ETHNOMEDICAL (FOLK) REMEDIES FOR CHILDHOOD ASTHMA IN A MAINLAND PUERTO-RICAN COMMUNITY

Background: Childhood asthma is the most common chronic illness of chi ldhood. The highest prevalence of childhood asthma in the United State s occurs in the Puerto Rican community, and there are many traditional beliefs and practices regarding asthma that coexist with biomedical t herapies. Objectives: To describe the ethnomedical treatment practices for childhood asthma in one mainland United States Puerto Rican commu nity and to determine whether any of these practices are effective or potentially harmful. Method: Home interview with caretakers of 118 Pue rto Rican children with asthma who seek care at two community health c linics in an inner city in the eastern United States. Results: Common home-based ethnomedical practices include attempts to maintain physica l and emotional balance and harmony, religious practices, and ethnobot anical and other therapies. Potentially harmful practices are uncommon , and other remedies are only harmful if not taken as directed. Many r emedies are not effective from a biomedical standpoint (ie, bronchodil ation or anti-inflammation), but if analyzed within the ethnomedical e xplanatory model-which includes the belief that expulsion of mucus and phlegm from the body is beneficial for the treatment of asthma-these remedies bring about the desired effect and are therefore considered e ffective to the user. Conclusions: Ethnomedical therapies for asthma i n the mainland Puerto Rican community are well known and commonly used . Most practices are not idiosyncratic but fit within a coherent ethno cultural belief system. The health care practitioner can lower the ris k for potentially toxic effects of some treatments by discussing these practices with patients and families. Some ethnomedical practices are not discordant with biomedical therapy. Incorporation of these practi ces into the biomedical plan may help to fit the biomedical therapy in to the lifestyle of the patient.