January 2006 newsletter

Going Global: Natural Doctors International

By Tabatha Parker, ND, co-founder and medical director of NDI

Most health care professions have relief organizations like Doctors Without Borders providing volunteer opportunities in developing countries. Until now, there has not been a nonprofit dedicated to providing opportunities for naturopathic physicians. The 2003 founding of Natural Doctors International (NDI) has changed all that. Dr. Laurent Chaix, Dr. Michael Owen and I - all naturopathic physicians - realized the gap in international relief medicine and recognized that the naturopathic profession needed to contribute to the growing global health crisis. Having a relief organization dedicated to providing opportunities for NDs and other practitioners of alternative medicine made the most sense, so we started a nonprofit 501(c)(3) to do just that.

Two issues were of utmost importance to NDI: developing a strong presence and being legitimate in each country we worked in. Not wanting to be short-term medical tourists, NDI began working first with Nicaragua's Ministry of Health to develop a program that would be both sustainable and sanctioned. We began by designing a program that would establish long-term clinical opportunities for naturopathic physicians. Because of the training involved, naturopathic physicians are the perfect gatekeepers for alternative medicine outreach teams - they easily can go from discussing pathology exams with an MD to discussing herbal medicine preparations with a traditional medicine healer. NDs also have the advantage of a license to practice medicine, which not all alternative health care professions have. By starting with naturopathic rotations, NDI will pave the way for other types of alternative medicine practitioners.

The decision was made to begin the pilot site in Nicaragua; negotiations with Nicaragua's Ministry of Health (MINSA) produced a three-year contract to have NDI physicians work in the Moyogalpa Center of Health on the island of Ometepe in southern Nicaragua. The contract recognizes naturopathic physicians and allows NDs to practice legally through NDI projects. NDs who apply must be licensed graduates from accredited, four-year institutions.

Currently, Dr. Michael Owen and I serve in the Center of Health on Ometepe Island. Since its inception in March 2005, we have provided over 800 patient visits, established five ongoing community outreach projects and completed two community support projects. Helping Hands, the backbone of NDI's success, is a free pharmacy supplying islanders with vitamins, homeopathic medicines, botanicals and pharmaceuticals.The generous donation from John Weeks and Dr. Jeana Kimball of their family's Isuzu Trooper, Esmeralda, has given Helping Hands the ability to run an ambulance service that has already saved two lives. NDI has sent more than $30,000 in donations to the Moyogalpa Center of Health from Dr. Eric Yarnell of Heron Botanicals; Al Czap of Thorne; Dr. Wayne and Lee Centrone of Portland, Ore. and Golden Lotus Botanicals; Boiron; Vital Nutrients; Hyland Homeopathics; NCNM; Oakmont Labs; and numerous personal donations over the past year. Heron Botanicals generously set up a program whereby doctors can request to have a percentage of their purchases go directly to NDI.

NDI offers both short- and long-term volunteer opportunities for doctors and students. Five students already have visited Casa NDI in Nicaragua this year: Christine Middleton (CCNM); Tyler Mongan, Holly Elmore and Alex Desoler (SCNM); and Ryan Sweeney (NCNM). "My experience visiting NDI was great, as I saw that medicine could be personal," said student Tyler Mongan. "Drs. Parker and Owen have made the effort to become a part of the community instead of just acting as foreign doctors who are in some way outside of and distanced from the people. They are willing to do things and fight for changes that demonstrate their commitment to a whole health perspective. I discovered more about naturopathic medicine and what it means to be a naturopathic physician in that week than I had in my entire first year of medical school."

With the establishment of a one-year volunteer rotation for licensed NDs on the island of Ometepe, NDI is able to provide continuity of care. Applications for this rotation were due this fall and NDI proudly accepted Dr. Ananda Steigler, an NCNM graduate, who will join team NDI in Nicaragua this month. I will complete my second-year rotation as the medical director in Nicaragua. Finishing up his rotation in December, Dr. Owen will return to his home in Oregon, where he will lead doctors on one-to-two week NDI medical trips throughout the year and start a private practice. NDI receives rolling applications for the volunteer position and might add a third naturopathic physician in fall 2006 as funds permit.

We could not have done any of this without help from the community. Dennis Becklin of Environmental Container Systems and Susan White of Whitespeed have been our two main contributors. In September 2005, NDI held its first annual fundraiser and silent auction at Kell's Irish Restaurant in Portland, Ore. More than 100 people attended the event, many of them NDs, raising in excess of $8,000 for NDI. Thanks to volunteer Amy McCandlish for her successful efforts in coordinating this event.

NDI is growing in leaps and bounds. We wanted to become the Doctors Without Borders of the alternative medicine community and we are doing just that. NDI recently received the community service award from the American Herbalist Guild and plans to start a botanical project in Nicaragua with the cash award. Our 2006 goal is to continue to strengthen Project Nicaragua and develop our presence in the international health community by coordinating with groups such as the World Health Organization, whose 2002-2005 Strategy on Traditional Medicine should be read by all naturopathic physicians (www.who.org). The world is changing, and naturopathic physicians are the future of medicine.

A recent study done at Harvard found that in 135 mothers and their infants, the more fish the moms ate during their 2nd trimesters, the better their infants later performed on tests at 6 months of age.

Another study in the Archives of Neurology found that older adults who ate fish at least once a week performed better on tests of mental acuity and memory than other elders who did not eat as much fish. The fish-eating elders also had a 10% less decline in mental acuity each year.

Dr. John Boockvar, assistant professor of brain surgery at Cornell University recommends eating fish twice a week. "Unless it's fish that has a lot of mercury, it's not going to harm you. And we know it improves brain functioning," he says.

Fish that are especially high in mercury are tuna, swordfish and shark. Distilled fish oil, on the other hand, has had mercury and other toxins removed.

Heath care professionals and medical students sometimes find themselves face-to-face with an individual who feels suicidal. Many of these people have daunting life circumstances: abuse, drugs, social isolation and/or intractable illness. On the other hand, I have sometimes found myself in the presence of a suicidal person who has life circumstances (family and friends, physical health, economic circumstances, etc.) that are approximately similar to my own. Yet that patient in front of me has wanted to end it all, while I feel the complete opposite. Because of the similarity of our lifestyles in other respects, I have to wonder: why? What is the crucial difference?

On further examination, I sometimes find a common thread of perfectionism, for both teens and adults who have considered taking their own lives. Needing to live up to the often-unreasonable expectations of oneself or others, and not doing so is a theme that comes up This may have to do with academic or professional achievement, or simply "needing" to be more beautiful or fashionable or athletic or wealthy or publicly recognized than others.

Here is a completely opposite point of view: My father once told me that even if I should one day find myself homeless on a street corner, with a cold rain pouring on me, I should simply laugh with the joy of being alive. Just having the great luck to be the select one of possibly millions of gametes that could have become other individuals, and being a member of the luckiest species, and living on the most perfect planet in the solar system, in a temperate zone no less (not Arctic, not Sahara) is reason to take great delight in every moment of this precious life. My dad lived up to his instruction. He was able to appreciate life and good humor up to his last day of life, even though the last sixty years of his life were marred by severe injuries from a traffic accident soon after his return from WW2 service.

I have found my own truth in between these two opposites, but closer to my father's: What keeps me happy is this: Maintain a low threshold for happiness and a high threshold for negative emotions.

A low threshold for happiness means that I derive much of my happiness from everyday household events: I can lose myself in complete contentedness simply pulling weeds in my garden or transplanting seedlings. Every new flower or fruit is a source of new delight and a reason to pester the next person I see with my "garden report." But for years I did not have a garden, and this time of year not much is happening back there. So there are other things that make life wonderful...

Back when my cat was alive, I derived great contentedness just from watching him sleep and listening to him purr. But I no longer have a cat, so there are other things that make life wonderful...

I once lived in a little town at the bottom of a mountain and taught classes at a small college at the top of the mountain. Everyday I hiked to work for about an hour, then walked back home at the end of the day, including in rainy weather. The exercise, fresh air, and mountain views were fantastic regardless of the weather. But I don't live or work there anymore, so there are other things that make life wonderful...

While in college, I had an old, chipped, warped, beaten-up piano. But I loved it and played it whenever I could. It gave me great pleasure to play, almost as intensely as it pained those within earshot. But I don't have a piano anymore, so there are other things that make life wonderful...

Above all, I derive immense joy from my 5-year old son, playing with him, teaching him, and watching him grow. But for most of my life, I did not have a child, and my joy came from teaching other youth, volunteering at an emergency room and many other activities.

In other words, your source of happiness does not require special events or unusual circumstances or particular locations or individuals. Happiness is not miles away on a distant beach or cruise ship or casino or on Mt. Everest; it lies no further than the boundaries of your home or yard or workplace or neighborhood. It consists of nothing more or less than those activities, people, or experiences that bring you the most pleasure and fulfillment and/or hope for the future.

My second rule is to maintain a high threshold for negative emotions, which can also be stated as "don't let things get you down." For example, bad drivers inspire irritability in other drivers. But I am in the habit of singing in the car. When somebody near me is driving badly, I continue driving defensively and just sing louder (with the window closed of course) and more dramatically. Sing anything. I'm no Ella Fitzgerald or Mariah Carey. Your singing is at least as good as mine, and will also be good for eliminating your frustrations by its cathartic effect. Our ancestors were free to take out their frustrations by being in motion: walking, running, etc. But we find ourselves frequently stuck in cars with no way to work off steam. Since being stuck in traffic immobilizes your limbs and torso, you can let your lungs exorcise your frustrations.

My 5-year old and I often find ourselves in conflict regarding childish misbehavior vs. parental strictness. At times we vocalize these frustrations in mock operatic singing, i.e., "Why don't you beha-a-ave?" No, I will not beha-a-a-ave!!" But the misbehavior does end for the time being, because my son's vocal catharsis distracted him from the desire to misbehave. We both end up laughing and feeling happy with each other.

Sad or mildly depressed patients whom I meet sometimes admit to making themselves sad in order to accompany a loved one's bad mood. Also, quite often patients have made major life decisions against their own desires but in order to please a parent or other loved one. A healthier approach is empathy for that loved one, who may be suffering from oppressive mental constraints or dragging themselves through a miserable purgatory. But you have no obligation to follow them into that purgatory. Make your major life decisions wisely and calmly and following your own best judgment, because it is you who will be most affected by them.

During the winter holidays, depression can surface more than at other times of the year. Is it the short days of winter? The pressure of the New Year promise to make our lives more perfect than they already are? Include in your new-year resolutions challenges for self-improvement. It is imperative for our mental and emotional well being that ongoing education be a part of every adult's life, during all eras of our lives. Browse the catalog of a community college near you, or look into online courses in an area that you have never studied before: foreign languages, computers, art history, anthropology, scuba diving, yoga, theology, history, cinematography, marine biology.

Whatever your outlook on life, whether happy to depressed or anywhere in between, try raising your threshold for negative emotions and lowering your threshold for happiness until happiness infuses all of your daily life, and negative emotions are beyond reach. This is my instruction and my wish for you this holiday season.