Thursday, November 6, 2014

The Benefits Of Having Both

Often in the United States we think of a dichotomy between the traditional remedial practices of a region and western medicine. One is all superstition, the placebo effect, and naive belief. The other is harsh, can be dangerous, and often works against the body instead of with it. I personally have always valued using natural therapies when possible, but I have not always found that alternatives to our institutionalized medicine have to be well received in the US.
Here in Costa Rica, that binary way of thinking is not nearly as prevalent. Traditional healers are esteemed members of the community and western doctors are valued for their contributions as well. People here use the two different approaches to medicine interchangeably in their lives, making both equally viable options to treat diseases or maladies.
This appreciation of the two medical approaches was never more clear than at the Ngöbe territory of La Casona in the Coto Brus region of Costa Rica. Our experience there began when all of us OTS Global Health students were off in front of six brightly painted octagonal buildings which constituted the Equipos Básicos de Atención Integral en Salud (EBAIS) of the area. Ngöbe people sat around on the steps and paths around the building looking at us gringos invading their EBAIS—the women draped in traditional dresses, and the men with machetes and dogs lounging by their sides. We walked past them up to the purple building where we were met out in front by the doctor on duty. She described to us what it was like to work with an indigenous population, the intricacies of navigating cultural differences, and what she saw as the cause for some of the most common diseases she sees patients for. Given her western training, the typical treatments she mentioned for common illnesses were by no means foreign to us. Glancing into the small examination room we could see the counter lined with hand sanitizer, gloves, cotton swabs, and all the other sterilized instruments common to a western doctor.
Walking 100 feet to right, we arrived at a slightly larger, almost bare, red octagonal room. There was a counter with a sink built into a wall, a few posters, an easel, an empty folding chair, and a man sitting on a garden chair behind a fold out plastic table. We had entered the traditional healers domain. From behind that table, he could diagnose patients and prescribe medicine with essentially nothing more than his hands and his mind. Over the course of our questions, another man came in from shoveling out in the yard of the EBAIS and sat in the empty folding chair. He was quickly introduced as another healer.
The juxtaposition of the two examination rooms was as stark as the different remedies suggested by the physicians for the diseases they were presented with. Treating asusto or "fear" for the traditional healers meant a completely different prescription than treating anxiety or a panic attack for the western doctor. To the people of La Casona, however, both were completely valid options to treat what they were feeling. If they tried one remedy and it did not work, they moved on to another prescribed by the other method of treatment.
This openness to different treatment approaches struck me, and the credibility that each side gave each other was refreshing. The western doctor spoke about diabetics having their blood sugar return to completely normal levels through a combination of traditionally prescribed cures, while the native healers acknowledged the incredible impacts that western medicine has had when surgery or invasive procedures were necessary.
Through this interchange of ideas and healing techniques, the Ngöbe population of La Casona have a wide variety of possible cures at their disposal. They do not have to choose between indigenous or western treatments, and can fluidly move between them when need arises. Hopefully, someday, us westerners will be able to learn a thing or two from this acceptance of both healing techniques, and in the process, make our lives and health a bit better too.

 Photo credit: Aidan Cobain (used with photographer's permission)

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