I’ve said elsewhere on this blog that health care problems that are too much for local walk-in clinics or over-the-counter medications represent the biggest challenge to someone living on the edge of the financial cliff. You can finagle or fake it with food, clothing, shelter, transportation and other essentials. It might not be pretty, but you can often find solutions that will work.
Health care is different. There’s a point beyond which you are basically screwed, which is why over 40,000 Americans die every year from preventable or treatable health care problems. Consider that almost no Americans actually die from starvation, although malnutrition is a serious national problem. The same goes for exposure from lack of shelter. It does happen, and it happens too often. But there’s just no comparison with the death toll exacted by our barbaric health care system.
This raises a question. Just how much health care can you do on your own? What’s the threshold for practicing medicine without a license? Obviously, applying a band-aid is okay, but a home liver transplant is not. Nor is prescribing controlled medications. But in between those areas, more or less, there is a lot one can do.
Years ago the Chinese sought to bring medical expertise to rural areas by taking ordinary peasants and giving them basic medical training and sending them back to their villages to provide basic care. These “barefoot doctors” as they were called also knew enough to send someone on for more advanced treatment when the case warranted it.
Although the current health care situation has improved in some areas, it has declined in others. I am not convinced that the individual mandate will result in affordable health care unless a true public options becomes available. Otherwise there is no provision to keep health insurance companies from jacking up prices the way they do now. And if the GOP finds a way to undo health care reform, not only will they do so, they will make sure nothing of the kind ever happens again, if they can.
Given these conditions, is there a place for “barefoot doctors” in America? Could ordinary people, perhaps working alongside sympathetic, public-spirited (and subversive) health care professionals learn enough that they can help others in their neighborhoods with basic health and medical care? I think it’s worth considering. Here are some resources that could get someone started.
First, you have to check out the books published by Hesperian.org. These people publish several volumes for health care providers working in places with little or no health care infrastructure. Sort of like here if you don’t have health insurance and/or money:
Where There Is No Doctor
A village health care handbook
by David Werner with Carol Thuman and Jane Maxwell
512 pages, illustrated
Second revised edition: 1992. Eleventh revised printing: August 2010.
English ed. ISBN13: 978-0-942364-15-6. ISBN10: 0-942364-15-5
Hesperian’s classic manual, Where There Is No Doctor, is perhaps the most widely-used health care manual for health workers, clinicians, and others involved in primary health care delivery and health promotion programs around the world. With millions of copies in print in more than 75 languages, the manual provides practical, easily understood information on how to diagnose, treat, and prevent common injuries and illnesses. Special attention is focused on nutrition, infection and disease prevention, and diagnostic techniques as primary ways to prevent and treat health problems.
Where Women Have No Doctor
A health guide for women
by A. August Burns, Ronnie Lovich, Jane Maxwell, and Katharine Shapiro
596 pages, paperback, illustrated
First edition: June 1997. Fourth revised printing: June 2010.
English ed. ISBN13: 978-0-942364-25-5. ISBN10: 0-942364-25-2
Where Women Have No Doctor combines self-help medical information with an understanding of the ways poverty, discrimination and cultural beliefs limit women’s health and access to care. Developed with community-based groups and medical experts from more than 30 countries, Where Women Have No Doctor is an essential resource for any woman who wants to improve her health, and for health workers who want more information about the problems that affect only women, or that affect women differently from men.
Note: these are just two of the books available from Hesperian. They also have similar books on dentistry, midwifery, community health, and so on. Also, Hesperians’ books are available to browse for free online or as free downloadable .pdf files.
Gerard S. Doyle, MD. When There Is No Doctor: Preventive and Emergency Healthcare in Challenging Times.
Process (2010)
Paperback
360 pages
ISBN 1934170119
From the Publisher: The fifth title in Process’ Self-Reliance series demystifies medical practices with a practical approach to twenty-first-century health and home medicine, particularly helpful in a financial downturn. When There Is No Doctor is smartly designed and full of medical tips and emergency suggestions. At a time when our health system has become particularly susceptible to strain, it should be no further than an arm’s reach away in your household. This is a book about sustainable health, primarily having to do with your health and what you can do to protect it—in bad times certainly, but also in good. I will help you ensure the health of those you love, yourself and, should you so choose, your community, if and when the world changes. World may come to mean your little town or the whole globe. It could change for a few days or weeks, or for a few years. It could change because of a flood, financial crisis, flu pandemic, or failure of our energy procurement, production or distribution systems. I will not teach you to be a lone survivalist who anticipates doing an appendectomy on himself or a loved one on the kitchen table with a steak knife and a few spoons, although I will discuss techniques of austere and improvised medicine for really hard times. Gerard S. Doyle, MD, teaches and practices emergency medicine at the University of Wisconsin, Madison, where he also plans the hospital’s response to disasters.
Note: I have not seen Doyle’s book personally, so I can make no assessment, but if you read the publisher’s description here, it sounds like they are thinking some of what I’m talking about in this post.
Special Operations Forces Medical Handbook
Steve Yevich, Warren Whitlock, Richard Broadhurst, Gay Thompson, Pete Redmond, et al.
Publisher: That’s the Point; Lslf edition (June 1, 2001)
Ring-bound: 680 pages
ISBN-10: 1893441547
ISBN-13: 978-1893441545
Special Operations Forces Medical Handbook provides step-by-step illustrated procedures for performance of surgical procedures under hostile and/or primitive conditions. It offers alternatives to conventional procedures for management of a given problem that can be used under less than optimal circumstances. The physical presentation is designed to hold up under adverse conditions. It is waterproof, tear resistant and ring bound so that updated material can be added at will. It is in a small trim size for ease of carrying and printed on a special stock to aid with reading under poor light conditions.
Created by the Editorial Staff of the United States Special Operations Command, Office of the Command Surgeon, and over 80 medical specialists from all branches of the military.
Editor’s note: This volume seems to focus more on trauma and the kinds of medical issues that one would encounter in a war zone, but still looks very worthwhile. There is another Special Forces Medical Manual out there in reprint and free download land that hails from the 80s. It draws the following warning from the Federation of American Scientists:
“That manual is a relic of sentimental and historical interest only, advocating treatments that, if used by today’s medics, would result in disciplinary measures,” wrote Dr. Warner Anderson, a U.S. Army Colonel (ret.) and former associate dean of the Special Warfare Medical Group.
Concluding Thoughts:
These books represent only a fraction of what’s out there. There is much, much more to be had.
I am under no illusions that the growing underclass can replace all the products and services of the current health care system, but we need some alternatives. If nothing else, doing it ourselves in a responsible way sends a message that we will not wait around for the moneyed powers that be to make health care universally available when they have stated flatly that they will do no such thing, and can buffalo Congress the way they have. They will do everything they can to co-opt the healing arts for maximum profit, and Devil take the rest of us. They are avatars of evil.
If I had to plead with a judgmental and destructive deity for the continued existence of collective humanity; make some cogent argument that we were worth saving, I would point to our millennia-long enterprise of the healing arts. It is one truly good and noble thing that humans do for each other, and for non-human species. When recommending something that society ought to undertake, one must consider what that society would have to become in order to reach the proposed objective. If we cultivated citizen and community healers among us, working alongside doctors and nurses and dentists and physician’s assistants of conscience who do what they can for those who would otherwise go without, how can we not become better as communities, as a nation?
