Mission accomplishments: OMT, respect for traditions earn DOs goodwill abroad

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Dr. Coupet says the traditional healers generally have been open to collaborating with DUFH staff. Those who prove uncooperative usually feel that Western physicians haven’t respected their profession, he says. “So even though we might not necessarily believe in everything the healers do, we should first show them respect. Then when I share with them what I do and our outcomes, I always suggest that we engage in a multidisciplinary approach to patient care. And they never disagree with that. They always feel Haitians deserve the best care available.”

Tibeten healers

In 2007, Natalie A. Nevins, DO, started AD World Health, a nonprofit humanitarian aid project focused on building sustainable clinics worldwide. (AD stands for Amrit Davaa, a Hindu phrase which means God’s nectar of medicine.) She also serves as the medical director of the Amrit Davaa Wellness Center in Hollywood, Calif.

Dr. Nevins opened her first clinic in Tawang, India, which was once part of Tibet, 60 miles from the China border. Dr. Nevins had learned of a Buddhist monk’s request for medical assistance at the orphanage he ran there. As with Dr. Coupet in Haiti, Dr. Nevins stresses the importance of collaborating with local healers.

“It’s not a challenge to work with them when you recognize that your way isn’t the only way to do things,” says Dr. Nevins, also the director of medical education for the family medicine residency program at the Downey (Calif.) Regional Medical Center.

Common ailments among the children at the orphanage included intestinal parasites, measles, mumps and other infectious diseases. Tibetan healers typically used herbal remedies to treat illnesses.

“The first thing we did in Tawang was ask the monks to invite the traditional healer they had been using to come and work with us,” Dr. Nevins says. The Tibetan healers, particularly their familiarity with the region and the people who needed treatment, proved a vital resource. “We didn’t go in there saying we have the answers to everything. We asked them to direct us on how we could help. And they came to us with a list of patients and said, ‘We don’t know what else to do with them, so please make them healthy.’ ”

Dr. Nevins explains that she and AD World Health volunteers also rely on local leaders to help educate villagers about proper health care. “People in Tawang had no understanding of bacteria or viruses,” she says. “So just introducing those concepts, along with the importance of washing hands and not drinking water from the river, was a profound challenge. For the people, those were paradigms that didn’t make any sense. They’d ask, ‘How can water that God provides be harmful?’ ” Dr. Nevins’ educational efforts consequently began with the Buddhist monks, who in turn could translate and explain the lessons to others. “Working with the monks was what helped us succeed.”

Invitations open doors

Establishing close connections with community leaders in developing countries is a prerequisite to successful medical missions, says Camille Bentley, DO, MPH, the chairman of community and global medicine at the Rocky Vista University College of Osteopathic Medicine in Parker, Colo.

Dr. Bentley has participated in more than 20 missions worldwide since 2000. She has found that when trusted village leaders invite her to set up a clinic, resistance from the villagers will be minimal. “First of all, I would never go anywhere without an invitation,” Dr. Bentley says. “That would just be setting yourself up for trouble. And when we are invited, the patients freely come to us. I’ve never had anyone say, ‘I don’t want you here.’ I’ve actually had traditional healers come by to see what we’re doing, and some even asked for antibiotics.”

Credibility in Kenya

In 2006, when Benson S. Bonyo, DO, opened the Bonyo Kenya Mission in the village of Masara in western Kenya, he didn’t need local leaders to help him connect with the community. Dr. Bonyo, a family physician in Akron, Ohio, grew up in Masara. He had firsthand knowledge of the villagers’ medical needs and the traditional healers’ methods.

Though Dr. Bonyo’s family was Christian and readily adopted Western medicine, he recalls his neighbors being strongly resistant to foreign cures. Healers often relied on bloodletting and prayer to rid people of evil spirits that they believe cause more serious conditions, such as convulsions. Villagers and healers often used herbs to treat nausea and pain.

But the influx of missionaries and others who introduced Western health care concepts during the past 40 years have eroded some of the old ways, he says. While many people still rely on herbal treatments, Dr. Bonyo figures that only 5% of the people in the area still attribute malaria to evil spirits. “They believe that chronic malaria is something that can be treated by making an incision with a razor all around a child’s abdomen,” says Dr. Bonyo. “I always tell my colleagues to check the children’s abdomens. And if they have been cut, that means we have to treat them longer for them to recover.”

While herbs have a place in treating minor ailments such as headaches, Dr. Bonyo stands firmly against resorting to them when it might delay treatment for serious illnesses. To avoid such problems he and other volunteers regularly visit nearby villages to inform residents about the treatments available at the clinic. “I do not compromise and say they can first try herbals and if they don’t work, bring the child to the clinic. That can cause horrible, unnecessary deaths,” Dr. Bonyo stresses.

As a Masara native, Dr. Bonyo has high credibility among the villagers. “I’ve gone through everything they have,” he says. “I have their respect and that has helped me get my message across. They know I’m talking from my heart.”

Dr. Bonyo drives home a familiar point when he cites the importance of respect. Mutual respect between physicians and villagers appears to be the integral component for successful medical missions—and, more broadly, the key plank in building bridgest between Western and traditional medicine. “I’ve never had a problem working with people with different religious beliefs and medical practices,” says Dr. Nevins. “I think if you walk in with respect and with the intent to care for people without making judgments you will be well-received.”