sábado, 20 de junio de 2009

HISTORIA DE LA ENFERMERÍA EN PUERTO RICO (1)

Cultura Taína
Los historiadores afirman que en Puerto Rico y en las Antillas Mayores (son un grupo de islas en el mar Caribe localizadas al este de Yucatán (México) y sureste de la Florida (Estados Unidos) y al oeste de las Antillas Menores o Pequeñas Antillas. El grupo está compuesto por las islas de Cuba, Jamaica, La Española (también conocida como Hispaniola o Santo Domingo y que incluye a los estados de República Dominicana y Haití y Puerto Rico), hubo presencia humana desde mil quinientos a dos mil años antes de la colonización europea. Se cree que las primeras inmigraciones de los pueblos indígenas llegaron desde lo que hoy es actualmente el estado de la Florida, América del Norte. No se sabe a cierta ciencia el por qué de dicha inmigración, pero se piensa que fueron presionados por otras tribus con mayores conocimientos en el uso de las armas y de la agricultura. Los arqueólogos han clasificado a esta cultura como arcaica.
Más adelante llega a las Antillas una segunda inmigración indígena, la cultura aruaca. El choque de culturas al llegar fue grande, permitiéndoles evolucionar pasando de la cultura ingerí a la sub taína y luego a la taína.

La evolución de la enfermería en Puerto Rico se deriva de un proceso de desarrollo histórico que tiene sus raíces en los cambios y eventos que ocurrieron en torno al cuidado del enfermo tan temprano como la época en que habitaban los indígenas en Borinquen (hoy Puerto Rico)

El cuidado de los enfermos siguió evolucionando según las tres épocas bien diferenciadas, los primeros años de la civilización de la Isla, la cultura taína, durante la dominación española y durante el régimen norteamericano.
La sociedad indígena daba al enfermo y a sus problemas de salud una atención de técnicas empíricas. Las mismas procedían de la experiencia interna (mente) y externa (cuerpo), fundamentadas en la práctica de ritos de magia, de superstición y uso de plantas.

La enfermería en Puerto Rico bajo la dominación española, se describe desde el siglo XVI hasta el siglo XIX. Aquí se reseña la historia de los hospitales de Puerto Rico, donde se considera su construcción, la reforma y la administración de los mismos. El período discurre por el acontecimiento de enfermedades, calamidades y epidemias traídas a la Isla, donde se establecen las prioridades del cuidado del enfermo.
El tercer período comprende la evolución de la enfermería y el cuidado del enfermo desde los inicios del régimen norteamericano (1898 – 1915), en un primer período. En él se destaca el cambio en la situación de la mujer en Puerto Rico, el cual ha sido fundamental para el desarrollo de nuestra profesión y la implantación de los sistemas de salud en la Isla. Y el segundo período de 1916 a 1930, en el se narra el progreso en el cuidado del enfermo, la salud pública y la educación en enfermería. En este período se crea la Asociación de Enfermeras Graduadas de Puerto Rico (1916) y se prepara y se aprueba la ley que regula la práctica y la educación en enfermería en Puerto Rico.
Hay tres imágenes que quiero destacar:

La primera imagen es un símbolo que representa la cultura taína.
La segunda imagen es la torre y el león, dos de las 16 piezas que bordean el escudo de Puerto Rico, que representa el dominio español. La tercera imagen es el águila, ave símbolo de los Estados Unidos de América y representa a la sociedad norteamericana.
Estas tres imágenes representan las corrientes culturales que influyen en los componentes sujeto – objeto del puertorriqueño y la puertorriqueña y por ende de la enfermería de Puerto Rico.

Y luego tenemos el sello oficial que representa el emblema del Colegio de Profesionales de la Enfermería de Puerto Rico (CPEPR).
El desarrollo social y económico de los taínos de la isla de Boriquén (Puerto Rico), así como los que habitaban en Santo Domingo (La Española) era más avanzado que el de los taínos establecidos en las islas de Cuba y Jamaica, e incluso que los llamados indios Caribes, quienes habitaban las Antillas Menores. El idioma, el gobierno, la religión y algunos usos y costumbres prevalecieron como elementos característicos de la cultura taína. Sus viviendas, sus armas y sus utensilios eran muy semejantes. Eran agricultores y pescadores, aunque también había cazadores, aunque muchos menos por los pocos animales que había en la isla. Sus poblados los construían cerca de corrientes de agua potable, pues la tenían cerca y en abundancia. Para ellos era conveniente tener agua para beber y cocinar a la mano y también para pescar y bañarse, pues eran bien conocidos por sus pulcros hábitos de aseo personal. Vivían agrupados en aldeas llamadas yucayeques, formadas por bohíos.
Su religión primitiva era politeísta. Honraban a una serie de dioses menores o secundarios llamados Cemíes. Estos ídolos hacían el papel de mensajeros de las fuerzas del bien. Los Cemíes eran representados en forma visible por medio de esculturas de piedra, madera, algodón u oro. El indio como todo pueblo relacionado con la naturaleza, rendía culto a la tierra, a la lluvia y al sol, los que eran fuentes de fertilidad, sin la cual la vida era imposible.

La mujer, como conservadora de la especie, era incluida en este culto a la fertilidad. La tribu tenía dos puestos políticos diferenciados, que eran el cacique y el bohique. El cacique, como jefe tenía a su cargo el planear y ordenar todo lo que fuese necesario para la salud, seguridad y bienestar de la tribu.

El bohique era el médico – brujo, hechicero, sacerdote, herbolario, adivino, sabelotodo y por lo tanto su influencia era poderosa. Era experto en curar las enfermedades, era el depositario de la historia de la tribu y un educador que había heredado de su antecesor los conocimientos referentes a los romances históricos, los areytos y las tradiciones de su pueblo.
Entre las medidas de prevención utilizadas para el mejoramiento de su salud, estaba el culto al agua. El agua era para ellos como para nosotros, un elemento natural indispensable para la vida. Además de asear el cuerpo, le atribuían condiciones purificadoras del espíritu. Comentaba Bartolomé de las Casas en su referencia al pueblo taíno que tenía la costumbre de bañarse en el mar y en los ríos cada hora; no sólo porque eran sumamente aseados y limpios, sino porque consideraban que el agua tenía el poder de limpiarlos de pecados dándole sanidad al cuerpo y al alma. Además Morales Cabrera nos narra que el baño frío era el principal medicamento para bajar la fiebre, para asear a las parturientas y para devolver la salud en todos los males. El historiador López de Gómara relata que los taínos demostraban predilección por los baños de agua fría: “lavaban las criaturas en agua fría para que se les endurezca la piel; y aún ellas (las madres) se bañan en agua fría recién paridas y no les hace mal”. Todos coinciden que los taínos usaban el agua como medicina, sobre todo para bajar la temperatura y asearse.

La sangría, la realizaban para combatir el cansancio por las largas caminatas y cuando pensaban que les sobraba sangre acostumbraban a practicarse sangrías. Para ello utilizaban unos pedernales muy delgados o los colmillos de las víboras y se hacían heridas por las pantorrillas y en los brazos, desde los codos hasta las muñecas. Se limpiaban el sangrado con el jugo de la jagua, sustancia astringente que comprime la piel.
Para la pérdida de apetito y a los enfermos que presentaban hastío, les daban a comer piñas (ananás comosus). Esta fruta nacía en unas plantas como cardos con muchas hojas y espinosas. Para la preservación del calor y repelentes de insectos nos narraba Pedro Tomás de Córdova: Todos los hombres y mujeres doncellas andaban enteramente desnudos. Aunque pintaban su cuerpo con mucha prolijidad y esmero con bija roja y achiote, llamado también urucú por los caribes. La naturaleza y la experiencia misma les habían dictado que las resinas y aceites con que pintaban su cuerpo les preservaba del calor excesivo y de la transpiración superabundante, sirviéndoles igualmente de defensa contra los daños del aire y de la humedad. Estas sustancias oleosas expedían un olor que ahuyentaban los enjambres de mosquitos y otros insectos que poblaban aquellos bosques.
Para el cansancio había una gran cantidad de árboles jobo, eran grandes y hermosos y daban buena sombra, su fruta era de gran sabor y olor. La cáscara y los cogollos de esta fruta los echaban en agua, los cocían, y el agua lo usaban para afeitarse y lavarse las piernas. Supuestamente les quitaba el cansancio y era un baño excelente y saludable. También les gustaba colocar su hamaca debajo de este árbol y dormir debajo de él, ya que no le causaba pesadez en la cabeza.

Creían que la tortuga o su carne curaban la lepra y que la enfermedad se curaba comiendo carne de tortuga, bebiendo y lavándose con su sangre. Esto equivale a la práctica de hoy en día de curar las enfermedades con vacunas del miso virus.
A las taínas les causaba terror la menstruación y trataban de ocultarla. Durante el periodo, la mujer se retiraba a un rincón del bohío, donde se sometía a escarificaciones y allí permanecían hasta que el flujo desaparecía. Se les suprimían las carnes de la alimentación y se ponían en uso ciertas plantas hemostáticas que diminuían el flujo menstrual.

Cuando alguien moría de enfermedad contagiosa como bubas o viruela, incineraban el cuerpo hasta convertirlo en cenizas. Esta acción revela el concepto moderno de asepsia en el pueblo taíno.

Los taínos eran muy supersticiosos y fetichistas ya que le rendían culto a los objetos a los que le atribuían poderes misteriosos. Elaboraban ídolos o cemíes para adorarlos, pues le traían buena suerte y los defendían de adversidades para su salud o vida. Modelaban sus fetiches en arcilla, hueso, madera, oro y piedras y los usaban como amuletos; con estos creían poder prevenir enfermedades y ahuyentar espíritus y fuerzas extrañas.
Oviedo nos narra que al caminar los indios por los campos se les pegaban las garrapatas de las hierbas, se le hinchaban las piernas y no había forma de despegarlas. El método utilizado para despegarlas era untándose aceite y luego de un rato que estaban impregnadas las piernas o las partes donde estaban las garrapatas, las raspaban con un cuchillo y así se las quitaban. Los indios que no tenían aceite, las chamuscaban aplicándose fuego. Lo que les provocaba mucho dolor al quitárselas. También nos habla de los piojos, animales pequeños e inoportunos que se criaban en la cabeza y cuerpo de los hombres. Todos los taínos tenían piojos. Estos se espulgaban unos a otros y en especial las mujeres eran las espulgadoras y todos los piojos que sacaban se los comían. Otra plaga era la de las niguas una pulga pequeñita, saltadora y amiga del polvo que se metía en los pies, dentro de la piel y formaba una bolsa tan grande como un garbanzo y se llenaba de liendres. Cuando aumentaba la generación de niguas los hombres quedaban tullidos quedando cojos y muchos de ellos perdían los dedos de los pies o el pie entero. Para sacárselas se aplicaba fuego. También para evitarlas empezaron a cubrirse los pies.

Nota:
El escudo de Puerto Rico lleva los símbolos de nuestra historia, cultura y religión. Fue otorgado por la Corona Española en el 1511, pero no fue hasta el 9 de marzo de 1905 que se aprueba la ley que establece el primer escudo de armas. Luego de varias investigaciones y enmiendas a la ley para obtener la interpretación del escudo, en el 1976 se aprueba el mismo como lo conocemos hoy.
El escudo se divide en tres (3) partes: jefe o parte superior, centro y punta o parte inferior. El color verde nos enmarca como isla pero a su vez puede representar las virtudes, la esperanza y la cortesía. En su interior se encuentra un cordero sobre el libro de los siete sellos del Apocalipsis. El cordero plateado simboliza la humildad, pureza, integridad y paz y sostiene una bandera blanca con una cruz roja. La bandera significa tregua o el entendimiento para cesar la lucha. El cordero junto con la bandera es el símbolo de San Juan Bautista, nombre que originalmente se le dio a la Isla.

El borde del escudo se compone de 16 piezas: castillos que representan el Reino de Castilla, leones por el Reino de León y una bandera de castillos y leones en representación de ambos reinos unidos y la cruz de Jerusalén usada por los reyes para expulsar a los moros de la Península. Sobre el jefe se encuentra una corona que simboliza la realeza de quienes otorgan el escudo. En la parte derecha aparece la inicial "F" de Fernando el Católico y a la izquierda "Y" de Ysabel, los Reyes de España. En la punta se encuentra inscrito en latín el lema "Joannes Est Nomen Ejus" que en español quiere decir "Juan es su nombre".

El Escudo Oficial de Puerto Rico, que simboliza nuestro nacimiento como pueblo, es el más antiguo de toda América pues las otras colonias hicieron nuevos emblemas al lograr su independencia. Es por esto que nuestro escudo es el único que recuerda la presencia de España en el Nuevo Mundo.

En el siguiente trabajo continuaremos hablando de las enfermedades y remedios del pueblo taíno.

Agradecimientos a:
Comisión de Historia del Colegio de Profesionales de la Enfermería de Puerto Rico: Rufina Aguirre de Torres; Elba R. Pereles Vélez; Raquel O. Portela; Olga Rosa Lugo López; Gloria E. Rivas Rodríguez y Gladis E. Vélez de Jesús.
Celia Guzmán y Lydia Pérez Gonzáles


Agradecimiento Especial al Enfermero
Jesús F. Encarnación. Catedrático. Profesor de Enfermería. Universidad de Puerto Rico Recinto de Mayagüez.
Fotos:
Las fotos están escaneadas de los libros de Historia de la Enfermería en Puerto Rico y de Internet.

Muchas gracias.
Un abrazo para todos
*Manuel Solórzano Sánchez; **Jesús Rubio Pilarte y ***Raúl Expósito González
* Enfermero Hospital Donostia. Osakidetza /SVS
** Enfermero y sociólogo. Profesor de la E. U. de Enfermería de Donostia. EHU/UPV
*** Enfermero Servicio de Medicina Interna del Hospital General de Ciudad Real
masolorzano@telefonica.net
jrubiop20@enfermundi.com
raexgon@hotmail.com

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Watches - this has no longer been only normally accepted standard monitoring of the time intervals. For a lot of people watches are much more meaningful. Watches - is surely an attribute of luxury, charm, chic, way to get noticed, to emphasize their standing and taste.

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Within the skeleton watch models is usually witnessed the many inner workings in the movement. The corps of watches is manufactured of lasting sapphire crystal with anti-reflective cover. Information of skeleton replica watches frequently decorated with diamonds from sapphire crystals engrave and make the cover of a noble metal, for example plated with gold. These days, forfeited curiosity during the skeleton watches was revived with new force.

Energetic, energetic families whose lives are rigidly subordinated to time, who worth every minute, choose to watches-chronoscopes. This observe not only accurately tells the time, but allows at all times remaining specifically where essential. Chronographs may also be capable to measure tiny time intervals. But don't abuse the watches using a good sized dimension.

1 of the most impressive present day watches will be the tourbillon observe. These are outfitted which has a exceptional mechanical gadget - a tourbillon - which improves the accuracy with the time. The principle of operation of this mechanism is it compensates for that impact of gravity over the anchor plug - the singular asymmetric feature throughout the watch mechanism. Not the many world's top rated watch providers can make such a mechanism, so its presence inside the watches is referring to their substantial class. This kind of watches indicate at the unique position of its owner. Some examples of fine tourbillon watches incorporate Breguet watches, Jaeger le Coultre Master Tourbillion observe and some others.

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The previous ten many years or so, has viewed an enormous resurgence in collecting vintage watches and this is often a trend that isn't going to seem to be slowing down anytime quickly.

Ordinarily speaking, a vintage watch might be 1 that is certainly above 20 many years outdated, still there exists an enormous niche marketplace for those watches that are nicely underneath this age.

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Maybe it should apply to Panerai Luminor observe, or maybe a Restricted Edition Breitling view or perhaps a re-issue of an earlier view such because the Tag Heuer Monaco re-issue, with these watches staying tremendously well known together with the underneath 50 yr previous bracket, as to the most element they are inexpensive, still not a widespread or less expensive observe that will be readily viewed.

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