Saturday, 30 July 2011

"I am a naturalist, that works with plants"

In the middle of a quiet neighbourhood, in a dimly lit room, we gathered around a middle aged man in shorts, a t-shirt and a baseball cap. A man who spoke Spanish in the husky voice of a chronic smoker and cataracts so bad he can Orly make out shapes and light. This is Don Humberto Huinapi, a Palero shaman of mixto descent and Catholic faith.

He explained to us how his work as a shaman. Like any good doctor, he begins with an open question: ¿Qué le pasa? He conducts a quick history to delineate the patient´s presenting complaint. But from there on, everything is wildly different. Instead of a stethoscope and penlight, he uses a broom of palm leaves and a fat herbal cigar with which the smoke he uses to comunícate to the spirits. His examination isn´t physical so much as it is spiritual. Drinking a brew from the bark of Ayuhausca (known for its hallucinogenic properties), he sees into the essence of the patient. This vision is where he determines what ailment the patient suffers from, and the precise mixture of plants necessary to cure.

The treatment is two fold. First, the prayer to the Father (God), Mother (Earth), Son of the Father (Jesus), and Fire, asking permission to enter their world, followed by a chant to ask the specific spirits to come and help restore balance in the patient. Secondly, he tells the patient what mixture of herbs and bark to brew and drink, typically over a course of one week to a month, where they must also abstain from certain foods and activities.

Don Humberto´s pharmacy is the Amazon Jungle, and his drugs are purely botanical, plants that sound so alien to my ear and sit so strangely on my English speaking tongue – huasai, achiote, albahaca, malva. The patient then leaves with his blessing, a recipe of herbal brew, and reassurance that they will be cured in a matter of time.

And why wouldn´t it work? Thirty percent of the world´s pharmaceutical products are derived from a plant product of the Amazon. Shamans, with an extensive and in-depth knowledge that has been based down for centuries, are the keepers of the jungle´s medicine cabinet.

Unfortunately, as globalization reaches even the most remote jungles, less and less people relieve in this form of natural medicine. Once upon a time, entire commuinties releed solely on the village shaman. Today, less than 10% will visit a shaman. This lack of demand has dealt a harsh blow to the trade, leaving behind only a small handful in Peru that remain.

For me, this shaman in particular is the resulto f a tremendous culture clash. He calls himself a naturalist, dealing with tradicional remedies but recognises the importance of Western medicine in augmenting his own methods. He says he is Catholic, calling upon both the spirit of God and the spirit of the Earth. I asked him if he sees God in his work, and he said yes – every vision, every blessing, every brew, every chant, God is there with him and his patient. And for a man between so many different worlds, he is phenomenally at peace. He has been practicing for almost half a century, and he has found harmony amongst all his polar opposites.

That day we saw him treat a 9 month old baby suffering from pellagra so severe his skin had turned black. After Don Humberto prayed and sang his blessing and offered words of advice, the young mother left with her child. Whether or not the baby dies within a days from infection or worse, we may never know. But we do know that where Western medicine has failed, shamans and their natural medicine have succeded.

I hope that time doesnt render their knowledge into legends of the jungle. Just the same, I hope the world doesnt deforest  all thats left of this untapped medicinal source. So I wish good luck to this dying breed of doctors with their own brand of medicine, and their incredible pharmacy.

Thursday, 28 July 2011

Guilt complex of the privileged

I wish I had photos to upload, to show you what I´ve seen in these past few days. I suppose words will have to do.

Being in Iquitos makes me so homesick. It´s no Singapore, but it feels like I´m back in South East Asia. It´s a mixture of Bali, Pnom Penh, Railey and Puli – chaotic traffic jams of tuktuk motorcars, children wandering barefoot, and carts of the most beautiful and bizarre tropical fruits I have ever seen. But during the day we visit the local slums, with ana rea called Belen being particularly harrowing.

Imagine a neighborhood where the pavement is made not out of concrete but mud and rotting trash, where a parasite infected river to simultaneously be your source of drinking water and toilet. In the clinic, we get kids that shit worms that are 5 inches long and then vomit them from the other end. That´s Belen.

Coming from a family split across three continents, with holidays in Europe or Australia, the idea that you´re never going to get the chance to escape is completely foreign to me. I hear people say “how horrible, how sad” but I don´t understand. How they can be sympathetic when they don´t know what their life is like? I mean I´m looking, I can see the way they live, but I can´t even begin to pretend that I know it´s like to live amongst garbage and feces. These people are really homing in the fact that I am a privileged and spoiled brat.

But I think the sympathy is useless. The Iquitos people are intelligent with a government that is trying to provide for them. In theory everyone has national insurance with access to health care. What they lack are funds. Yes, there are doctors, nurses, equipment and hospitals, but for most people there is simply no money to spend. No soles for even a saline drip or sterile gauze, let alone the money to get from Iquitos to Lima where all the specialised care is. People complain about having to take a 30 minute bus ride to their gynaecologist. Here, your gynaecologist, your urologist, any specialist, any surgeon is a 10 hour boat ride away.

So I say bullshit to all the sympathetic comments, bullshit to all the sad faces we pull at the kid missing a leg. Pick up that box of supplies and carry it to the truck, and work just a little bit faster, a little bit harder to see more patients. If we´re not going to give them cash, then the very least we can do is make use of this life-saving (albeit basic) clinical knowledge we´ve been passed on. This is how we, as doctors in waiting, can make a difference. Well... that´s the most I can hope.

Saturday, 23 July 2011

Hero

For those who have traveled with me, you know I go prepared. Ear plugs in place to block out noise, a pair of dark shades on to discourage conversation, and a book or Sudoku handy - this is how I like to get from point A to B. So it was to my dismay that on my 11 hour flight to Lima, I found myself in an aisle seat next to a chatty old man with severe BPH (two bathroom trips before we had even taken off!) and an annoying habit of lifting up the window shade to let in that painfully bright sunlight when the rest of the cabin was dark. A grandpa too ancient to respectfully ignore, but too senile to follow what he was nattering on about... que problema.

But somewhere over the Atlantic, I started to actively participate in our conversation. Born a Scotsman with a serious case of wanderlust, he´s traveled across Rwanda, been to refuge camps in the Congo, and seen the view atop a certain Kilimanjaro. And as it turns out, we were on a similar journey - he had never been to South America before and was travelling on his own to meet a group of strangers to trek across the Andes. This is a man, I realised, who after all these years still has the yearning, energy and cojones to travel into the unknown. What a hero! 

By the end of the flight, we were both on the edge of our seats peering out of the window, trying to catch our first glimpse of a continent neither of us had ever seen before in our lives - him at 76, me at 24. As the plane landed in Lima and all the passengers applauded, I noticed we both already had our jackets on and backpacks in hand, legs jittering to disembark.

Bienvenidos a Perú !


An update: Oh my word I love it here in Iquitos... The people are great, the Peruvian team just won their match against Venezuela in La Copa América (4-1), and the weather is exactly like home - erratic monsoon showers with humidity so thick you could cut through it with your ice cold beer. Una cerveza más por 90p? Yes please!

Wednesday, 20 July 2011

Hasta luego, Londres

7 hours before I get on my first flight, I figure yeah, why not. Now's a good time as any to start a blog. 

An introduction - I'm an American girl from New Jersey that grew up in Singapore and now a 5th year medical student at King's College London. I love medicine and using it as an excuse travel. I hate being hungry and I will try anything. 

I'm about to begin my medical elective, where for 10 weeks I'll be in South America working in the hospital and running clinics. The itinerary: London - Madrid - Lima - Iquitos/Amazon Basin (4 weeks) - Santiago - Mendoza (4 weeks) - Buenos Aires… and back again, with goodness knows what else in between. 

So this blog is for my mom and dad. Like any other Asian parent, they love that I want to be a doctor, a very respectable and reliable profession. Except... there's a lot I plan to do with this skill set (eg venture into a parasite infested, electricity and running water deprived jungle village to treat isolated communities). So I dedicate each post to my parents: hope you guys can breathe just a little bit easier with each new update! 

As for going to South America, I know i'm meant to be revving to go, but I'm actually a bit hesitant. My Spanish is comparable to a 5 year old's, I don't want to wear that massive backpack, and for some unbeknown reason, I can't seem to get the hang of salsa. But heck it's going to be fantastic anyway. Impossible for things to go wrong with steak and wine eh? 

To all my fellow medics out there - buena suerte y tenga buen viaje!