title: Maya phytomedicine in Guatemala - Can cooperative research change ethnopharmacological paradigms?
abstract: BACKGROUND
  This paper presents one of the first large-scale collaborative research projects in ethnopharmacology, to bring together indigenous stakeholders and scientists both in project design and execution. This approach has often been recommended but rarely put into practice. The study was carried out in two key indigenous areas of Guatemala, for which very little ethnopharmacological fieldwork has been published.
  
  
  OBJECTIVE
  To document and characterize the ethno-pharmacopoeias of the Kaqchikel (highlands) and Q'eqchi' (lowlands) Maya in a transdisciplinary collaboration with the two groups Councils of Elders.
  
  
  METHODS
  The project is embedded in a larger collaboration with five Councils of Elders representing important indigenous groups in Guatemala, two of which participated in this study. These suggested healing experts reputed for their phytotherapeutic knowledge and skills. Ethnobotanical fieldwork was carried out over 20 months, accompanied by a joint steering process and validation workshops. The field data were complemented by literature research and were aggregated using a modified version of the International Classification of Diseases (ICD-10) and Trotter & Logan's consensus index.
  
  
  RESULTS
  Similar numbers of species were collected in the two areas, with a combined total of 530 species. This total does not represent all of the species used for medicinal purposes. Remedies for the digestive system, the central nervous system & behavioral syndromes, and general tissue problems & infections were most frequent in both areas. Furthermore, remedies for the blood, immune & endocrine system are frequent in the Kaqchikel area, and remedies for the reproductive system are frequent in the Q'eqchi' area. Consensus factors are however low. The Kaqchikel, in contrast to the Q'eqchi', report more remedies for non-communicable illnesses. They also rely heavily on introduced species.
  
  
  CONCLUSIONS
  The transdisciplinary research design facilitated scientifically rigorous and societally relevant large-scale fieldwork, which is clearly beneficial to indigenous collaborators. It provided access and built trust as prerequisites for assembling the largest comparative ethnopharmacological collection, vastly extending knowledge on Maya phytotherapy. The collection represents knowledge of the two groups' most reputed herbalists and is a representative selection of the Guatemalan medicinal flora. ICD-10 proved useful for making broad comparisons between the groups, but more refined approaches would be necessary for other research objectives. Knowledge in the two areas is highly diverse and seems fragmented. New approaches are required to assess how coherent Maya phytotherapy is. The documented 'traditional' ethno-pharmacopoeias demonstrate dynamic change and acculturation, reflecting the two linguistic groups' sociocultural history and context. This highlights the adaptive potential of phyto-therapeutic knowledge and calls the equation of local indigenous pharmacopoeias with 'traditional' medicine into question. We suggest using the term 'local' pharmacopoeias, and reserving the term 'traditional' for the study of indigenous pharmacopoeias with a clear delineation of ancient knowledge.
authors.affiliation: ETH Zürich, TdLab, Universitätsstrasse 22, CHN, 8092 Zurich, Switzerland. Electronic address: martin.hitziger@usys.ethz.ch.
authors.forename: Martin
authors.initials: M
authors.lastname: Hitziger
authors.affiliation: Research Cluster Biodiversity and Medicines/Centre for Pharmacognosy and Phytotherapy, UCL School of Pharmacy, London WC1N 1AX, UK. Electronic address: m.heinrich@ucl.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Heinrich
authors.affiliation: Director, Singapore-ETH Centre, 1 CREATE Way, #06-01 CREATE Tower, 138602, Singapore. Electronic address: peter.edwards@env.ethz.ch.
authors.forename: Peter
authors.initials: P
authors.lastname: Edwards
authors.affiliation: Universidad del Valle de Guatemala, Instituto de Investigaciones, Herbario UVAL, 18 Avenida 11-95, Zona 15, V.H. III, Guatemala. Electronic address: epoell@uvg.edu.gt.
authors.forename: Elfriede
authors.initials: E
authors.lastname: Pöll
authors.affiliation: Universidad del Valle de Guatemala, 18 Avenida 11-95, Zona 15, V.H. III, Guatemala. Electronic address: lop.marissa@gmail.com.
authors.forename: Marissa
authors.initials: M
authors.lastname: Lopez
authors.affiliation: ETH Zürich, TdLab, Universitätsstrasse 22, CHN, 8092 Zurich, Switzerland. Electronic address: pius.kruetli@usys.ethz.ch.
authors.forename: Pius
authors.initials: P
authors.lastname: Krütli
mesh_terms: D000884:Anthropology, Cultural; D035843:Biomedical Research / Q000379:methods; D003256:Community Participation; D003299:Cooperative Behavior; D020834:Ethnopharmacology / Q000379:methods*; D006166:Guatemala; D006801:Humans; D008519:Medicine, Traditional; D008517:Phytotherapy; D010936:Plant Extracts; D010946:Plants, Medicinal
chemical_list: D010936:Plant Extracts
keywords: Comparative research; Culture change; Guatemala; Participative research; Traditional medicine; Transdisciplinary research