Jungle Cure
By Abigail Wright

In a small jungle hut, hundreds of miles from the nearest road, a man urges a frail woman to drink a brown liquid. Another man, notebook in hand, watches intently. The woman, weak from diabetes, raises the cup to her lips and swallows the bitter potion. By tomorrow her blood sugar level will be normal, and the ravages of her disease will wane for a month.

The healer is a Tirio Indian from the remote northeast corner of the Amazon in the little-known country of Suriname, South America. The man taking notes is Mark Plotkin, PhD, one of the most renowned ethnobotanists in the world. By studying the medicinal plants and healing practices of native peoples in the rain forest, Plotkin hopes to preserve the knowledge—and the ecosystems—that may lead to tomorrow's cures. His quest is a race against time: Enemies such as cancer, diabetes, AIDS, schizophrenia, deep depression, and bacterial infections are slowly gaining on the human species. Although treatments for these conditions exist, true remedies are in short supply.

Eighty-three percent of all antibiotics come from nature, Plotkin points out. Ethnobotany, the study of the relationship between people and plants, has led to the discovery of many of humankind's most important drugs: aspirin, morphine, quinine (for malaria), reserpine (for hypertension), vincristine (for pediatric leukemia), and many more. Twenty-five percent of all prescription medicines are derived from plants, and four out of five people worldwide use plants as components of their primary health care.

But botany alone rarely uncovers which plants have healing properties. Knowledge about how to use plants for healing is embedded in folklore and religious mysteries, and it's usually preserved through oral tradition. "Few, if any, therapeutic compounds from plants have been discovered by botanists," says Plotkin. "It's like Columbus—the Indians got there first." The knowledge held by natives must be sought out, and this labor can take decades.

In the jungle, the immense steaming wall of forest trembles, as if ready to pounce on the Tirio village and swallow it whole. It is just past dawn. Plotkin and two Tirio guides are already far from the settlement, walking single file down a tiny footpath in the rain. Plotkin, of medium height and build by U.S. standards, towers over the other men. His graying hair and trim beard also set him apart—the Tirios pluck all their facial hair, even their eyebrows—and Plotkin wears his pants tucked into his socks to avoid trespass by one or more of the forest's trillions of insects. In pictures from his younger days, Plotkin appears brooding and intense. Age has softened his face, but has not dimmed the ferocity; he looks something like a lion in repose. All the men carry machetes, and Plotkin totes an empty backpack and a notebook.

Plotkin likens the Amazon to a giant warehouse of treasures, its plants rich with chemicals that have powerful effects on the human body. With more than 80,000 species of flowering plants, however, the Amazon is utterly bewildering. It's like going into a store in a foreign country where nothing—not the writing, not the packaging, not one item—is familiar. Plotkin's Tirio friends are his translators, their people having had access to the peculiar language of the rain forest by virtue of many thousands of years of cohabitation. The three men hack their way along the paths of the jungle as the Tirios point out salient items: This is for fevers; this is chewing gum; this is for diarrhea.

They stop periodically to collect plant specimens, which go into Plotkin's backpack, later to be pressed and dried over a fire and stored in the herbarium in the capital of Suriname. The men address each other as jako, the Tirio word for brother. Plotkin clearly loves his companions and jokes with them, while they tease him about sweating so much.

"You know," Plotkin says later, "people ask me, 'how can you stand to work in the Amazon? It's hot, humid, lots of mosquitoes, political corruption' ... I'm quick to point out that I grew up in Louisiana, so it's all second nature to me."

Born 47 years ago to a Jewish family in New Orleans, Plotkin and his brother spent their childhood roaming the bayous of the surrounding countryside, hoping to find dinosaurs and settling instead for reptiles. The first shock of Plotkin's early life came when he learned that dinosaurs were extinct. The second came when his beloved grandmother died a slow and agonizing death from diabetes. Years of daily insulin injections, today still the standard treatment for the disease, prolonged her life but could not change the deadly course of the disease. "I am second to none in my belief that Western medicine is the best, most successful health system in the world," Plotkin comments. "But it's full of holes." A few years later his other grandmother was dying from diabetes, and nothing, in the end, could save her either.

Plotkin, a disaffected college student who dropped out of the University of Pennsylvania, attended a lecture in 1974 by the legendary Harvard ethnobotanist and explorer Richard Evans Schultes. The professor, who offered a mind-boggling slide show of images from his 14 years in the Amazon, enraptured the class with his profound knowledge of the rain forest's cultures and plants. Young Plotkin was hooked. He educated himself at Harvard, Yale, and Tufts and then, 25 years ago, took off to see the Amazon for himself.

Schultes, who remained Plotkin's mentor and hero until he died in 2001, steered Plotkin toward a course of study in the northeast Amazon, where few scientists had worked. From then on, Plotkin established friendships, learned languages, and wrote scholarly papers on rain-forest botany. Then, caught in the middle of a civil war in Suriname, he fled the capital on a cargo plane and found himself marooned on the airstrip of the isolated Tirio village of Kwamalasamutu. Here were a people so ancient that one of their legends recalls crossing the Bering Strait into the Americas, yet they were all but unknown to the West. It was an unparalleled opportunity for a young ethnobotanist, and Plotkin asked the tribe's leaders if he could remain awhile.

The Tirios were not impressed with the pananakiri, this alien from another world, but they agreed to humor him. Plotkin began his study with the shamans of the tribe—the healers and spiritual leaders sometimes disparagingly referred to as witch doctors—and found they possessed a remarkable depth of knowledge about their ecosystem. He earned their trust over time and learned about medicines to treat fungal infections, migraines, skin lesions, ulcers, and more. But to his dismay, he found that his Tirio teachers were not passing on their knowledge to the next generation. The chief of the tribe, it appears, had embraced Christianity and was discouraging the practice of the tribe's own traditions, including the medical arts of the shamans. Most of the villagers were now going to the poorly supplied missionary clinic when they became ill, and as a group their overall health was deteriorating.

This crisis accelerated Plotkin's rush to document as much Tirio medicinal lore as possible, knowing full well that a lifetime's research could only record a tiny fraction of the Tirios' knowledge. After eight years, he gave what he had learned back to the Tirios in the form of a handbook. The chief, persuaded by Plotkin that the teachings of Jesus would have been lost forever had they not been written down in the Bible, asked that the medicine handbook be translated into the Tirio language. This gave Plotkin an idea, one of the most innovative of his career: Why not perpetuate this extraordinary knowledge within the tribe itself by setting up an organized apprenticeship program supported by outside funding?

The thought blossomed into a formal project, devised by Plotkin and the Tirios, which provides funding for and acknowledgment of the healers and their students. For Plotkin, one of the fruits of this program was learning about the diabetes medicine. Plotkin had asked if the Tirios had a treatment for diabetes. Hearing of Plotkin's quest, a mysterious old shaman of the Sikiyana tribe came forward with a recipe, whose ingredients included several vines, barks, and leaves. He taught this treatment to a Tirio apprentice, who was then able to care for the people in the village who were suffering from diabetes.

Will this medicine, which appears to cause a near-miraculous remission of symptoms, be appearing in pharmacies soon? The short answer is no. Although drug companies have shown some interest in exploring what are called natural products, the barriers to their development as pharmaceuticals are formidable, including costs and intellectual property issues.

One major obstacle is science itself. Shamanic medicines almost always involve spiritual and emotional components, and these invisible elements—hope, desire, love, fear—are immaterial in a materialistic science. Plotkin took the diabetes medicine to a laboratory to be analyzed; the concoction was broken into its constituent parts, as scientific method dictates, and each chemical was tested for activity. Nothing happened, and the scientists, unable to understand the basic mechanisms of the medicine, handed it back to Plotkin. When asked, the old shaman told Plotkin that no single ingredient was potent in itself—that everything worked together to create the healing effect. Disassembling the mixture to reveal its secrets was, in this case, akin to vivisecting a great musician to uncover the source of her talent.

"Some of these rain-forest chemicals are fiendishly complex," claims David Newman, PhD, a chemist within the Natural Products Branch of the National Cancer Institute in Frederick, Maryland, "and in effect, the more we know, the less we know." To complicate matters, much of the excitement in medicine these days (and the focus of research dollars) has been in genomics, the science of gene sequencing. It's an abstract world, far from the messy and complicated molecules of the rain forest. Proponents of genomics hope to understand how certain diseases do their deadly work by identifying specific genes. "Genomics is like taking off the back of a clock and figuring out how it works," says Plotkin, "but you then have to figure out how to stop it, how to jam the gears. We still need new therapeutic compounds, and Mother Nature has been inventing weird chemicals for 3 billion years."

Plotkin firmly believes that technology will eventually enable us to understand and replicate rain-forest molecules in the laboratory. As for how long it may take for some genuine breakthroughs in medicines using natural products, Newman replies, "Stay tuned." In the meantime, the diabetes medicine, along with many promising treatments made from rain-forest plants, must wait for another shift in the paradigm. That is, if the rain forest itself can survive that long.

Across the Potomac from Washington, D.C., down an alley and up a narrow set of stairs, are the Arlington, Virginia, offices of the Amazon Conservation Team, or ACT, founded in 1995 by Plotkin and his wife, Liliana Madrigal. Their mission is to help preserve and protect health, biodiversity, and culture in tropical America, and they have devised ingenious schemes to accomplish these goals on a shoestring. Madrigal, a beautiful black-haired conservationist with a runner's body, orchestrates the activities of the small staff and the constant stream of international visitors.

Plotkin and Madrigal are an unusual pair. He is urbane, demanding, a great storyteller and intellect with a sardonic sense of humor. He's fond of saying that what's wrong with most people is either a lack of gray matter or not enough sex. She is a Costa Rican peasant with the stamina of a thoroughbred. She bends in half when she laughs. She loves shoes, hates to talk in public, and does most of the driving.

At their modest ranch home in a Washington, D.C., suburb, Madrigal and their two girls, aged 9 and 14, unwind after dinner by dancing to the Latin rock band Maná. Plotkin is hiding out in his study, working on the notes for a botanical study of the lianas, or woody vines, of Suriname (see "Miracle Vines").

This evening at home is only a brief respite in the midst of an exhausting book tour for Plotkin's just-published The Killers Within (Little, Brown and Co., 2002), co-authored with Michael Shnayerson, a frightening report on the rise of drug-resistant bacteria. Plotkin was researching the book when he was thoroughly rattled by the anthrax scare that followed the events of September 11; he knew better than most that our best weapons in medicine will soon be outrun by evolving diseases. He believes fervently that we must look to nature—with its billions of years of experimentation—to come up with chemical compounds for the medicines of tomorrow. "Eighty-three percent of all antibiotics come from nature," Plotkin points out. All of nature must be respected and protected, he warns, not just the rain forest. "We, in our ignorance and greed, could be destroying the very thing that could save us. If we screw with Mother Nature, she could come right back to bite us in the you-know-what."

Although married to Plotkin since 1987, Madrigal had never traveled with him to the Indian areas of Suriname until three years ago, when they attended the opening ceremonies of ACT's brand-new shaman's clinic in the Tirio village. The old shamans, once shunned by the community, were now the guests of honor. The nurses from the missionary clinic came, and so did the chief, donning his ceremonial headdress."It was incredible," Madrigal says. "Mark could hardly sleep that night. These guys [the Tirios] made it back from the edge of cultural extinction. We gave them just a little bit of help, and they have a huge amount to give us in return." The clinic, where shamans practice their medicine, has been so popular that it operates seven days a week. It's become the model for similar clinics in other villages throughout the countries where Plotkin and Madrigal work, and the inspiration for a plan to build a full-fledged shaman's hospital in Bogotá, Colombia. In South America, the greatest healers often live in the most remote or impoverished places in the Western Hemisphere. The city hospital, it is hoped, will be a place where people can practice and study alternative medicine in relative safety. The facility will be for locals and outsiders alike who don't want to wait or can't afford to wait for rain-forest medicines to go mainstream.

Straddling the two parts of his life—his work in South America and his work Stateside—is a complex yet rewarding puzzle. When in the forest, Plotkin gazes longingly at pictures of his family before climbing into his hammock each night, but in the comforts of suburbia, the enthralling, verdant, and vividly alive jungle is never far from his thoughts. "I have the most interesting job you can imagine," he says. "I go to the Amazon, I hang out with people I love, and I'm totally happy."

For more information on Mark Plotkin and the Amazon Conservation Team (ACT), go to www.amazonteam.org.