This article was originally published March 2014 on a previous rendition of www.drlaurahughes.com, and sheds light on the role of natural healing in global medicine.
It’s just past noon when the large woman slides into a plastic lawn chair and offers me a smile. The Nicaraguan sun radiates over our al fresco physical exam station, but her weathered skin doesn’t seem to notice. Like most of the patients who make the pilgrimage to the NDI clinic in Ometepe, she’s been waiting since the crack of dawn for her chance to be seen by our ‘Brigade’, which includes a physical exam by students from the Canadian College of Naturopathic Medicine, and a consultation with a seasoned naturopathic doctor. Despite her size, there is a gentle spirit about this patient, and I can’t help but return her smile. I’m on a tropical island in the middle of Central America, and I’m about to examine my first patient. Ever.
Ometepe rises out of Lake Nicaragua, flanked at either end by the peaks of the Concepción and Maderas volcanoes. It is home to more than 40,000 people who depend on livestock, agriculture and a burgeoning tourism industry for a living. There is a haunting beauty to Los Angeles, the village that houses both the NDI clinic and our homestays. Set against the backdrop of Concepción, children and animals share a playground in the dusty streets, and open doors require only a greeting to enter. Despite the bustle and knowledge curve of being in clinic, my life here slows down, and as I walk to and from my homestay each day, I can’t shake the feeling that I am in a special place. As one young tour guide will later tell us, “There is something about Ometepe that draws you in. It draws you home. Life here is simple, but it is good.”
For a privileged few, life in Nicaragua is very good; several billionaires reside behind gated estates in the large cities of Managua and Grenada. However, Nicaragua remains the second poorest country in the Western Hemisphere. Per capita health care expenditure is $59 US a year, the lowest in Central America. Consequently, general medical appointments are limited to a few minutes. Diabetes is rampant, but the average citizen cannot afford standard treatments such as metformin. Antibiotic resistance is the norm, not the exception. The teenage pregnancy rate is 25%, one of the highest in Central America, and clinical psychology is almost unheard of. According to UNICEF, 1 in 5 children suffers from malnutrition, but achieving health goals through diet and lifestyle is difficult when sugar is a staple and most families survive on less than $2 US a day. I am naïve to all of this when we roll in, armed with nothing more than excitement, our medical equipment, suitcases full of generously donated supplements, and vague clichés that this trip might change our lives.
I focus on my patient and prepare to take down her information. “¿Como se llama?” I say. What is your name? She mumbles something that I don’t understand, and my confidence wavers. “¿Dónde vives?” I try. Where do you live? It is an important question; the medical registry is organized by village or town, and NDI records link patients accordingly. Either my accent is horrible, or she doesn’t seem to remember where she came from that morning. The line of people waiting is so long that I decide to start her physical and then walk with her to the doctor and explain. We go through the checklist in my broken Spanish, from the top of the body to the bottom. Some parts go better than others. What kind of doctor will I be if I can’t even see down her throat? I think. Is she really missing an eye, or has she just been squinting into the sun for too many years her lids are frozen shut? Finally we are done. I hold up my hands, “Finito!” Finished. She jumps up grabs my hand again. Then, she proceeds to hand me a small bag, full of lemons. “Limón! Vitamina!” she says. Lemons! Vitamins! Indeed. Is she trying to show me what she eats? I give her a thumbs up and hand the bag back, but she won’t take it. There are four of us on physical exams this afternoon, and everyone else is occupied. We’ve had months of physical exam practice at CCNM, but they didn’t teach us what to do with a bag of lemons. Another question for the doctor.
NDI is the oldest naturopathic global health organization in North America, and operates under the mantra that healthcare is a human right. Since 2005, the clinic on Ometepe has provided more than 20,000 patients with free naturopathic care, and has dispensed nearly half a million dollars (US) in natural medicines and supplements. As NDI founder, Dr. Tabitha Parker, explains in a recent video created by a recent American Brigade (and can be seen in its entirety at www.ndimed.org), “This all started out as just an idea. We were just all inspired to do international medicine, we wanted to be able to give back as naturopaths to our greater global community, and at the time, we didn’t have a vehicle to do that. Because we are such a holistic profession, we also, from the beginning, wanted to be able to include everyone in that that dream, to be able to bring natural medicine to underserved communities around the world.” In addition to providing naturopathic care and jobs to the community (the clinic employs a local Clinical Psychologist and office manager, as well as offers stipends to women in the community to host a student at their home for the duration of our trip), NDI also offers each Brigade a week-long course on Global Health and Social Justice. It is a truly revolutionary experience.
I stare at the ever-evolving white board in the front room of the clinic, and see that Dr. Dawson Farr is almost ready for his next appointment. I find him buzzing around the NDI dispensary, a marvellous room made possible only by generous donations from companies such as Seroyal. He’s finalizing a treatment plan for a young patient with chronic migraines. I hold up the bag of lemons and being to explain myself. He just laughs. “You’ve met Maria,” he says. My body floods with relief that he knows her. He explains that Maria has a mental disability, and comes from a community not too far away. Although relatively healthy compared to other patients here, she makes the trek to Los Angeles for every NDI Brigade. She brings fruit in exchange for multi-vitamins. Last month it was oranges.
The afternoon wears on, and I have a few more physical exams under my belt when I see Maria again. She is swinging her bag, empty of lemons, but full of vitamins, krill oil, and a blend of herbal tea. She wanders over to our table and before I can react, plants a wet kiss on my cheek. Then she does the same to every other student in the field. “Gracias doctora!” she says to me. “Ángel!” Thank you doctor. Angel. Is this what people meant when they said that this trip would change my life? I am not yet a doctor, and I am certainly not an angel. But Maria put her faith in our medicine, she put her faith in me. The feeling gives me chills.
And the feeling sticks with me, even now, more than a month after returning to chilly Toronto. Maria was one of 190 patients that our Brigade treated that week on Ometepe. There were babies with giardia, an elderly man who had to be rushed to the ER because of a blood glucose reading five times the normal level, countless cases of MSK pain from a lifetime of work in the plantain fields, depression over losing a child, excitement over a pending birth, headaches, sore throats, the list goes on. But no matter what the problem, Dr. Parker and Dr. Farr shared their knowledge and worked to heal, if only just by listening for half an hour about the problem.
My Spanish improved marginally. I can do vitals in under three minutes. I actually remembered how to calculate botanical tinctures. I still have no clue how to read TCM pulses. But most importantly, I have seen our medicine work in the direst cases. I have seen our medicine draw people from miles away. I have seen that naturopathic medicine has a place in the world, far beyond the constraints and whatever political situations may exist in our own jurisdictions. It is our duty as naturopathic doctors and healthcare professionals to use our privilege; we can make a difference. The people of Ometepe taught me that.
For more information on Natural Doctors International and this work in Nicaragua, click here.
For more information on supporting global health and development through the doTERRA healing hands foundation, click here.