The Role of Natural Medicine in International Health
Date: August 2006
Radio Interview: 90.7FM KBOO radio station interview in Oregon
Interviewees: Dr. Tabatha Parker and Dr. Tania Neubauer
Q:Who is NDI?
A: NDI was co-founded by 3 Portland naturopathic physicians, Dr. Laurent Chaix, Dr. Michael Owen, and Dr. Tabatha Parker. The coordinator for the NCNM student chapter is Dr. Tania Neubauer. These 4 individuals went to Nicaragua in 2003 as part of the first naturopathic medical delegation to Nicaragua. A lasting relationship was formed with one of the hospitals we worked with and NDI was founded, with two of the founders, Drs. Parker and Owen, serving as the first staff physicians on the island. NDI is the first international naturopathic nonprofit. We provide free naturopathic primary care to underserved populations of the world.
Q: What does NDI do?
A: We place naturopathic physicians in long-term rotations, for one-year terms, in international clinical settings – our pilot site is a small rural hospital on the island of Ometepe in Nicaragua, Central America and we are looking to expand to other sites. We also bring brigades of naturopathic medical doctors and students to the sites to learn about international medicine and provide healthcare to underserved populations.
Q: Why start an international non-profit for naturopathic physicians and acupuncturist?
A: Volunteering has been a long established tradition within all medical professions, however those outsde of the traditional allopathic setting do not have the same opportunities to volunteer internationally. In its first year of operation, NDI doctors donated over 700 days of service delivering free-medical services and to date we have seen nearly 2000 patients. We are setting a precedent that shows naturopathic medicine is viable in a third world setting and that we as naturopathic physicians have a lot to contribute to the global public health crisis that is occurring.
Q: Why establish long term clinics – why not just run short medical volunteer trips?
A: We are not medical tourists. We place doctors for long-term rotations – terms of one year – at our clinical sites. One year a minimum term to achieve cultural competence and a relationship of trust in the community. By developing this trust and stability with our long-term volunteer placements, we are able to bring short-term medical brigades with more success and less potential to do harm instead of good due to inadequate follow-up, language, communication, and cultural barriers.
Our long-term presence also allows us to support the local economy where we are. Natural medicines, which have far fewer side effects and can often be cheaply locally produced, are an excellent alternative to allopathic medicine in many cases. We purchase locally-made herbal medicines whenever possible and work with local natural-medicine practitioners. Why? It just makes sense. Importing herbs or medicines from distant areas is unreliable and chokes out the local herbal traditions. There are often local herbs that work just as well for most illnesses as the top ten fad herbs of commerce that are popular at the moment in American natural medicine. Buying locally helps local traditional medicine practitioners continue to practice.
Q: How has your long term presence better enabled you to serve the people of Nicaragua?
A: Our long-term presence has also allowed NDI to expand beyond the traditional doctor-patient one-on-one consult model into a more social health model. By that we mean that because we are living in the culture, we are able to see first hand on a day to day basis what the needs of the community is. Often we have found that the health of the community can be bettered by a simple community project that engages and empowers people. While the majority of our long-term programs are health focused, NDI recognizes that healthcare delivery does not happen solely in a clinical setting. Some of NDI’s most important service work happens thru its community enhancement projects. By developing health programs and community enhancement projects, we believe we can make a more lasting impact on the communities we serve. Since we began on the island we have established 4 long term projects and completed 2 short term projects.
Q: What kind of healthcare solutions are there in Nicaragua?
A: When I (Dr. Tania) was on the island of Ometepe, I stayed with an herbalist who did massages and consultations for her farmer neighbors in exchange for whatever they could trade – a few eggs, some produce, and a few cents – and made and sold her own tinctures and salves. How many people do we have left like that in the US? Anything I can do to keep that person practicing is going to expand access to healthcare for an exponential number of people. NDI has also established a medicinal herb garden in Ometepe.
I (Tania) have often been inspired by the healthcare solutions I have seen in Nicaragua. Healthcare practitioners working in challenging situations have often come up with imaginative solutions to seemingly intractable problems. We often use the term “holistic medicine” , but I have seen new ways of seeing the situation holistically. For example, community health workers that start community gardens and chicken coops to ensure access to real food. Interviewing every female patient about domestic violence at every visit and informing them of their legal rights. Problems that are so pervasive require approach from many different angles to make a dent.
Many cross-cultural relationships in natural medicine, just like other cross-cultural relationships, have historically been exploitative. We are working to create a relationship based on mutual respect – what is sometimes called solidarity – that of standing together rather than exploitation or missionary aid. Recently the council of indigenous people in Mexico voted to cease teaching any traditional medicine to non-indigenous people, especially graduate students. Why did they do this? Because three US graduate students went and studied traditional medicine with the Tarahumara, a tribe in Northern Mexico, and then sold the traditional medicine formulas to a pharmaceutical company. The company then sued the tribe for patent infringement. This is the kind of exploitation that has long been occurring and the natural medicine world, sadly, is no different in this regard than any other industry. We are not selling indigenous medical traditions to participants in our brigades – we are working to establish cross-border bridges that are based on respect.
In Nicaragua, the Central American Free Trade Agreement was recently passed. Most so-called free trade agreements, as well as debt-repayment stipulations, contain provisions mandating the cutting of government spending, including health and education. Government health clinics are opened with the intention of rapidly privatizing them. Here in the US, we know just how ineffective the privatized healthcare “system” that we have is for providing healthcare to the non-wealthy. Imagine how ineffective it is in a place where 80% of the population survives on less than $2 a day, where jobs infrequently include health insurance, and how many people are absolutely dependent on the social safety net of government hospitals and clinics. The CAFTA, as part of its provision, further restricts the manufacture and sale of generic drugs in Central America, which as one can imagine are a lifeline. We try as naturopaths to avoid using chemical medicines whenever possible, but we are talking about a place where people may die for lack of access to one dollar’s worth of antibiotics.
Now is a critical time for the roots of natural medicine. Now is the time when people all over the world are being forced out of their homes, off their land, and into the city or even across borders to work in sweatshop or agribusiness labor. This entails the breaking of cultural traditions and intergenerational links. While many people in Latin America still know some of the plants that grow around them, and how they can be used for medicine, the passing on of that knowledge is terribly threatened. At the same time, natural medicine is mushrooming in the United States, with little consideration for the global consequences. Think of what has to happen for there to be ginseng on the shelf at Wal-mart. The repercussions of our choices in healthcare are vast.