Alternative therapeutic systems in belize: A semiotic framework

Abstract

The first part of this paper presents data on the socio-medical system of an ethnically heterogeneous society collected during 16 months of fieldwork. Special attention is given to the Black Caribs (or Garifuna). The focus is on the possible functions of alternative therapeutic systems. The second half of the paper provides a semiotic framework for the analysis of illness episodes. It is concluded that the sign of disorder in this context has no single interpretant. Rather, there exist a variety of interpretants from which the therapist and patient may select. There are constraints on this process, but the process is enhanced where the patient (and the social group) are free to negotiate a ‘diagnosis’. Negotiation implies selecting from among a variety of potential meanings: it implies a dialogue in which one goal is an interpretation which is acceptable in cultural terms and which leads to a therapy which is perceived as ‘appropriate’. Negotiation may also mean the realignment of signs into new ‘syndromes’ which indicate different etiologies or therapies. The existence of alternative therapeutic systems facilitates this process by providing access to new codes governing interpretation. The confrontation with biomedicine and its largely intractable codes may require that the ensuing interpretation incorporate, account for, or partially assimilate the ‘diagnosis’ or interpretation of biomedical personnel. Nevertheless, a single sign may have multiple referents, each consistent with one of the various interpretations imposed by multiple therapeutic systems. These referents may exist simultaneously without inherent contradiction. But to achieve such a consensus may require the development of new models based on an articulation but not an identification of two or more codes.