Health for sale: The medicinal plant markets in Trujillo and Chiclayo, Northern Peru

Abstract

Traditional methods of healing have been beneficial in many countries with or without access to conventional allopathic medicine. In the United States, these traditional practices are increasingly being sought after for illnesses that cannot be easily treated by allopathic medicine. More and more people are becoming interested in the knowledge maintained by traditional healers and in the diversity of medicinal plants that flourish in areas like Northern Peru. While scientific studies of medicinal plants are underway, concern has arisen over the preservation of both the large diversity of medicinal plants and the traditional knowledge of healing methods that accompanies them. To promote further conservation work, this study attempted to document the sources of the most popular and rarest medicinal plants sold in the markets of Trujillo (Mayorista and Hermelinda) and Chiclayo (Modelo and Moshoqueque), as well as to create an inventory of the plants sold in these markets, which will serve as a basis for comparison with future inventories. Individual markets and market stalls were subjected to cluster analysis based on the diversity of the medicinal plants they carry. The results show that markets were grouped based on the presence of: (1) common exotic medicinal plants; (2) plants used by laypeople for self-medication related to common ailments ("everyday remedies"); (3) specialized medicinal plants used by curanderos or traditional healers; and (4) highly "specialized" plants used for magical purposes. The plant trade in the study areas seems to correspond well with the specific health care demands from clientele in those areas. The specific market patterns of plant diversity observed in the present study represent a foundation for comparative market research in Peru and elsewhere.

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Journal of Ethnobiology and
Ethnomedicine
Open Access
Research
Health for sale: the medicinal plant markets in Trujillo and
Chiclayo, Northern Peru
Rainer W Bussmann*
1
, Douglas Sharon
2
, Ina Vandebroek
3
, Ana Jones
4
and
Zachary Revene
5
Address:
1
Head and William L. Brown Curator of Economic Botany, Wm. L. Brown Center, Missouri Botanical Garden, PO Box 299, St. Louis, MO
63166-0299, USA,
2
San Diego Museum of Man, 1350 El Prado, San Diego, CA 94804, USA,
3
Institute of Economic Botany, The New York
Botanical Garden, Bronx River Parkway at Fordham Road, Bronx, New York, USA,
4
University of California at Berkeley, Berkeley, CA, 94720, USA
and
5
12413 Pleasant Run Terrace, Richmond, VA, 23233, USA
Email: Rainer W Bussmann* - rainer.bussmann@mobot.org; Douglas Sharon - dk_sharon@sbcglobal.net;
Ina Vandebroek - ivandebroek@nybg.org; Ana Jones - aejones@berkeley.edu; Zachary Revene - honeybadger33@yahoo.com
* Corresponding author
Abstract
Traditional methods of healing have been beneficial in many countries with or without access to
conventional allopathic medicine. In the United States, these traditional practices are increasingly
being sought after for illnesses that cannot be easily treated by allopathic medicine. More and more
people are becoming interested in the knowledge maintained by traditional healers and in the
diversity of medicinal plants that flourish in areas like Northern Peru. While scientific studies of
medicinal plants are underway, concern has arisen over the preservation of both the large diversity
of medicinal plants and the traditional knowledge of healing methods that accompanies them. To
promote further conservation work, this study attempted to document the sources of the most
popular and rarest medicinal plants sold in the markets of Trujillo (Mayorista and Hermelinda) and
Chiclayo (Modelo and Moshoqueque), as well as to create an inventory of the plants sold in these
markets, which will serve as a basis for comparison with future inventories. Individual markets and
market stalls were subjected to cluster analysis based on the diversity of the medicinal plants they
carry. The results show that markets were grouped based on the presence of: (1) common exotic
medicinal plants; (2) plants used by laypeople for self-medication related to common ailments
("everyday remedies"); (3) specialized medicinal plants used by curanderos or traditional healers; and
(4) highly "specialized" plants used for magical purposes. The plant trade in the study areas seems
to correspond well with the specific health care demands from clientele in those areas. The specific
market patterns of plant diversity observed in the present study represent a foundation for
comparative market research in Peru and elsewhere.
Introduction
Northern Peru is what Peruvian anthropologist Lupe
Camino calls the "health axis" of the old Central Andean
culture area stretching from Ecuador to Bolivia [1]. The
traditional use of medicinal plants in this region, which
encompasses in particular the Departments of Piura, Lam-
bayeque, La Libertad, Cajamarca, and San Martin, dates
back as far as the first millennium B.C. (north coastal
Cupisnique culture) or at least to the Moche period (AC
100–800), with healing scenes and healers frequently
Published: 10 December 2007
Journal of Ethnobiology and Ethnomedicine 2007, 3:37 doi:10.1186/1746-4269-3-37
Received: 31 October 2007
Accepted: 10 December 2007
This article is available from: http://www.ethnobiomed.com/content/3/1/37
© 2007 Bussmann et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0
),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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depicted in ceramics [2]. Early ethnobotanically oriented
studies focused mainly on the famous "magical" and
"mind altering" flora of Peru. A first study on "cimora" -
another vernacular name for the San Pedro cactus (Echi-
nopsis pachanoi) dates back to the 1940's [3]. The first
detailed study on a hallucinogen in Peru focused also on
San Pedro, and tree datura (Brugmansia spp.) [4-6]. A vari-
ety of works on these species followed [7,8]. Coca (Eryth-
roxylum coca) also attracted early scientific attention [9-
13], as did the Amazonian Ayahuasca (Banisteriopsis caapi)
[14-16]. Chiappe et. al [17] were the first to attempt an
overview on the use of hallucinogens in shamanistic prac-
tices in Peru. General ethnobotany studies in Peru and
Bolivia focused mostly on Quechua herbalism of the
Cusco area [18-22]. Other comprehensive studies cen-
tered on the border region of Peru and Bolivia around
Lake Titicaca [23-26] and the Amazon [27-29]. Northern
Peru, in contrast, has always been in the shadow of these
more touristically important regions, and very few studies
have been conducted to date [30-33]. During the last
years, the contemporary use of plants by local healers
(curanderos) in Northern Peru has been well documented
[34-38].
However, as in other areas worldwide, both, healers as
well as the population in general, buy their medicinal
plants often in local markets. In contrast to the wealth of
available ethnobotanical information, literature on local
markets, market flows and the value of the plant material
traded is rather scarce. Although the value of the interna-
tional market for medicinals receives high interest
[39,40], and ecosystem services as well as non-timber for-
est products do receive some attention [41-45], studies on
the trade volumes of local medicinal markets hardly exist,
and mostly focus on the export market [46-48].
Latin America is still terra incognita with regards to its
medicinal plant markets, and detailed studies are of high
importance because even the local health care authorities
start propagating complementary alternative medicine
[49]. Macía, García & Vidaurre [50] provided the first
study of a high Andean market, focusing on La Paz,
Bolivia. However, no data on plant origin and sales vol-
umes were given.
Thus, virtually no information exists so far on the compo-
sition of the market flora, the origin of the plant material,
and the quantities of plant material sold, and the present
study attempts to fill this gap by providing an inventory of
medicinal plants of the local markets in Northern Peru,
and delineating the most important areas for conservation
efforts. In addition, we provide a comparative analysis of
these markets based on their similarities and dissimilari-
ties in the plant species being sold.
Methods
Surveys
Surveys focusing on medicinal plants sold and their prop-
erties were conducted at the markets in Trujillo (Mayorista
and Hermelinda) and Chiclayo (Modelo and Mosho-
queque) each summer (June/August) from 2001–2006. In
June–July 2007 an additional questionnaire including
questions about plant origin, pricing and quantities sold
was included in the follow-up survey. Surveys were con-
ducted in Spanish by fluent speakers. Surveyors would
approach the vendors and explain the premise for the
study, including the goal of conservation of medicinal
plants in the area. All vendors were asked to participate,
but due to expected resistance information could not col-
lected from everyone. From those who gave their prior
informed consent, information was collected regarding
their inventory of medicinal plants. The vendors were also
asked to list the ten most commonly sold plants, and ten
plants that were disappearing from the market. Of the
plants that were most commonly sold and declining,
information was also collected on the location (montaña –
mountain forest, costa – coast, sierra – highlands, or selva
– jungle), origin (pueblo – village), cost per unit sold
(soles), units sold per week (bultos – bundles, paquetes –
packets), the time when the vendors' suppliers distribute
goods, and any other information concerning the popu-
larity of the plant. At each market, the number of medici-
nal plant vendors was counted to estimate how the
vendors who participated in the study were representative
for the entire market.
Voucher collection
The specimens are registered under the collection series
"RBU/PL," "ISA," "GER," "JULS," "EHCHL," "VFCHL,"
"TRUBH," and "TRUVANERICA," depending on the year
of fieldwork and collection location. Vouchers of all spec-
imens were deposited at the Herbario Truxillensis (HUT,
Universidad Nacional de Trujillo) and Herbario Antenor
Orrego (HAO, Universidad Privada Antenor Orrego Tru-
jillo). In order to recognize Peru's rights under the Con-
vention on Biological Diversity, especially with regard to
the conservation of genetic resources in the framework of
a study on medicinal plants, the identification of the plant
material was conducted entirely in Peru. No plant mate-
rial was exported in any form whatsoever.
Nomenclature
The nomenclature of plant families, genera, and species
follows the Catalogue of the Flowering Plants and Gym-
nosperms of Peru [51]. The nomenclature was compared
to the TROPICOS database. Species were identified using
the available volumes of the Flora of Peru [52], as well as
[53-55], and reference material in the herbaria HUT and
HAO. Species and author names for all species encoun-
tered are given in Additional file 1. For a complete over-

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view on traditional uses, recipes, and botanical vouchers
collected see Bussmann and Sharon [34,35].
Market turnover of plant material
In order to assess the amount of plant material sold, ven-
dors were asked to estimate the daily and weekly amount
of material sold for every species in their inventory. For
further analysis, vendors were grouped in size-classes
according to the number of species in their inventory (1–
40, 41–80, >81). Based on this classification, the vendors
studied (n = 54) were compared to the total number of
vendors in the markets (n = 110), and, based on size class,
a total weekly and annual market turnover was calculated
for each plant species in the market, and multiplied with
the observed sales price for every species, in order to cal-
culate a weekly and annual market value.
Cluster analysis of markets
The goal of cluster analysis is to group objects together
that are similar. Market data were organized in an Excel
spreadsheet that contained species as rows and markets as
columns. Individual cells contained qualitative presence/
absence data, represented by numerical values "1" or "0".
The excel spreadsheet was imported into NTSYSpc (ver-
sion 2.10L) and a (dis)similarity matrix was produced
using the Simple Matching coefficient that measures the
degree of similarity/dissimilarity between all pairs of mar-
kets. Next, a dendrogram (tree) was generated with the
UPGMA-SAHN method. Since a cluster analysis will
always yield clusters, it is necessary to demonstrate how
well the analysis represents the original (dis)similarity
matrix. To this end, the tree matrix is transformed into a
matrix of ultrametric distances and the latter matrix is sta-
tistically compared with the original (dis)similarity
matrix. The resulting correlation coefficient "r" between
both matrices (normalized Mantel statistic Z) can be used
as a measure of goodness of fit for cluster analysis. The
degree of fit can be interpreted subjectively as follows: 0.9
= r: very good fit; 0.8 = r < 0.9: good fit; 0.7 = r < 0.8: poor
fit; r < 0.7: very poor fit.
Results and Discussion
The inventory of 54 of 110 vendors in the Mercados May-
orista and Hermelindas in Trujillo, and Modelo and
Moshoqueque in Chiclayo yielded a total of almost 400
medicinal plants and preparations sold at any given day.
This was expectedly lower than the reported medicinal
flora of the region ([34], 512 species), because many heal-
ers interviewed in the former studies rely for their treat-
ments on additional self-collected species or material
bought outside the regular market. To evaluate if the cur-
rent sample size of market vendors represented the com-
plete plant inventory in the various markets, species
saturation curves were used (Fig. 1). A 95% species satura-
Species accumulation curve for markets studiedFigure 1
Species accumulation curve for markets studied.

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tion in comparison to the final number of species
observed was reached in all markets with the number of
vendors studied. This indicates that the sample size was
sufficient to capture the market inventory.
The market inventory
In the main markets (Modelo, Mayorista and Mosho-
queque), the number of small vendors with an inventory
of 1–40 plant species, was comparable to the combined
number of all larger vendors, and comprised about 50%
of the stands. The main exception was Mercado Hermelin-
das in Trujillo, where only small and very small vendors
were present. While the number of mid-size vendors was
twice as high as the number of large vendors in the Chi-
clayo markets, the two groups were about equal in Merd-
cado Mayorista in Trujillo (Figure 2).
Exotics played an important role amongst all plants sold.
Fifty-nine species (15%) found in all markets were exotics.
However, amongst the species most commonly encoun-
tered in the inventories, 40–50% were exotics. Matricaria
recutita (chamomile) was found in the inventory of
approximately 70% of vendors. The next most popular
species sold in these markets included Equisetum gigan-
teum, Phyllanthus urinaria, Phyllanthus stipulatus, Phyllan-
thus niruri (chanca piedra – stone breaker), Eucalyptus
globulus (eucalyptus), Piper aduncum, Uncaria tomentosa
(cat's claw), Rosmarinus officinalis (rosemary), Peumus
boldus, Bixa orellana (achiote) and Buddleja utilis (Fig. 3).
However, when taking sales volume into account, Croton
lechleri (dragon's blood), Uncaria tomentosa, and Eucalyp-
tus globulus were clearly the most important species (Fig.
4).
While it was very easy for all vendors to name their most
important and frequently sold species, it proofed impos-
sible to get detailed information about species that ven-
dors observed as "rare" or "disappearing". In most cases,
vendors mentioned species as rare because they them-
selves did not sell them, in many cases these plants were
very common outside the market (e.g. Plantago major or
common plantain), or because demand was so low, that
it would not have made sense to carry them in their inven-
tories.
A cluster analysis of the four main markets (Fig. 4) indi-
cated that both markets in Chiclayo (market 1 = Modelo,
market 2 = Moshoqueque) were expectedly closest related
to each other, with Mercado Mayorista in Trujillo (market
3) being next similar, and Mercado Hermelindas (market
4) forming a branch of its own. The dendrogram repre-
sents a good fit (Matrix correlation r = 0.805; Normalized
Mantel statistic Z). This result is little surprising. Her-
melindas contained mostly very small vendors (carrying
less than xx plant species). Their inventories represented
the most common medicinal plants available, and
excluded most species in the large "witchcraft" segment of
the pharmacopoeia. On the other hand, the large markets
in Trujillo and Chiclayo (Mayorista, Modesto and Mosa-
hoqueque) had several well-established large stands spe-
cializing in supplies for healers (including "magical"
plants), and thus the inventories of the main markets were
relatively similar (Fig. 5). Mercado Mayorista in Trujillo
proved to be the most species rich market (325 species
and preparations), followed closely by Modelo (305),
Moshoqueque (257), and far off Hermelindas (75).
When the 54 vendors in the four main marketplaces are
considered individually, 4 large clusters appear which
form several subgroups. The dendrogram represents a very
good fit (Matrix correlation r = 0.981; Normalized Mantel
statistic Z). (Fig. 6):
Cluster 1 (markets 3–19) includes small vendors from
Mercado Mayorista in Trujillo (3–31) and vendors from
all other markets with a similar portfolio. These stands
had a very limited inventory comprising especially the
most common exotic species used medicinally.
Cluster 2, including market 1 and 25-6 groups vendors
from all 4 markets, but has a high emphasis on all vendors
from Mercado Hermelindas in Trujillo. This segment of
small vendors carries the 20–30 most important medici-
nal species and little else, and the portfolios overlap
widely. These were, so to say, the vendors for the "every-
day cure" where patients could find plants for herbal
decoctions they can prepare themselves (e.g. for common
cold) without consulting a traditional healer.
In contrast, cluster 3 incorporates mid size vendors who
carry the regular pharmacopoeia, plus species needed by
Number and stand size of market vendorsFigure 2
Number and stand size of market vendors.

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traditional healers (curanderos) for the treatment of more
complicated illnesses. Most vendors in Mercado Mosho-
queque fell in this category. However, their respective
plant portfolios were often lacking specific "magic" and
hallucinogenic species.
Cluster 4 grouped markets that sell species for the real
"curing specialists." Markets 30–42 (Modelo), 8–43
(Moshoqueque) and 9–39 (Mayorista) represent clear
sub-clusters of vendors in one given market. This indicates
that the healers of a given city or suburb use a very well
Most important medicinal plant species by sales volume (* marks exotic species)Figure 4
Most important medicinal plant species by sales volume (* marks exotic species).
Plants carried most frequently by vendors in Trujillo and Chiclayo (* marks exotic species)Figure 3
Plants carried most frequently by vendors in Trujillo and Chiclayo (* marks exotic species).

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defined pharmacopoeia, which is provided by specialized
vendors. The remaining 4 markets (14, 17, 21 and 51)
represent the true curandero suppliers in the two biggest
markets. Markets 51 and 21 (and 14 and 17) were the two
biggest stands in Mayorista Trujillo, and Modelo Chi-
clayo, respectively. All four markets had inventories con-
taining more than 50% of all inventoried plant species,
but lacked many of the "generalist" plants sold by other
vendors. The portfolio of these stands focused almost
entirely on "magical" species that are needed to cure ill-
nesses like "susto" (fright), "mal aire" (evil wind), "daño"
(damage), "envidia" (envy) and other "magical" or psy-
chosomatic ailments [34]. At the same time, all four ven-
dors catered also to the esoteric tourism crowd that tends
to frequent the large markets, and carried a variety of
plants that were not used by curanderos, but instead were
sold to meet tourist demand. Markets 14 and 17 were of
particular interest. These represent the stands of two
brothers, who, together, carried almost the complete
inventory of Mercado Modelo, and as such were the most
distinguished specialist vendors of the region.
A look on sustainability – how much plant and for which
price?
An overview of the observed and calculated value of the
medicinal plants traded annually in the organized mar-
kets of Trujillo and Chiclayo is given in Additional file 2.
More than two thirds of all species sold were claimed to
originate from the highlands (sierra), above the timber-
line, which represents areas often heavily used for agricul-
ture and livestock grazing.
The overall value of medicinal plants in these markets
reaches a staggering 1.2 million US$/year. This figure only
Similarity of individual marketsFigure 5
Similarity of individual markets.

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represents the share of market vendors, and does not
include the amount local healers charge for their cure.
Thus, medicinal plants contribute significantly to the local
economy. Such an immense market raises questions of
the sustainability of this trade, especially because the mar-
ket analysis does not take into account any informal sales.
Most striking was the fact that 7 indigenous and 3 exotic
species, i.e. 2.5% of all species traded, accounted for more
than 40% of the total sales volume (with 30 and 12%
respectively). Moreover, 31 native species accounted for
50% of all sales, while only 16 introduced plants contrib-
uted to more than a quarter of all material sold. This
means that little over 11% of all plants in the market
accounted for about three fourths of all sales. About one
third of this sales volume includes all exotic species
traded. None of these are rare or endangered. However,
the rising market demand might lead to increased produc-
tion of these exotics, which in turn could have negative
effects on the local flora.
A look at the indigenous species traded highlights impor-
tant conservation threats. Croton lechleri (dragon's blood),
and Uncaria tomentosa (cat's claw) are immensely popular
at a local level and each contributes to about 7% to the
overall market value. Both species are also widely traded
internationally. The latex of Croton is harvested by cutting
or debarking the whole tree. Uncaria is mostly traded as
bark, and again the whole plant is normally debarked.
Croton is a pioneer species, and apart from C. lechleri a few
other species of the genus have found their way in the
market. Sustainable production of this genus seems possi-
ble, but the process has to be closely monitored, and the
current practice does not appear sustainable because most
Croton is wild harvested. The cat's claw trade is so
immense, that in fact years ago collectors of this primary
forest liana started complaining about a lack of resources
Similarity of vendor portfolios in Trujillo and ChiclayoFigure 6
Similarity of vendor portfolios in Trujillo and Chiclayo.

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[56] and during the years of this study other Uncaria spe-
cies, or even Acacia species have appeared in the market as
"cat's claw" (own observation). As such, the Uncaria trade
is clearly not sustainable.
Some of the other "most important" species are either
common weeds (e.g. Desmodium molliculum), or have
large populations (e.g.Equisetum giganteum). However, a
number of species are very vulnerable. Tillandsia cacticola
grows in small areas of the coast as epiphyte [51]. The
habitat, coastal dry forest and shrub, is heavily impacted
by urbanization and mechanized agriculture, the impact
of the latter worsened by the current bio-fuel boom. Gen-
tianella alborosea, G. bicolor, G. graminea, Geranium ayava-
cense and Laccopetalum giganteum are all high altitude
species with very limited distribution. Their large-scale
collection is clearly unsustainable, and in the case of Lac-
copetalum collectors indicate that supply is harder and
harder to find. The fate of a number of species with similar
habitat requirements raises comparable concern. The only
species under cultivation at this point are exotics, and a
few common indigenous species.
Conclusion
Northern Peru occupies the middle sector of the "health
axis" of the Central Andean cultural area stretching from
Bolivia to Ecuador. Few other places on the planet boast a
medicinal flora as rich as this region. Archaeological evi-
dence traces the use of plants used in traditional healing
and divination practices of the region back at least 2,000
years. Current research indicates that the composition of
the local pharmacopoeia has changed since colonial times
[38]. However, the overall number of medicinal plants
employed seems to have increased. This indicates that the
Northern Peruvian health tradition is still going strong,
and that the healers are constantly experimenting with
new remedies. Recent indications of this are the appear-
ance of Noni (Morinda citrifolia) products in large quanti-
ties in plant pharmacies and markets in the region. This
makes it quite obvious that local herbalists are carefully
watching international health trends to include promising
species in their own repertoire.
The knowledge of medicinal plants is still taught orally,
with no written record. An illustrated identification guide
for the medicinal plants of Northern Peru and their uses
[35] will hopefully help to keep the extensive traditional
knowledge of this area alive. However, Traditional Medi-
cine is experiencing increasing demand, even from a Peru-
vian perspective as indicated by the fact that the number
of herb vendors, in particular in the markets of Trujillo,
has increased in recent years, and the markets have an
immense economic value. Also a wide variety of medici-
nal plants from Northern Peru can be found in the global
market. While this trend might help to maintain tradi-
tional practices and to guarantee traditional knowledge
the respect it deserves, it poses a serious threat, as signs of
over-harvesting of important species are becoming
increasingly apparent.
Today the most serious threat to this millennial tradition
is the destruction of medicinal plant habitats. Urban
sprawl and the sugar industry have already greatly altered
the coastal plains around Trujillo and Chiclayo. Climatic
change and deforestation are threatening the mountain
forest systems that are the source of many medicinal spe-
cies. Most importantly, the high Andean ecosystems and
sacred lagoons where many medicinally active species are
found are in danger of being destroyed by large-scale min-
ing activities [57,58].
Competing interests
The author(s) declare that they have no competing inter-
ests.
Additional material
Acknowledgements
The authors gratefully acknowledge the financial support of the fieldwork
through MIRT (Minority International Research and Training) and MHIRT
(Minority Health Disparity International Research and Training), a grant
from the National Institutes of Health (Fund: 54112B MHIRT Program,
Grant: G0000613), administered by the Fogarty International Center for
Advanced Studies in Washington, D.C. Thanks to Yasmin Barocio, Mirna
Garcia, James Sarria and Jennifer Ly who helped with the surveys, and espe-
cially the vendors in the markets in Trujillo and Chiclayo for their cordiality
and cooperation.
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Additional File 1
Medicinal plant species sold in the Trujillo and Chiclayo Markets
Click here for file
[http://www.biomedcentral.com/content/supplementary/1746-
4269-3-37-S1.pdf]
Additional File 2
Quantities of medicinal plants traded in Trujillo and Chiclayo markts
(species with more than 1% total sales volume BOLD, exotic species
RED)
Click here for file
[http://www.biomedcentral.com/content/supplementary/1746-
4269-3-37-S2.pdf]

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