Integration of Biomedicine and Traditional Medicine

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By Destiny Ho, University of North Carolina, Chapel Hill ’18

Destiny is currently in Costa Rica with our Spring 2017 Tropical Diseases, Environmental Change, and Human Health program.

In our recent lectures we have been learning about the intercultural health care system, which is interactions between both biomedicine and traditional medicine, and discussing the importance of collaboration and eventually integration of the two forms of medicine. Today, we visited the La Cosana indigenous community, about twenty minutes away from Las Cruces Biological Station, where we had the opportunity to learn about their EBIAS (Los Equipos Básicos de Atención Integral en Salud), as well as talk to one of the Primary Healthcare Technicians and some of the indigenous healers. The EBAIS of the La Cosana community is a success story of the integration of biomedical practices with traditional medicine, mostly due to the respect and communication between the biomedical physician and traditional healers.

The traditional healers we spoke to told us the community is greatly affected by diabetes, anemia, and prostate problems, among other diseases. We also learned the community is affected by chronic diseases, as well as dental issues. These diseases could be coming from the imposition of the Westernized lifestyle and diet upon the indigenous community, especially with the increased access to high-sugar foods and chips. The healers also talked about how the “imposition of civilization” has led to a loss of tradition within the community, especially around eating habits. When asked about the EBAIS, the traditional healers enforced that there is a better relationship nowadays due to the respect that the healers and physicians have for one another and the collaboration of both parties. When a patient comes in and the traditional healers cannot aid the patient, they will refer them to the biomedical physician and vice versa.

One of the Primary Healthcare Technicians spoke of her role within the community, as well as a few of the problems with the EBAIS currently. One of the key roles of the Primary Healthcare Technician is prevention, through going house to house and recommending a trip to the EBAIS when necessary. Some of the problems that the community is facing are barriers to having a skilled birth attendant present during birth, as well as the computerization of the EBAIS system. Since the system has become computerized, it is harder for community members to access the healthcare since not every member has access to the internet and a computer. The Primary Healthcare Technician stated the importance of policy makers to look into the effects and ask communities before administering new systems.

Visiting the EBAIS was a wonderful experience, especially in seeing how traditional medicine and biomedicine can actually work together if there is effective communication and respect for one another.

 

In the Mangrove Forest

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By Andres Ripley, Wheaton College, MA ’18

Andres is currently in Costa Rica with our Tropical Biology on a Changing Planet semester program.

On the way to the mangrove forest, I was excited because I had seen mangroves before, but never a forest full of them. When we got to the forest, our professors explained how the zonation of a mangrove ecosystem works due to different plants being able to tolerate different salinity levels in the soil.

We walked farther in, and all of a sudden the smaller shrubs turned into massive, eighty-foot-tall trees. The roots of the trees could be seen almost twenty feet off the ground in some cases. Some mangrove plants have pores in the leaves that secrete the salt the roots are taking in, and others send all of the salt to the older leaves because they will be falling off the branch soon. In addition, since the clay is very good at holding water for long periods of time, and the presence of water makes it is hard for gas exchange to occur underground, mangroves have lenticels on the roots above ground that are used for gas exchange, which is one of the reasons why the roots come so high above ground.

After discussing more about different adaptations plants and animals have in a mangrove ecosystem, we talked about the importance of mangroves, like how they are very good storm barriers that help protect the mainland, they help reduce erosion that can occur along bodies of water, and they help filter pollution that is heading from rivers out into the ocean. It was very interesting to learn about mangroves, because there are less and less mangrove ecosystems due to the rising of sea levels and humans destroying them, so it is important that more people educate more people on the importance of mangroves.

Sweet, Sustainable Pineapples: An Afternoon at Finca Sura

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By Kelsey Porter, Macalester College ’18

Kelsey is currently in Costa Rica with the Spring 2017 Tropical Diseases, Environmental Change, and Human Health program.

During the time that we studied at La Selva earlier in the semester, we had the chance to visit Finca Sura, a natural pineapple farm nearby. Finca Sura is considered “natural” because its caretakers use sustainable methods to grow pineapples, unlike most large-scale plantations. As we approached the farm, I admired the crimson decorative palms that line many of the roads and pathways.

When we arrived, we were greeted by one of the farmers, who led us to the open-air dining room and offered us some initial refreshments: fresh, cool pineapple juice. The sweet taste was quite welcome on such a warm, sticky day. Next, we went on a guided tour of the farm to learn about the plants of Finca Sura and the methods by which they are grown. Before reaching the pineapple field, we were surprised and delighted to become acquainted with Matilda, the family pig:

Throughout our visit, we learned about the factors that differentiate Finca Sura from its “organic” and “conventional” pineapple farm counterparts. Organic pineapple farms avoid using chemicals, but they place black plastic across the ground to keep out pests. Unfortunately, the plastic is not always effective, and it also contributes to waste production since it can only be reused two or three times. Conventional (large-scale) farms use a mixture of pesticides, insecticides, and fungicides to kill off potential threats. They also allow pineapples to grow quite close to each other, and as a result, each individual does not receive adequate nutrients from the soil. Furthermore, conventional farms often lack effective crop rotation methods. They plant the same crop in the same place for many years and only let the land rest for one month between growing seasons, leaving the soil in a state of perpetual depletion.

Finca Sura, in contrast, has developed sustainable (and fairly simple) ways to keep their pineapples healthy. For starters, they are completely chemical-free. This may seem impossible in the Age of Pesticides, but the farmers at Finca Sura use creative strategies to keep the critters away. They plant a variety of tasty supplementary plants, such as bananas and papayas, in various sections of their farm. As a result, many of the birds and insects that would normally devour the pineapples instead choose to munch on the delectable diversity of other fresh fruits. Additionally, the farmers make sure that individual pineapples have enough room to grow by separating and re-planting young plants as they sprout. To maintain a balance of pineapples at different stages of development, the farmers also sometimes cut the green leaves at the top (the crown) to delay maturation of the fruit. Lastly, Finca Sura uses a crop rotation cycle—3 years on, 1 year off—to allow the soil to fully recover between growing seasons.

After learning all about the pineapples, we had the chance to taste them. Our guide picked a couple mature ones from a nearby field and skillfully diced them into bite-sized pieces. I usually don’t like pineapple in large proportions, but these were so sweet and fresh that I could have kept eating them for awhile!

When we returned from our tour, we were treated to a second, even more decadent round of refreshments: guanábana juice, sugarcane juice with ginger, fresh coffee, and pineapple bread. Since it was close to dinnertime, everyone thoroughly enjoyed the hearty snacks.

Overall, I really enjoyed learning about the techniques used by Finca Sura. I wondered why other farms don’t adopt similar methods to make their practices more sustainable. Are these methods considered too labor-intensive? Too costly? Too slow? Whatever the reasoning, I think that the long-term effects of heavy chemical use have already started to reveal themselves in daunting and widespread ways. I hope that farms like Finca Sura are able to teach others, so that sustainable farming practices can expand beyond the scope of small family farms.