Missionary doctors, culture clashes

The good news is that I am better... so I went back to Vozandes Hospital in Shell today.

Vozandes is a missionary hospital started by Nate Saint. (Mom and Dad, he´s that guy that ended up dead on the end of the spear in the movie of that name.) The four American doctors that work there now are also missionaries. The missionaries in Shell also run Alas de Socorro, which are planes that fly into the rainforest to remote villages from the Shell airstrip.

I had some very interesting conversations with the doctors today about the role of missionaries in developing countries. One doctor told me how much anthropologists really don´t like missionaries, because they come in and change the local culture, etc. But then he brought up some good points. For example, the anthropologists want the missionaries to leave the indigenous people alone. But then, according to the missionaries, some of these same indigenous people are begging for the gringo doctors to come to their village when there are malaria epidemics and other rampant illnesses. As the doctor said, "Are we supposed to let children die of malaria for fear of altering an indigenous culture?" They seem to think that anthropologists can be unrealistic, as change is definitely coming for these cultures, and the missionaries see themselves (and, actually, Jesus) as a force to assuage the pains of cultural transitions. If we can´t stop the oil companies, then why not at least help cure people made ill from diseases introduced by oil company workers? That is what they think.

He also explained that the missionaries wanted to bring the Huaorani to Christ out of fear that malaria and inter-ethnic group war would kill them off...

Obviously, I don´t think expecting people to convert to Christianity is a good goal, but I did learn a lot from his perspective, and I don´t have answers to his questions about letting children die of malaria in order to not harm their culture. It´s very complicated. And fascinating. He told me I should come back and would be welcome to do some research about these topics with them...

As usual, there were a couple cultural discrepancies between us North Americans and the patients today. The doctor told me that people always ask two questions "Can I eat everything, even pork? and Can I bathe?" This is because of an indigenous belief that certain foods hurt certain organs, and that bathing makes you wet and cold and therefore will worsen your illness. I had been confused when a teenage Quichua kid was diagnosed with epilepsy based on his EEG, and his father kept asking "but can he eat pork?"!!

Fathers do all the talking. In indigenous families, the women often don´t even speak Spanish. We had a Quichua woman come in. She told her husband her symptoms in Quichua, then he translated them into Spanish for us. It is rude for a male doctor to talk to another man´s wife, so he asks the husband all about the woman´s health, as if she´s not there! Needless to say, this would be very offensive in the United States, but the doctor told me if he talks too much directly to the women, the families sometimes get offended and refuse to say much more.

When women are talking about female problems, like menstruation, they won´t look at the male doctor. They would suddenly look directly at me. The doctor told me they were more comfortable telling me about these things. He would listen to her and answer all her questions, but she would only make eye contact with me, as I was a woman. I just nodded my head and looked interested, but obviously I couldn´t diagnose her or tell her anything.

I saw problems with people saying they understand when they really didn´t. For example, the doctor asked a Quichua man if his wife had any secretions. He nodded and looked nervous, saying "yes." A minute later, he said "um, doctor, excuse me, actually, um, what does 'secretions' mean?" Another time, a young woman insisted that she didn´t understand what "menstruation" or "periods" were. You wonder how many times people don´t understand and just remain silent. Sometimes it is a language barrier if the family doesn´t speak a lot of Spanish, but more often it is a simple lack of basic healthcare knowledge.

In addition, I am learning basic medical stuff. I know the difference between rheumatoid arthritis and osteoarthritis, that it´s pretty pointless to treat gestational diabetes, and that ulcers caused by varicose veins can easily be healed with ACE bandages.