Shamans have been called in as back-up following an outbreak of a mysterious madness among Nicaragua’s Indigenous communities, according to the Ministry of Health.
So far, 21 cases of 'grisi siknis' have been reported in the cities of Santo Tomas, San Carlos, Rio Coco Arriba, primarily affecting people between the ages of nine and 25.
'Collective madness' is reportedly common among the Miskito Indigenous group. The ministry lists common symptoms as including hallucinations, anxiety, convulsions, restlessness, violent outbreaks, coma-like unconsciousness, and short-term memory loss.
One of the most common side-effects is a frenzied schizophrenic panic, with the afflicted seizing any available weapon to defend themselves from invisible attackers.
Local media reports that those affected seem to experience a surge in strength and often require at least four men to restrain them.
Some have attributed the behavior to sorcery, but scientists say it's a reaction to severe depression possibly caused by extreme levels of poverty, stress and emotional exhaustion often present in northern Caribbean societies.
Nicaraguan anthropologists insist ancestral techniques are best used to treat the outbreak, which "Western medicinal treatments" cannot cure.
"On the Coast (Caribbean), the majority have recognized traditional doctors as maintaining a leading role that remedies allying the oratory, spirituality and the cosmos have helped to overcome these episodes," said one anthropologist to El Nuevo Diario.
However, many districts are forced to pay exorbitant prices to receive traditional treatments for such mental illnesses.
"If (the affected) are given anti-convulsive drugs or anti-depressants there is no improvement, but if they are given remedies by the healer they feel better," said Health Minister Jose Antonio Alvarado during an outbreak in 2003.
One of the most recent outbreaks occurred in 2015 in the Indigenous community of Kring Kin, when almost 60 people were affected. The health ministry sent in a team of doctors, but they promptly fled.
The ministry then hired a traditional physician with experience in herbal medicine, who was finally able to contain the outbreak.
During the 2003 epidemic, seven cases were reported in Namahka, all girls aged 14 to 18, one of whom reportedly died while sprinting to a nearby village.