When medical traditions collide

When medical traditions collide

first_imgMADERA – A thick tangle of marigolds reaches chest-high around 19-year-old Caritina Cruz, who plucks one of the deep orange flowers and explains to her little sister how to prepare it in a tea that soothes indigestion. The teenager was born to one of Mexico’s native Indian tribes, and grew up steeped in healing traditions that predate the Spanish conquest. To her and other immigrants to Mexico’s dozens of indigenous groups, a garden tucked behind a whitewashed church in rural Madera County is a pharmacy. With Cruz’s care, the plot eventually will sprout plants that other Mexican Indians in the area may use to treat insomnia, kidney problems, stomach cramps and other ailments. The garden is part of a larger effort to preserve pre-Columbian health care customs even as community leaders work to forge ties with the local medical establishment. It was planted with the help of a nonprofit group that speaks up for the Mixtecs, Zapotecs, Triquis and other native Mexicans who labor as migrant farmworkers in California’s Central Valley. AD Quality Auto 360p 720p 1080p Top articles1/5READ MORERose Parade grand marshal Rita Moreno talks New Year’s Day outfit and ‘West Side Story’ remake The arrival of immigrants with radically different beliefs about health and the patient-healer relationship is pushing doctors to broaden their understanding of what it takes to care for their new patients. For example, doctors working with Hmong refugees who arrived from Southeast Asia in the 1980s have had to bridge a language barrier and a gap between Eastern and Western medicine in situations where miscommunication could be the difference between life and death. Indians from Mexico unwilling to let go of customs that have served them for generations are also reaching out to health care providers here, trying to find a delicate balance between the Old World and the new. Members of Mexico’s 60 Indian groups are even more likely than other recent immigrants to fall outside the reach of the American health care system, said Nayamin Martinez Cossio, of the indigenous organization Centro Binacional para el Desarrollo Indigena Oaxaqueno. Isolated in remote farm worker settlements and usually uninsured, they often speak languages most Spanish-speaking Mexicans don’t recognize. It’s an added barrier when a baby gets sick or when a pregnant woman wants a prenatal checkup. Often discriminated against in Mexico, they also are “at the bottom of the ladder” in the United States, said Jonathan Fox, a researcher at the University of California, Santa Cruz. “No one represents their interests, here or in Mexico,” Fox said. “They have to speak up and do it themselves.” The 2000 Census showed there were about 154,362 such immigrants in the state, according to an analysis by researchers at UC Santa Cruz. But Mexico’s Indians are making up a growing share of migrants entering the country, according to estimates from the National Agricultural Workers Survey. Between 1993 and 1994, Mexicans from states such as Oaxaca, Chiapas and Guerrero accounted for 9 percent of immigrant farmworkers coming to the country, a figure that rose to 19 percent between 2001 and 2002. As the population grows, the need to ensure its health also increases – and not just for the immigrants’ well-being. The itinerant group may carry infectious diseases from state to state while following the harvest, health officials said. “They’re difficult to reach and they’re difficult to treat because they travel so much,” said Norma Penalosa, a communicable diseases specialist with Fresno County’s Department of Community Health. “One case can become many cases spread around the country.” In 2003, Fresno County health workers identified a tuberculosis outbreak that would eventually spread to dozens of Mixtecs. Centro Binacional raised money, held education meetings in the community, and tested more than 1,000 people – playing a key part in containing the outbreak, said Penalosa. There have been other successful public health campaigns, but permanently closing the cultural and physical distance between the rural, migrant population and English-speaking health providers who tend to be city-bound takes years of work. Martinez and others with Centro Binacional are taking on the task. They have sent 15 immigrants who speak a variety of Indian languages to train as interpreters at the Monterey Institute of International Studies. They’ve visited hospitals and clinics around the Central Valley to offer translation – something hospitals are legally required to provide. They’ve delivered workshops in far-flung rural towns on AIDS prevention, diabetes, nutrition, and other health problems farmworkers might encounter in the United States. In November, they brought three healers from the southern Mexican state of Oaxaca to California for a conference. Hundreds of American nurses, doctors and social service providers heard about some of the health customs and beliefs held by Indians from the region. Traditional healers told their American counterparts they rely heavily on herbal remedies and rituals to treat diseases, many of which are believed to be caused by problems outside the body, such as offending the spirits or doing an injustice to others. Since health problems are thought to have a “hot” or “cold” quality to them, the patient’s diet and surroundings are very important, they said. Enriqueta Contreras, a Zapotec midwife, said that being in a foreign land where nothing is familiar can itself be a source of physical and mental illness. “People who come here start feeling disconnected,” Contreras said in Spanish. “They stop eating their food. They are away from their family, their language. They can’t get the herbs they’re used to. They don’t know who they are anymore. That makes them sick.” Several doctors attending the conference said having access to traditional medicine can comfort patients by giving them a connection to home – something Western doctors can’t do. But they also warned against relying only on traditional healers and herbs, which can interfere with prescribed medication or offer a false sense of security. “They’ll go to a healer for as long as they can and by the time they come in, they might have advanced diabetes and be at risk for losing a limb,” said Jesus Rodriguez, a family practitioner at Fresno’s Sequoia Community Health. Rodriguez encourages his patients to bring in any herbal remedies they might be taking so he can evaluate them and work them into a regimen that might include conventional medicine. Poised between the familiar and the new, Cruz and other immigrants who will use the recently inaugurated garden hope to find the best of both, they said after meeting with the visiting healers. “I know where I came from, but this is where I am,” Cruz said, standing in the patch of dirt she hopes will preserve the community’s health and cultural identity. “I want to keep what we know and be able to use what’s here, too.”160Want local news?Sign up for the Localist and stay informed Something went wrong. Please try again.subscribeCongratulations! You’re all set!last_img

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