SOLVING PRIMARY CARE IN RURAL COUNTRIES
Prof. [Dr. of Med.] Charles McWilliams, Grand Master, Sacred Medical Order of the Knights of Hope
Rural Health - Clinic Recovery Program for Primary Care
[Frugal Plant and Mineral Medicines for the Common People]
¥ Practical and Cost Effective Medicine
¥ Employment of Rural Medics
¥ Better and Proper Care for the Poor & Needy
prepared and researched in 2006, updated 2011 - by
Prof. [Dr. of Med.] Charles McWilliams
Grand Master – Sacred Medical Order of HOPE
Deputy Member (Diplomat) - International Parliament for Safety & Peace
Chancellor - Pastoral Medical Association [www.pmai.us]
Pres. World Organization for Natural Medicine Practitioners
Commissioner on Natural Medicine - World Goverment of Citizens
Nevis Integrated Medical/Naturopathic Clinic
email@example.com ¥ ph/fax (869) 469 9490
¥ This paper outlines practical, cost-effective measures that can be implemented by rural health facilities with minimal costs. The methods cited have been employed more than fifteen years now on the island of Nevis and can be attested to by case files and reputation on more than 6,000 patients. What may be viewed in this document today as Ôalternative medicineÕ, it is actually nothing other than medicine as it was practised prior to World War II. The author has gone to great lengths and efforts to resurface and employ standard office procedures that were medically valid then (1930Õs) as they are now. The treatment methods employed are really not ÔalternativesÕ but practial measures during times when sulfonamides and penicillin were about to be discovered. Herbal medicine is as old as man. Thus, there is nothing radical in this shift. The author purports, it is timely and needed and very adapatable to economically poor and impoverished communities where the flora and fauna is readily available to remedy many of the common day-to-day complaints.
Problems of Practical Import to Health Ministries
1. Advancing technology and Costs
2. Health Care Prevention & Delivery
3. Drug costs and effectiveness ?
4. Nursing Staff Skills and Improved Health Care Delivery
1. Advancing technology and Costs
As a physician practicing in a country where by definition more than 30% live below the poverty level, the expense of medical tests becomes of significant concern. I have seen family finances drained by other doctors sending their patients overseas for expensive CAT Scans and MRIÕs that are often not needed and rarely provide resolution to the illness. I have seen many patients spend a monthÕs paycheck on expensive blood tests when all that was needed was some common sense and some in-house tests that requires a few minutes of time on the microscope and a few cheap chemical reagents to determine a course of treatment.
At the level of primary care, 80% of most point-of-care medical tests can today be done by the doctor and staff. For less than a few thousand dollars, obtaining used equipment like a light microscope, a centrifuge, a basic 3-lead EKG (electrocardiogram), portable blood meters (glucose, cholesterol tests), some chemical reagents and glassware, etc. the rural out-patient clinic can be equipped and a doctor or team of doctors, a team of nurses, and can deliver a high degree of proper care with the protocols that have been worked out by the author.
Additionally, as technology has advanced, there are a number of portable and tabletop instruments to measure blood glucose, cholesterol, and a number of enzymes and electrolytes for the more serious cases.
While most doctors look to torpedo (target) the diagnosis, that is, label it with a disease name and match it to a tablet prescription, an additional functional diagnosis (naturopathic diagnosis) can ascertain the patientÕs dietary and lifestyle, stage the illness, and at the outset determine if dietary and lifestyle reform can offset the illness, rather than prescribing a tablet as the first-end measure. Functional diagnosis is an assessment of all bodily systems - neurologic, endocrine, digestive, etc. - and is only rational since the body is completely interrelated. Most all disorders are systemic. For example, while the hayfever patient is routinely medicated with antihistamines, it is well known that sinus allergies are a cumulative breakdown of the bodyÕs immune system. I utilize in my clinic functional medicine, by this measure we search for bowel and food allergies, immune dysfunction, the date of the last round of antibiotics, anti-histamines, etc. as there are at least two body systems in breakdown when any complaint becomes chronic. This is not a radical or new understanding but doctors are not taught this, although the physiological understanding is at hand.
It is a matter of reorientation and medical educational reform that will go a long way in solving primary care problems in the rural setting, as this paper points out.
The facts are obvious: advancing medical technology has not translated into better primary care, worldwide! In fact, the medical models of the US, Canada, and UK are systems that face profound dissatisfaction among the populace. Patients with ordinary fractures must first see their primary care doctor [not of their choice] and then require up to four weeks to obtain an appointment with an orthopedist, is just one example I read recently. Primary care doctors routinely see the patient in minutes and post-diagnose from a piece of paper from the laboratory results or radiological definitions obtained later. In my clinic, I look at all blood and urine samples myself and can still manage more than 8 patients per hour! Its a matter of team work and dedicated coworkers fervently interested in good care delivery combined with a physician properly trained in diagnosis of signs and symptoms of illness. Consider these practical dynamics:
¥ Hemoglobin count: A single drop of blood dried on white paper can be compared to the TallqvistÕs color scale [plastic card] with a reasonable degree of accuracy. This test is more than 100 years old. Even though historically, the test is often touted as inaccurate, if the test is done properly, it is better than no test at all. Cost $: 0.
¥ Endocrine evaluation: Gross endocrine abnormalities do need confirmation with blood serum assays, however, the large majority of subclinical endocrinopathies, e.g. hypothyroidism and obesity, functional hyperglycemia (diabetes type II) and hypoglycemia, dysmenorrhea, etc. remain undetected by standard laboratory tests. The author was informed recently that a professor of endrocrinology in San Juan asserts that all forms of obesity failing to respond to dietary reform is hypothyroidism until proven otherwise, irrespective of laboratory blood levels of T3, T4, and TSH.
A little known, old naturopathic assessment, utilizing proper brachial blood pressures on both arms provides a general picture of endocrine imbalances. The fact that endocrine gland our of balance can distrurb vascular tensions is not a novel idea, but a functional perspective is, and readily available. Blood pressures should always be taken on both arms for accurate assessment, yet most doctors never do this; further, the comparative values provide endocrine data due to rather complex vasomotor responses. The author has performed these evaluations thousands of times, and has verified its accuracy with hundreds of blood tests and other indices. Additionally, other simple tests, like the old achilleÕs reflex, has long been known to be associated with hypothyroidism when absent. Cost $: 0 + time, effort, and caring.
Functional Diagnosis: Trace mineral deficiencies are common in poor people that have adopted a refined food dietary. Thus in hypothyroidism, we not only suspect inefficient iodide utilization, but we also know that selenium is required to convert T3 to T4. In hypoglycemia and diabetes, the pancreas has increased need for chromium and zinc. Supplementation of iodine is readily accomplished with inexpensive (cheap) LugolÕs solution. In the amounts iodine that LugolÕs solution can supply, not only adjust a dysfunctional thyroid, it can assist with a host of glandular imbalances as well as a wide assortment of internal as well as external infections by bacteria, fungi, and virusÕ. Lugol's iodine, also known as Lugol's solution, first made in 1829, is a solution of elemental iodine and potassium iodide in water, named after the French physician J.G.A. Lugol. Lugol's iodine solution is often used as an antiseptic and disinfectant, for emergency disinfection of drinking water, and as a reagent for detection in routine laboratory and medical tests. It should have remained in medicine period, its has both diagnostic and therapeutic use, is very cheap to prepare, and eliminates the need for a host of drugs.
¥ Menopause: Women reaching their fifties will begin to complain of vague and unusual complaints, if not the infamous hot flashes and depression. However, a proper medical evaluation should confirm prevailing estrogen or progesterone deficiency and rule out other possibilities. What doctor today performs the old vaginal smear ? This test was developed in the 1940Õs and was used routinely by thousands of gynecologists, it takes about ten minutes. The nurse obtains the smear on a glass slide. The slide is set over a tiny vial of LugolÕs solution for 3 minutes, and then is observed with the naked eye.
Cost $: < 1.00
¥ PAP smears: The Papanicolaou smear is only as good as the method of taking it and the cytologist reading it. Recent studies have shown it to be less than 40% accurate, thus it is recommended that women take these tests annually to increase accuracy of results. What is generally not known is that cervical examination with a blue light and a cervical smear of ordinary vinegar is more than 80% accurate and poses no discomfort and little cost. The diagnosis is instant, no blood needs to be drawn and sent to a laboratory.
Also long forgotten is Schiller's test, a test for nonglycogen-containing areas of the portio vaginalis of the cervix, which is a usual site of early carcinoma; such areas fail to stain dark brown with iodine (LugolÕs) solution; loss of glycogen due to erosion and other benign conditions may also give a positive result.
Also, the iodine test for menopause, again long forgotten, is a simple vaginal smear, iodated for presence of glycogen, is a simple and rapid offer test to screen the disheartened female with unusual symptoms at the onset of menopause.
Costs $: < 1.00
¥ Mammography: Tender or lumpy breasts are one of the most common reasons why women consult their gynecologists for assessment and treatment. Since painful breasts are not always lumpy, and lumpy breasts are not always painful, it is useful to create descriptive categories of symptoms and conditions to replace the generic term "fibrocystic".
What women are not told is that by the time they receive their 3rd or 4th breast x-ray, they have already received a possible lifetime dose of radiation. Adding an annual mammogram to a careful physical examination of the breasts does not improve breast cancer survival rates over getting the examination alone. The use of mammograms in young women (up to age 49) is misleading and more likely to give rise to false positives because of the lumpiness of their breasts. The mammogram is a screening tool - not a diagnostic test - in that a radiologist can't see whether there is actual cancer, or whether there is something suspicious that should be checked by biopsy.
A mammogram, which is an X-ray of the breast, shows fat as black and dense tissue as white. Cancer masses show up white. Therefore, a mammragram shows a white cancer mass in stark contrast on a predominantly black fatty breast, but a small white spot that may be cancerous can go undetected on the white mammogram of a dense breast. Ultrasound screening depicts most cancers as black spots - much easier to see against the white of dense breast tissue. As far as how effective a mammogram is for a particular woman, it is more important for that woman to know her breast density than her age.
Ultrasound screening and Thermography can detect cancers that mammograms missed in women with dense breasts. A spot thermogram can be performed with a simple hand-held device. Breast Examination is routinely performed by our nurses on all new patients over age 20. Hundreds of examinations have been performed. More than fifty cases of nodule and shotty mass cases have been treated with very high degree of success. Only one mammogram was ordered in the year 2001.
Electrodermal screening, thermographic inspection using a spot electronic thermometer costing less than $100, and thorough palpation constitute the core approach. This results in a high degree of satisfaction with female patients wanting to avoid harsh mammograms. The author can also attest as having several visiting family physicians that the Nevis clinic approach is vastly superior to a usual superficial examination and recommended annual mammogram generally performed elsewhere. No breast exam can be considered complete without palpation, just as no cardiac exam can be considered complete without an electrocardiogram.
Cost $: pennies
¥ Renal evaluation & kidney disease: There is no method available to evaluate the kidneys properly without direct examination of the urine. Kidney disease, kidney stones, and kidney infection can remain silent for a decade or more. Standard urinalysis with the office dipsticks only rules out gross pathology and is only the first step in a proper evaluation of renal function. The urine must be examined under the microscope. This method is more than 100 years old, yet is rarely performed by physicians. The end result is that the patient ends up on expensive dialysis or dies of renal failure since the pre-renal phase was never diagnosed. Probably 80% of these tragic cases could have been prevented with proper, primary care assessment, and the patient advised to increase water intake, reduce protein load, take a multiple vitamin supplement, insure adequate dietary carotenoids (vitamin A from colored fruits) and ascorbic acid, and drink diuretic teas for beverage as medication, e.g. yerba mate, parsley or carrot tops, corn silk, water melon seeds, etc.
Cost $: < 1.00
¥ Diabetes: Standard blood sugar testing machines cost less than $50 US, while the disposable inserts are less than $1.00. No evaluation of glucose function is complete without examination of the urine, which ordinary dipsticks costing less than 0.50¢ readily provides. It is common practice in the West Indies for health centers to check for glucose in the urine only, which by the time hyperglycemia is realized, dietary reform has already been delayed. Thus, the standard medical tablet practice always is doomed from the outset, and even with medication, without dietary reform, no patient will be properly managed of their disease. The author manages a large number of diabetic patients and has cured many cases, and stabilizes the large majority of others. Herbal medicine with two outstanding measures that rarely fail to drop blood sugar within two weeks and can be implemented very easily are Green bean (phaseolus nana) tea and cinnamon oil or extract, both of which can be obtained in a grocery store. The broth of ordinary string or green beans is a potent hypoglycemic agent. I have seen it drop blood sugars over 400 mg.% to under 200 within two weeks time. Additionally, when cellular control is lost, cinnamon comes to the rescue as it increases insulin response at the cell membrane (muscle) level.
¥ Hypertension: recent articles have adequately pointed out that the standard prescriptive pills over the last fifty years has failed to adequately manage the epidemic of hypertension. Renal hypertension, thought to be the main problem, and thus the prescription of diuretics, accounts for less than 40% of the cases as recently published. The author has found herbal diuretics, drank as beverage teas, adequate to assist these cases. Celery juice, as researched by a Chinese hospital, is a potent vasotension reducer due to its phthalide content; combined with cucumber juice, it is assisted by strong diuretic effects. However, hypertension also has hepatic and neurological underpinnings. We first perform a salt [sodium] count on urinary excretion with an ordinary refractometer and is almost always high in hypertension cases. Again, dietary reform is the rule, elimination of table salt is the rule, it costs nothing but saves untold damage to the body.
Sodium content of urine can be assessed with a simple, hand-held refractometer.
Most hypertensive patients are calcium deficient as a result of vitamin D deficiency from lack of adequate sunlight exposure. Although the West Indies presents ample solar exposure, it is know that the black skin reduces considerably conversion of cholesterol to vitamin D precursor. Vitamin D intakes can be increased with the old time favorite of cod liver oil. Calcium supplementation is easy. One simple measure is to take several chicken eggs, immerse them in vinegar for several days, and to take teaspoon doses of the vinegar broth for potent assimilation. I view hypertension as a systemic disease which requires complex management. Some cases are due to pain and stress, once that is resolved, the pressure goes down naturally. Insomnia also contributes to the condition. A high protein (animal meat) intake with reduced fresh fruits and vegetables also contributes to the problem by raising blood ammonia levels, a potent hypertensive agent. Again, urinary ammonia is easily measured with a cheap reagent to assess the hypertensive status.
¥ Cancer: more than fifty years and billions of dollars of research has scarcely found any cure for cancer. By the 1950Õs, many famous cancerologists and cell biologists had rejected VirchowÕs concept of cellular pathology as a basis of the cancer manifestation as a focal disease. It is now rather established that most cancers are a systemic manifestation of a long term breakdown due to dietary intoxication, a disturbance in the acid-base mechanism [which is greatly influenced by the dietary], exposure to pollutants, and a disturbed liver losing its ability to detoxify dietary and environmental poisons. More than 60% of adult onset cancers are located in organs directly drained by the liverÕs portal system. Once a doctor recognizes that such diseases as peptic ulcer, colon polyps, hemorrhoids, uterine fibroids, recurring gastroenteritis, irritable bowel disease, chronic constipation, diabetes mellitus, obesity, etc. are already precancerous phases, it is here where dietary reform must begin, and a great number of cancers can be offset or slowed in their manifestation and severity.
The conclusion therefore, is that cancer prophylaxis and early cancer treatment should start in the precancerous stages, and not wait until the tumor becomes manifest. The generally accepted period of 5 years of life after operation, chemotherapy or x-radiation, considered as proof of cancer cure, is preposterous, painful and costly. Many statistics prove that cancer mortality is longer than 5 years treated solely by dietary reform. The pain of cancer, as pointed out by Blond, Revici, and others, is best managed with dietary reform and calcium supplementation. That by a change of the acid-base balance alone, the pain of cancer is manageable without drugs and opium. Dr. Pelai, medical director of the Maharagama Government Cancer Institute of Sri Lanka, was most receptive to my instructions for high frequency lymphatic therapy and uses of the equipment I donated. Pain is primarily a manifestation of a disturbed acid-base balance in the local tissues and is readily detected by checking the urine pH as it mimicks the interstitial pH rather closely. Copious forced fluids, minerals salts, and electrotherapy readily change the picture of the cancer patient in pain.
For the treatment of cancer, electrotherapy (galvanotherapy) is in pronounced application in Chinese hospitals. It is a topical therapy, requiring little surgery, with a high percentage or resolution. It is a method that is inexpensive and should undergo rigorous research.
Cost $: pennies.
Conclusion: Despite scientific evidence to the contrary, conventional doctors in the West Indies and their patients are still, by and large, sold on the diagnostic and predictive values of the annual (superficial) physical exam, Pap test, mammogram, chest X-ray, serum cholesterol levels, PSA, and other popular screening tests. Unfortunately, these procedures without other measures can often do more harm than good. If such tests are "normal" and the doctor gives his or her patient "a clean bill of health," as this could potentially create the false impression that a patient's risk can be reduced to zero. Nothing could be further from the truth. Routine examinations as they are now done, the author posits, is chronic disease on the installment plan. The prescriptive practices of medicating away high blood pressure, sugar diabetes, high cholesterol, aches and pains, etc. IS cancer or other degenerative disease (e.g. arthritis, renal failure, etc.) on the installment plan.
The author posits that clinics and health centers installed in the rural areas under the proposed protocols will actually be delivering better health care and receive increased patient satisfaction and compliance with preventative measures, dietary reform, and the use of indigenous herbs or easily imported products for point-of-care maladies as first tried measures. West Indians are a receptive people to common sense and generally take physician advice seriously. Under these protocols, patients and physicians have nothing to lose, and everything to gain.
2. Health Care Prevention & Delivery
¥ TodayÕs medical gradaute, of which is no secret, is generally inept at bedside diagnosis without elaborate and expensive technology. The art of practical diagnosis is more or less lost. Simple office diagnoses as vascular exams, urine exams by light microscopy, routine EKGÕs, palpation diagnosis, prognostication by signs a nd symptoms, etc. can pick up early signs of disease, yet most doctors in the West Indies generally do not employ these measures as part of routine primary care.
showing patients the state of their urine and blood enforces a high degree of instructive compliance!
Simple measures, as this report points out, can act preventatively to save adult patients from:
¥ The daily needle of insulin
¥ Prerenal failure that ends up in mandatory dialysis
¥ Expensive drugs to attempt to combat hypertension
¥ Expensive tablets to attempt to control high blood sugar, and do only for a short period of time.
¥ A variety of malignancies that could have been either aborted or slowed in their manifestation with dietary and lifestyle changes for those willing to accept practical advice. It is no secret that orthodox treatment of cancer generally does not prolong life but does drain the financial resources of the family at the same time. Statistics have long proven that many malignancies are best left alone, e.g. prostate cancer, with a concomitant administration of dietary reform and hygiene that extends the years of life of the patient many times beyond surgery and radiation therapy.
In terms of pediatric and adolescent problems, the author has profound experience in managing a host of medical complaints with relatively simple measures:
¥ Asthma afflicts a significant number of children, yet many doctors have failed to identify that many cases are due to milk product intolerance as well as worm infestation of the intestines, especiall Ty in rural districts. Herbal medicine quickly resolves these complaints within weeks. Somethng as simple as the ingestion of 8-10 papaya seeds daily acts as an adequate vermifiuge starts are reduction in the severity and number of attacks. This any mother can easily do for her child. An expectorant tea prepared from dried orange peels, anise seeds, or other simples are helpful when combined with ascorbic acid. Once remedied, the asthma rarely returns except when the child returns to eating diary products.
¥ Chronic snuffles afflicts a significant number also and here dietary change and discontinuation of cowÕs milk combined with strong doses of vitamin C resolves more than 60% of the cases.
¥ Ear infections (otites) are generally resolved with bowel changes and ear drops from oil of garlic or other effective herbal antibiotics. Troubled tonsils that contribute to the recurrence are often the result of inadequate water intake coupled with constipation. Tonsils can be painted with LugolÕs solution using an ordinary Q-tip.
¥ Fever of viral origin, is readily amenable to dozens of herbal fluids from a variety of sources; lemon grass, field yarrow, cinnamon stick tea; but is most often prolonged by administration of antibiotics since viral disease is not treated with antibiotics. Cheap vitamin C crystals, purchased by the pound, given on 1gram doses rapidly stabilizes the immune system. For high fever, a simple enema is usually all that is needed with forced fluid intake. Again, LugolÕs solution is an effective oral agent.
¥ Cough of viral bronchitis, is only made worse with antibiotics, but is generally and easily treated with herbal medicine mixed with apple or grape juice for palatability. Licorice in strong doses is an effective cough suppressant as well as an expectorant. Again, LugolÕs solution is an effective oral agent and expectorant.
¥ Diarrhea should first be treated with a few tablespoons of yogurt and herbal antibiotics from the broad family of berberines, again mixed with apple, grape or ordinary fruit juice. Ginger root tea is effective for colic, the grippes, as well as simple food poisoning.
¥ Thrush, oral, intestinal, vaginal: Today moniliasis is quite prevelant and known to be fairly drug resistant to standard drug treatment. Coconut oil, water and meat is of great utility and cheap for the patient, and also provides nutriment for the entire body. The intestines can be reinoculated with yogurt. Vaginal candidiasis responds well to an infusion of Neem tree and other leaves with high tannin content given by lavage.
These are just a few examples and many provided in my book: MODERN PASTORAL MEDICINE
3. Drug costs and effectiveness ?
The reliance on prescriptive drugs at the primary care level no doubt strangles governments at providing cost effective measures for the rural people since average medical doctors are generally at a lost without expensive hospital technology and technicians, prescriptive drugs and delivery. Their relative lack of knowledge in medical botany and natural medicine (naturopathy) prevents governments from using a cheap, effective, and readily reliable source of medicine, ready to be harvested almost year round. In the jungles, forests and bush, as well as the backyard of gardens and agricultural crops, of most any country lies an entire pharmacopeia of medications, only waiting to be picked, dried, eaten and stored. Many of the needed ÔdrugsÕ can be found right in the grocery stores and markets, and this proposal does not require an immediate implementation by the agricultural department, consider these proven simples:
¥ Green bean tea to control blood sugar.
¥ Watermelon seeds, parsley flakes and corn silk as potent diuretics.
¥ Eggplant, soaked in water raw for 7 days, then taken in tablespoon doses does help some cases of hypertension.
¥ Celery juice in 2 oz. doses with an equal amount of cucumber juice and a teaspoon of honey lowers blood pressure in some of the most obstinate cases.
¥ Papaya seeds: several seeds swallowed daily for 1-2 weeks clears out intestinal worms. This was taught to the author by the famous botanist, Dr. Bhatt of Venezuela. Something everyone should do once a year for prophylaxis. Worm infestation is more common than generally believed. The foreign proteins off ered by their metabolism is a significant contributor to a depressed immune system.
¥ Corn silk and carrot tops: so often, people buy food, and throw away the medicine. Corn silk tea is helpful to reduce prostatic hypertrophy resulting in strangury. Carrots tops are also a diuretic and supply a refreshing tonic.
¥ Coconut oil and meat: systemic candida has reached epidemic proportions due to the abuse of a Antibiotic therapy and in people that continue to eat products contaminated with antibioitics (meats) and foods containing white sugar. Coconut oil has many health benefits but is specific to kill candida, and interestingly the virus HIV [although the author has no direct experience with this use].
* LugolÕs Solution. The Lugol solution contains 5% iodine and 10% potassium iodide (16). It has been available since 1829 when it was introduced by the French physician Jean Lugol, and was used extensively in medical practice during the early part of the 20th century. The recommended intake for supplementation at that time was 2 drops/day corresponding to 12.5 mg Iodine. This recommendation was still mentioned in the 19th Edition of RemingtonÕs Science and Practice of Pharmacy, published in 1995. Certain roles of in wellbeing and protection against infections, degenerative diseases and cancer involves its action on specific organs and tissues. Derry (15) has reviewed some beneficial properties of Iodine: the antimicrobial effect of Iodine in organs capable of concentrating it to reach effective Iodine levels; the apoptotic property of Iodine in the bodyÕs surveillance mechanism against abnormal cells; the ability of Iodine to trigger differentiation, moving the cell cycle away from the undifferentiated characteristic of breast cancer, for that matter of all cancer.
The author has found from extensive experience as evidenced based medicine the following:
1. The incidence of silent urinary tract infections is inordinately higher than many suppose; and
2. It is effectively treated with single drop doses of LugolÕs, as iodide exits through the kidneys within four hours after ingestion.
Iodine is excellent for toenail fungus, ringworm, fever blisters, moles and skin tags, hangnails, infected ears and tonsils, etc. Just a few drops on a q-tip is all it takes. It should also be considered in Fibrocystic breasts, weight gain, fatigue, depression, over all poor health, impending cold or flu, iodine also cures acne, PMS, cervical dysplasia, bronchitis (excellent expectorant), allergies, hypothyroidism, bladder infections, and dermatitis. It is also an effective antidote for lead and mercury poisoning.
Iodine is also a very effective method for water purification. Iodine destroys bacteria, viruses and cysts, and its action is dependent on its concentration, the water temperature and duration of contact. A concentration of 8 mgs per litre at 20 degrees centigrade, will destroy all pathogens if left for 10 minutes. Lower concentrations and lower water temperatures require a longer duration of action.
Prophylactic health measures that cost nothing
¥ Eliminate all forms of table salt for daily dietary. Salt is a poison, several tablespoons is an adequate dose to kill a 20 kilogram child.
¥ Eliminate white sugar, it is a dietary poison that contributes heavily to diabetes, obesity and high cholesterol.
¥ Eliminate white flour, it too can be defined as a poison - any substance, either taken internally or applied externally, that is injurious to health - that contributes heavily to diabetes, obesity and high cholesterol.
"About 90% of the patients who visit doctors have conditions that will either improve on their own or that are out of reach of modern medicine's ability to solve."
(New England Journal of Medicine, Feb 7, 1991).
4. Nursing Staff Skills and Improved Health Care Delivery
Effective primary care cannot be based on the solo doctor with a secretary or nurse. It is a matter of teamwork. The doctor that spends a few minutes in an interview with the patient, skips most essentials like palpation, auscultation, and then targets the diagnosis only to quickly reach for the prescription pad, is not practicing medicine proper. The chance of misdiagnosis is thus very high.
As this report is emphasizing, gain in health stature of a nationÕs people will come more from prevention, early recognition of the signs of disease, dietary/lifestyle reform, and employment of simples when the first signs of illness appears. Contributing monies to large institutions and buildings, purchasing enormously expensive diagnostic technologies, stocking health facilities with synthetic medicines, etc. will not solve the health problems for the common people, and in the great majority of cases, are actually not needed, and may only contribute to a more complex and wasteful health care system.
What is needed is medical educational reform. Rural doctors must go back to the basics and not look to technology and prescriptive drugs as methods of effective delivery. In more than 70% of the cases that reach primary care, prescriptive drugs are simply and generally not needed at the first point-of-care.
The author has found nurses as a ready resource to effectively manage clinic functions. To manage health care volume, the floor plan of a clinic is critical. The doctor becomes the end point of steps and measures taken to deliver primary care for first time patients. The stations of a clinic floor plan are as follows:
1. Entry, sign in, interrogation of the nature of the complaint. Red flags are noted by the receptionist if emergency care must be implemented. In the waiting room the new patient fills out a comprehensive health questionnaire and nutritional deficiency survey. Already the diagnoses begins.
2. Interview station, nurse notes vital signs, performs preliminary diagnostics, takes note of the patientÕs lifestyle and dietary. A form for the doctorÕs file is implemented. Vital signs are taken.
3. Physician interview and diagnostic work up - electrodiagnosis, EKG, EEG, etc.
Electrodiagnosis & EKG provide ready diagnostics
4. Laboratory station - urine and blood is taken from the patient for instant assessment.
Lab station, friendly atmosphere at all times
5. Physician examination room, the patient is disrobed. The doctor with lab results, vital signs, etc. in hand performs palpation, auscultation, etc. Special diagnostics, pelvic/rectal examination, orthopedic exam, neurological exam, etc. is performed by either doctor or nurse. Therapeutics are implemented.
6. The tragedy of todayÕs medicine is the lost art of touch and the various physiotherapies - ultrasound, high frequency therapy, electrotherapy, massage, ozone therapy, thermotherapy, etc. are enormously beneficial for a large majority of patients, especially those in pain or in a stage of acute infection. The practice of medicating away pain and discomforts with pills and tablets is in itself a practice of inducing the precancerous diathesis. Pain is a warning signal of the body not to be ignored and is not a difficult challenge to manage once the doctor is provided educational reform, and the nursing staff is trained on the various methods of application.
In terms of cost, physiotherapy equipment is inexpensive, ranging from $50 for electric vibrators, and heat lamps, to ~ $3,000 for high frequency, ultrasound, electro-transdermal and ozone units. Once equipped, the units last for years and deliver care and pain relief thousands of times over.
The added bonus is the high degree of patient satisfaction that being touched brings. Doctors have generally lost the art of touch, in terms of diagnosis and treatment. Reliance on technology _and tablets has not brought the world better primary care. Touch, caring, dietary reform, self-help home treatments, herbal teas, vitamins, mineral salts, etc. can resolve more than 80% of the complaints that reach the primary care clinic. The author has proven this thousands of times over.
High frequency physiotherapy for breast nodule
Electric evaluation of Nerve damage by injury
Implementation of Rural Health Centers
Sadly, most medical students today, enter the profession more for economic gain rather than humanitarian interests. Rather curiously, many governments that have sponsored education for medical students goes in vain as many end up unemployed, unable to apply their profession for successful economic gain in todayÕs rapidly changing marketplace. Thus, a resource exists for governments to employ struggling doctors of medicine for gainful employment and apply their art in a proper, rewarding, and useful manner.
Similarly, there is also a ready resource of Ôtherapists,Õ in various disciplines who may be inclined to move their educational level upscale through a combined method of tutelage, work experience, and academic studies.
Most young people, entering medical school, have little to no experience in the health field. They are immersed in 3 years of sole academic study with little, hands-on experience. The memorize material, effectively words on paper, and rarely see the real disease they are taught to learn, let alone treat. They are then immersed their last year or two into hospital situations and see only the drastic and iatrogenic cases in preparation for graduation. This, in the authors opinion, is why most graduate doctors are in many regards, unfit for primary care upon graduation and will only learn it by self-study, discipline, and in some cases, by using ÔunconventionalÕ, i.e. ÔalternativeÕ methods.
In the authorÕs opinion, from the outset, medical students should perform as orderlies and assistants day one upon entry to medical school. The reality of changing bed pans, assisting the ambulatory, listening to the stories of woe and pain, seeing the suffering, etc. is the only way to learn real medicine. It does little good to memorize pictures in textbooks of blood, sputum, and tissue smears, as every doctor learns it never looks like that in real practice. The author has learned down through the years that practical experience and tutelage is a much more valuable asset than textbook memorization, although that is needed also. Therefore, with medical educational reform, a ready resource of virtual labor exists, as medical students could be mandated and assigned to rural clinics for work experience. It also would act as a screening objective, to eliminate those who do not belong in medical practice.
Proposal to Governments
Many have commented that thousands of clinics like the author has developed should be in rural areas all over the world. As mentioned, all that is needed is a building, some instruments, and qualified personnel. However, for that to happen, educational reform for doctors, therapists, and staff is paramount. Further, it will require the full support of a government to start a pilot project, which is one of the objectives of this report.
What is needed is a new form of medical university that could be the launching point to reach out to doctors, nurses and therapists to train an army of dedicated workers. This university must receive a government charter or affiliation to be valid. The author would be willing to establish operations of the PanAmerican University to a country where a government charter is granted and authorities put in place to execute the project.
The author is prepared to begin timely, to train a pilot staff to operate ten rural clinics under this new and bold program. A two week crash course could act as preparation to screen a group of candidates. Following the course, studies for enrolled students can begin and rotations to the Nevis Clinic can also begin to further the training process. In the meantime preparations can be made by government to locate and outfit ten representative pilot clinics in the selected rural districts.
The enormity of this project, the author does not underestimate. It is a bold, new example for rural medicine at a dire time of need. The technological model of medicine, produced by the corporate world, is a failure of primary care. The medical universities have failed in this aspect and continued reliance upon an old model of academia does not translate into better care for the poor and needy. A new form of medical training, at a grass roots level, is what is needed combined with a new model of Ôfunctional medicineÕ and drugless and herbal therapy, representative clinics delivering proper care to the common people, under due authority and sanction by a government body.
His Excellency, Prof. [Dr. of Med.] Charles McWilliams
medical students in training, rotations
serum, microbiological & urinalysis laboratory can fit in a small space and be managed with ordinary equipment
Rural herbal pharmacy costs less than $1,000
Reflexotherapy being applied for relief of backache due orthopedic causes
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