Where are the hakims?
Source : Google photo of a Muslim hakim
Synopsis : The escalating cost of healthcare in many countries is hurting the poor people the most because they do not have the medical insurance and do not have the money to pay for the hospital care so die needlessly of common treatable diseases. The hakims and the traditional herbal doctors do a real service to the humanity where they are allowed to practice without prejudice and mistrust. Without them many people would die so this blog is about the plight of the poor people.
Recently I was bitten by a worm in my hand that came from the chicken poop in our garden where I was digging and cleaning. I saw a stray chicken and its brood that had somehow come into our garden but could not escape so I opened the gate and let it escape to its great relief. It probably thought that it may end up in a cooking pot somehow so was desperate to go out , gave a frightened sound and hurried past me to safety . The little ones did not need any prodding so also quickly followed the hen.
But the hen did a terrible mischief before leaving because while pecking for worms and things to eat , it also dropped its poop carrying the hook worms that found its way into my hand and quickly disappeared under the skin. I often marvel at the nature of self preservation that the little worm was capable of because it was very sensitive to human temperature and could sense that I was nearby so wasted no time to enter my skin where it started making no end of trouble for me right away .
Now a hook worm ( 1) by its very nature is a mean character and it only has procreation on its mind so it found the host in me and started immediately to burrow deep under the skin of my hand and released some dreadful chemical that make it very itchy and began to swell.
Now I am no new comer to this dreadful experience because it had happened to me years ago while I was working in Mali , West Africa where a distant relative of this hen was just as naughty and good in making mischief so pooped all over my garden there that I happened to be working in and accidentally came in contact with the hook worm that was eager to find a host in me.
The terrible itch and the swelling was just the same so I drove fast to the nearest pharmacy and found Mintezol tablets that I bought over the counter and swallowed one right away. It worked miracles because the itch stopped and the worm was killed so my finger was back to normal in a week or so.
Now if you live in Africa especially in rural areas, you may come in contact with hook worms or even Guinea worms ( 2) that can cause tremendous swelling of the legs called elephantiasis which is a dreadful disease. There are other dangers from mosquitoes and tse tse flies and the larvae in the rivers and lakes that can cause blindness in people but with normal precautions, one can survive in Africa anywhere or so I thought.
I never suspected a stupid chicken to have such malicious intent so one must not judge them by their beautiful and colorful feathers because these birds are mean and are capable of causing grief as I learned first hand. The Africans are quite casual about it and know that a tablet of Mintezol will clear up the matter in no time so I got this piece of wonderful advice from them while they were sipping their horrible tea under the mango trees.
That was some 40 years ago so the incident slipped out of my mind but what you know? These stupid chickens must be related maybe like cousins thrice removed and had to come into my garden of all places to make trouble.
Now let me explain what I had to go through in the last seven days or so. The first doctor I went to see told me that she had never seen anything like this and did not know what to do so she sent me home and charged me 10 US dollars for doing nothing. You have to pay for their precious time you know. So I went to see another doctor some 30 kms away where after two visits and waiting , I was received by a doctor who claimed to be a surgeon but said that he could do nothing and sent me to a dermatologist who by the way sits only once a week and was not available. He also laughed at my explanation that I had been bitten by a worm and showed clear disbelief.
So after burning a lot of gas and two trips in two days, I was no where near any solution. The gasoline costs one dollar /liter now and my car is a gas guzzler so that did not help either. I was just eager to find someone who could take care of this worm that was making so much trouble for me and was having a good time doing it but today luckily I found a young dermatologist who seemed more competent than others so she prescribed some ointment and other tablets so hopefully this problem will be resolved soon. By this time I had spent over one hundred US dollars equivalent.
But I must back track a bit here and tell you that google told me that several medicines that are generic in nature are available and cost only 2 cents a piece. Armed with this useful information my sweet wife went to the pharmacy where she was told that no such medicines can be sold without a doctor’s prescription meaning you have to pay their hefty consultation fee and wait for several hours like refugees in front of their clinic . She is quite a fighter and said that these are over the counter medicines and we have done our homework so finally she was given four tablets at a hundred times the retail price but that is the racket here.
Then we went to another hospital on campus where we were flatly refused any help because it was exclusively for the students and the staff of the University here so we went to another hospital emergency ward where we were told that it is not an emergency so they can’t help either . The nasty worm was causing havoc under my skin and it was not an emergency? What could be more urgent? By this time we were quite irritated and looked for other alternatives.
So the Africans were far better in helping but they are called primitive and all kinds of names by those who have never been to Africa and do not know if Mali is the name of a breed of cow or a donkey. People are very illiterate here when it comes to geography and cultures of other people.
Anyway this is what prompted me to write this blog to show the state of health care here in the Philippines where the doctors show contempt for their patients who have traveled all over the world and have previous experience like I had. They also make you wait for hours and never apologize when they are 3 hours late because they feel that their time is more precious than yours so you have to wait.
When I was just a kid, I had a cut in my ankle that got infected because of the dirty grease of my bicycle chain so it oozed pus and was very painful for me to walk so my father brought me to a hakim. The hakims are Muslim traditional doctors who have been trained over centuries in traditional hakim schools so they are really good. Now I will tell you how good they are.
This hakim was an old man with white flowing hair and beard and looked like a saint of some sort. He received me right away and took a very sharp surgeon’s knife and cut off all the dead tissues around my wound and made it bleed. Then he washed it with soap and scrubbed it until I felt pain. He then made an ointment himself using the ingredients that only the hakims know and put it on my wound and sent me home. The nasty wound began to heal almost right away and cleared up completely within one week. For all his effort and care plus the ointment, my father paid him one dollar or its equivalent in Rupees .
The health care costs in some countries are skyrocketing beyond belief so the poor people who can’t afford so high cost of medicines and doctor’s fees suffer the most. It is common news that most of them die of illnesses that are quite treatable but can’t afford the cost. The national health insurance which is free for people over 70 does not cover more than 20 percent of the cost of hospital care that can run into thousands of dollars so where they will find the rest of the money? This is a very serious issue here.
I have heard horror stories in the United States where a woman had to give birth in the parking lot in front of a hospital that refused her admission because she did not have insurance and another hospital charged 10000 US dollars for a band aid. I don’t know why someone would go to a hospital for a band aid but this made news in the internet.
The traditional doctors like the hakims are not allowed to practice in many countries but thankfully India is not one of them. They also do not allow the homeopathic doctors to practice here either who can cure all sorts of illnesses at a very low cost . The mafia of doctors is behind all these rules and regulations and are now requiring the pharmacies to not sell even non prescription drugs meaning you have to go to a doctor, wait for several hours and pay a very high fee just to get a prescription for over the counter medicines. Clearly there is something very wrong here.
The extremely high cost of medicines is another reason why so many people suffer needlessly but the doctors who prescribe such medicines are given free tickets to enjoy short vacations in Singapore and Hong Kong by the drug companies that have a total monopoly on imported drugs. Some doctors have created monopoly for certain treatment and will not allow the importation of equipment by others for the treatment like lithotripsy so that they can charge enormous fees.
The escalating health care costs all over the world hurts the poor the most but the people are not given cheaper alternatives like the hakims and homeopathy doctors in many countries because of the pressure from the allopathy doctors who claim that their education and training makes them better doctors .
There was a scene in the Godfather movie where an old mafia man who was sick in Havana refused to be treated by the Cuban doctor because he did not trust any doctor who could not speak English. This sort of prejudice is quite widespread in the United States but also happens in many other countries.
Now let me tell you about the health care system in Mexico . We were once visiting Mexico for our annual vacation when our son who was then only 4 years old fell from a swing and fractured his elbow bone. Within a few minutes a social worker appeared at the park and asked us how she could help. She was fluent in English. She then called the Red cross hospital right away that sent an ambulance right away but we were not allowed to go with them so we took a taxi and arrived at the gleaming modern hospital.
There a doctor appeared quickly and asked us many questions about the health, family history of illnesses etc. and sent our son to be X rayed immediately. The X ray showed clear fracture that needed immediate surgery but he said that he could patch him up temporarily so that we could go back to the US for further hospital care.
We said that we trust the doctors at this wonderful hospital and hope they will fix our son up so he was taken to the operation room right away and they joined his broken bone properly with steel pins and made a plaster cast to hold it in place. He was just a child in a strange country and where no one spoke English so it must have been traumatic for him to be alone there because we were not allowed to stay with him so we visited him everyday to comfort him.
A beautiful Mexican girl who had an automobile accident was also recuperating there so she made friends with our son and comforted him in her broken English. After a few days we brought him back to our hotel but our surprise was complete when the hospital did not charge us anything for all the cost and even gave us the X ray plates that normally they keep in their care. We could not believe it .
This could not have happened in any other country with Cuba as an exception. We donated about 60 dollars to the hospital that the insurance company in the United States refused to pay but it did not matter. What mattered was that he was given the best medical care by expert surgeons and did so with a smile very promptly.
The traditional doctors in Africa, the hakims in India and many Muslim countries, the herbalists in Latin America, the faith healers of Colombia, the traditional Chinese medicine men all help the poor of this world because they believe in the oath they take to heal people with the best of their ability and at a minimal cost.
The doctors here also are required to take the Hippocrates oath but they do not believe in it and surely they do not practice it.
I miss the old hakim and still recall his kind face after all these years.
Hippocratic oath:
I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.
I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
Note : (1) Hookworm infection. Hookworms have infected some 428 million people in 2015. (Wikipedia) Apparently, they could be resistant to the immune system, since there are cases where the same patient contracted it again. (induction of the translator)
(2) The parasite Dracunculus medinensis. (Wikipedia)
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