Herbal Medicine among the Karo People of North Sumatra: A Narrative Review from a Medical Anthropology Perspective

Abstract

The Karo of the North Sumatran highlands maintain one of Indonesia’s most elaborate herbal traditions, yet research on it consists largely of botanical inventories that say little about how illness is understood, who heals, and why remedies remain in use alongside biomedicine. This narrative review synthesises ethnobotanical, ethnopharmacological, ethnographic, and health-services literature on Karo herbal medicine from a medical anthropology perspective. Peer-reviewed articles, monographs, and policy documents identified through scholarly search engines, publisher platforms, and Indonesian journal portals were synthesised thematically using the frameworks of Kleinman, Foster, and Leslie. The materia medica is extensive: a single market survey in Kabanjahe recorded 344 species in 90 families. This knowledge is organised into named therapeutic genres, namely param or kuning, tawar, minyak Karo, oukup steam bathing, and kem-kem citrus remedies. These practices rest on a relational model of health in which wellbeing depends on the soul (tendi) and on proper relations with kin, ancestors, spirits, and the landscape. Care is provided by ritual specialists (guru sibaso), herbalists, midwives, market traders, and household caregivers, most of whom learned through inheritance, and patients combine these practitioners with biomedical services in a pattern of medical pluralism. Pharmacological validation remains thin, several widely used plants raise safety concerns, and national regulation has yet to accommodate the ritual and relational dimensions of Karo healing. Future research should pair ethnographic fieldwork with chemically characterised pharmacology, address gender and commercialisation, and follow access-and-benefit-sharing principles that recognise Karo communities as knowledge holders.