168 pp, US$ 49.95, ISBN 0‐313‐34542‐1, Westport, CT: Praeger, 2008

This is not a travel medicine book—yet, ayahuasca, the “spirit vine” of the Amazon, is of relevance to travel health professionals. Marlene Dobkin de Rios, medical anthropologist and associate professor of psychiatry and human behavior, has conducted extensive fieldwork in Peru on the uses of hallucinogenic plants and healing rituals and published several books and several hundred papers. Roger Rumrrill, a Peruvian journalist, is a well‐known expert on ecological, political, and cultural Amazonian topics.

This book consists of six chapters, endnotes, glossary, references, and index. Chapter 1 “Introduction” includes a description of the brew and its effect. The second, and largest, chapter (“Native use of ayahuasca”) gives an overview of many different topics illustrating the enormous area of hallucinogenic plant use by native South American people. Traditional belief systems, shamanism, the effect of hallucinogens on ritual healing, witchcraft, ayahuasca use in Peru and Brazil, and many other interrelated topics are presented. Interviews with healers illustrate the content of the chapter, which is important as a background for the rest of the book. Chapter 3 (“Drug tourism”) is highly critical of the use of ayahuasca outside its traditional cultural context, for commercial purposes. Westerners book expensive tours to partake in ayahuasca sessions in the search for self‐actualization and spiritual growth (what the book omits are the on‐the‐spot offers of instantaneous “trips” to thrill seekers in touristic centers, such as Cusco/Peru). On the one hand, there is the potential for serious health problems, even after the tourists return home. On the other hand, this trade leads to the demise of traditional healing systems and cultural loss, as recently alerted to elsewhere.1 Unscrupulous practices (chapter 4 “The new shamans”) are of concern for the dangerous lack of knowledge of body functions, dosage, contraindications, and interaction of psychedelic plants with people’s medication or dietary restriction. Chapter 5 (“The União do Vegetal and the US Supreme Court”) describes the legal aspects of ayahuasca as a religious sacrament in Brazil and the United States, while the last chapter (“Globalization and the future of ayahuasca”) provides a future outlook examining a range of directions.

The authors’ expertise is as obvious as their unapologetic contempt for the abuse of ayahuasca in which tourism plays a considerable role. The topic is fascinating and possibly new to many. Where the book falls short is in the publishers’ domain. The title is perhaps the weakest in surely a range of more attractive options. Tighter editing throughout the book would avoid frustrating repetitions; a firm structure would make the material more accessible and offer readers clear points of reference. The glossary is helpful, but the endnotes consist only of a list of references, which still have to be looked up in the reference list, and should be removed. The reference list needs proofreading for missing/incorrect details and the spelling of non‐English/non‐Spanish text. Some illustrations, photos, drawings of the plant, and maps would have been a welcome addition.

This book is of great value for travel health clinicians. Pretravel advice on psychedelic plant use may be appropriate not only for people who travel to South America for that reason but also for those who travel to areas where spontaneous opportunities arise. The book also alerts to the possibility of psychedelic plant use when diagnosing psychological and physiological effects in returning travelers.


The health impact of tourism on local and indigenous populations in resource‐poor countries
Trav Med Inf Dis