Vernacular Medicine and the Creation of Locality: Understanding Holistic Healing Processes in Creolized Cultures

By Carter Louis Pesson

 

Creole Identity and Vernacular Medicine Practices

Conducting fieldwork as an undergraduate at Louisiana State University (LSU), I ventured to Cuba to learn more about vernacular healing processes. Journeying to the Caribbean allowed me to examine a creolized culture that held unmistakable parallels to Louisiana's own creole culture, a culture composed of individuals raised in colonial societies who were often of mixed ethnic origins. Following my research in Cuba, I expanded my research to South Louisiana, where I examined vernacular healing practiced by traiteurs, practitioners of vernacular medicine that utilize faith healing and even herbal remedies to cure illness.

This study evaluates vernacular medicine as a cultural treasure that has been passed on from Native American tribes, enslaved Africans, Spanish and French colonizers, and other ethnic groups that together made manifest a dynamic vernacular medicine system.

For the purpose of this study, vernacular medicine will be defined as any healing processes associated with use of herbal remedies, ritual processes, or spiritual healing. As a comparative study, this project discusses creolized vernacular medical practices in Cuba and Louisiana. Data for the portion of the study conducted in Cuba was primarily collected for one month in three provinces—La Habana, Pinar del Río, and Trinidad de Cuba—while studying abroad with LSU/Honors in Cuba during June 2017. Through formal interviews, participation in healing rituals, and observations during interactions, the study documents and analyzes the perception that Cubans have concerning vernacular medicine practices. In Louisiana, ethnographic research was conducted as part of an ethnography course at LSU, and it occurred over a three-month period.

Comparative research in Cuba and Louisiana demonstrates that healing through several different modalities is indeed beneficial, and often essential, in successfully treating patients. The outcome of this study considers the possibility that medical treatment through both the modalities of biomedicine—allopathic medicine practiced by physicians in hospitals—and vernacular medicine allows for creole societies to think of healing holistically. By incorporating spiritual, mental, and physical healing when healing individuals, practitioners of both biomedicine and vernacular medicine address health of the individual as a whole.

Positionality

Pursuing dual degrees in Anthropology and Biological Sciences at LSU, I conducted ethnographic research over the course of twenty-two days in Cuba, where I interviewed and interacted with vernacular healers and physicians. As a native of South Louisiana, proficient in Spanish yet new to Cuban culture, I am also personally part of a creolized culture where influences of Native American, Spanish, and French cultures are evident. This creolized culture formed through a process termed creolization: a formative process of transculturation that brought about unique societies in regions colonized by the Spanish and French. Although creolization in these two regions occurred simultaneously with some similar sociocultural groups, the process resulted in the creation of two unique cultures due to transculturation, which can be defined as "the highly varied phenomena that have come about . . . as a result of the extremely complex transmutations of culture that have taken place" (Ortiz 1940:98). As an outsider aware of the complexities of creolized cultures, I will explain the utilization of vernacular medicine and why it is a critical cultural resource.

Often, anthropologists studying vernacular healing cite difficulty in opening conversations about religion, belief systems, and ritual processes. However, asking about vernacular medicine from a medical perspective, I never faced difficulty. This observation demonstrates enthusiasm concerning vernacular medicine practices that invites individuals of differing perspectives to participate in ritual and learn about this cultural resource. Priests of Cuban religions of African origin, Regla de Ocha, called Babalawos, priestesses of a Cuban religion called Regla de Palo, physicians, and university professors all answered my questions with support and interest.

Returning to Louisiana, I realized parallels between my Cajun/Creole culture and the Cuban creole culture I experienced in Havana. Growing up on a farm in South Louisiana in a Cajun household, I was raised within a unique culture where small communities fostered local knowledge, which is gained by experiential means and often outside of the academic realm, and informal networks. Being a part of these networks, or the ties that link together the individuals in a community and that allow for the sharing of local knowledge, exposed me to the prevalence of vernacular medical practices in south Louisiana and allowed me to analyze cultural change and its impact on vernacular healing perceptions in the United States.

Methodology

Before traveling to Cuba, I consulted foundational anthropological works that provided a method to interpret the ritual practices and cultural knowledge of medicine (Appadurai 1995; Appadurai 1996; O'Connor 1995). Reading foundational Cuban works, I gained insight into methods of vernacular medicine practiced in religious and secular contexts (Cabrera 1984). I also learned about various Cuban religions of African origin and the healing ritual processes utilized in those religions. In order to better understand the importance of African healing traditions, I consulted sources about vernacular healing and religions of African origin in Brazil and Puerto Rico (Voeks 1997; Romberg 2009). Additionally, through Beliso-De Jesús' book Electric Santería: Racial and Sexual Assemblages of Transnational Religion (2015), I learned how technology and diasporas have spread Cuban culture, including religion and vernacular medicine practices. For example, I spoke with Cubans living in the United States who purchased plants with medicinal properties to grow in their homes, continuing vernacular medicine practices while living in the United States. The sources I utilized provided me with a background to deconstruct the multifaceted sociohistorical and cultural contexts of vernacular medicine in Cuba.

During the course of my research, I gathered information by spending the day with an Iyaloricha—the spiritual godmother of the professor with whom I worked—and a Babalawo (de las Flores 2017), exploring an important Regla de Ocha religious site (Fornaguera 2017), and by touring a farm where vernacular medicine was common knowledge among community members (Correa 2017; Tamayo 2017). The experiential knowledge I gained far outweighed the direct questions I asked individuals with whom I interacted.

In observing incorporations of ritual practices into daily life, perceptions of healing remedies, and utilization of curative religious rituals, I compiled extensive field notes. For example, when I was touring a farm called La coincidencia, I took notes as the guide discussed plants used for food as well as vernacular medicine practices. Even as an artist and farmer by trade, the guide was well-versed in vernacular medicine practices (Correa 2017). Coalescence of my notes during my time on the island influenced the findings of my research about the unusual interactions between healing and daily life. For the privacy of and protection for the collaborators with whom I worked, I will use some aliases instead of collaborators' proper names. Following recommendations from Kristina Wirtz's (2014) work, I recorded my transcriptions verbatim, including pauses and inflections to best encapsulate the conversation. Wirtz defends her methodology when she writes, "I prefer to leave transcripts a bit messy and indeterminate to serve as reminders about all that we cannot definitively know or reconstruct about instances of interaction" (2014:158). These transcriptions proved invaluable in determining the deeper context of ritual healing processes both in the context of vernacular religion and secular practices.

Through formal interviews, I gained perspective on vernacular medicine from a professor studying Ensalmos—a prayer-based healing practice (Santos Garcia 2017)—and a retired psychiatrist trained in traditional medicine at Instituto Superior de Ciencias Médicas in Camagüey (Maricela 2017). During these interviews, I also spoke with Maria de las Flores, a practitioner of vernacular medicine and a retired nurse (de las Flores 2017). From these interviews I was able to gain insight into the interactions between vernacular and biomedical healing processes. In Cuba, individuals often utilize multiple avenues of healing in order to address health holistically. However, patients still maintained concern over the qualification of the individuals from whom they received diagnosis and treatment (Maricela 2017). Through the course of these interviews, I gained an understanding of how vernacular healing processes supplement biomedicines resulting in a treatment plan that addresses illness on myriad metaphysical fronts.

During research in Louisiana, I employed the same techniques as I did during my ethnographic research in Cuba: conducting formal and informal interviews, pursuing knowledge vis-à-vis local networks, and asking questions about ritual healing from a medical standpoint. Although interviews were conducted in mixed English and French, at the preference of the interviewee, the rest of the interview format remained similar. Traiteurs were open to sharing their healing processes, healing spaces, and even their healing prayers during my ethnographic research. Further, consultation with local professors, community members, and even family members provided me with an invaluable background on vernacular healing practices in South Louisiana.

Ritual Healing Processes in Cuban Religions of African Origin

From the outside, the home seemed like an oasis surrounded by plants with a welcoming front porch. Through the gate, I saw mariwo—palm fronds utilized to denote Regla de Ocha religious practices in the household—on the entryway, and I knew that I was walking into a sacred place where Cuban religions of African origin were practiced. I was greeted by a practitioner of vernacular medicine and a retired nurse named María de las Flores, who was happy to see the professor who invited me to journey with her to a family reunion of sorts. Immediately, ritual began, but not the formalized ritual of a church service. My professor went with de las Flores to undergo a cleansing ritual. Albeit a private ritual, I observed the interaction between such healing rituals and the pace of everyday life. Ritual did not stop the flow of life; it was a secure part of that flow. I could not help but look around to see how ingrained Regla de Ocha was into this family's daily life. Glasses filled with water sat upon shelves, some higher than others. These glasses of water, though I did not know it at the time, represented ancestors (de las Flores 2017).

The purification healing ritual ended, and my professor and de las Flores walked back into the kitchen. They called to me, and I left the bedroom to begin one of the most foundational interviews of this study, one encompassing vernacular healing, Cuban religions of African origin, and the locality of vernacular medicine. Initially, we spoke about de las Flores' altar, a common part of homes where Regla de Ocha is practiced. This altar is a place for offerings to the orichas—spirits honored and consulted by practitioners of Regla de Ocha—and a center of ritual practice in the home. There, Obbatalá sat atop the altar, as that is de las Flores' oricha. Each practitioner is paired with an oricha, and they position that oricha at a prominent location on the altar with other orichas positioned on lower shelves or levels. On each altar, offerings representative of the various orichas are positioned. This altar serves as a central part of the home where ritual ceremonies occurred and where the orichas essentially lived. Some orichas were not placed on the altar. For example, Elegua's pot is positioned by the door to protect the home. As the warrior oricha, Elegua protects the family from misfortune and needs to be placed by the entryway to the home (Wehmeyer 2007). Through this altar's intricate representation of the various orichas, it demonstrates the intricate ties between these orichas and the daily lives of practitioners of Regla de Ocha. Rituals and healing are not formal; they are tied seamlessly into everyday life (de las Flores 2017).

de las Flores discussed her home, revealing its use as a ritual space by her spiritual family. Walking through the doorway protected by the palm tassels, all individuals enter an ever-shifting liminal space determined by perceptions of the tassels either as decoration or key ritual items (Turner 1987). From the garden (see figure 1) where we discussed the healing properties of nearly forty herbs to the Palo temple where readings occur, the home serves as a spiritual center.

Orichas live in the altar spaces in the living area, ritual foods are prepared in the kitchen, the dining area serves as a ritual space for offerings, and the garden serves as the source of herbs that are essential for ritual processes. During my time at this home, I found three principal liminal zones: the garden, the altar, and the Palo temple. Each zone is essential in understanding the intersection between vernacular healing and Cuban religions of African origin (de las Flores 2017).

In the first zone, the garden, de las Flores showed me her medicinal and ornamental plants, explaining their significance in both vernacular medicine and ritual processes. de las Flores' garden serves as a ritual, yet also public, space because she uses its herbs as remedies that are often part of ritual practices in Cuban religions. Perceptions of the garden as either a ritual or public space is dependent on the locality, which is layered and experienced differently depending on participants in the space. For some, the garden is a more liminal space than for others, based on their experiences with Regla de Palo and the vernacular medicine that shapes their perceptions. Therefore, during readings or other ritual processes, if herbs are needed, the garden itself becomes a critical part of the ritual. Instead of waiting for the procurement of herbs and the continuation of ritual, the ritual process can proceed without prolonging the ritual process (de las Flores 2017).

Within the garden's space, de las Flores grew a variety of plants that held both ritual and medicinal significance. de las Flores spoke about a variety of herbs, and I will use their scientific names. Zerzrina discolor, a plant located on de las Flores' porch, is important in ritual cleansings that purify the body as well as homes and businesses. Kalanchoe daigremontiana is a plant whose leaves are added to the "leaves of Verdolaga and Frecuara, milk, cocoa butter, and powdered eggshell" (Carlos Díaz 2008:66) to create a bath to purify individuals. When the ritual is utilized to purify the home, powdered eggshell is spread from the front to the rear of the home, and Obbatalá brings good health to those living in the house. Malanga, scientifically named Xanthosoma sagitifolium, is a plant I personally encountered whenever a student on the study abroad program experienced stomachaches. The plant's root is known to cure stomach ulcers and aches, and water from the stem strengthens the brain. This plant is used in numerous Santería practices; in fact, author José Carlos Díaz states that "it must never be absent" (2008: 100). de las Flores' massive garden serves as a source for those herbs as well as myriad others. She even hosts many rituals at her very home because it contains such an extensive Santería garden, a critical space in the liminal process bringing an individual from a state of illness to wellness (de las Flores 2017).

Practitioners of Regla de Ocha place emphasis on rituals that promote health and wellbeing while intending to help their spiritual family to maintain longevity. With increased longevity, individuals are able to gain more wisdom that can be utilized by later generations who call upon ancestors for help in daily life, in times of struggle, and even in health crises (de las Flores 2017). During my time in de las Flores' ritual spaces, I was allowed to participate in one ritual to consult my own ancestors. The ritual involved all three liminal spaces, but it began at the altar. One of my professors began the ritual process by picking up an object and touching a certain part of the ground, asking the ancestors and orichas for permission to begin the ritual. When the ancestors said yes, de las Flores immediately approached me and instructed me to follow her as she began the ritual process. The first part of the ritual was public, but the following portion, the reading, was private. We walked from the altar's ritual space to the Palo temple. It was a small, metal structure covered with firmas—metaphysical maps—that denoted ancestors and, in this case, the priestess herself. If some individual obtains a copy and learns how to reproduce these maps within ritual context, that individual can experience backfire. Within that Palo temple, ceramics lined one wall, each filled with differing types of wood. Each pot held relics of ancestors, and one pot was filled with herbs and flowers from the garden, incorporating the third ritual space into this ritual process.

de las Flores invited both the professor and I into the structure. We sat down, and she prepared for the ritual. The professor tapped on a tile; I did the same. A single candle and cigar were lit, and de las Flores smoked, beginning the ritual with prayer-like words. With chamalongos—dried coconut shells used by santeros to divine—she asked the ancestors permission to begin the ritual reading, and the response was yes. The professor began with his questions, and although I listened intently to gain a better understanding of the process, I will not describe those questions here. Essentially, those getting readings ask ancestors advice concerning matters of daily life: workplace issues, relationship problems, problems concerning the future. When the professor's reading ended, I was asked to begin. de las Flores proceeded to tell me facts about my life that no one could possibly know without being told. She discussed my love for both anthropology and biology, and she continued to state that I have many passions and that I often wonder if medicine is the right career path. Following that, I decided to ask a singular question: should I pursue medicine since I have so many varied passions. In response, the ancestors said that I should definitely study medicine because of my noble heart and willingness to make a difference in the lives of those less fortunate than myself. Furthermore, the ancestors, working through de las Flores, went on to tell me that I should refrain from trusting easily, as individuals behind my back would try to ruin my reputation. After this phrase, the ritual was closed by asking a question, saying a few words in Spanish, and turning over the candle while extinguishing its flame in the Palo temple, which through ritual allows individuals to take their experiences and bring them to their ancestors for advice on living a better life (de las Flores 2017).

Participating in this ritual gave me insight into the holistic way that practitioners of Regla de Ocha and Regla de Palo understand preventative healthcare. By using ritual, practitioners are able to adjust their lifestyles in order to live in a way to extend longevity and existence beyond materiality, including aspirations, dreams, and goals (O'Connor 1995a). Regla de Ocha especially focuses on extending the longevity of practitioners' lives in order for them to gain experiential knowledge and wisdom to pass on to new practitioners. Further, this ritual involved all three liminal spaces, although the ritual's separate preparations coalesced in the space of the Palo temple (de las Flores 2017).

Anthropologists continue to observe similar phenomena in other regions influenced by Yoruba culture. Robert Voeks describes perceptions of vernacular healing within the context of ritual processes when he writes, "illness is perceived to represent reactions to forces outside the realm of secular comprehension. African American religious leaders frequently occupy the role of community curers, acting as spiritual brokers between the physical and material worlds" (1997:4). de las Flores acted as one of these community leaders among her spiritual family and friends. She is a knowledgeable individual who holds powerful positions in Cuban religions of African origins; further, combined with her medical expertise as a retired registered nurse and vernacular healer, de las Flores is a source of local knowledge (Appadurai 1995) within her community.

Vernacular healing traditions are ingrained in Regla de Ocha, Regla de Palo, and Espiritismo, which is a faith-based healing prayer that originated with Spanish folk healing practices. These healing rituals have been well documented by a number of anthropologists and folklorists, including one professor with whom I worked closely during my fieldwork in Cuba: Solimar Otero. In Otero's (2008) work on La Limpieza, she writes, "The limpieza ritual is arguably a focal point where body and spirit can actively be remedied at the same time. Due to this perceived connectedness between body and spirit in the belief system, the limpieza ritual is an excellent starting point for exploring notions about health, cleanliness, and the body in Santería" (4). In understanding the relationship between la limpieza and multifaceted healing, Otero (2008) describes how medicine of a padrino (spiritual godfather), madrino (spiritual godmother), and physician is often used together to confront disease through spiritual, herbal, and biomedical healing.

Additionally, this holistic approach to healing is expressed through Regla de Ocha's oricha of medicine, Inle. Holistic healing approaches through herbal remedies are also expressed through Osain, the oricha of plants. Osain's priests, herbalists, indispensable to Babalawo in both Africa and Cuba, are called Onisegun and Osanyistas. Acting as an oricha who governs the area where rivers meet the ocean, Inle is present in a constant state of liminality by governing regions where both Yemayá, oricha of the sea, and Ochún, oricha of the rivers, reside. Inle not only spans regions; the oricha spans sexualities as well. As a sexually fluid being, Inle serves as an example of how "everybody has a role, everybody has a role in the ritual" (Pérez 2016b:112), no matter their sexuality. By existing "betwixt and between" (Turner 1987), Inle plays a critical role in the religious traditions that contribute to Regla de Ocha's unique view of medical treatment through vernacular healing rituals as an ungendered process (Otero 2015).

Vernacular Medicine in Clinical Settings

Upon speaking with the woman who ran my casa particular, I realized that she was a retired psychiatrist who earned her master's degree in traditional medicine in Camagüey (Maricela 2017). When I asked if she would be okay with collaborating in a formal interview, Maricela said that she would be more than willing. Apologetically, she also said that she had not practiced in Cuba in nearly twenty years, as she spent the past eighteen years living and practicing in South Africa, where she used no Cuban vernacular medicine. In her interview, Maricela spoke about the interactions between vernacular medicine and biomedicine, the receptivity of vernacular medicine to individuals, and how much vernacular medicine is commonly used in the home (Maricela 2017).

I first asked Maricela if she saw any hesitation or taboos about treatment with vernacular medicine. Immediately and without hesitation, Maricela said no (2017). Proceeding to discuss the multifaceted nature of Cuba's treatment of disease, she told a story of a dear friend:

I personally had a friend who was a babalow and a neighbor, a good friend. He was . . . he is a veterinarian, and also [a] babalow. I remember his wife was operated [on] for cancer, and all of the procedures, you know, were at the hospital with doctors and so on, independently of all the ritual they did trying to save her. I remember for some reason she . . . she had some problem using contraceptives. She didn't tolerate this or that, and at the same moment they had only one child. She was advised not to have another child because she was operated of that cancer. Eeh, I remember the doctor recommended a ligation, you know? In order to have a safe sexual relationship without any risk of being pregnant, and everything was through the doctors. But, at this point they consulted the ancestors and the ancestors said, "no operation." Then, she was not operated. At some point there was a dilemma, and these people have a strong belief like them, but they still keep all of the procedures in the doctor's hands. But, she used other methods. All of these kinds of things tell you that people look for the safe area, you know, even if they believe. (Maricela 2017)

Maricela's friend, an individual who uses biomedicine as a veterinarian, also acted as a practitioner of Cuban religions of African origin. He trusted and allowed his wife to be treated by a physician; however, that decision was reached after consultation with the ancestors through ritual readings. In the case of the surgery allowing for safe sexual relations, the ancestors recommended that she refrain from having the surgery. Because the woman maintained belief that these readings allow for consultation of ancestors and that those ancestors use their wisdom to inform the best decisions for a long and prosperous life, the woman trusted and proceeded to live without that seemingly life-enhancing surgery. Maricela said that she continued to have safe sexual relations with other contraceptive methods, but she also continued to live a healthy life. The practicing physician seemed to have no qualms about this trust of ritual, for in Cuban culture, medicine itself is practiced in many differing modalities. By combining a utilization of biomedicine with vernacular medicine practices, individuals have the ability to heal holistically, and they use biomedicine where vernacular practices are deemed ineffective. Vernacular practices pervade biomedical treatment to enhance quality of life and help during the healing process (Maricela 2017).

Talking more about the use of several medical modalities, Maricela described her master's thesis in detail, which addressed the use of vernacular medicine. As research for Cuba's then recently-created master's program in traditional medicine, the study was conducted on a massive scale. Maricela and her classmates spatially divided the city of Camagüey into three sections, physicians were contacted in each section, and those healthcare professionals were interviewed. Further, willing patients were interviewed, and those volunteers originated from a variety of socioeconomic classes from various neighborhoods within the city. The findings of this study were astounding: over 90 percent of the population was found to use some type of vernacular healing. However, Maricela also found that individuals were extremely careful when seeking vernacular treatment. Patients often saw physicians first and then consulted vernacular healers after having a medical diagnosis. If the medical issue was treated by a physician, then patients often sought vernacular treatment to supplement biomedicine by reducing pain or other factors stemming from the biomedical treatment itself (Maricela 2017).

Analysis of both Maricela's story and thesis work yields results consistent with my conversations with de las Flores: vernacular medicine is a critical part of Cuban culture. However, it is not used alone. Medicinal practices seemingly parallel practices of Cuban religions of African origin: more than one religion and more than one type of medical treatment can be used. During Maricela's (2017) interview, the retired physician stated the following concerning Cuban religions: "You know in Cuba, it's a very syncretic case about religion. You know you can mix. You can go to church on Sunday morning, maybe the following day go to see a babalow of Santería, an Afro-Cuban religion. You know people mix all of that" (Maricela 2017). Through a willingness to mix religion and healing mechanisms, Cuban religion and medicine thrive with multifaceted modalities. Like Cuban religions of African origin, medical practices of biomedical and vernacular natures are used together to supplement and holistically treat ailing individuals. Even in hospitals, departments of traditional medicine thrive, allowing patients to use both biomedical and herbal remedies. This seemingly dialectical argument is considered a multifaceted method of combatting disease and facilitating healing on different metaphysical planes (Maricela 2017).

Ensalmos as a Spiritual Healing Practice

Researching at Instituto Cubano de Investigación Cultural Juan Marinello, I was provided with the opportunity to speak with Caridad Santos Garcia (2017b), an expert on the Ensalmos vernacular healing practice in Cuba, and we spoke concerning the use of spiritual healing. Ensalmos uses formalized prayers said between a healer and the sick, calling upon God to heal the ill person. Firstly, Garcia stated that Ensalmos could be used alongside biomedicine, but it was also effective alone. As an expert in the cultural study of this ethno-medical practice, Garcia writes that "se valen de palabras mágicas—desde antaño, estimadas como instrumentos de poder—dirigidas a una divinidad, santo o ente sobrenatural para obtener la curación milagrosa de una enfermedad propia o ajena, denotando marcada función utilitaria"¹ (Santos Garcia 2017a). Although this quote seemingly contains a functionalist perspective on Ensalmos, it tells of a ritual healing practice that functions specifically for healing. Ensalmos draws upon traditional religious practices as well as a tradition of asking for religious intervention in healing processes. The Ensalmos prayers themselves act as a ritual, asking for divine healing of a disease either for the person praying or for another individual (Santos Garcia 2008, 2017a).

Although these prayers call for divine intervention in addressing healing, they are not largely believed to have African origins. Garcia's study of Ensalmos led her to believe that it is a facet of vernacular Catholicism rooted in Iberian-American culture. For example, Garcia writes that "algunos de los procedimientos y textos mágicos estudiados presentan múltiples analogúas con fórmulas afines en el ámbito iberoamericano"² (Santos Garcia 2017a), which also have a strong tradition of vernacular healing. Because this vernacular religious healing practice developed from Spanish and Cuban culture in the Americas, it is a product of transculturation. Further, similar Ensalmos practices are known to exist throughout Latin America and have spread to former Spanish colonies throughout the Americas, even in the United States. Interestingly, these prayers often take the form of a dialogue, as Garcia writes, "se manifiesta a través de oraciones que poseen una antigüedad muy remota, versos que adoptan—principalmente—la estructura de cuartetas o la presencia de diálogos entre el 'curador' y el 'enfermo'"³ (Santos Garcia 2017a). This method of prayer is also an example of hagiography and prayer traditions of the Archangel Rafael, who is syncretized with the oricha Inle. The prayer operates as a method of conversation between the healer and the patient; further, it adopts a formalized ritual process. Although the ritual itself can be conducted informally, the prayers are rigidly adhered to throughout the liminal phase between illness and healing. Although different from some ritual process in Cuban religions of African origin, this process addresses supernatural holistic healing (Santos Garcia 2017b).

Louisiana's Caribbean Creole Identity

Louisiana is inextricably linked to the Caribbean, and it has been interconnected since the beginning of the colonial period. Cultural belief systems, creole identities, languages, and vernacular healing practices persist even at present in both regions. In-depth study of the impact that the colonial period had on Louisiana's dynamic and diverse culture will likely yield an interesting reinterpretation of history. In analyzing Louisiana's link to the Caribbean vis-à-vis Saint-Domingue, or modern Haiti, and its associated islands (e.g., Cuba), Thomas Fiehrer writes:

Official versions of Louisiana's past are not inclined to map the past connections between the Gulf Coast and the adjacent islands or the common populations, cultures, tradition—the civilization—they share. Louisiana's history awaits a general reinterpretation that transcends the confines of national boundaries, metropolitan democracy, and the program of American imperialism in the Caribbean. There is a past to be uncovered, a lost reality awaiting discovery. History, until recently, was the president of the politically privileged, and as such it imprisoned and negated local reality and homogenized the past through fabrication and omission. (1989:437)

In examining the sociohistorical connections between Louisiana and the Greater Antilles—especially Cuba, Puerto Rico, and Hispaniola—a historical anthropology approach can be useful for outlining a broader context within which to understand vernacular healing practices (Fiehrer 1989).

With an inextricably linked colonial history, colonies such as Cuba and Louisiana should be studied comparatively to best understand processes of transculturation and, more specifically, creolization that perpetuates in both populations. Creole identity is centered around four bases: birthplace, ancestry, race, culture. Birthplace is critical, as creole originally meant "born in the colonies" (Henry and Bankston 1998:560) and, in this case, being a native of Louisiana. Birthplace also was important, as creoles were individuals born in Louisiana with foreign origins (e.g., European, African). Creole identity also centered around ancestry, as different ethnocultural groups began to inhabit Louisiana following statehood, such as Anglo-American settlers. Race is critical in defining creole identity, especially for this study, as creole identity is often defined as being of African descent (Henry and Bankston 1998). For the purpose of this study, creole identity is defined as being born in the colony into a transcultured society, which includes descendants of colonists, free people of color, slaves, and even indigenous populations present during the colonial period. Especially in the context of cultural practices that arose largely in creolized contexts, understanding a historical framework is essential in understanding cultural developments. For example, practices of vernacular healing that are found throughout the Caribbean basin arose within the colonial context, and without proper understanding of the context in which these complex practices originated, anthropologists choose to ignore the larger sociocultural context (Henry and Bankston 1998).

These complex practices were transferred to Louisiana specifically by all three populations that compose Louisiana's three-caste system, perpetuated by Le Code Noir, that existed throughout the colonial period: the ancient population, descendants of European elites born in the French or Spanish colonies; enslaved Africans; and gens de couleur, people of color. As individuals from these populations settled in Louisiana, they brought along their creolized heritage, which included both linguistic and ritual healing elements. These healing elements were often derived from the African ritual healing practices associated with religion and the French and Spanish folk healing traditions intimately linked to Catholicism (Dormon 1992; Fiehrer 1989). Unfortunately, this caste system ignored Native American populations, which influenced vernacular healing traditions in both Louisiana and Cuba (Walker 1994).

Ritual healing in Louisiana emerged from a mosaic of cultures that made manifest a creole society from which ritual healing traditions emerged. Although associated closely with Catholicism, ritual healing has folk roots in French, Spanish, Native American, and African cultural practices. These healing traditions are never used solely by a member of one religious or ethnocultural group, as treatment can and is administered to anyone who seeks it. Often, ritual healing is sought out when biomedical practices does not provide a holistic solution to health problems. Traiteurs provide vernacular medical treatment, often in ritual context, to those who seek out healing in South Louisiana (Sexton 1992).

Traiteur Ritual Healing

Being exposed to vernacular medical practices through informal networks, Becca Begnaud, a traiteur from Scott, Louisiana, recounted a story of her first encounter with a traiteur, a community healer who happened to be her grandfather. She told a story about her grapop:

One time my momma called my grandpa because I had a sunstroke. She said, "I'm gonna call grapop. He's gonna come treat you." I'm like, I didn't know if he was going to treat me good or treat me bad or buy me a treat. But I didn't know shit about that. . . . So then grapop comes and says this prayer. She [Begnaud's mother] had some water put in a basin. He did like that [making the Sign of the Cross]. Of course I wasn't afraid. He was my grandpa. He went visit with momma. Me, I'm ready to go play. Well I didn't know anything about my grandpa doing that. But the community knew. We don't have any more community knowledge anymore. We don't have community connections. We don't even know who are those people at church anymore. We knew where they sat, where they lived, what they did for a living. (Begnaud 2017; Begnaud 2012)

Before that experience, Begnaud did not realize that her grandfather was a traiteur, nor did she realize the level of respect he held among his fellow community members. As a traiteur, Begnaud's grandfather played a critical role in South Louisiana culture by serving as a healer who incorporated liminal transitions between illness and health into his daily life. Being a well-informed and well-connected citizen allowed for the participation in local knowledge, which Begnaud believes is fading as Cajun/Creole Louisiana culture changes. Discussing her belief that local culture is changing, she speaks of her hometown where neighbors used to know each other, and families once sat in the same pew every Sunday at the Catholic church nearby. Now, Begnaud does not know her neighbors and believes that informal networks that once linked entire communities are lost (Begnaud 2017).

Although the town's tight-knit community was aware of the work Begnaud's grandfather did, the community's residents today are less informed of local knowledge, especially through informal networks. In continuing cultural healing traditions as a traiteur, Begnaud faces challenges, and states, "So, part of my conflict has been, how do I carry on tradition that was given to me after my grandpa died that comes from my culture, when my culture is not here anymore. I mean we're still here, but it's not the same culture." Typically, becoming a traiteur requires a ritual that passes the healing traditions on from one family member to another. The practicing family member traditionally passed on this gift by giving a prayer to a son or daughter on their deathbed; however, they could also pass on this tradition during their lifetime. The healing tradition is transferred to their son or daughter once they stop practicing and pass along the gift. However, this tradition of passing along the gift proves difficult in present-day Cajun/Creole culture, where communities are no longer as close-knit, some family members are skeptical of healing traditions, and dominant U.S. culture stigmatizes vernacular medical practices (Begnaud 2017).

Begnaud believes that healing rituals do not require Cajun French or the traditional method of passing down the gift of being a traiteur, as changing culture requires adaption of tradition in order for its continuation. However, Begnaud's personal beliefs are not generalizable to Cajun/Creole culture as a whole, as passing down the gift is typically a critical event in becoming a traiteur. Prior to her grandfather's passing, Begnaud never received the gift; however, she still successfully heals on a regular basis. As a community vernacular healer, Begnaud recounts an experience she had while healing her uncle:

I went to his house and I treated him. I treat you, then bye. You know, don't say thank you, and don't give me anything. Some people do give gifts; some people do give money. I say okay, but I tell them to make sure they know that it's God and not me. Don't make a God out of me. They came back to visit. [Imitating her aunt] "Mais, he never complained of his back since you worked on him." Nothing could have made me happier. For them to know that the gift that came into my family from his dad, my grandpa was manifested in me, and I could help my uncle. (Begnaud 2017)

Although Begnaud did not receive her gift for healing in a traditional sense, she successfully heals with prayers from traiteurs. By gaining access to these prayers as well as other healing rituals, Begnaud uses local knowledge and informal networks to spread her own ritual healing knowledge. As a member of a society influenced by many cultural traditions, Begnaud analyzes the connections between varied healing traditions from those of French, Native American, and even Japanese origins. Her use of multiple healing traditions demonstrates that multiple modalities of healing can be successfully intertwined (Begnaud 2017).

As a healer in a creolized society, Begnaud's rituals are considered a part of daily life, as they are informal; however, they also use informal spaces, as traiteurs often make space for God to heal the sick seeking treatment. For example, Begnaud told a story of another traiteur, an elderly man, who was visited by news reporters who were eager to learn more about ritual healing processes. Throughout her story, Begnaud described the reporters as seemingly kneeling before the traiteur, questioning how he talked about such an intriguing gift so simply. The traiteur, in response, stated, "Mais la, they come, I say a prayer, they better, and they leave." Traiteurs incorporate their rituals seamlessly into daily life, invoking prayer to facilitate healing. Begnaud assured that traiteurs themselves do no healing, but that they make the space for God to enter the patient's life to heal them from ailments. Traiteurs typically decline payment, as they ask the patient to thank God for the healing. Begnaud never recorded which patients were healed, as she believed that affair was between the individual and God. Making these spaces a part of daily life, many traiteurs do not formalize ritual practices (Begnaud 2017).

As vernacular healing traditions do not conform to institutional healthcare systems in the U.S., in the past, Begnaud strove to incorporate vernacular healing methods into U.S. biomedicine; however, Begnaud's attempts have proven largely unsuccessful. She described a time when she participated in a healing touch for infants at local hospitals. During those sessions, Begnaud reached out to nurses at those institutions, asking them to help incorporate vernacular medical practices into biomedicine already practiced at hospitals. The nurses were resistant, mandating that patients request the vernacular treatment themselves or that doctors order those treatments independently. The nurses told Begnaud that she should provide these healing rituals at her home. Begnaud told me, "I was already doing it at my house. They won't do it until it becomes a part of their system." By continuing to practice healing-touch ritual healing, Begnaud works to promote the use of vernacular healing practices among her own local network in the Lafayette area. Although vernacular healing practices are stigmatized by some U.S. healthcare professionals, these practices still thrive though informal networks. Although some cultural regulation has changed, such as strict use of Cajun French and Roman Catholic prayers, this method of vernacular healing continues to provide South Louisianans with another modality of healing apart from U.S. biomedicine while also serving as a cultural treasure in Cajun/Creole tradition (Begnaud 2017).

In understanding the vernacular healing rituals of Begnaud, a traiteur and an author, I recognized her engagement with discourses about an accommodation to cultural change in the passing down of vernacular healing knowledge, the importance and fading use of local knowledge, and the perception of vernacular healing processes among individuals in the U.S. During a conversation about how traiteurs have adapted tradition to allow for its passing down from one generation to the next, Begnaud and I discussed the persistence of Cajun/Creole culture in South Louisiana. Despite the loss of some community knowledge throughout South Louisiana, other community knowledge does, in fact, persist, and it allows the sick and curious alike to contact traiteurs for healing or simply for gaining a better understanding of this cultural treasure. While speaking about her motivations to continue vernacular healing processes, Begnaud said:

I just have to keep doing it and talking about it, and singing, and letting them keep thinking I'm crazy. I understand beyond the shadow of a doubt that I'm doing my grandpa's work even though he died before giving the gift to me. I don't have to start making an artificial connection based off what we believe based off the traiteur system because that takes away from the organic reality of what we believe, that we are all healers. (Begnaud 2017)

In gaining a better understanding for the practice of vernacular healing in South Louisiana, I used my own local networks and community knowledge to meet and learn more about Begnaud. By continuing to talk about vernacular healing, spreading the word about its importance in Cajun/Creole culture, and embracing it as a part of the cultural heritage of Louisianans, community members can help Begnaud keep this living tradition alive for generations (Begnaud 2017).

Vernacular Medicine and the Creation of Locality

During my short time in Cuba and my continuing research in Louisiana, I made connections with vernacular healers, retired physicians, and professors concerning a topic-vernacular medicine-that spans sociocultural groups. Many anthropologists describe difficulty finding collaborators who are part of religious groups, as some practices are secretive and others require initiation into the religion. Fortunately, I did not encounter those issues in either Cuba or Louisiana. Perhaps the difference between my research and those anthropologists who cited difficulty is simple: the basis of our questions. When discussing vernacular medicine, I often asked questions concerning the aspects of medicine and the treatment of ailments rather than directly questioning ritual practices. Providing answers, my collaborators typically described the ritual practices in detail. However, had I directly asked about rituals and how they are carried out, I believe that I would have been told that those rituals can only be known by individuals initiated into Cuban religions of African origin. Being exposed to a multitude of local knowledge concerning religious practices and vernacular medicine, I learned about local knowledge—a key part of Appadurai's (1995) concept of the production of locality. Appadurai writes:

Local knowledge is substantially about producing reliably local subjects as well as about producing reliably local neighborhoods within which such subjects can be recognized and organized. In this sense, local knowledge is what it is not principally by contrast with other knowledges—which (from some nonlocal point of view) the observer might regard as less localized—by virtue of its teleology and ethos. (1995:181)

Here, Appadurai discusses core ideas that I saw in observations made throughout my research in both Cuba and Louisiana. When investigating vernacular medicine, especially within religious contexts, I asked questions that drew upon the specifics of medical treatment. By asking questions about specific herbs or specific preventative health treatments, I was welcomed into the locality of those practitioners. By asking simple questions and observing de las Flores, I was welcomed into a ritual that many anthropologists find only with difficulty.

Appadurai takes on notions of local knowledge and locality further, concerned with the "divergent interpretations of what locality implies" (1996:55). In gaining an understanding of creolized vernacular medicine practices, I was able to become an observer within several neighborhoods: the neighborhoods of a retired psychiatrist (Maricela 2017), a retired registered nurse and Palo priestess (de las Flores 2017), a professor (Santos Garcia 2017b), and a traiteur (Begnaud 2017). I realize that Cuban vernacular medicine practices indeed create their own localities (Appadurai 1995). The practices I discuss here link individuals of numerous sociocultural groups, as individuals travel to meet with acclaimed vernacular healers for treatment. Vernacular medicine creates its own network, its own dispersion of local knowledge, and its own communities of users. By linking individuals, even on a transnational level, vernacular medicine plays a key role both in Cuba's transculturation and translocalities (Ortiz 1940). By fostering the development of an entire locality (Appadurai 1995) that connects individuals of numerous sociocultural and ethnic groups, vernacular medicine continues to bring individuals of different backgrounds and even nationalities together. Study of the varied openness to vernacular healing practices on an institutional level could serve as a factor for building relationships between the fields and places, potentially benefitting the overall well-being between these two related populations.

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This article was first published in the 2018 Louisiana Folklore Miscellany. Carter Louis Pesson is pursuing a Doctor of Medicine and Master of Public Health at Louisiana State University Health Sciences Center in New Orleans, Louisiana. Prior, Mr. Pesson pursued degrees in Anthropology and Biological Sciences at Louisiana State University in Baton Rouge, Louisiana. During his undergraduate years, Mr. Pesson studied vernacular healing methods from both anthropological and biomedical perspectives.

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