[Marxism] Traditional Medicine / Western Medicine

["Hunter Gray" <hunterbadbear@xxxxxxxxxxxxxx>]

      NOTE BY HUNTER BEAR:  [September 21 2008]

      I must say, in all honesty, that I am not a great admirer of "western 
medicine".  I was at least generally wary of it even back in the days when I 
was many decades away from elder status -- taking my basic cues from my Native 
father, who I recall went forty years or more without consulting a "western" 
physician. [If he, a fine father, excellent artist and teacher, and admirable 
figure on many significant fronts, had not consulted a new quart of 100 proof 
Old Crow each day for decades, he would have lived far beyond the 80 years he 
completed before transition.]  When it was clear, a little over five years ago, 
that I was seriously ill with something, I did, after dragging my feet for a 
good while, go to a doctor.  At that point, ignorance of autoimmune diseases by 
those particular docs, confused opinions and a botched colonoscopy searching 
for non-existent cancer -- all of this in the context of severe anemia -- led 
to near death via cardiac arrest [my heart was fine before that and is just 
fine now]. And even when, after a dozen medics finally  and jointly diagnosed 
"it" as a full blown case of systemic lupus [genetic and incurable], the 
initial primary control med -- prednisone -- gave me a severe case of diabetes 
and a near death coma. [The diabetes ended when that medicine was terminated 
and replaced.]  Now, I go as infrequently as I can to a good and listening doc 
who honors my concerns and inhibitions, and I take as little western medicine 
as possible -- avoiding all chemo drugs.

      Anyway, that's my pitch on that.

      We have a great deal of faith in traditional medicine as practiced by 
bona fide medicine people.  A Navajo medicine man often trains for as many as 
17 years before he's considered a full-fledged practitioner.  There are 
comparable examples in numerous other Native tribal society/nations in the 
Americas -- as well as globally.  Anyone who observes a trained medicine person 
practice is genuinely impressed from many perspectives.

      On the other hand, one can find some good things to say about "western 
medicine" -- properly used.  In several months, our grandson/son, Thomas, will 
become an M.D. via the University of Minnesota -- but his program also 
contains, by design and by his own initiative, exposure to inter-cultural 
[especially vis-a-vis Natives] traditional medical approaches. His spouse, 
Mimie [Yrengah], from Zambia is in the health field as well.  We take their 
advice quite seriously.

      Around 1950, when I was sixteen, my parents and I, traveling from 
Flagstaff to Window Rock and Fort Defiance and Chinle on the vast Navajo 
reservation, stopped at nearby Ganado and visited a hospital.  The head person, 
a Dr Clarence Salsbury, complained that few Navajo people came -- and no 
elders.  My parents and I did not find that unusual.  That cultural inhibition 
at Navajo [and many other Native settings] modified a little as subsequent 
years passed, but it was not until United States Indian Health Service reached 
out to the medicine people, and indicated a willingness to work jointly in a 
context of mutual respect, that some things changed for the better.  The 
increasing number of Native people entering the mainline health fields-- M.D.s, 
R.N.s, the full array -- is a signal and obviously positive development.  But 
Natives into professional western medicine are almost always very cognizant of, 
and very sensitive to, the critical importance of traditional cultural views 
and practices.

      The following article from the Salt Lake Tribune discusses some of this 
-- with the focus on the Navajo and cancer.  It should be emphatically noted 
that most cancer at Navajo [and Laguna Pueblo] -- and some other serious 
diseases as well -- stem directly from the mining, milling, and refining of 
uranium within the Navajo Nation and its environs and some other Western 
American settings. [Canadian Natives have had their own lethal experiences.]  
That all began in the late '40s and the '50s and continued for decades, with 
broadly lethal effects, killing and profoundly impairing thousands of people in 
many locations -- and wreaking poisonous havoc on livestock, wild animal life, 
air and water and earth. [The Navajo Nation government has now banned any 
uranium development in and around the vast reservation.  [We have things on our 
website about the Southwestern uranium tragedy and here is one page with a few 
related background pieces:
      http://www.hunterbear.org/a_native_rights_sampling.htm

      Hunter [Hunter Bear]


      Cancer taboo: The Navajo and Western medicine 
      Program aims to break down elders' distrust and fear about health care 
      By Lisa Rosetta 
      The Salt Lake Tribune
      Salt Lake Tribune 
      Article Last Updated:09/21/2008 05:35:17 AM MDT 
     
      NAVAJO MOUNTAIN, San Juan County - Buck Navajo Jr. sits on a bed inside 
his hogan as afternoon light illuminates dust motes twirling in the air. His 
left arm suspended in a sling, the medicine man's free hand waves as he gently 
chides his granddaughter. 
          Paulette Smallcanyon, his kin by clan, has come here this July day 
toting a 22-page questionnaire about cancer screening. But he considers the 
topic taboo, and is reluctant to answer. 
          Smallcanyon is a "patient navigator," seeking Navajo who are enrolled 
in Medicare but are not getting the cancer screenings it offers. Along with 
other American Indian navigators working with the Huntsman Cancer Institute, 
her mission is to help seniors in her tribe get tested and treated for cancer. 
          "Probably over half of them have never had a cancer screening," said 
Eleanor Yazzie, a Navajo Mountain patient navigator who has interviewed about 
40 elders since she was hired a few months ago. "They said they're healthy and 
they don't need to go to the clinic." 
          Research shows minorities don't receive the same level of cancer care 
as the general population, but American Indians may be the most underserved. 
Cancer was their second leading cause of death in 2004, regardless of gender. 
          While American Indians generally have a lower incidence rate of 
cancer than non-Hispanic whites, they have the highest five-year mortality rate 
of any group in the country. Research published in the journal Cancer in 
August, however, challenged the low incidence rate, showing the race of 
American Indian patients in central cancer registries has been misclassified. 
          Since 2006, Huntsman Cancer Institute has been working to develop 
patient navigators in Utah and Montana tribes as part of a pilot study with the 
Centers for Medicare and Medicaid Services. Navigators guide elders through the 
maze of doctor's offices, clinics, hospitals, payment systems and other 
features of the Indian Health Service. 
          Nationally, navigators are seen as an innovative tactic to reduce 
racial and ethnic disparities in medical treatment. Among Utah's tribes, 
however, the program is struggling to overcome indifference, suspicion and 
other hurdles American Indians face in getting health care. 
          n n n 
          'I don't want to talk about it': The first challenge for Navajo 
navigators: finding their way to the elders. 
          The Navajo Nation is 25,000 square miles, an area roughly the size of 
West Virginia. Much of it is considered "frontier," meaning fewer than five 
people call a square mile home. Many don't have phones, and those who do have 
spotty coverage. 
          Navigators rely on Medicare rolls to identify eligible elders - but 
records are outdated and unreliable. Scores of the people listed died years 
ago. 
          The journey to an elder's home can also be unpredictable. Rain can 
transform the reservation's reddish-brown dirt into goop, making its 4,800 
miles of unpaved roads slick and impassable. 
          Once a navigator has finally arrived, elders may refuse to discuss 
cancer, a disease for which the Navajo language has no word. It is instead 
"lood doo na'ziihii" - literally translated, "the sore [or wound] that does not 
heal." It finds people who cross the path of an animal, such as a snake, Buck 
Navajo Jr. explains. Or those who are near lightning bolts charging from the 
sky and striking the Earth. 
          Merely uttering "lood doo na'ziihii" can bring it on oneself. 
          "They say, 'I don't want to talk about it,' " said Janice Jumbo, site 
coordinator for the pilot program on the Navajo Nation and a doctoral candidate 
in epidemiology and public health. "Or they say, 'Why are you asking me these 
questions? I'm a healthy person now,' " she said. 
          Many will closely guard a diagnosis, embarrassed to tell family or 
friends since they feel it was their misstep or indiscretion that caused it. 
Some Navajo fear treatment cannot conquer cancer and see it as a death 
sentence. 
          Willa Mae Jones, a case manager for the Breast and Cervical Cancer 
Prevention Program on the reservation, said cancer-survivor and other disease 
support groups are rarely successful. 
          "They don't have anonymity," she explained. 
          n n n 
          Putting traditional care first: Navajo have turned to the Evil Way, 
the Lightning Way and other healing ceremonies for generations. Today, some 
postpone modern treatments to give the care from a medicine man first priority. 
          Nathan Redhouse, Jumbo's kin by clan, arranged an Enemy Way ceremony 
in July after suffering for years from inexplicable joint and body pain. High 
in the trees of the northern Arizona mountains near Lukachukai, he sat on the 
dirt floor of a stick hogan. Smoke and the medicine man's singing flowed 
through the air. 
          Outside, a dozen men on horseback waited to ride with Redhouse, who 
would soon accompany the healer to another patient's home and pass on a 
ceremonial staff dressed in yarn and feathers. Others planned to follow in a 
convoy of cars and trucks decorated with yarn. 
          In a cook shed nearby, relatives prepared food for the guests. Jumbo 
arrived with a watermelon, candy, soda and a sack of Bluebird flour. At the 
other patient's home, Redhouse, his family and guests would feast on mutton 
stew and fry bread. The night - one of six in this nearly weeklong ceremony - 
would end with a Squaw Dance lit by a bonfire. 
          Some ceremonies are performed seasonally, requiring Navajo to delay 
other treatment for up to a year. And they're costly. Some medicine men charge 
$1,000 or more - plus the cost of items needed for the ceremony, such as 
Pendleton blankets, sheep or jewelry. 
          "A lot of elders spend so much time and money on traditional help, 
they don't have the money to get conventional treatment," Jones said. 
          Suspicion of white health-care providers, too, keeps some Navajo out 
of clinics. 
          "In their mind, I guess, the big picture is that white man brought 
cancer to the Navajo people," Jumbo said, "and the Navajo people are going back 
into the clinics so the white man can study them." 
          n n n 
          'Ship them out:' Tribal members receive free primary health care from 
Indian Health Service (IHS) hospitals and clinics. Although there are 12 on the 
vast reservation, an appointment can still mean traveling hundreds of miles. 
Getting cancer care is even more difficult. The IHS Contract Health Service 
makes such specialty treatment available from providers off the reservation, 
but it can be unaffordable and hard to access - as Priscilla T-Yazzie found. 
          Passing through Flagstaff, Ariz., in January 2006, she stopped at an 
emergency room to investigate her coughing spats and high fever. 
          "I thought I had bronchitis," the 58-year-old retired social worker 
said. 
          A chest X-ray, however, revealed spots on her lungs. The ER doctor 
referred her for more testing. A CT scan at the Tuba City Indian Medical Center 
- not arranged until seven months later - revealed she had cancer. A year after 
the spots were first identified, she finally started chemotherapy. 
          "If someone requires neurosurgery, we have to ship them out," said 
Douglas Peter, director and chief medical officer of the Navajo branch of the 
Indian Health Service. "We don't have the resources nor the capacity nor the 
location to serve people with all kinds of tertiary [or specialized] care." 
          Bringing in specialists is not an option, since most doctors can't 
justify spending the time or expense to treat a small number of people in an 
isolated rural area, he added. 
          So cancer patients who need chemotherapy and radiation face road 
trips to Salt Lake City, Flagstaff, Phoenix, Albuquerque, N.M., or Gallup, N.M. 
- sometimes multiple times a week. 
          "There is no cancer treatment available other than surgery - which is 
not always the standard of care," said Linda Cothron, community health nurse 
director of the Kayenta Public Health Nursing Program in Kayenta, Ariz. "The 
fact that somebody can be suffering from cancer and not have anything available 
is outrageous." 
          For low-income Navajo without cars, a shuttle is available - but some 
board as early as 3 a.m. to collect their fellow passengers. "And then they're 
coming back late at night and heaven forbid you should have [nausea] or 
diarrhea because you got chemotherapy or radiation," Cothron said. "You're in a 
vehicle of strangers." 
          T-Yazzie's husband left her after she was diagnosed with lung cancer 
- "He knows I'm not going to get well." 
          At first, she traveled to Gallup several times a week for seven hours 
of chemotherapy - but not for long. 
          Doctors "told me it was an 'option,' " said T-Yazzie, who was 
spending the day in a three-person room at the Tuba City Indian Medical Center, 
receiving intravenous antibiotics for an infection. "So I didn't go back." 
          n n n 
          Mixed reception: Between the Utah and Montana sites, 1,072 American 
Indians have been recruited to participate in the navigator project - 728 shy 
of the 1,800-person goal. Half will be mentored by a navigator, and their 
experiences will be compared to the half who receive less help. 
          Sandra Marsh, project coordinator at the University of Utah, 
approached multiple tribes in Utah: Utes, Paiutes, Goshutes and Shoshone among 
them. All tribes, except the Navajo, either didn't express interest, didn't 
follow up with signed agreements or had too few elders on Medicare who were 
eligible to participate. 
          On the Navajo reservation, navigator turnover is a problem. As of 
mid-September, Marsh said, only Eleanor Yazzie was still actively working. 
          Tribes' suspicion and the mistreatment of members during past studies 
may be partly to blame, she said, but "we're aware of that and we want to learn 
the lessons from that." 
          Still, she's hopeful. The Navajo site in Utah and the Blackfeet and 
other sites in Montana could still yield data by 2010 - when the pilot project 
ends - that justifies using navigators in Medicare and other federal health 
programs, she said. 
          In the end, Buck Navajo Jr. answered Smallcanyon's questions and 
completed his questionnaire. In coming months, a patient navigator will be back 
to try to talk him into his first cancer screening. 
          lrosetta@xxxxxxxxxx 
           

HUNTER GRAY [HUNTER BEAR/JOHN R SALTER JR] Mi'kmaq /St. Francis
Abenaki/St. Regis Mohawk
Protected by Na´shdo´i´ba´i´
and Ohkwari'

Check out our Hunterbear website Directory http://hunterbear.org/directory.htm
[The site is dedicated to our one-half Bobcat, Cloudy Gray:
http://hunterbear.org/cloudy_gray.htm

See our Community Organizing Course [With new material]
http://hunterbear.org/my_combined_community_organizing.htm

And see The Destroyers [Lethal racism in a major forest fire]
http://hunterbear.org/the%20short%20story.htm

In our Gray Hole, the ghosts often dance in the junipers and sage, on the
game trails, in the tributary canyons with the thick red maples, and on the
high windy ridges -- and they dance from within the very essence of our own
inner being. They do this especially when the bright night moon shines down
on the clean white snow that covers the valley and its surroundings.  Then
it is as bright as day -- but in an always soft and mysterious and
remembering way. 
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