"The penalty good men pay for indifference to public affairs is to be ruled by evil men." attributed to Plato

"Bad men need nothing more to compass their ends, than that good men should look on and do nothing." attributed to Edmund Burke

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Wednesday, 11 May 2011

The doctor as shaman - a point of view

‘To be a good doctor you have to be a compassionate chameleon, a shape shifter, a shaman,’ wrote the late Cecil Helman, family doctor, medical anthropologist, poet, traveler and observer of health systems worldwide, in his book Suburban Shaman. From fascinating anecdotes of consultations with traditional South African shamans or Sangomas to the curative trance dances in the Brazilian favelas, he reflects on how western Doctors can learn much from the folk wisdom and shrewd knowledge of human nature as demonstrated by these indigenous Wounded Healers.In the midst of the poverty, illiteracy and appalling living conditions of the shanty - towns of Southern Brazil, a Brazilian doctor, Carlos Grossman, has developed an innovative Community Health Program. The ‘social doctors’ who work in such areas not only provide the primary health care for their patients but also devote as much as half of their time to community development, to health education, to campaigning for improved conditions and generally engaging with the underlying social conditions of those patients in their care. This, says Helman, is ‘real’ medicine.
FavelasThe shantytown conditions of Brazil or the indigenous medicine man may seem far removed both culturally and geographically from our own Western experience. But the healing methods of indigenous tribes are found in the culture of the Native Americans, in the Ayurveda of native Indian, in Chinese Oriental medicine and in many other cultures worldwide. These traditions go back thousands of years. Nevertheless I would suggest that the importance of the personal, subjective and social elements of patient care are no less relevant in mainstream healthcare provision in the USA or the UK than they are in the favelas of Brazil.
The World Health Organization (WHO) first recognized the value of these traditional shamanic healers as long ago as 1978, but only as being really relevant in areas where there were few conventional doctors. The shamans, the WHO said, should be allies of conventional healthcare, not opponents, as they had the holistic advantage of ‘viewing man in his totality within a wide ecological spectrum, and of emphasizing …that ill health or disease is brought about by an imbalance…of man in his total ecological system…’ The shaman could work cooperatively alongside conventional physicians in helping to combat AIDs, to promote family planning, child health and mental illness for example, as ‘social workers.’
Unfortunately the genuine holistic healing skills of the true indigenous shaman are too often today confused with the fads and abuses introduced by some of those unscrupulous ‘medicine men’ and ‘faith healers’ in our twenty first century culture, who are driven more by monetary gain than by any altruistic motive. This insults true shamanism and its origins.

As I watched President Obama make his inaugural speech to the American nation early in 2009, I was concerned. ‘We will restore science to its rightful place,’ he said, ‘and wield technology’s wonders to raise health care’s quality and lower its costs.’
With the emphasis on technology there was no recognition of the need to support an integrated healthcare. Perhaps that was neither the appropriate time nor occasion to raise such issues. But it may be that Obama’s two aims for healthcare are incompatible. Ever more complex drug regimes and technological advances are alone unlikely to lower the costs of healthcare. Also hurling more money at the present healthcare system seems to me like handing out more pills to deal with the side effect of a prescribed drug, rather than looking for a more appropriate initial treatment without that unwanted reaction.
Let me stress, by contrast, that the healing power of the spirit is free and wholesome, with no unwanted side effects.
We know that the American president understands the compassion and empathy of the Wounded Healer. He also understands that government policies cannot work alone, but require changes in our own hearts and minds. I hope that healthcare professionals enlightened in the latest advances in integrated healthcare are involved in any discussions on reform and that Obama’s own empathic sentiments will spill over into America’s healthcare system as soon as possible.
What do readers think?

© Eleanor Stoneham 2011

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