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In desperate times, what works, wins

When one of the worst natural disasters in history hit Haiti earlier this year I worried what sorts of  alternative medicine “help” the Haitians might have thrust upon them.  From around the world, health care workers with expertise in trauma and disaster relief offered their skills, realizing that anyone who came to Haiti must bring with them a lot of value—taking up valuable space, food, and water without providing significant benefit will hurt far more than help.

But others have used this disaster to benefit themselves and their own quasi-medical cults.   There have been many reports of the Church of Scientology’s faith healers walking around in yellow t-shirts trying to “assist” people’s nervous systems.  Homeopaths, the folks who sell water panaceas, have been offering to “help” as well.

Poor and less-industrialized countries are a target-rich environment for alternative medicine cults, but may conversely be a tough nut to crack.  Since many alternative medicines don’t require an industrial base, they can be made readily available anywhere.  Homeopathy is just water;  if a homeopath can simply provide a water remedy that contains fewer fecal coliforms than the local water, they can get away with quite a bit before people realize they’ve been duped.  In fact, unless a population has had exposure to real medicine, the altmed folks can fool people for a very long time. But hungry people can also be very pragmatic, and they know that eating grass will only give a false satiety.  The same may be true of medical help.

When face with an immediate threat to life and limb,  most people find out rather quickly the difference between real and fake medicine.  In rich countries such as the U.S., people have the luxury of indulging in alternative remedies.  We have good public sanitation and vaccination and so suffer more from diseases of excess rather than those of desperate poverty.  If you have access to food and clean water, so much that you even consume to excess, then you may have time to explore fake cures.  But when the feces hits the rotating blades…

From our friends to the north (and my email from Dr. Gorski) I learned about a naturopath’s struggle to provide help to Hatitians post-quake.  Canada seems to have a serious naturopath problem.  Naturopaths in Canada tried to co-opt the flu pandemic with a worse-than-misleading educational campaign, and have made in-roads into getting the same rights as real doctors (without the concomitant responsibilities—we real doctors have to have at least some evidence on our side).

So it was with no small amount of Schadenfreude that I read about a naturopath’s failure in Haiti (but also sadness for the Haitian people for being subjected to him).  Denis Marier, a naturopath practicing not far from me, took his altruistic impulse and a whole lot of fantasy and boarded a plane for Hispanola.  His particular medical fantasy seems to be centered around vitamin C.

I’m also trying something new this mission – intravenous vitamin C injections to assist with tissue and wound healing. I don’t have access to refrigeration, but should be able to keep the vitamin C, calcium, magnesium, selenium and zinc stable for a few days. I’ve brought enough from my clinic to give approximately 100 treatments of 5 grams of vitamin C plus support minerals.

Well, I’m sure that vitamin C will fix up those traumatic amputations just fine.  And with neonatal tetanus, it sure couldn’t hurt, right?

The elderly lady with the maggots in her sinus cavity from an earthquake injury went to surgery today – she’s expected to recover well. I’m hoping the IVC administered over the last several days, as well as the homeopathic (Pyrogenium) have contributed to her positive prognosis.

You can hope all you want, but unless devitalized tissue is debrided, no amount of magic water will help.   In an unsanitary environment like a disaster zone, any extra skin punctures simply add to the risk of infection, so rather than being simply useless, Mr. Marier’s medicines are likely to cause additional harm.  The Haitians seem none too impressed with Mr. Marier anyway:

Unfortuantely, as I’ve experienced on previous missions, the local community is arriving at a free “medical clinic” expecting medications, not homeopathic remedies to help with post-traumatic stress from the original disaster.

Those pesky Haitians!  Coming to a medical clinic expecting medical help!  You’d think centuries of crushing poverty would have sucked the hope out of them by now, but apparently they still expect medical clinics to practice medicine.  According to the Globe and Mail report:

After he saw two patients the lineup just melted away, he told me, frustrated, towards the end of his final day. Before he [Marier] left, he disposed of the leftover injectable Vitamin C he brought with him from Canada (it’s a new-ish remedy, apparently, to stimulate tissue healing) because he was worried that, in his absence, it would be used improperly. When I left him, he was also contemplating disposing of a huge load of traumeel, a homeopathic anti-inflammatory.

Yeah, let’s hope all that magic water doesn’t fall into the wrong hands.

I understand the altruistic impulse; it’s largely responsible for my decision to go into medicine.  But an altruistic impulse directed improperly can cause great harm.  Marier sounds like a nice guy who has his heart in the right place.  Maybe he and people like him can refocus his efforts on providing real help, such as raising cash for MSF or PIH, organizations with a track record of providing real help.

Posted in: Science and Medicine

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13 thoughts on “In desperate times, what works, wins

  1. bluedevilRA says:

    I have never been so filled with shock and outrage from reading an SBM post before. Don’t worry, it’s not directed at SBM or Dr. Lipson. I just cannot believe this asshole naturopath!

    What the f***!!!! He openly admits that he is going down to Haiti to try “something new.” I mean, holy hell. If I was a surgeon and I said I was going to Haiti to try a new surgical technique, I would probably be sued, arrested and delicensed.

    A natural disaster of such horrific proportions is not an excuse to try out a new, unproven and entirely useless therapy. Despite his good intentions, it is completely unethical for him to try a new therapy on such a vulnerable population. I would love to smack some science into this guy. Or just smack him period.

  2. Dr Aust says:

    Hear hear.

    When the first rumours started circulating online about the homeopaths wanting to provide “homeopathic first aid” (!) I wrote something about it – ER docs and nurses, trauma surgeons, and water sanitation engineers, I reckon, would be useful, but anyone else should send, or raise, the money the NGOs and Aid organisations need and suppress the urge to feed their own vanity along with answering their more altruistic feelings:

    “Why money is better disaster aid than homeopathy”.

    Sadly, though, follow-up on other blogs indicates that the homeopaths are probably there now dishing out the Magic Water. *sigh*

  3. daijiyobu says:

    Coincidentally, I’m about put up on Naturocrit a blogpost that includes this ND.

    What has fascinated me most with Dr. M. is his explanation of naturopathy, http://www.drdenismarier.com/Naturopathic/whatis.php .

    No transparency concerning the actual vitalistic context of the ruse.

    Perhaps accidentally, if you go to the good Dr.’s homepage, you must choose between a link for naturopathy and a link for humanitarianism.

    -r.c.

  4. reidelbach says:

    I don’t know if I agree that third world countries are especially good opportunities for our alt-med practitioners. They’ve got their own voodoo, they don’t need ours.

    But that’s not really why I’m writing. I wonder about the fact that this guy went down there in the first place. The things I read tend to suggest that these guys are hucksters taking folks for every penny they can get. So why does this guy go to Haiti? There’s no money in Haiti. Did somebody sponsor him, or did he have to pay his own way? Does he make so much money being a Homeopath that he needs a humongous write-off? Was it a publicity stunt?

    Or does he really believe this stuff? When my wife sees someone from another culture doing something atrocious on the news, she starts going on about ‘How can these people do these things?’ and I point out that people have different sets of beliefs, to the extent that even concepts as basic as right and wrong aren’t always agreed upon. And we’re still married.

    But I have a hard time suspending my understanding of medical science, limited as it is, enough to accept that alt-med purveyors can really believe in what they do. I think; ‘How can anybody believe this crap? It’s ridiculous.’ Then this guy goes to Haiti, and even sounds disappointed when he gets kinda laughed out of the country. (Well, really more like ignored out.)

    Cable TV reassures us that the world is still filled with the afore mentioned hucksters, and there are obviously plenty of people ready to eat-up the their crap. But there’s a group kind of in the middle that really thinks they’re doing good. Maybe they’re the True Believers.

    So what do we do? Slap them up-side the head and say ‘Look dumb&%$#, you’re wrong. You’re an idiot. Get a brain. Look at this study. And this one. And this one. (etc).’ And they say ‘But look at what all these people said….’ And we say….And they say….

    How do you convince the true believers that they’re wrong?

  5. Mandos says:

    I didn’t realize that there *could* be such a thing as homeopathic first aid, but apparently there is.

  6. StatlerWaldorf says:

    reidelback, that is very true. The naturopaths think it works, many of their clients think it works, where to go from there?

    And there are the Scientologists who believe in the alien Xenu. Just what Haiti needs. *shaking head*

    What a sad state of affairs when people need REAL medical and practical help and this is what comes their way.

  7. Mark P says:

    In rich countries such as the U.S., people have the luxury of indulging in alternative remedies.

    … on top of conventional medicines.

    As woo-friendly as much of the population is, they almost always try conventional medicine as well. People who refuse to take any conventional medicine are mostly regarded as nut-cases.

  8. Michelle B says:

    The ‘true believers’ are being wasted in their field of alternative medicine. They often have great bedside manners and compassion for their patients, wanting to sincerely help. And they can’t because they are not practicing effective medicine.

    After decades of plying their trade, do these true believers realize that they could do so much more as in working with other effective practitioners and with patients other than the ‘worried well’ using effective methods? Wonder if they get burned out, channeling all their positive energies into a dead end.

  9. TsuDhoNimh says:

    I don’t have access to refrigeration, but should be able to keep the vitamin C, calcium, magnesium, selenium and zinc stable for a few days.

    “Should be able to” … when he is discussing IV injections? What does it destabilize into? What sort of testing for bacterial contamination has it had?

    And what idiot takes things that apparently need to be refrigerated into a place where he knows that there will be NO REFRIGERATION?

  10. DREads says:

    Homeopathic first aid? If you’re in the mood for a laugh, check out this short British comedy sketch, http://www.youtube.com/watch?v=HMGIbOGu8q0

  11. Deetee says:

    I wonder just how people like this end up foisting their services on a country like Haiti.

    This chap seems to have been part of a Canadian charitable support group, “Hearts together for Haiti”, which from its web site seem to be well intentioned and suitably altruistic, but there is a dearth of detail as to what it has actually done or plans to do.
    http://www.htfhaiti.org/Hearts_Together_for_Haiti/Who_we_are.html

    Presumably this quack approaches the charity, brimming with ideas of how to help the terminally ascorbic acid deficient Haitians. Someone must critically assess what he has to offer, and decide whether he gets to be part of their Haitian relief efforts.

    On the Haitian side, surely there are tight controls on who comes in and what exactly they will be doing – they wouldn’t want more “kidnappings” or similar scandals. So who approves and authorises the relief agencies at the Haitian end?

    Do neither of the organisations in charge of all this have anyone with an ounce of common sense in a suitably executive position? Are matters so chaotic that just about anyone can waltz in with their quack remedy of the day in tow?

  12. Calli Arcale says:

    Tight controls? In Haiti? The country was barely functional *before* the earthquake, and corruption was so widespread that everyone just accepted it as normal. On the Haitian side, the controls on who comes in and what they will be using will likely consist mostly of how much cash they bring along, and to whom they give it. (There are other controls, of course. I believe the US Coast Guard is still providing air traffic control, for instance. They aren’t generally open to bribery, but having the right political contacts may make up for that, as the Scientologists proved, and they’re not exactly in a position to vet everyone coming in.)

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