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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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