The Future of Medicine
Date: November 2005
Publication: The Journal of the American Herbalist Guild
Author: Dr. Tabatha Parker
If you were lucky enough to attend the 16th Annual American Herbalist Guild Symposium in Portland, Oregon this year, you may have seen Dr. Laurent Chaix receive the AHG’s 2005 Community Service Award for Natural Doctors International (NDI). NDI was started by three naturopathic physicians in 2003 to give alternative medicine practitioners opportunities to work and serve in developing countries worldwide – for all intense purposes the new “Doctors Without Borders” of the natural medicine community. As the Executive Director of NDI, I am blessed to be a part of this grassroots organization. We are not only bringing natural medicine to at-need communities, we are working to unite the natural medicine profession to collaborate more on international projects. While medical professionals commonly work side by side – MD’s, nurses, physicians assistants, etc – the alternative medicine community has been slower to carve out a place in the ranks of medicine as a solidified group. NDI’s vision is to create an organization that unites our diverse community of ND’s, acupuncturists, herbalists, homeopaths, midwives, and traditional medicine healers and build a global organization of leaders in alternative medicine collaborating on projects around the world. This is one of the reasons we did not choose the title “Naturopaths Without Borders.” We wanted to be inclusive and saw the value that all alternative medicine professionals bring to the table.
The world of medicine is changing and the alternative medicine community is both the past and now, the future of medicine. Until now, there has not been a non-profit dedicated to providing opportunities for naturopathic physicians and alternative medicine practitioners. The founding of NDI occurred when myself and two colleagues, Dr. Laurent Chaix and Dr. Michael Owen, realized the gap in international relief medicine. We recognized that the naturopathic profession needed to contribute to the growing global health crisis. Having a relief organization dedicated to providing opportunities for ND’s and other practitioners of alternative medicine made the most sense, so we started a non-profit 501c3 to do just that.
World Health Organization Policy
With groups like the World Health Organization making alternative medicine a priority, we created an organization to give people who have committed themselves to natural medicine the same opportunities that medical professionals get. We also wanted an international organization that could get involved in the global conversations and projects that are defining the very fields of study we have dedicated our lives to. If you haven’t read the WHO Traditional Medicine Strategy 2002-2005 (www.who.org), you need to jump on your computer and download it right now! The document defines and analyzes the use and validity of alternative medicine globally. Written by professions outside the alternative medicine community - MD’s, PhD’s, NGO’s and other public health policy makers – its sends a message that alternative medicine is not a “trend” but a valid solution to many public health problems. The authors clearly acknowledge difficulties in defining and differentiating “traditional medicine (TM)” from “alternative and complementary medicine (CAM)” that many of us within these professions have struggled with.
The global health community is finally taking a serious look at the legitimacy of natural medicine. In many countries around the globe, natural medicine has and will always be first line therapy. It offers solutions to growing public health problems like malaria. The WHO document is clearly one of the most important of its kind as it is defining world health policy on natural medicine. The one thing that is a shame is the lack of participation by the “experts” of natural medicine – naturopathic physicians, herbalists, traditional medicine practitioners and midwives. How is it that a global policy on Traditional Medicine can be created without professions that are best suited to be delivering it? Why is it that the professional communities of natural medicine have not organized themselves to become a part of these projects? NDI is an avenue for alternative medicine practitioners to enter into the international health arena and join the frontline of global medicine. Because NDI’s main goal is providing free medicine in developing countries, we bring to the table first-hand experience of natural medicine delivery and understand the sensitive and complex issues that arise working in international settings.
Sustainability and Medical Tourism
Bringing legitimate international opportunities in developing countries to practitioners of alternative medicine was first and foremost on our task list, so we began negotiations with the Nicaraguan Ministry of Health (MINSA) in 2003 and by early 2005 we had signed a 3-year contract. NDI presented a program to MINSA that would be both sustainable and sanctioned. Our goal is to build long-term relationships, not just be medical tourists.
Tourism is defined as “the visiting of places away from home for pleasure”. We can extrapolate to define medical tourism as “the visiting of places away from home for pleasure as a practicing medical professional.” Medical tourists volunteer their time work in developing countries usually as part of a in short-term medical relief team of volunteers. While the basic goal is altruism, the result is often less so without the knowledge of this by the docs. Medical tourists don’t realize they are being tourists – they come in smiling, often bringing medicines to communities that clearly have a need. Unfortunately, the result is patients get put on the same drugs by different teams and often run out of a drug after 1 or 2 months and cannot replace it. This system does not provide continuity of care. Medical tourists receive a lot more than they give – although their services are usually welcomed and readily accepted by the at-need communities. Although we work with many medical brigades and host our own, we do not condone medical tourism. Be aware of how your short-term altruistic choices may have a long-term impact and make your decisions accordingly. If you are going to volunteer for a medical brigade, make sure they are sanctioned by the local government and if possible, permanently operating in your country of destination.
Students stand to gain the most from these experiences – a ton of education in pathology that you are simply not going to see in the United States, second-language immersion, and a glimpse into the realities of third world living. This glimpse often sheds light on how everyday choices in the USA impact people on a global level. I personally believe that all students and professionals of medicine, be it western, eastern, herbal, or otherwise, should seek out cross-cultural international opportunities as they push the boundaries of reality more than any book or botanical test will. If we are working towards equality in medicine, this is an invaluable tool to show people first hand how unequal the playing field is right now. However, we also must be responsible and seek out opportunities that are truly beneficial to both sides. NDI is dedicated to creating lasting programs that integrate into the community as much as possible. Tyler Mongan, an SCNM student that visited the program in Nicaragua, writes, “My experience visiting NDI was great as I saw that medicine could be personal. Drs. Parker and Owen have made the effort to become a part of the community instead of just acting as foreign doctors who are in some way outside of and distanced from the people. They are willing to do things and fight for changes that demonstrates their commitment to a whole health perspective.”
Global Gatekeepers - Naturopathic Physicians
After we decided to begin our pilot site in Nicaragua to have NDI physicians work in the Moyogalpa Center of Health on the island of Ometepe in Southern Nicaragua, our first hurdle was negotiating a contract for a diverse group of natural medicine providers. We needed a profession that had the educational, licensing and scope of practice requirements to work in a third world hospital. Formal training in naturopathic medicine not only focuses on alternative medicine, but also prepares doctors to do minor surgery and prescribe pharmaceuticals. The degree allows naturopathic physicians to be primary care providers, capable of legally diagnosing and treating disease, which makes them the perfect gatekeepers for alternative medicine outreach teams. ND’s can easily go from discussing pathology exams with an MD to discussing herbal medicine preparations with a traditional medicine healer. ND’s also have the advantage of a license to practice medicine, which many non-licensed professions do not have.
Our contract with MINSA recognizes naturopathic physicians and allows ND’s to practice legally thru NDI projects. This does not exclude non-ND’s from becoming involved with NDI, in fact, it is all the more reason to jump on board to help get recognition for your specific profession. Our goal was to get this first project off the ground and we are more than happy with the results. Getting contracts for naturopathic physicians is the best place to start and down the road we are confident we will be able to incorporate other types of alternative medicine professions into the medical delivery arm of NDI. Acupuncturists and Chinese Medicine Doctors are a perfect example – with formal education and licensure – they are clearly the next group that will be formally included in upcoming contracts.
NDI offers both short and long-term volunteer opportunities for doctors and students. In this year we have received five students from different naturopathic programs Christine Middleton, Tyler Mongan, Holly Elmore, Alex Desoler and Ryan Sweeney. We have also received non-medical volunteers for different community projects – Josue Roxas, a journalist and artist from San Francisco, CA coordinated a community art project that more than 100 folks participated in; Clifford Parker, a retired electrician from Old Saybrook, CT used his skills to bring needed electrical fixes to the Moyagalpa Center of Health. The only thing required to get involved with NDI projects is a big heart, a good sense of humor, and a desire to learn about other cultures.
Our everyday mission is simple - helping people one patient at a time. Currently, both Dr. Michael Owen and I serve in the Center of Health on Ometepe Island. Since its inception in March of 2005, we have provided over 800 patient visits, established 5 ongoing community outreach projects and completed 2 community support projects. One project, Helping Hands, is a free pharmacy that supplies islanders with vitamins, homeopathic medicines, botanicals and pharmaceuticals. The generous donation from John Weeks and Dr. Jeana Kimball of their family’s Isuzu Trooper, Esmeralda, has given NDI the ability to run an ambulance service that has already saved 2 lives. We have sent over 30 thousand dollars of donations to the Moyogalpa Center of Health from Dr. Eric Yarnell of Heron Botanicals, Al Czap of Thorne, Dr. Wayne and Lee Centrone of Portland, Oregon and Golden Lotus Botanicals, Boiron, Vital Nutrients, Hyland Homeopathics, NCNM, Oakmont Labs, and numerous personal donations over the last year. Heron Botanicals has generously set up a program where customers can request to have a percentage of their purchases go directly to NDI. We urge you to sign up when buying from Heron Botanicals.
NDI has developed a 1-year rotation for licensed ND’s and those who apply must be graduates from accredited 4-year institutions. With the establishment of this rotation on the island of Ometepe, NDI is able to provide continuity of care. Applications were due this fall and NDI proudly accepted Dr. Ananda Steigler, an NCNM graduate who will join team NDI in Nicaragua in January of 2006. Having attended Michael Moore’s, Southwest School of Botanical Medicine, Dr. Steigler will add to the NDI team the expertise in botanical medicine we are looking for.
Receiving the AHG’s Community Service Award is truly an honor for NDI. We will use the cash award to develop a botanical medicine project and are meeting with a group of women on the island that are the keepers of local herbal knowledge. Early discussions have included planting an medicinal community garden and publishing a book of herbs found on Ometepe. In the upcoming year, we will continue to strengthen Project Nicaragua, develop our presence in the international health community, and build strong bonds with our patients by providing medical care with heart. NDI is growing in leaps and bounds; we wanted to become the “Doctors Without Borders” of the alternative medicine community and we are well on our way to doing just that.