Experts: Improved access to standard health care could erode use of folk medicine

McALLEN — People visit Margarita Calvo every day seeking cures for myriad maladies.

Talismans, candles and statuettes clutter her modest south Alamo home. The smell of incense wafts through the air, and hand-painted, wooden boards outside advertise the woman’s “miraculous gift.”

“The spirit of Jesus came to me last night and gave me this,” Calvo said in Spanish, reaching for a blank sheet of paper and pouring a green, fragrant liquid over it. “God comes to me and teaches me to heal.”

The curandera, or folk healer, tells her clients she can channel the Holy Spirit, giving her the supernatural ability to prevent cancer and cure stomach ulcers. Calvo says she counts on monetary donations from customers to keep her small healing business running, though she accepts all types of offerings from visitors.

“I tell the rich they have to bring money and pay, so I can help the poor,” Calvo said. “But people bring everything they can to me — fruit, bananas, food. Everything.”

The Rio Grande Valley — with some of the lowest rates of health insurance coverage in the nation — is coping with uncertainty over the full impact of the new federal health care reform law, which will bring health care to thousands in South Texas. That change could mean fewer people visiting folk healers who specialize in complementary and alternative medicine, some scholars and medical experts suggest.

“Many people go see (folk healers) because they don’t have other resources,” Dr. Miguel Aleman, a family practice doctor in Edinburg, said in Spanish. “More access to medical care will remove complexes, myths and beliefs from the less educated. …It will help them understand things in a scientific way.”

Curanderismo is common along the U.S.-Mexico border, where residents sometimes can’t afford standard health care and seek free or inexpensive forms of unconventional treatment. Some older Mexicans choose treatment from shamans because they don’t trust doctors and rely on healers out of tradition.

‘IT’LL BE INTERESTING’

Dejun Su, director of the South Texas Border Health Disparities Center at the University of Texas-Pan American, said people who are more educated are less likely to resort to unconventional medical treatment.

“CAM (complementary and alternative medicine) is very prevalent everywhere,” Su said. “It’ll be interesting to see the full effect (of the health care reform law) once health insurance becomes more affordable.”

A provision of the Affordable Care Act, as the law is known, requires people to buy health insurance or pay a penalty, something that would give South Texas residents incentive to head to the doctor’s office.

“But some people could just pay the penalty if they perceive a greater benefit,” Su said. “It’s a complex issue.”

The use of complementary and alternative medicine has been growing in the United States over the last two decades, according to a study by Su published in 2008 in the journal Social Science & Medicine. The annual number of visits to providers of unconventional treatment is now higher than the number of visits to primary care physicians, and yearly out-of-pocket expenditures on such services exceed $27 billion.

According to Su’s research, the growth is taking place at the same time the size of the foreign-born population is increasing in the United States — in 1990, about 8 percent of Americans were immigrants. In 2003, that number grew to 11.7 percent.

About 29 percent of people living in Hidalgo County are foreign-born, according to the most recent data from the U.S. Census Bureau.

Experts believe immigrants’ language barriers, health literacy and low socioeconomic status lead many to resort to unconventional therapies, such as herbal medicine, homeopathy and acupuncture.

“If you don’t have the $60 or $100 to pay for an office visit, you’ll probably rather spend $5 or $10 going this route,” said Frank Ambriz, chair of UTPA’s Physician Assistant Studies Program. “But if someone’s telling me that I have insurance that’ll cover it, then I’m probably going to take advantage of it.”

‘NOT AN EITHER/OR’

Alberto Salinas, a popular curandero who practices out of his home in Edinburg, says his clients only ask for his remedies to complement conventional treatments.

If someone came into Salinas’ home seeking treatment for a broken foot, for example, “I won’t see them,” he said. “I’ll tell them: ‘After you see a doctor, I’ll pray for you.’”

Some people who request his healing services are medical professionals, he said.

“I do this for policemen, lawyers, judges, doctors, nurses,” Salinas said, his voice trailing off. “People who are very well-off come here.”

Some scholars say the practice is part of a belief system that is ingrained in Latin American culture and will continue to grow in popularity. Most people who use curanderismo in the United States use it to complement conventional medical treatment, not replace it, said Antonio Zavaleta, director of the Texas Center for Border and Transnational Studies at the University of Texas-Brownsville. Zavaleta is also an anthropologist who co-authored a book with Salinas titled Curandero Conversations.

“It’s not an either/or,” Zavaleta said. “It doesn’t work that way.”

The growing use of complementary treatment highlights the need for medical providers to understand their patient’s cultural values and make sure they aren’t consuming substances that could react negatively with prescribed medication, experts said.

“We don’t want to discourage people from visiting curanderos,” Ambriz said. “We only ask them to stop if we see they are being harmed — for example, if they are fed lead to cure an ailment.”

One woman who made a six-hour drive from Austin on Friday to visit Salinas for the first time said she only visits curanderos for spiritual cleansing, not for medical treatment.

“I don’t see it in the same spectrum,” Laurie Cerda, 40, said.

Alonzo Cavazos, a professor of social work at UTPA, said doctors and curanderos may have to work together more closely once more people have access to conventional health care.

“The problem has not been a lack of curanderos. They’re here,” Cavazos said. “The problem has been access to (standard) health care. That’s going to be fixed, so that’ll be a new dynamic … the spiritual and physical together.”

‘THE GIFT’

Calvo has been practicing curanderismo in South Texas for more than two decades.

“Us curanderos, we’re born with a very bright light,” she said. “We suffer to receive the gift. There is so much sacrifice.”

Curanderos, dedicated to curing physical or spiritual illnesses, use Catholic elements such as holy water and prayer in their practice. They are often respected members of the community, and their powers are considered supernatural, as it is commonly believed that many illnesses are caused by lost evil spirits, a lesson from God or a curse.

“I can make a person feel better just by looking at them,” she said. “My touch can heal people.”

Calvo usually offers clients a barrida — a ritual cleansing commonly performed by healers in Latin America by sweeping a branch of herbs, reciting a prayer and waving incense over the afflicted person.

But when people show signs of serious disease or injury, she recommends a doctor.

“I can sense when people have tumors, cancer or other sad illnesses,” Calvo said. “I can’t heal everything. I know what a doctor should treat.”

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Ana Ley covers business and general assignments for The Monitor. She can be reached at (956) 683-4428.