The Sacredness of Pampapu as a Religious Healing Ritual in the Andean Worldview

Abstract

This work focuses on the study of traditional Andean therapeutic knowledge of spirituality, understood as current practices that articulate health, territory, and sacredness. In a setting invaded by modernity and conventional medicine, Pampapu survives as a healing ritual that expresses a symbolic and spiritual relationship with the Earth and Andean deities. The objective is to understand the religious, cultural, and symbolic meanings that the inhabitants attribute to this ritual. It was carried out using qualitative research methods with an ethnographic and interpretive approach, based on participant observation and in-depth interviews with traditional healers, older adults, and patients’ families. Thematic and hermeneutic analysis confirmed categories such as sacredness, illness of the Earth, generational transmission, and religious syncretism. The results show that the ritual fulfills therapeutic functions, identity, and social cohesion, and is transmitted through generations. It is concluded that this practice constitutes a living expression of the Andean religious worldview and an essential component of intangible cultural heritage.

1. Introduction

The Andean communities of Peru maintain a solid network of ancestral beliefs, which are practiced with particular intensity in the face of common illnesses in their community. A symbolic coexistence has developed between the Christian religion and the Andean worldview, in which “its focus on family, tradition, and Peruvian identity, conservatism has been adept at spreading in rural communities and among the lower classes” (Casey-Pariseault 2022, p. 50). This process shows how conservatism managed to expand by articulating family values, cultural tradition, and a sense of Peruvian identity in rural and working-class sectors. The Catholic faith occupies a central place within the local worldview, given that “Quechua-speaking peasants assimilated the Christian religion in their own way, integrating it into their worldview and adopting syncretism as a way of life” (Gutiérrez-Gómez et al. 2025b, p. 9). In sacred rituals, the articulation of both religious elements is fundamental, because only through this complementarity is it considered possible for Pachamama to accept the offering and heal the patient’s ailment.

There are various studies related to the Andean worldview and ancestral practices, which possess their own forms of organization and systematization. The present research is directly related to the analysis of Pampapu, a Quechua term that refers to a burial ritual performed in special places, which can affect the patient’s health. This practice expresses a fusion between Christian faith and belief in Andean deities, since “according to the logic of the ritual gesture, it celebrates its corresponding rites by systematically invoking its special beings (a spirit or a special being), in whom it believes it finds the form of perfect realization” (Reyna 2023, p. 3). The ritual organizes symbolic action through repeated invocations of sacred entities, conceived as mediators of wholeness and spiritual fulfillment. For generations, Quechua-speaking populations have treated various ailments through Pampapu, performed by a yachaq (community sage), recognized and revered as the healer of the community.

The problem lies in the fact that many residents of remote communities, even when they have access to state health centers, do not incorporate these services into their local identity or ancestral practices, such as the ritual of paying homage to the Earth. There is evidence of resistance to Western medicine, which is perceived as transgressive and ineffective in healing processes, since “Good Living is a project under construction that envisions the possibility of resistance to the dominant model and is configured as a voice not only of resistance, but also of an alternative to civilizations; therefore, of a counter-hegemonic nature” (Silva and Guedes 2017, p. 686). Buen Vivir, or allin kausay in Quechua, thus proposes an emerging ontology that questions the dominant hegemony and proposes civilizational alternatives based on subaltern knowledge and practices. Faith is deeply rooted in the Andean peoples, where “it gave rise to a particular form of popular religiosity in which Catholic images acquired their own meanings linked to nature, agricultural cycles, and community protection” (Gutiérrez-Gómez et al. 2025a, p. 696).

The objective of this study is to analyze the sacredness of Pampapu as an Andean healing ritual, closely linked to the worldview that guides the daily life of Andean populations. It is understood that “the cosmos is organized along a vertical axis in which the three vital forces of the Andean world are located: Kay Pacha (the world of here), Hanan Pacha (the world above), and Ukhu Pacha (the world below)” (Guerrero Támara 2022, p. 19). Various questions arise regarding the rigor and legitimacy of healing through offerings to the Earth made on behalf of the patient, as well as the role of the intermediary, represented by the sage of the community. Conventional medicine does not form part of the belief system associated with Pampapu, which is conceived as capable of curing a wide range of ailments, from psychologically rooted fright (susto) to terminal illnesses—domains in which, according to local perception, Western medicine lacks competence. These assertions are supported by testimonies and interviews collected in the study community, located in the district of Cangallo, Ayacucho region, Peru.

2. Materials and Methods

This study was conducted using a qualitative methodology with an ethnographic and interpretive approach, aimed at understanding the symbolic, religious, and cultural meanings that Andean populations attribute to the Pampapu ritual. This methodology enabled prolonged engagement with the sociocultural context in which the ritual is practiced, as well as its analysis as a living practice embedded in everyday life, collective memory, and the Andean worldview. As far as possible, the transcription of interviews conducted in Quechua was preserved intact, including linguistic interferences, understood as a natural process derived from the interviewees’ mother tongue.

Participant observation constituted the primary data collection technique, given that healing ceremonies are frequently conducted in the communities studied. Throughout this process, ritual restrictions and the ethical principles established by the practitioners were strictly respected. This technique made it possible to record behaviors, ritual sequences, the use of symbolic objects, participants’ roles, and the relationship with the land and the places sacralized by the population. In addition, in-depth and semi-structured interviews were conducted with traditional healers, older adults, and patients’ family members. The interviews were carried out in Quechua and Spanish, prioritizing oral accounts, testimonies, and narratives related to the preservation of the tradition, its transmission to younger generations, and its symbolic effectiveness in the healing process.

The sample selection was intentional, choosing key informants recognized by the community as legitimate bearers of traditional knowledge associated with the ritual. Theoretical saturation guided the number of interviews, reaching a total of 15 testimonies, in which recurrent discourses were identified, enabling the construction of analytical categories. The systematization of the information was carried out through thematic and hermeneutic analysis, articulating emerging categories such as sacredness, illness of the land, generational transmission, religious syncretism, and cultural continuity. This analysis was complemented by a dialogue between the empirical data and specialized anthropological and philosophical literature.

Essential ethical considerations were taken into account, such as informed consent, confidentiality, respect for local knowledge, and refraining from making audiovisual or photographic recordings of the rituals when requested. The methodological work allowed us to understand Pampapu not only as a therapeutic practice, but also as an expression of the Andean religious worldview, closely linked to the identity and social cohesion of the community. (See Supplementary Materials)

3. Results

3.1. Sacralization of the Healing Ritual

Andean populations conceive Mother Earth as a life-giving principle and recognize mountains as sacred entities, bearers of an infinite divinity. In this regard, “the relationship of reciprocity during this period is established between the runas at the family level and the sacralized landscape” (Pérez Galán 2010, p. 9). Such reciprocity is expressed as a sacred bond between the Andean family and the ritualized natural environment that sustains life. The settings where the ritual is performed are spaces of particular significance. When the specific place where the alcanzo occurred (when the Earth has “taken” the person) cannot be precisely identified, the ritual is carried out at a crossroads. As one interview states: “Yes, pampapu is performed when pacha, alcanzo, or susto affects people, both children and adults; I work performing pampapu.” This testimony reflects a personal experience and, at the same time, the voice of an Andean sage who performs the healing ritual.

The healing process is a sacred act aimed at restoring health, closely linked to Christian faith and to Mother Earth. A meaningful relationship is established between the patient’s family and the sage, insofar as “this understanding has the potential to revolutionize medical practice and ultimately generate better outcomes for patients” (Alzeer 2023, p. 3). This is reinforced by the testimony of an interviewee: “The requirement is that the healer who performs it must have faith and must know how to do it properly.” When the ritual is carried out with little faith, the outcome is ineffective and, at the same time, there is a loss of trust and patience for the healer. The healing process is currently framed within an argument that “radically diverges from the ethnographic tradition that for decades described Andean communities as closed, immobile, and attached to their rites and customs” (Anderson 2013, p. 14). Various elements are present in the ritual: “Mountain carnation flower, coca leaves, sugarcane liquor, Inka cigarette, a newborn black animal, rue, holy Mary herb, assorted candies in pairs, purple chicha gum in pairs, and seeds of different cereals in pairs.” As noted in an interview, particular importance is given to the use of products arranged in pairs.

Within the healing ritual, the use of Catholic prayers combined with invocations to the spirits of the mountains recognized by each community as protectors is fundamental. Understanding the Andean worldview is essential, since “a synthesis and substitution occurred, implying that the rites and religious ceremonies offered to the saint are, subterraneously, being directed toward the sacred mountain of the area” (Guerrero Támara 2022, p. 16). This reveals a clear case of religious syncretism, in which apparent Christian rites conceal Andean practices, symbolically redirecting devotion toward the local, ancestral, and communal sacred mountain. Testimony collected in an interview reaffirms the symbolic effectiveness of healing: “If the alcanzo is severe, it is performed with newborn black animals.” The interviewee recounts a case in which a wounded man was cured using a black puppy, passing the animal over his body during the ritual, praying, burying it in the form of a cross, and not looking back; the man was healed. The use of black-colored animals, sacrificed in the ritual when they are newborn, is also emphasized. These ritual items are obtained by the patient’s family, who, in some cases, transport the sick person to the site where the ritual is performed, generally on the outskirts of the community, in spaces considered sacred within the Andean worldview.

The public health process promoted by the state led to the creation of medical posts in most of the most densely populated centers. This highlights a conflict between the ancestral medicine of the Pampapu and conventional medicine. Many residents question the effectiveness of the biomedical system, as expressed in an interview: “First, I read the coca leaves to diagnose: earth, fright, or doctor; if appropriate, I send them to the hospital. The symptoms vary depending on the pacha and alcanzo, especially after midday: fever, numbness, vomiting, diarrhea, progressive swelling; without timely treatment, it can cause death.” This testimony confirms the primacy of traditional medicine in the community’s perception. The value and importance attributed to this practice are deeply rooted, since “the healer is a specialist who has undergone an initiation in which he receives power and knowledge from the deity that triggers the initiatory process, usually saints and virgins and even God himself” (Arteaga 2010, p. 398). In this way, the healer acquires ritual legitimacy through a sacred initiation, receiving power and knowledge from Christian deities who authorize his therapeutic practice.

Places of healing are deeply revered spaces among the inhabitants, who have transformed them into sacred settings through their ritual practices and collective beliefs. Over time, these perceptions are transmitted to new generations, who regard these places with respect, fear, and sometimes skepticism. Around these sites, various symbols and cultural norms have developed to protect nature and prevent its profanation, since an irreverent relationship with these spaces is believed to bring negative consequences, such as serious or incurable illnesses interpreted as punishments from nature itself.

3.2. Spiritual Mediation of the Healer

The population and patients of Andean communities maintain a deep belief in the spiritual agency of healers and in their connection with benevolent spirits and the deity. The ritual action of the healer is conceived as sacred; therefore, economic retribution is usually symbolic and voluntary, a fact that requires particular analytical attention. In this regard, one testimony states: “Because when susto or pacha affects you, you cannot be healed just like that, nor with medicine; that is why only with Pampapu can it be cured. Pampapu is performed on people of all ages because pacha can affect anyone.” From a historical perspective, the ceremony is configured through human mediation, in a manner analogous to what is proposed when it is argued that “from the perspective of origin theory, the cultural memory of ceremonial ceramics is shaped by the specific historical trajectory and the productive life of society” (Liu and Wang 2024, p. 201). This assertion allows us to understand that cultural memory, like Andean rituals, emerges from concrete historical processes and productive practices that consolidate and socialize shared ritual meanings.

The population attributes a special gift to healers, insofar as, through actions perceived as coincidental, the patient manages to recover through the intervention of the Pampapu. This process consolidates a spiritual heritage transmitted within ritual families devoted to healing. It is pertinent to underscore the continued relevance of ancestral healing practices, since “from the twentieth century onward, there has been a marked concern for cultural identity and its necessary interweaving with integrative aspirations” (Morón Tone 2010, p. 18). This assertion reflects the emergence of a modern identity-related concern linked to integrative projects that seek to articulate cultural diversity and social cohesion. Cultural integration between the mediator and the patients is fundamental, as evidenced by an interview: “He requested various ritual supplies and performed a ceremony on a Tuesday at noon, which included prayers, the use of a guinea pig, rue and carnation water, with the assistance of a helper, aimed at spiritual healing through invocations and traditional practices.” The mediator’s requirements are essential for the patient to be healed and for the hills or the Earth to properly receive the ritual, which is carried out in a small hole dug with a sickle rather than with other implements.

The Quechua-speaking community, in particular, attributes to healers a special ability to communicate with Mother Earth or Pachamama and, similarly, with the Apus, through the practice of rituals. In many cases, illness in the Andes is associated with falls that occur in places not permitted by Pachamama, as noted in one interview: “After the ritual, he instructed us not to leave until the next day; then he took the elements to the site of the accident, buried them after identifying the site, praying, chewing coca, smoking, drinking cane liquor, and invoking Pampapu for his acceptance.” This process is an essential element in the relationship between humans and the divine, since “Andean rituals are often formal behaviors prescribed for certain ceremonies offered to beings that possess mythical powers, such as the Apus (mountains) and Pachamama (Mother Earth)” (Reyna 2023, p. 3). This statement describes Andean rituals as standardized practices that structure a symbolic and sacred relationship between communities and mythical entities. For the Andean people, the Earth and the hills are expressed through symbols that healers interpret and transmit to the patient and their families.

According to accounts gathered through participant observation, healers who offer their services through advertising or other media do not inspire trust within the community. Instead, those who are regarded as bearers of cultural heritages in which discretion and ethics are essential are valued. Likewise, they are protective regarding the presence of outsiders during ritual practice; as they state, the intervention of a stranger who lacks belief may undermine the proper unfolding of the ceremony. The fusion of Andean and Catholic religiosity is fundamental, as expressed in an interview: “Ari, chay padre nuestro y ave María nisqanchiktaya rizakun.” These are prayers belonging to the Catholic tradition; however, they are integrated into a ritual directed toward the Earth, since “with regard to deities and spirits as supernatural beings, in the Andes no clear distinction is established between what we call religion and the secular; life is conceived as a unity, determined by human and spiritual forces” (Sáenz 2017, p. 1). This perspective articulates an integrative Andean worldview in which the religious and the secular are intertwined within a vital unity governed by human and spiritual forces.

3.3. Religious Conception of Illness

The various illnesses that afflict Andean people are often attributed to the evil of the Earth, known as alcanzo or pacha (the Earth wins the soul); in other, less frequent cases, they are explained as divine evil of Christian influence. According to the interview, Christian devotion is essential: “Yes, our father asks Jesus and the Holy Spirit.” The healer entrusts himself to the saints mentioned in the testimony. Illness is interpreted as a probable breach of the sacred order, since “there are, then, specific ways of acting in these rites, learned and inherited as part of the identity of the peasants, which play a role in generating memory and knowledge” (Vimos 2019, p. 93). This statement maintains that rituals transmit inherited identity practices that produce collective memory and cultural knowledge in peasant communities. The ritual ceremony constitutes a sacred space; therefore, if an outsider coincides with its performance, there is a belief that the illness can be transferred to that person in an untimely manner, regardless of whether they are only passing through the place, especially at night.

Respect for Mother Earth constitutes an essential principle in the daily life of Andean peoples, who believe that an improper relationship with Pachamama leads to negative consequences, such as the onset of illness. Divine powers are attributed to mountains and little-explored places, in which, when one “behaves improperly or fails to comply with the rules of reciprocity, worship and offerings may be suspended. The god/huaca was not superpartis, but could be directly affected by human action and judged by human thought” (Tassi 2012, p. 929). This representation posits a relational divinity, conditioned by human reciprocity, whose cults depend on moral behavior and social judgment. From an intercultural perspective, “to achieve and to share, insofar as ideas were exchanged and new knowledge from other cultures and contexts was acquired, which made it possible to address the concept of interculturality, leading learners to recognize and reciprocally accept the culture of the other” (Solano-Gutiérrez and Rojas-Perdomo 2022, p. 302). One testimony states that the only form of healing is: “everything that is taken by the pacha or fright cannot be cured by medicines; it can only be cured through Pampapu and by people who know about these matters.”

Pachamama and the Apus (sacred mountains) sanction the profanation of their natural state for various reasons, understood as acts that damage their sacrality. Ambition or the desire to extract elements from divinized nature is conceived as a transgression that may lead to deadly illnesses, whose cure is possible only through the Pampapu, performed by a recognized specialist. In this regard, one testimony states: “The ritual employs specific materials and repeats the prior steps. After bodily cleansing, the Pampapu is carried out outside the dwelling, invoking mountains according to the patient’s place of origin, repeating the procedure three times, on the same days and at the same hours, in order to achieve healing.” Harmonious coexistence with nature constitutes an essential condition of communal life, since “Buen Vivir, which stands in opposition to the hegemonic model, is found in the agricultural mode of multicrop production (as opposed to monoculture), because it respects the land’s capacity for regeneration, which is destroyed by large-scale specialized production” (Silva and Guedes 2017, p. 688). This representation outlines multicropping as an alternative to the hegemonic model by prioritizing sustainability, land regeneration, and ecological balance over intensive production.

Mother Earth, known as Pachamama, coexists harmoniously with human beings, provided that her sacred environment is not violated. This conciliation is expressed through ritual practitioners, as reflected in one testimony: “I began at a young age curing fright with an egg and prayer, through faith in the Lord of Quinuapata and Jesus. My nephews and other children were healed; in this way my faith grew, I learned pacha and alcanzo, and now I travel wherever I am called to heal.” Once they gain recognition for their commitment and trajectory, these healers are sought in different locations. This practice is not foreign to contemporary science, as it responds to a widely acknowledged need: “Traditional and Complementary Medicine is a very important component of health service provision in Peru and worldwide; it is practiced daily and the demand for these services is increasing” (Gómez Gonzales 2015, p. 143). Traditional and Complementary Medicine thus positions itself as a key component of Peruvian and global health, in everyday use, with growing demand and increasing social recognition. This is further reaffirmed by the assessment of one interviewee: “Because if it is pacha, it is healed with pampapu; medicine is useless, because my child did not heal with the syrup the doctor gave.” These testimonies highlight the need for reconciliation with ritual practice and with nature as a condition for the healing of illness.

The manifestations of illness are often interpreted as punishments or warnings from the Earth, or Pachamama, arising from an improper relationship with nature or from the profanation of certain sacred places. When the ailment does not find relief, some inhabitants attribute it to a divine affliction, understood as the consequence of past actions or as part of the destiny determined by God. In such cases, some people accept the illness with resignation and avoid going to health centers, believing that biomedical medicine could worsen their condition. Therefore, they choose to remain at home and follow the recommendations and treatments of traditional healers.

3.4. The Body as Sacred Space

There are various beliefs and testimonies that circulate orally in the Quechua language in Andean villages, including the need to take care of the human body in relation to nature and avoid indiscriminate exposure. It is essential to understand the manifestations of the body, as one interviewee points out: “Working in Vilcas Huamán, after having lunch by the river, I began to experience afternoon fever, sweating, and numbness. A colleague attributed the illness to the local soil and suggested a healer; skeptical, I asked for permission and traveled to Huamanga to seek treatment at a clinic.” This experience is part of a historical continuity of the sacred, “which in a sense closes the most fertile cycle of Peruvian colonial historiography, emphasizing above all the importance that the cult of Pachamama had during the Inca period” (Di Salvia 2013, p. 92). In this way, the cult of Pachamama is revalued as the central axis of Inca religiosity and its persistence in contemporary practices.

Belief is not limited solely to healing through rituals directed toward the Earth in the name of Andean and Christian deities, but also extends to human contact with sacred elements of the environment. Rivers, mountains, stones, hills, and unexplored lands are understood as spaces that, when neglected or profaned, may cause illness for the Andean individual. Such ailments can only be cured through special treatments, as expressed in one testimony: “I went to a clinic without any improvement; the pain and fever worsened. A neighbor recommended a healer, who, through coca leaves and a candle, diagnosed pacha and indicated a ritual with specific offerings for my healing.” This conception resonates with the notion of “our increasing vulnerability as a consequence of these multiple exposures. It has been reported that the harmful effect of air pollution on cognitive performance becomes more evident as we age” (Chen and Nakagawa 2018, p. 9), underscoring how cumulative exposures heighten vulnerability and exacerbate age-related cognitive decline.

The family, the patient, and the community share an essential principle of veneration for the sacredness of the land. The small holes dug by the healer in sacralized places are fundamental because “the Andean world revolves around symbolism due to its Quechua and illiterate culture, and symbolism in relation to the surrounding nature plays a fundamental role” (Gutiérrez-Gómez and Munaris-Parco 2025, p. 449). This statement underscores that the Andean worldview is symbolically structured, with nature as the central axis of cultural and practical meaning, as expressed in the interview: “A female healer performed a nighttime ritual with prayers and offerings to sacred hills, imposed subsequent restrictions, and after a week the affliction disappeared, consolidating the belief in pacha caused by the land.” The testimony is expressive and confirms an ongoing reality, since “in this complex panorama, the concepts of health and illness, as well as therapeutic resources, are today also highly diverse, and different medical systems coexist, the most notable being biomedicine and traditional medicine” (Canavire 2020, p. 529). Thus, the coexistence and diversity of conceptions of health, illness, and therapies in contemporary contexts become evident.

Faith constitutes a fundamental element in the healing process, both in the specialist’s requirements and in the materials requested for carrying out the Pampapu ritual. These considerations complement the patient’s proper healing, as confirmed by the testimonies collected in the research and by the healers themselves, who, despite being protective of their secrets of faith, acknowledge their importance. Likewise, oral testimonies linked to remedies are recorded, “accompanying this response with a detailed compendium of popular medicines to heal local illnesses, prepared by the indigenous healer of the village” (Bonavia 2002, p. 426), which highlights the role of the indigenous healer as a therapeutic agent who systematizes and transmits local medicinal knowledge. There is also a legitimate concern regarding the transmission of this knowledge, as noted in an interview: “More than anything, by sharing—meaning that older people should share with their grandchildren and children, so that they can know and understand that pacha, alcanzo, and other conditions exist.” In this way, transmitting faith in the relationship between the human body and nature, as well as in bodily sensations, constitutes an integral part of Andean life.

In the Andes, care of the body is understood in close relationship with nature. Phenomena such as wind, lightning, rain, and thunder, as well as certain places in the landscape, are considered spaces with energy or life of their own and therefore require respect and caution. Sitting or passing through an inappropriate place may cause an imbalance in a person. For this reason, the relationship with nature is based on reciprocity, expressed through occasional payments or offerings, or ritual gestures such as tracing a cross on the ground before sitting, seeking protection and harmonious coexistence with natural forces.

3.5. Religious Memory and Ritual Continuity

There are various accounts of ancestral knowledge that are undergoing a process of gradual disappearance due to the lack of practice and transmission to younger generations, as well as the intrusion of modernity. In this regard, a ritual practitioner states: “We must talk to them about the existence of pacha or alcanzo and that we must have great respect for the land, and that pacha can also take hold of us when we fall.” It is pertinent to consider the views of older community members, who warn that “today there is a new type of religious believer, one who moves through social networks and consumes the goods of the cultural industry without completely disaffiliating from their non-virtual or co-present religious community” (Casey-Pariseault 2022, p. 5). This statement describes a hybrid believer—both digital and face-to-face—who combines mediated cultural consumption without breaking traditional religious community ties. For another interviewee, the generational transmission of knowledge is essential: “We must share what we know and what our elders do, that is, so they know that there are people who can heal the ailments you suffer, such as pacha, susto, and alcanzo.” Illness and healing are conceived as inscribed in the relationship with the land, which is restored through burial rituals or Pampapu.

Based on the interviews and participant observation, it became evident that learning the ritual is fundamentally generational, inherited from parents to children. In this way, entire families have devoted themselves to assisting community members, exercising the gift of healing and maintaining a close relationship with the deities and places sacralized by the community. An aspect of particular interest in this inherited practice is expressed in a Quechua testimony from one interviewee: “Llapa quipa qamuqtaqa willanam yachanankupaq qinaptin paykunapas churinkuman willanqaku.” This testimony indicates that young people should be comprehensively taught the ritual practice so that, in turn, they may transmit it successively to their children, thereby preventing the loss of ancestral knowledge. It is pertinent to understand this as a “possibility of thinking about discourses surrounding traditional therapeutic knowledge and resources as part of a population’s intangible cultural heritage” (Canavire 2020, p. 527). This perspective proposes recognizing traditional therapeutic knowledge and discourses as intangible cultural heritage, valuing their symbolic and social dimensions.

In the process of healing illnesses considered to be the product of the Earth and sacred places, the practice is mainly carried out by older adults with symbolic authority, recognized as zealous guardians of Andean knowledge. For a deeper understanding of the subject, it is pertinent to consider the words of one interviewee: “Sharing experiences from childhood allows us to teach and prevent. By involving grandchildren, they learn the practice, support the work, and pass it on, even bringing their friends to be healed.” This form of transmission is understood by researchers as “pointing to a rare case of cultural continuity, which we have been able to trace and document along the coastal strip of the central Andean area, from pre-ceramic times to the present” (Bonavia 2002, p. 421). This highlights the exceptional persistence of an Andean cultural tradition, historically documented from pre-ceramic times to the present.

Migration to cities, a phenomenon present in nearly all regions of the world, is also evident in Andean communities for various reasons. This displacement enables residents to carry their ancestral customs and traditions with them, which they practice discreetly in urban spaces, often in tension and controversy with conventional medicine. In this regard, one interview states: “Because when alcanzo takes hold of you, doctors cannot cure you; on the contrary, it can kill you more quickly. Medicines work against it—if they had taken me to the hospital, they surely would have given me a sedative injection, and I would probably already be dead.” This testimony expresses a complete rejection of contemporary medicine when the cause of illness is attributed to the land. It is necessary to note, “alongside selective rejections of one system or another, and considering that ‘ways of healing’ play an important role in the processes of identity construction and social cohesion within a population” (Canavire 2020, p. 16). This indicates that healing practices, through selective acceptance and rejection, strengthen collective identity and community social cohesion.

There is evidence of a process of juxtaposition between Catholic faith and Andean beliefs in everyday peasant practices. Both traditions coexist in rituals and in the interpretation of illness. Beliefs in pampapus, associated with envy or malevolent intentions, persist and are treated by ritual specialists. Burials function as symbolic exchanges with Pachamama, an Andean deity distinct from the Virgin Mary. Evangelization allowed a certain form of religious coexistence, whose impact on health and illness among Andean populations requires further research.

4. Discussion

Andean communities in Peru, particularly those who speak Quechua, continue to practice the ritual of healing illnesses through Pampapu, which remains alive in modern spaces, both within and outside their communities. The advent of modernity has limited its practice, especially among older adults, who fight for its continuity and find followers who trust in ancestral medicine, even without scientific validation. Interviews and participant observation confirm the ritual’s continued relevance, as well as the presence of individuals considered to possess special gifts, capable of communicating with beings perceived as divine and interacting with sacred spaces during the healing process.

Concern about the transmission of this knowledge to younger generations is constant, due both to a lack of practice and, in some cases, to attitudes of jealousy and competition within the healing process. These forms of spiritual healing are usually restricted to the family sphere, where special gifts are inherited from parents to children and transmitted only to close relatives. There is no single origin or uniform ritual procedure, as it varies from one community to another and according to the illnesses being treated. The presence of specific elements requested by the healer is essential for the fulfillment of the healing, depending on what, according to their belief, the land demands. The performance of the burial ritual or Pampapu, in small holes dug with a sickle, constitutes reserved knowledge mastered only by the healer and, in some cases, by a close family member of the patient, since the prayers and the dialogue with the land and the deities are imperceptible to an external observer and are carried out with prior authorization, under strict principles of ethical confidentiality.

Religious syncretism constitutes an essential element of this practice, as participants firmly believe both in the divine benevolence of the Catholic religion and in the divinity of the apus. This fusion is an aspect that must be understood by patients and their families. Particular attention is given to families, since they are responsible for fulfilling all the requirements and processes of healing when the patient is confined to the home. If the affliction does not limit the patient’s participation in the ritual, it may be carried out in person; however, in many cases, the intervention is predominantly indirect.

The space where the ceremonies take place is sacralized by the entire population as a site associated with their Andean deity. It is believed that individuals who happen to pass through these spaces may carry the patient’s fortune and experience the phenomenon of transference. In these communities, conventional medicine occupies a secondary place among those who firmly believe that the land has taken the patient’s soul and that, therefore, the ritual must be performed as a form of supplication and offering to the deity.

5. Limitations of the Research

One of the main limitations is the lack of trust in strangers, who are considered potentially disruptive to the ritual and the patient’s healing process. For this reason, the rituals are performed only in the presence of the closest family members and, in some cases, with the direct participation of the patient in the ritual site.

Another relevant aspect is the refusal to allow recordings or photographs, which reveals a protective and distrustful attitude toward the disclosure of what is said and done during the ceremony. The healer buries the offerings and recites prayers almost in whispers, using words that are difficult to understand. Conversations are usually brief and preferably conducted in Quechua, and the entire activity unfolds as a special ceremony that requires various products specific to the occasion, arranged in a small pit dug with a sickle.

Likewise, there is a refusal to accept any medical intervention on the part of family members when they place their full trust in the healer, who does not recognize himself under that label, but rather as a person gifted with a special gift and a pact with the Earth and the apus.