely to be expressed in relation to specialized and Knowledge redundancy and knowledge system lay knowledge. Furthermore, within lay knowledge, gen- adaptive capacity dered knowledge may increase functional knowledge redundancy, which helps communities to cope with a The concept of ecological redundancy relates to the fact changing environment and may affect the adaptive capacity that more than one species can perform the same function of the knowledge system and the resilience of the local or functions in a given ecosystem (Walker 1992). So, if one medical system more generally. species disappears, functionally redundant species provide the system with the capacity to either resist change or bounce back after disturbance (resilience). Drawing on this CASE STUDY concept, Albquerque and Oliveira (2007) proposed a model of utilitarian redundancy in local medical systems. They We worked in villages within the Tsimane’ Territory in the argue that such redundancy is important because it may Department of Beni, Bolivian Amazonia. The majority of reduce the potential impacts of overharvesting of particular contemporary Tsimane’ are forager-horticulturalists who species, allowing the functions of the system to be main- rely upon forest resources for food and medicine. The tained even when a species population is reduced, thus Tsimane’ succeeded in resisting Catholic and Protestant ensuring local medical system resilience. The measure of proselytism throughout the 1950s when the Protestant New redundancy that they propose aims to identify and quantify Tribes Mission was established in the area. The Mission the relation between species richness (or medicinal plants has profoundly influenced Tsimane’ culture through species that are known) and their functions within the local schooling and the provision of basic biomedical services. medical system (uses or therapeutic categories according to Contact with merchants, loggers, anthropologists, and the local illness classification system). This model assumes conservationists have also affected Tsimane’ culture in that, although people have preferences for some plants over diverse ways (Reyes-Garcı́a et al. 2014). Even though the others when treating any given ailment, other species can government has expanded primary health care services, substitute when the preferred species are unavailable. The access to biomedical healthcare is still very limited for the assumption dovetails with research that reports that people Tsimane’, especially for those living far from towns. use substitute species only when preferred species are The Tsimane’ increasingly participate in the regional absent (Santoro et al. 2015). However, other research economy, mostly through direct sales of thatch palm, rice, shows that, in such circumstances, people may instead and plantain in towns or to traders who visit their villages. recur to biomedical resources (Ferreira Junior et al. 2011). Some Tsimane’ men also engage in wage labor for local Following Albuquerque and Oliveira’s utilitarian loggers and ranchers. Tsimane’ livelihoods and healthcare redundancy model (2007), we add a new concept—func- are still highly self-sufficient and dependent on local forest tional knowledge redundancy—which explicitly considers resources, which increase their vulnerability to rapid knowledge distribution within a local medical system. We ecosystem change (Fernández-Llamazares et al. 2015). For define this as the number of species that each distinct group example, research has documented increased landscape of social actors (population sub-group) knows that treat the fragmentation and deforestation (Paneque-Gálvez et al. Ó The Author(s) 2016. This article is published with open access at Springerlink.com www.kva.se/en 123 S266 Ambio 2016, 45(Suppl. 3):S263–S275 2013), processes that have direct consequences for the Qualitative methods diversity and abundance of wildlife and therefore that affect Tsimane’ food security and health (Luz 2013; Qualitative data were collected through participant obser- Zycherman 2013). vation in medicinal plant foraging expeditions and remedy Rapid cultural changes have also been occurring among preparation. In the first months of fieldwork, 12 semi- the Tsimane’ over the past few decades, which reverberate structured interviews were conducted with key informants in their local medical system. For example, traditionally, (six women and six men) on the Tsimane’ healing system. the cocojsi’ (shaman) played a very important medicinal In these interviews, we asked about the most common role partly due to their ability to mediate between humans health concerns in the area and how informants responded and spiritual beings that have curative powers. Today, only to those ailments. To address perceptions and socio-cul- a few elders know how to administer traditional remedies tural norms around access to and control over medicinal against witchcraft, and people sometimes refer to them as plants, biomedicines, gendered behaviours and responsi- cocojsi’ (Huanca 2014), but they are not recognized gen- bilities regarding health care giving, three focus group erally as shamans. These practices persist mostly in more discussions were carried out. We invited women and men remote villages where people attribute illness and death to of different ages in each village to the focus groups, what witchcraft. Similar changes are also observed in lay resulted in two groups of ten and four women, respectively, medicinal knowledge systems. The Tsimane’ have a great and one group of seven men. Qualitative information was deal of local medicinal knowledge and, in general, lay used to contextualize the research and interpret the results. Tsimane’ use medicinal plants to treat illnesses (Reyes- Garcı́a et al. 2003). This lay knowledge seems to have Quantitative methods positive effects on a household’s health profile (McDade et al. 2007). However, medicinal knowledge is changing as Assessing the diversity of medicinal plant knowledge the Tsimane’ adapt to economic, social, political, and environmental change, where knowledge loss is more acute The first step in estimating knowledge diversity was to for men than for women, and for people living in villages identify plants with medicinal uses known by people in the that are closer to towns compared with those in remote two communities. To achieve a representation of knowl- villages (Reyes-Garcı́a et al. 2013). Recent research has edge held by women and men of different ages, in each shown that the Tsimane’ use a combination of medicinal study village we purposely interviewed a sample of 10 plants and pharmaceuticals to treat illnesses, presenting women and 10 men aged 16–91 (mean = 47 years) who another example of medical pluralism (Calvet-Mir et al. were thought to hold good knowledge of medicinal plants 2008; Tanner and Rosinger 2014). according to the information collected through participant observation and the focus groups. We asked informants to list all of the medicinal plants they knew. We then asked the informants to list all of the ailments that could be MATERIALS AND METHODS potentially treated with each plant listed. With results from the free-listings, we designed a We applied a mixed methods approach throughout 18 medicinal plant knowledge survey consisting of structured consecutive months of fieldwork. The first and second questions about 16 medicinal plants.1 To develop the sur- authors lived in two Tsimane’ villages from January 2012 vey, we selected medicinal plants listed by at least two to August 2013. We obtained consent to carry out the people. We calculated their salience according to each research from the Gran Consejo Tsimane’ (the Tsimane’s plant’s occurrence and position in the free-listings and then governing body). Subsequently, a community meeting was created three salience groups (Thompson and Zhang 2006). held in two villages (V1 and V2) along the Maniqui River We randomly selected three plants from the high and low (Fig. 1) to explain the project to villagers and to assess their salience groups and four from the medium salience group. willingness to participate. Once we obtained consent to live Women’s and men’s free-listings were analyzed separately, in the villages, all adults (16 years of age and older) were and six more plants (three listed only by women and three invited to participate in the research. Women and men were listed only by men) were selected. To administer the equally encouraged to participate, resulting in a sample of 68 women and 79 men, for a participation rate above 90 % in both villages. To minimize the risks of gender bias in data collection, we trained a team of male and female assistants and translators (see Morgen 1989 in Pfeiffer and 1 Available at: http://icta.uab.cat/Etnoecologia/Docs/[423]-lektests. Butz 2005). pdf. Ó The Author(s) 2016. This article is published with open access at Springerlink.com 123 www.kva.se/en Ambio 2016, 45(Suppl. 3):S263–S275 S267 Fig. 1 Map of the Tsimane’ Territory survey, local assistants read the vernacular names of the Exploring the functional redundancy of medicinal plant selected plants and asked informants whether they knew knowledge the plant and, if so, to list a maximum of three different symptoms or ailments that could be treated with it. Infor- To explore functional redundancy in Tsimane’ medicinal mants were also asked their age. A total of 63 women and plant knowledge, we collected data on the use of medicinal 58 men answered the survey questionnaire. plants through a health survey. We differentiate between We used data from the medicinal plant knowledge sur- knowledge and use of medicinal plants because previous vey to construct the following individual-level variables: research indicates that the two do not necessarily overlap (1) number of plants known, (2) number of illnesses treated and medicinal plant knowledge may not be an accurate with the plants known, and (3) average number of uses per proxy for the actual use of medicinal plants and vice versa medicinal plant known. We used a Kolmogorov–Smirnov (Reyes-Garcı́a et al. 2005; Wayland and Walker 2014). test to test for normality of distribution in our data. As data The health survey was administered up to six times over were normally distributed, we then compared the values of the course of 12 months to the sample of 68 women and 79 such variables by sex and age groups using a t test of mean men, most of whom had also answered the knowledge comparisons. By aggregating women’s and men’s medici- survey. We asked about the ailments suffered in the nal plant knowledge, we can explore whether these two 2 weeks prior to the interview and the treatments used. groups hold diverse types of knowledge that may affect Adults self-reported and mothers (or the adult in charge) knowledge system performance. reported children’s health. We recorded ailments or Ó The Author(s) 2016. This article is published with open access at Springerlink.com www.kva.se/en 123 S268 Ambio 2016, 45(Suppl. 3):S263–S275 Table 1 Results of statistical analyses (t test) of women’s and men’s knowledge of medicinal plants from the knowledge survey Variables Definition Total Women (n) Women Men (n) Men P value Number of plants known No. of plants with a medicinal 7.61 (2.21) 63 7.95 (2.98) 58 7.25 (2.83) 0.09* use (from 0 to 16) Number of different illness (uses) No. of different illnesses 7.42 (2.95) 63 7.92 (2.93) 58 6.87 (2.90) 0.02** treated with the selected plants Average number of uses Average no. of uses known per 0.81 (0.39) 63 0.87 (0.40) 58 0.74 (0.38) 0.03** medicinal plant recognized By age groups Number of plants known \25 6.26 (2.13) 19 6.78 (2.27) 15 5.6 (1.80) 0.05* [25 \ 50 8.12 (2.87) 33 8.39 (2.88) 32 7.84 (2.87) 0.22 [50 8.23 (3.50) 11 8.64 (3.93) 11 7.82 (3.16) 0.30 Number of different illness (uses) \25 6.35 (2.37) 19 6.89 (2.40) 15 5.67 (2.22) 0.07 [25 \ 50 7.94 (3.09) 33 8.24 (3.16) 32 7.63 (3.03) 0.21 [50 7.55 (3.04) 11 8.73 (2.80) 11 6.36 (2.91) 0.03** Average number of uses \25 0.65 (0.36) 19 0.74 (0.39) 15 0.54 (0.28) 0.05** [25 \ 50 0.86 (0.40) 33 0.89 (0.41) 32 0.83 (0.40) 0.26 [50 0.90 (0.38) 11 1.03 (0.36) 11 0.78 (0.37) 0.06 therapeutic categories as cited by the informants so that was known to be equivalent to the vernacular name their illness classification (or nosology) was retained. The reported. Vernacular names are used throughout the text; treatments reported were then coded as (1) traditional see correspondence to botanical genera in Supplementary (medicinal plants or others), (2) biomedical (pharmaceuti- material. cals), or (3) mixed (a combination of traditional and biomedical treatments). To assess functional knowledge redundancy, we evalu- ated the potential correspondences between the data col- RESULTS lected through free-listings, the knowledge survey, and the health survey. Specifically, we constructed a matrix in Diversity of medicinal plant knowledge which rows correspond to the medicinal plants used to treat among the Tsimane’ the same ailment and columns correspond to our measures of the number of plants that women and men knew to treat A total of 78 medicinal plants were registered in the free- the same ailment, including (1) the ailments most fre- listings (Supplementary material). Some plants were quently reported in the health survey, and (2) the number reportedly used to treat only one affliction, but others, such and names of plants that women and men listed as remedies as ere’, saute, and tamtac’, were used to treat up to six for such ailments. As these data were not normally dis- different illnesses. tributed according to the Kolmogorov–Smirnov test, we Results from the knowledge survey indicated that there calculated Spearman correlations between frequency of is gendered variation in the ability to name medicinal uses reported ailments and functional knowledge redundancy for 16 selected plants species (or number of plants known) reported by women and men for each ailment. (p\0.1) (Table 1). Women knew more medicinal uses Plant voucher specimens were not collected for this (p\0.05) and more uses per plant (p\0.05) than men study. Vernacular names given by informants were recor- (Fig. 2a, b). From the various age–sex categories, young ded and linked to botanical genera based on previous eth- men (B25 years of age) reported fewer medicinal plants nobotanical research in the area (Huanca 1999; Reyes- and uses per plant than people in any other age category Garcı́a 2001; Ticona 2010; Guéze 2011); therefore, the (p\0.05), whereas older women ([50 years of age) decision to associate a local name with a scientific species reported the largest number of medicinal plants and uses name was made only when a single member of the genus (Table 1). Ó The Author(s) 2016. This article is published with open access at Springerlink.com 123 www.kva.se/en Ambio 2016, 45(Suppl. 3):S263–S275 S269 whereas men used pharmaceuticals for 20 % of the repor- ted ailments. Women used a combination of traditional and biomedicines in 13 % of the treatments, versus 20 % in the case of men. When parents were asked about the treatments administered to children, they reported not applying any treatment in 18 % of the cases, using traditional medicine in 26 %, pharmaceuticals in 39 %, and a combination of both in 16 %. Biomedicines used included pills for pain and fever relief (e.g., aspirin, diclofenac, or paracetamol), vitamins, and antibiotics. With some exceptions, we observe greater functional knowledge redundancy among all participants for the most frequently reported ailments—e.g., colds, diarrhea, and aches (Table 3, columns A–D). Overall, we found a cor- relation between the frequency with which an ailment was reported and the functional knowledge redundancy of medicinal plants used to treat them (women’s Spearman q = 0.68, p\0.001; men’s Spearman q = 0.61, p\0.05). The number of plants known per ailment was similar for women and men for all ailments except for headaches, where women knew more plants than men. Despite similar number of plants listed per ailment, there were differences in the medicinal plants that women and men reported (see Table 3, columns E–H). For example, both women and men reported 17 plants for treating body aches, but women listed tam tac’, rovodyes, and punucvadyes more fre- quently, whereas men listed saute and morifi more fre- quently; only women reported vambason and arara’, Fig. 2 Results from knowledge survey. Comparison of box-plot whereas only men reported mashaty and potona. Fever and distributions of a the number of ailments a person can treat using back pain (sometimes described as body pain) presented medicinal plants, and b average number of uses known by medicinal plant known exceptions because, although they were highly reported, knowledge related to them displayed low redundancy. For example, while fever was the second most frequently A close examination of the knowledge survey data reported ailment, only three plants were free-listed as suggests that gendered differences refer both to the number remedies, although three more plants were reported in the of plants known, to uses, and to the content of knowledge health survey. Women and men agreed more about the itself. For example, although women and men generally least frequently reported ailments (bewitchment, eye ail- agreed on the most commonly reported medicinal uses, ments, intestinal parasites, and skin conditions) both in only women reported uses related to reproductive health terms of the total number and the names of medicinal (e.g., fertility, labor, and contraception) and to childhood plants used to treat them. ailments such as chickenpox. In turn, only men reported medicinal uses related to the gallbladder (Table 2). DISCUSSION Functional knowledge redundancy Gendered knowledge as a source of knowledge A total of 22 ailments were reported by different people in diversity the health survey (Table 3, column A). The most com- monly reported ailments were colds, coughs, diarrhea, Previous work suggests that Tsimane’ botanical knowledge body or muscle aches, and fever (Table 3, column B). is widely shared (Reyes-Garcı́a et al. 2003), but the data When asked about the treatments used, respondents presented here show that there are also gendered differ- reported not using anything in 24 % of the cases, and tra- ences in medicinal plant knowledge. This diversity seems ditional medicine use in 34 % of the cases. Women used to reside in women’s greater knowledge of medicinal uses pharmaceuticals for 29 % of the ailments they reported, associated with reproductive and childhood ailments, a Ó The Author(s) 2016. This article is published with open access at Springerlink.com www.kva.se/en 123 Table 2 Women and men answers to the knowledge survey by medicinal plant S270 Tsimane’ name Scientific name Women Men 123 No. of $ No. of Most common ailments Specific ailments No. of # No. of Most common Specific ailments that give a ailments that can be treated with that can be treated that give a ailments ailments that can that can be treated medicinal that can the plant with the plant medicinal that can be treated with the with the plant use be treated cited by $ use be treated plant cited by # Vambason Aspidosperma aff. rigidum 44 15 Stomach pain, diarrhea Menstruation 44 16 Diarrhea Gallbladder Rusby Back pain Macha Amburana cearensis 25 13 Back pain Post labor 25 12 Back pain Scabies Flu Muscle ache Buisi Entada sp. 57 15 Stomach ache Muscle ache 40 14 Stomach pain Menstruation Contraception Parta Persea americana 6 5 Diarrhea 10 7 Diarrhea Flu C. Miller Back pain Stomach pain Cravu 24 11 Flu Labor 26 10 Flu Diarrhea Tooth ache Jamo’tarara Margaritaria nobilis L.F. 22 8 Leishmaniasis Fertility 17 5 Leishmaniasis fungus Muscle ache Fungus Punuvacdyes 24 11 Infected sore (boil) Muscle ache 19 10 Infected sore (boil) Muscle ache Muscle ache Que’tsejtse Davilla nitida (Vahl) Kubitzki 18 5 Muscle ache 15 8 Muscle ache www.kva.se/en Tyi’mujmure Piper peltatum 37 12 Infected sore (boil) Fever 30 13 Infected sore (boil) Ruiz & Pav Fever Diarrhea Fever Yavitus 20 13 Muscle ache Menstruation 12 10 Muscle ache Dizziness Infected sore (boil) Arara’ Urera laciniata (Goudot) 51 8 Fungus 52 9 Fungus Wedd urticaria. Muscle ache Muscle ache Banana 23 8 Bullet ant sting Stomach pain 15 7 Bullet ant sting Muscle ache Muscle ache Ñetas 30 12 Muscle ache Chickenpox 20 14 Stomach pain Menstruation Ó The Author(s) 2016. This article is published with open access at Springerlink.com To gain weight Marva 58 19 Wasp sting Menstruation 41 14 Wasp sting Labor Scabies Cuts pre-labor Mature Acmella oleracea 55 17 Fungus Babies weeping 48 19 Fungus Labor Tooth ache Tson’sonty Ampelocera edentula 26 12 Leishmaniasis 33 9 Leishmaniasis Kuhlm. Fungus Fungus Ambio 2016, 45(Suppl. 3):S263–S275 Table 3 Information on ailments reported in the health survey (columns A and B), and the knowledge of medicinal plants reported that could be used to treat them in free-listings and knowledge survey (columns C–H). Each row corresponds to the set of medicinal plants reported by ailment, where Columns C, E, G are plants reported by women and D, F, H are the plants reported by men. Columns C–H are used as indicators of functional knowledge redundancy A B C D E F G H Ailments Report No. of plants reported No. of plants reported Most frequently reported Most frequently reported Plants reported Plants reported frequency by $ in FL as treatment by # in FL as treatment plants by $ in FL as plants by # in FL as exclusively by $ exclusively by # treatment treatment Cold 211 18 16 ere’, shepi shepi, chorecho coti, cravu ashashaj Ambio 2016, 45(Suppl. 3):S263–S275 Fever 62 2 3 shepi bejqui, viyucure bejqui viyucure Cough 41 6 7 tamtac, saute tamtac, saute shepi’is Backpain 33 3 3 vambason macha vambason macha Diarrhea 32 16 16 oveto’, vambason oveto’, chura’ Headache 30 7 2 saute, shepi, rovocdyes, chito’, ufjare saute,shepi, rovocdyes, viyujcure, vujnare viyujcure, vujnare Body ache 27 17 17 tamtac, rovocdyes, morifi, saute vambason arara’, mashaty, potona punuvacdyes Stomach pain 16 8 10 tamtac, oveto’ tamtac, saute ujfare, vijsi Fungus 11 9 12 tamtac, saute, conojfoto saute, tamtac jämecatidye, undye, uruuru Chickenpox 11 – – www.kva.se/en Anemia 9 – – Vomit 5 – – Skin 4 1 1 tyi’ tyi’ Bewitchment 4 2 2 conojfoto, yän conojfoto, yän Intestinal 3 1 1 titij titij parasites Eye 3 1 1 cajin’si cajin’si complaint Toothache 3 – – Boil/skin sore 2 1 2 titij mojmosh mojmosh Ó The Author(s) 2016. This article is published with open access at Springerlink.com Injury 2 2 4 yantes Ijmeme, itsi shiveñi yantes Knee pain 2 – – Post labor 2 – – Hemorrhage 2 – – 123 S271 S272 Ambio 2016, 45(Suppl. 3):S263–S275 finding that accords with other research among the Tsi- example, the study by Santoro et al. (2015) among rural mane’ showing a positive association between maternal communities in northeastern Brazil showed that an ail- botanical knowledge and children’s health (McDade et al. ment’s frequency of occurrence is positively associated 2007). Gendered knowledge is thus a source of knowledge with the number of taxa that were known to treat it. diversity—diverse types of knowledge are applied by dif- However, we also found a few exceptions, such as fever. It ferent social actors to treat different ailments. may be that, as a very specific symptom, it is treated with A few researchers have considered the implications of fewer plants in comparison with ailments such as colds, intra-cultural knowledge distribution for the resilience and which may include a diverse topology of symptoms. We adaptive capacity of knowledge systems. Some argue that a also observed that fever is commonly treated with phar- normal distribution (from a probabilistic perspective) of maceuticals. The use of an alternative treatment could, knowledge in a local medical system may reduce the sys- therefore, explain lower plant knowledge redundancy for tem’s vulnerability to disturbances (Ferreira Júnior et al. this ailment. 2013; Santoro et al. 2015). For example, if only one person Despite finding similar degrees of functional knowledge holds specialist knowledge, when this person leaves the redundancy in the number of medicinal plants that women system the knowledge is lost (unless, of course, it has and men reported for frequent complaints, gendered already been fully transmitted). But, if knowledge is more knowledge and preferences are also evident. Differences in widely distributed, then it is less likely to disappear since the plants that women and men reported contribute to there is at least partial redundancy between the bodies of redundancy within the knowledge system since, despite the knowledge held by different people. It has also been fact that they reported a similar number of plants, the plants claimed that knowledge diversity may contribute to reported were different. adaptability in the long-term (Ruelle and Kassam 2011). For some of the least frequently reported ailments, there For example, in the context of climate change, a diversity is greater agreement between the sexes. For example, of knowledge about species and their phenology may offer women and men reported the same plants used to treat eye options for coping with variation in seasonality, plant ailments, intestinal parasites, and skin conditions, which extinctions, and local extinction of certain species. may indicate that knowledge related to these ailments is Here we have found that gender relations foster widely shared (common) or that, when only a single or a knowledge diversity which likely contributes to Tsimane’ few species are effective, this is more generally known. wellbeing and adaptive capacity. Such a finding is also The lower functional knowledge redundancy regarding acknowledged by the Tsimane’ who, in focus group dis- medicinal plants used to treat bewitchment, might also cussions, attributed caregiving to women (Fig. 3). As Tsi- suggest that such treatments are more often part of the mane’ women reported: shamanic or specialized domain of knowledge. Finally, our study also indicates that, at a practical level, ‘‘We are the ones who take care of the family. When Tsimane’ women and men use plant treatments slightly our children are sick we take care. We sometimes more often than biomedical or combined treatments. This gather medicinal plants, and sometimes we ask our is important, since indigenous and rural communities rely men to bring them; they also know where to find on a variety of treatment options at a local level (Gio- them’’ (Women, 28–78, V1, April 2012). vaninni et al. 2011), and the diverse knowledge associated As principal caregivers and health custodians at house- with them also contributes to health sovereignty (Kassam hold and community level, Tsimane’ women contribute et al. 2010), as it enables individuals to opt for those with their more diverse knowledge about reproductive and treatments that they consider appropriate. As an informant childhood ailments, producing benefits that are enjoyed by reported in a semi-structured interview: the entire Tsimane’ society. ‘‘When my son catches a cold I use medicinal plants; also to treat his scabies. If we feel very weak we can Functional knowledge redundancy and adaptive also go to the hospital. There, doctors can cure capacity leishmaniasis but they cannot cure us if we got bewitched in the forest. Then we have to go to the The second important finding is that, overall, there is a cocojsi’’ (Woman, 44, V2, May 2012). greater medicinal plant functional knowledge redundancy for the most frequently reported ailments, which may offer Consequently, the adaptive capacity of communities’ a variety of options for treating such ailments. This is local knowledge and medical systems may lie in the use of similar to what has been found in other settings. For medicinal plants as the primary source of healing or as an Ó The Author(s) 2016. This article is published with open access at Springerlink.com 123 www.kva.se/en Ambio 2016, 45(Suppl. 3):S263–S275 S273 Fig. 3 Tsimane’ woman preparing a medicine from medicinal plants Photo Álvaro Fernández-Llamazares alternative to, or in combination with, biomedical options 2011). This would allow for a more nuanced understanding at a practical level. of the local medicinal knowledge system’s adaptive capacity and resilience. CONCLUSION Acknowledgments This research was funded by the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ERC Grant Agreement N° FP7- The conceptual framework and case study provided in this 261971-LEK to Reyes-Garcı́a. We express our profound gratitude to paper to assess knowledge diversity and functional our informants, for their willingness to share their time and knowl- knowledge redundancy within local medicinal knowledge edge. We thank the Gran Consejo Tsimane’ and the CBIDSI for providing logistical support and office facilities in San Borja; and we systems may be useful for researchers who seek to evaluate thank Marta Pache, Paulino Pache, Sascha Huditz, Vicente Cuata, adaptive capacity and resilience. Consuelo Campos, Isabel Virginia Sánchez, Óscar Plata, and Sandra Beyond medicinal plant functional knowledge redun- Martı́nez for field assistance. dancy and its effects on knowledge system adaptive Open Access This article is distributed under the terms of the capacity and resilience, future research should also pay Creative Commons Attribution 4.0 International License (http:// attention to complexity in the treatments, e.g., the use of creativecommons.org/licenses/by/4.0/), which permits unrestricted combinations of medicinal plants, and of medicinal plants use, distribution, and reproduction in any medium, provided you give used together with other traditional remedies, to treat ill- appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were ness. 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Length of residence, age and geningen, The Netherlands. patterns of medicinal plant knowledge and use among women in Address: Center for Biocultural Diversity Studies, School of the urban Amazon. Journal of Ethnobiology and Ethnomedicine Anthropology and Conservation, University of Kent, Canterbury, UK. 10: 1. e-mail: p.howard@kent.ac.uk Zycherman, A. 2013. The changing value of food: localizing modernity among the Tsimané Indians of lowland Bolivia. Victoria Reyes-Garcı́a is an ICREA Research Professor at the PhD Thesis. Columbia University. Institut de Ciència i Tecnologia Ambientals at the Universitat Autònoma de Barcelona. Her research interests include ethnoecology, AUTHOR BIOGRAPHIES local ecological knowledge, and community-based conservation. Address: Institut de Ciència i Tecnologia Ambientals (ICTA), Isabel Dı́az-Reviriego (&) is a research associate to the Institut de Universitat Autònoma de Barcelona, Barcelona, Spain. Ciència i Tecnologia Ambientals at the Universitat Autònoma de Address: Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona (Spain) and postdoctoral researcher at the Internet Inter- Barcelona, Spain. disciplinary Institute at the Universitat Oberta de Catalunya (Spain). e-mail: victoria.reyes@uab.cat Her research interests include ethnoecology, biocultural diversity, local ecological knowledge, global environmental change, and gender studies. Ó The Author(s) 2016. This article is published with open access at Springerlink.com www.kva.se/en 123