Tapia C/ Enfermería Investiga Vol. 8 No. 4 2024 (December - January)

COVID-19 PANDEMIC, A LOOK FROM THE ANDEAN WORLDVIEW IN THE SHUAR COMMUNITY

Cristina Belén Tapia Ruiz1https://orcid.org/0000-0002-9116-8639, Mariela Alexandra Idrovo Vallejo2https://orcid.org/0000-0002-

5555-0099, Sharon Gabriela Torres Abrigo1https://orcid.org/0000-0003-0389-9835, Diana Margarita Gómez

Salgado2https://orcid.org/0000-0002-0645-6733

1Student of the Nursing Career Faculty of Human Health. National University of Loja. Loja, Ecuador.

2Nursing Career Professor. Faculty of Human Health. National University of Loja. Loja, Ecuador.

Creative Commons License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: July 15, 2023

Accepted: September 25, 2023

ABSTRACT

Introduction: The COVID-19 pandemic has generated a severe

global economic, social and health crisis. In some communities,

aspects such as habitat and behavior patterns influence the

perspectives and experiences of their inhabitants regarding the

management of the disease. Objective: Characterize the

COVID-19 pandemic from the Andean worldview of the Shuar

community of the Los Encuentros parish. Methods: Qualitative

study with phenomenological design, in which 10 informants

participated. A semi-structured interview was used to collect

data, consisting of 15 questions, which allow three categories to

be encompassed: Perception of the COVID-19 disease, the

community's experiences in the face of the pandemic and the

practices of traditional medicine applied Results: Most of the

participants express that the disease comes from the air, is

transmissible and can cause death. Likewise, they considered

the biosafety and vaccination measures contemplated by the

Ministry of Health to be positive and adequate. As for the

experiences, to prevent contagion, they used access restriction

to their territories. They identified the sick people due to

characteristic manifestations of the disease, cared for them at

home and in case of death they proceeded to bury them

immediately, without performing farewell rituals for their relatives,

generating annoyance among members of the community. For

ancestral practices in the treatment, medicinal plants such as

eucalyptus, ginger, lemon and orange were used. Conclusions:

The ancestral knowledge and practices of the Shuar community

allowed them to face the COVID-19 pandemic from their beliefs

and culture, but incorporating provisions of the national health

authority, which allowed better control of the disease in the

community.

Keywords: perception, worldview, medicinal plants, pandemics,

COVID-19

Corresponding author: Cristina Belén Tapia Ruiz. Email:

cristina.b.tapia@unl.edu.ec

Tapia C/ Enfermería Investiga Vol. 8 No. 4 2024 (December - January)

INTRODUCTION

The COVID-19 pandemic, caused by a mutant strain of

coronavirus SARS-CoV-2, has generated a severe economic,

social and health crisis throughout the world.(1). The first cases

of the disease were reported, in December 2019 in the city of

Wuhan, China, as outbreaks of rapidly spreading severe

pneumonia, manifested by flu-like symptoms, including fever,

cough, dyspnea, myalgia and fatigue(23). Globally, according to

the World Health Organization as of November 8, 2022,

629,978,289 confirmed cases of COVID-19 have been recorded,

including 6,582,023 deaths.(4).That is to say, the COVID-19

pandemic had a global impact both at a health level and on the

way of life of the population in general. The impact was more

evident in vulnerable populations such as those belonging to

native peoples, since inequities in health care, sanitation and

preventive measures still persist and require greater

attention.(5.6).

The Shuar population is located in Los Encuentros parish, in the

province of Zamora Chinchipe. It can highlight that the origin of

this community is the product of a fusion of an Amazonian group

of Arawak language with another Puruha Mochica language, of

Andean background. Their traditional practices include rituals,

songs, use of natural elements that are part of their cultural

heritage, emphasizing ancestral medicine among them.(7).

The Shuar community has a fervent belief in nature as a healing

method. For both men and women, it is of great importance to

have extensive knowledge of nature, however, men have

traditionally been allowed the work of shamanism. In the Shuar

culture, the shaman is the one who cures diseases by taking

advantage of the properties of medicinal plants through the

performance of rituals.(8).

Based on the above, the perception of the COVID-19 pandemic

and its management in the Shuar community can be explained

through their Andean worldview, which is a product of the socio-

historical context of the people with a natural and cultural

environment (9). In this sense, the perception of things as part of

a whole and not as fragments of consciousness must be

assumed (10,11). Likewise, thanks to phenomenology, we can

focus our interest on understanding the human being, and the

experiences lived in their daily lives, since everything that

happens is a phenomenon (12,13). Phenomenology as a

philosophy focuses on the understanding of lived experiences,

which helps guide our practice in the performance of the

profession (14). Therefore, the objective of the present study was

to characterize the COVID-19 pandemic from the Andean

worldview of the Shuar community of the Los Encuentros parish.

METHODS

This research corresponds to a study with a qualitative approach,

with a phenomenological design. It was developed in the Shuar

community of Los Encuentros parish, Yantzaza Canton (15),

located in the south of the Ecuadorian Amazon, 67 km from the

province capital of Zamora Chinchipe. The study population was

made up of 10 participants who met the following inclusion

criteria: at least one person within the family nucleus who has

had COVID-19, people over 18 years of age who belong to the

Shuar community of Los Encuentros, who have lived in the parish

during the pandemic and who wish to participate in the study.

To collect data, a semi-structured interview was applied,

consisting of 15 questions that covered 3 categories related to

the perception of the study participants regarding the COVID-19

disease, the community's experiences in the face of the

pandemic, and ancestral practices applied by the study group for

the treatment of the disease. From these previously mentioned

categories, 12 subcategories were derived (Table 1).

The transcription of the information and the analysis of the results

were carried out manually according to the guidelines of Tong et

al.(16) proposed in the Consolidated Criteria for Reporting

Qualitative Research (COREQ). To present the results, subjects

were identified using the interview letter “E” with a numerical

code that represents the interview number and followed by the

letter “H” or “M” to identify whether the participant is male or

female. respectively. For data coding, the color technique was

used, which allowed the classification of each response into the

different subcategories, allowing those that are repeated most

frequently to be identified and consolidate the information

provided (Table 2).

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Finally, as part of the ethical considerations, prior to data

collection, the purpose of this study was discussed with each of

the participants, who agreed to be part of it through the informed

consent document. In addition, the right to autonomy, respect

and confidentiality of the information collected was guaranteed.

Due to the fact that no personal data was requested from the

participants, a numerical coding was assigned to each

interviewee in order to guarantee their anonymity and therefore

the Helsinki ethical principles(17).

RESULTS

Category 1: Perception of the COVID-19 disease

Subcategory. Origin of the disease

In this subcategory, participants express their ideas about the

origin of the COVID-19 disease, in relation to their culture, beliefs

and values. One of the most relevant results is the description

that the participants made about the way the disease presents

itself, which is through the air.

“Well, we believed that this disease is a product of the air,

because the air is dirty” (E1-H)

“We believed that it is a result of the air” (E5 – M)

“Because of the dirty air that brought it here, that air was” (E6 –

However, some participants have a different view regarding the

origin of the disease, which is more related to the information that

was disseminated by different organizations and media.

“That was because of the Chinese” (E9 – M)

“It is because the Chinese had eaten the bats and from there it

spread all over the world” (E10 – M)

Subcategory. Knowledge of COVID-19

In this subcategory, participants mention their opinions about

what they know about the COVID-19 disease, showing as one of

the most notable results that the disease is transmissible and

deadly.

“Yes, we believed, because it was kind of contagious and we had

been talking to someone and we were getting infected and for

me I do believe it was contagious” (E1 – H)

“That disease did pass to other people because when we talked

and sneezed, the air carried it away and we got that COVID which

was death” (E2 – M)

“This disease is transmitted by coughing, sharing utensils and

sneezing” (E4 – M)

“Transmissible yes, but not deadly because as long as the

necessary care is taken, this disease will not kill us” (E10 – M)

Subcategory. Biosafety measures

As for this subcategory, the majority of those interviewed

indicated their position regarding biosafety measures,

specifically the use of masks and alcohol.

“Yes, we wear the mask above all” (E6 – M)

“Not so much. That's why in my family we only wear the mask

and that's only when we were going to leave, the rest of us don't

wear them because when we're here we just don't wear anything”

(E7 – H)

“Yes, because those were very important to not infect others” (E8

– M)

“Yes, we wore the mask because many times we didn't know how

it was spread, so these things did help us not get infected when

we went out” (E9 – M)

Subcategory. Vaccine appreciation

Regarding the appreciation of the vaccine, they stated that they

agreed with the vaccine because it helped them improve their

health.

“I do think they are good, although some say vaccines continue

to eat organs and are bad” (E2 – M)

“The vaccine is good and I got vaccinated, that was the first dose

and it went well too, so it took away my fever and everything” (E8

– M)

“Good because when I got the vaccine, I didn't get COVID again,

my arm only hurt for two days” (E10 – M)

On the other hand, some interviewees stated that they did not

agree with the vaccine because they considered it bad for their

health.

Tapia C/ Enfermería Investiga Vol. 8 No. 4 2024 (December - January)

“It is not good. It is not necessary to get vaccinated because

before they lived for a long time without getting vaccinated” (E4

– M)

“I think it's bad because some family members' bodies and arms

hurt when they put that, so I didn't even get any of those vaccines

because it hurts us” (E9- M)

Category 2: Experiences in the face of the COVID-19

pandemic

Subcategory. Signs and symptoms

Regarding signs and symptoms, the interviewees expressed that

the main sign presented was the general discomfort of the body.

However, it is worth mentioning that there are certain variations

that depend on the individual manifestations of the immune state.

“Bone pain, body discomfort, headache” (E4 – M)

“Regardless the fatigue and the sweat, that wanted to kill me. It

left me without spirit, without spirit” (E2 – M)

“This was just a pain in the body that did not allow me to eat and

did not allow me to walk. I normally had no taste” (E3 – H)

“He had a cough, a little fever, and body discomfort. He said his

bones hurt and had a lot of mucus” (E10 – M)

Subcategory. Diagnostic methods

In relation to this subcategory, the participants express their

experiences about the diagnostic methods for COVID-19 where

one of the most relevant results is that they used the symptoms

as an indicator to know that they had the disease.

“It was because of the discomfort we had, because of that and

we knew it was COVID because they already told us that they

got it and knew what it was like” (E3 – H)

“We already knew the people who had COVID, because the first

ones with that had the same thing as us” (E6 – M)

“So, they had breathing problems, they had no taste, because of

the flu and so on” (E7 – H)

Despite the above, some participants resorted to other diagnostic

methods that are more in line with the ways promoted by the

authorities for the detection of COVID-19.

“I got tested after I had symptoms, so I got tested and it came

back positive” (E4 – M)

“Because he was coughing, he had a fever, they didn't leave the

house too, that's why. Yes, I had the one where they pricked your

finger with a needle and the blood came out and everything came

back positive” (E9 – M)

Subcategory. Management of corpses

In this subcategory, the interviewees expressed their

experiences related to the handling of corpses where one of the

most notable results is that alterations occurred in the common

rituals carried out by the community regarding the vigil of the

deceased.

“We kept vigil here privately. We kept vigil over them and then

we came here to the cemetery and we buried him” (E5 – M)

“They didn't keep vigil over them at all, only those who took him

buried him directly on the same day” (E6 – M)

“They packed them up and took them straight to the cemetery”

(E4 – M)

“They didn't let them keep vigil over them, they made them go

and bury them directly in the cemetery because it was prohibited

and people were scared of us” (E10 – M)

Subcategory. Preventive measures

Regarding prevention measures, the participants indicated that

the entry and exit of the population was restricted in the

community as the main method to avoid infections.

“It is forbidden for unknown people to enter” (E2 – M)

“We didn't just let people leave the community like that” (E3-H)

“No, we didn't go out or let them come in from anywhere else”

(E7 – H)

“We put a sign there on the bridge that strangers should not

enter” (E8 – M)

“People who are not from here were not allowed to enter” (E9 –

Subcategory. Access to health

Regarding access to health, the participants express that in their

community the majority of people did not go to health services by

their own decision. Therefore, the management of their illness

was at home.

“We didn't go to the hospital; we didn't go. I'm not going to lie to

you I didn't have medical attention” (E3 – H)

“Yes, we may have gone to the hospital, but we never went

because it was better for us to stay at home” (E8 – M)

“There was a way to go, just get us treated at the hospital, but I

didn't go” (E10 – M)

However, different experiences were presented in which it was

evident that some did go to receive care at a health facility.

“You could just go, but the truth is I didn't go there, I went to

what's called a clinic or laboratory, then the health centers at the

meetings followed me up” (E4 – M)

“Yes, it was accessible. That's why I went to get that test done,

the I told you about and from there they sent me those pills that I

didn't take” (E9 – M)

Subcategory. Vaccine application

In this subcategory, the interviewees express that the majority of

the population did get the vaccine but that it was more out of

obligation than of their own decision.

“Yes, they were asked to do so, but they were forced to do so

because from there they said that it was bad” (E1 – H)

“Of course, they got it because the certification was, as I say,

required so we could get on those buses, taxis, lately in the

restaurants. And we had to go and get them, out of obligation”

(E7 – H)

“The majority did get it, but some said that it is good because it

cured them and so it was more like they got it out of obligation”

(E8 – M)

However, some participants point out that in the community they

did not accept the vaccine.

“No, they didn't accept it at first, because, because it scared

them” (E5 – M)

“They didn't accept because they didn't want to, because they

said that if they got vaccinated those people would die” (E6 – M)

Subcategory. Pharmacotherapy

In this subcategory, two participants mention that they underwent

pharmacological treatment to recover.

“A vial of vitamins” (E3 – H)

“Well, the doctor sent us to take some pills for COVID and with

that we were cured” (E10 – M)

Category 3: Traditional medicine practices

Subcategory. Use of medicinal plants

In this subcategory, the interviewees express that they used

medicinal plants as a treatment for COVID-19.

“We ate ginger with orange, eucalyptus, lemon” (E2 – M)

“I took it, drink it, we have a product. We really have natural

bitters from here that we used that ginger, eucalyptus. That's

what I had” (E3 – H)

Tapia C/ Enfermería Investiga Vol. 8 No. 4 2024 (December - January)

“We made a preparation with orange, lemon, ginger, a little drink

and we also drank a lot of hot water” (E7 – H)

“Ginger, lemon, orange and alcohol, also use lemon verbena,

and garlic” (E8 – M)

DISCUSSION

The Andean worldview represents a vision of reality, built through

the socio-historical context of the people and their natural

environment. During the health emergency due to the COVID-19

pandemic, native communities such as the Shuar community had

a perception and experiences of the disease based on their

customs and beliefs. These aspects are best explained from

phenomenology, since it allows an understanding of the lived

experience, an experience that is assumed as part of a whole

through sensations, considering that nothing is learned

immediately but through the experiences of events.

In this sense, from the analysis of the categories in this study, the

following results were obtained:

In the category “perception of the COVID-19 disease”, origin and

knowledge of the disease, application of biosafety measures and

appreciation of the vaccine against the disease were assessed.

Thus, regarding origin, one of the most common expressions

among the participants was that this disease is a product of the

air. On the other hand, in terms of knowledge, the opinion of the

participants was that the disease is communicable and fatal. In

the subcategory related to biosafety measures, participants

highlighted that they consider the use of masks and alcohol to be

appropriate and useful as the main method to stop infections.

Regarding the appreciation of the vaccine, the participants stated

that they agreed with its application because it helped them

improve their health.

These results are comparable with other studies such as that of

Reyes Gomez(18) carried out in the indigenous population of

Chiapas, in which it determined that the origin of the disease,

according to the perception of those interviewed, was that the

coronavirus is present in "dirty air", contaminated with "cold

property", which is potentially harmful and probably cause of

death. Regarding knowledge of the disease, there is similarity

with the study carried out by Flores Choque et al.(19), which

shows that the majority of the population knows the

characteristics of the pandemic. Also, regarding biosafety

measures, a certain similarity was found in the study carried out

by Malán Lema (20) where the participants also wore the mask

despite stating that it bothered them, they could not breathe and

they had a headache. Regarding the appreciation of the vaccine,

the results obtained differ from a study carried out by Castrillo

Guzmán et al.( 21) since although the majority of the residents

declared their intention to get vaccinated, there was another

proportion that had no intention of doing so, either due to fear,

distrust and considering that it is not safe.

Regarding the category of “experiences facing the COVID-19

pandemic”, aspects related to signs and symptoms of the

disease, diagnostic methods, handling of corpses, prevention

measures, access to health, application of vaccines and

pharmacotherapy, the results indicate that the majority of those

interviewed experienced general body discomfort, including

fatigue, sore throat, fever, headache and chills. The

manifestation of these symptoms constituted, for the study

population, a diagnostic method to deduce that a person suffered

from COVID-19. Regarding the handling of the corpses, those

interviewed expressed that they were not able to hold a wake for

the deceased. Regarding prevention measures, the community

restricted the entry and exit of the population as the main method

to avoid infections. The majority decided not to access health

services; however, a large proportion of the population did get

the vaccine, indicating that it was more out of obligation than of

their own free will. In reference to the use of pharmacological

treatment, only two participants stated that they had used

medications to recover from the disease.

These results were contrasted with the study carried out by

Flores Choque et al.(19) where it was evident that the

interviewees presented characteristic symptoms of COVID-19

such as high fever, discomfort throughout the body, lack of

appetite, muscle pain, back pain, loss of strength, weakness and

stomach pain. They also stated that, within the treatment used,

the use of a conventional drug such as paracetamol stood out.

Regarding the handling of corpses, there were differences with

what was determined in Tuaza Castro's study(22), since it

pointed out that the residents remained with the deceased,

without accepting the restrictions of the emergency operations

center (COE). However, there was similarity with regard to

prevention measures, since the participants stated that they

accepted the isolation protocols, understanding “stay at home”,

as staying in the community. In this same sense, in the study of

Malan Lema (20), it was evident that in the community studied,

controls were carried out, restricting entry to the community,

complying with the mandatory quarantine for those who wished

to enter and preventing the departure of community members.

Regarding the application of the vaccine, similarity was found

with the study carried out by Flores Choque et al.(19) since the

results showed that the majority of the population received the

first dose.

Regarding the third category related to "traditional medicine

practices", specifically with the use of medicinal plants, it was

evident that the majority of the participants in this research used

eucalyptus, ginger and lemon for their medicinal properties.

These results are similar to those of the study carried out by

Chicaiza Calapaqui (23) where the most used plants were

eucalyptus, mint, plantain, onion and ginger. This was also

evident in the study by Tuaza Castro(22) where vaporizations

with mint, eucalyptus, Marco and Santamaría plants were used.

CONCLUSIONS

The Shuar community has a fairly accurate perception regarding

the origin of COVID-19, since the majority of the participants

express that the disease comes from the air, is transmissible and

can cause death. Likewise, they considered the biosafety and

vaccination measures contemplated by the Ministry of Health to

be positive and adequate, which allowed them to use these to

avoid contracting the disease. Regarding the experiences, they

implemented measures to prevent contagion, such as restricting

access to their territories. Regarding the identification of sick

people, it was done by manifestation of characteristic symptoms

of the disease, the same ones who were treated at home and in

case of death they were buried immediately, without being able

to perform the farewell rituals for their relatives, generating

annoyance among community members. Regarding the

ancestral practices used to treat the COVID-19 disease, the use

of medicinal plants such as eucalyptus, ginger, lemon and

orange was evident, which thanks to their healing properties

allowed the health of people sick with COVID-19 to be restored

in a natural way.

Tapia C/ Enfermería Investiga Vol. 8 No. 4 2024 (December - January)

CONFLICT OF INTERESTS

The authors state that there is no any type of conflict of interest.

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