Between their own and the western: the experience of Emberá communities in Chocó with malaria

Objective. To explore how the Emberá communities of Chocó, Colombia, coexist with malaria, through the recognition of the meanings they construct about the disease, its treatment, and care. Materials and methods. This was an ethnographic study. Between October 2022 and November 2023, 250 hours of participant observation were conducted in six Emberá indigenous communities, and 25 interviews were conducted with community members, including authorities and Jaibaná. The data were analyzed according to Constructivist Grounded Theory, using NVIVO software. Results. The central category «Malaria: a disease that accompanies indigenous communities» emerged, supported by three subcategories: «Disease from the West,» which moves with people, can be prevented, and is always present; «The mosquito as the master of the disease,» which is controlled through training, cleanliness and hygiene, use of mosquito nets, and organic food; and «Health Care for Indigenous People with Malaria,» which begins with the Jaibaná, who controls the spirits that hinder the process and Western treatment. Conclusions. Communities perceive malaria as a Western disease and attribute its origin and transmission to mosquitoes, without recognizing humans as the main source of outbreaks. The Jaibaná plays a fundamental role in patient care, addressing spiritual conditions that complement Western treatment. Although the incorporation of ancestral practices into health care for Indigenous communities is recommended, this is done empirically and based on public demand.