Sustainable Medicine
Imagine a world without oil. If that is too much of a stretch, imagine a world where oil is scarce and energy is too expensive for the average person(1). Imagine for profit healthcare management organizations struggling to keep business in the black amidst the spiraling energy costs.
The current medical model is heavily based on petroleum and petroleum products(2). Every aspect of modern medicine uses petrochemicals. In a hospital or clinic, petrochemicals are used for syringes, intravenous tubing, surgical tools, and all aspects of modern diagnostics. Specialised plastics are used in heart valves as well as common items such as alcohol and synthesizing polyethylene used in tubing, sheeting, splints, prostheses, blood bags, disposable syringes and catheters. Sterilization of equipment uses ethylene oxide. Petrochemicals are used in radiological dyes and films, dermatological creams, speculum probes, endotracheal tubes, intravenous tubing, syringes, and oxygen masks(3). Without petrochemicals, pharmaceutical companies would not be able to conduct research or develop their products. Petrol is used for ambulance transport and electricity. Without these conveniences, the ability to provide healthcare would diminish greatly.
Over the past few generations, medical doctors have increased their reliance on technological advances that enhance their diagnostic capabilities. More time is spent in medical school and internships on technology and less on clinical examinations, and physical diagnostics(4). This tendency to rely on technology to diagnosis and treat people creates a possibility for a vacuum if technology fails.
For the past 100 years we have had an unrelenting supply of cheap energy that not only jump started the industrial revolution, but modernized medicine as well. This energy and the use of petrochemicals derived from petroleum has enabled vast amounts of medical discoveries ranging from MRIs, rebuilt hearts, IV tubing, and disposable syringes.
Originally the move into petrochemicals meant progress for the medical community. It removed the need for constant sterilization, it was cheaper to purchase a new plastic syringe than sterilize and reuse glass. Contagious diseases diminished with the decrease of cross contamination of reusable supplies. Even if the medical community manifested the desire to become sustainable, the health maintenance organizations would quickly become bankrupt by the cost of switching back to using renewables.
Sustainable medicine envisions an empirical system of maintaining health for people in today’s society and for the following generations. This medicine is based on ancient wisdom, knowledge of traditional and non-traditional healing
arts and combined with the advantages and technical achievements of modern science along with other areas of medicine. It is an integrated approach to preventive, safe and affordable health.
Since antiquity health care providers have practiced sustainable medicine. Ancient Greek and Roman physicians did not rely on petrochemicals to provide medical care. The obvious argument would be to compare the quality of medical care between that of Galen (129-216 AD) and a current medical doctor. Granted, the average lifespan in ancient times was less than it is now. Diseases, accidents, war and famine killed countless millions. Indeed if today’s society was forced to return to past medical models the current lifespan, level of health and comfort, and the odds of survival would greatly diminish.
The key to transitioning into a sustainable medical model is that we are not required to return to first century levels of healthcare. We have a hundred years of available medical research that will still be applicable to healthcare in the 21st century.
Submissions from current scientific literature indicate the benefits of alternative (read sustainable) healthcare. Naturopathy(5), acupuncture(6), herbalism(7), Homeopathy(8), and Osteopathy, have shown their benefit to the healthcare community. Each of these modalities are but a few examples of successful applications of sustainable medicine.
Cuba as medical model
A great example of a country embracing alternative medical options is Cuba. After the Cultural Revolution in 1959, Cuba made healthcare a priority. Article 50 of the revised Cuban constitution states "Everyone has the right to health protection and care.” This push created a system where medical education was free, and all socioeconomic levels could apply to become doctors. This caused an excess of healthcare providers. According to the World Health Organization, Cuba provides a doctor for every 170 residents, and has the second highest doctor to patient ratio in the world after Italy(9).
A primary care physician in Cuba usually spends the morning seeing patients in a room turned into a clinic in their home. Then they spend the remainder of the day making house calls to patients in the surrounding community who are unable to travel to the clinic(10). Additionally, the Cuban model of healthcare is of special interest to a changing economic culture. Cuba spends only 7.4% of its gross national product on healthcare. To put that into comparison, the United States spends 13.6%. The money spent on healthcare per person is US$193 in Cuba compared to US$4540 spent in the United States.
Cuba was one of the leaders in terms of life expectancy, and the number of doctors per thousand of the population ranked above Britain, France and Holland. In Latin America it ranked in third place after Uruguay and Argentina(11). According to the World Health Organization, the chance of a Cuban child dying at five years of age or younger is 7 per 1000 live births in Cuba, while it's 8 per 1000 in the US.
Cuba has also addressed sustainable medicine when it created Community Based Practitioners. These are healthcare providers who are not sent to medical school. They are trained in alternative therapies based on traditionally used herbs and other plant materials, especially in the Afro-Cuban population. During the early 1990s, the American embargo decreased the availability of many pharmaceutical medications. This caused a heavy reliance on the Community Based Practitioner and their “green medicine.” This sustainable option continues to flourish and expand
Sustainable Healthcare in Ireland
Here in Ireland and the West there is a need to create a new model for the future of medical education. Future health care providers need to learn how to diagnose and treat accidents and illnesses without the use of petrochemicals. There needs to be a totally new medical system that embraces sustainable options while using known medical research and capabilities to provide excellent medical care for the future generations.
Although medical schools could possibly transition into a post petroleum world, few students would be able to either travel to them or afford the educational costs. There is a need to fill the void between the practicing physician and the needs of the multitudes of unseen patients who will be located far out of physical reach of doctoral level care.
This niche can be filled by an educational model very similar to the “Barefoot Doctor” phenomena created in the aftermath of the Maoist cleansing in China in the years after World War II. These sustainable medics would have both the
skills of scientific learning and the successful and proven skills of medical herbalism, naturopathy, acupuncture, and osteopathy. They will have the use of a limited laboratory for diagnostics and clinical investigations, and a basic
understanding of anatomy and physiology, pathology, and epidemiology. Of utmost importance for the success of this methodology is the ability for these sustainable medics to reach a physician for consultations in difficult medical
cases. This medical model is similar to the methods and treatment capabilities found in Cuba and other third world clinics today. It is also found in wilderness medical protocols for remote expeditions found far from western medical facilities.
This is not an easy task. There will be extreme opposition from all sides. The government health authorities will not be willing to change or to lose control of their educational models. They will be unwilling to allow advanced diagnostic
and medical procedures to be used by the layperson. The most significant and malicious refusal for the creation of a sustainable medicine will come from the pharmaceutical companies. There will be litigious battles to prolong the current medical model as long as the coffers of the big companies are in peril.
We as citizens have the choice to both keep the status quo and watch as modern medicine has a catastrophic meltdown due to skyrocketing petroleum prices, or we can use the limited time to transition into a sustainable model of
healthcare. We now have the ability to change medical education, to amend the practice laws, and to educate the population in order to be able to provide sustainable medicine for accidents and illnesses for the coming generations.
References
1. Borger, C., et al., (2006). Health Spending Projections Through 2015:
Changes on the Horizon. Health Affairs Web Exclusive
2. Frumkin, H., et al. (2007). Peak Petroleum and Public Health. Journal of the
American Medical Association;298: 1688-1690.
3. Glenn, D. (1976). The hidden energy crisis. Texas Medicine. Vol. 72
4. Feddock, C. (2007). The Lost Art of Clinical Skills. The American Journal of
Medicine;120(4):374-37
5. Chou, R. et. al. (2007). Diagnosis and Treatment of Low Back Pain: A
Joint Clinical Practice;Annuals of Internal Medicine.147(7):478-91.
6. Sources, D. et, al.(2005). Meta-Analysis: Acupuncture for Low Back Pain.
Annuals of Internal Medicine;142:651-663.
7. Grauer, R. (2004). Preoperative use of herbal medicines and vitamin
supplements. Anesthesia Intensive Care;32(2):173-7.
8. Brinkhausa, B. et. al. (2006). Homeopathic arnica therapy in patients
receiving knee surgery: Results of three randomised double-blind trials.
Complementary Therapies in Medicine;14(4):237-246.
9. De Maeseneer, J. (2005). Primary health care as a strategy for achieving
equitable care. International Journal of Health Services;2005;35(4):797-816.
10. Dresang, L. (2005). Family Medicine in Cuba: Community-Oriented Primary
Care and Complementary and Alternative Medicine. Journal of American Board
of Family Practice;18:297–303
11. Hood, R. (2000). Cuban Health System offers an uncommon opportunity.
Journal of National Medical Association;92:547–9.
12. Gott, R. (2004) Cuba: A New History. Yale University Press p165.
13. Waitzkin, H. (1997). Primary care in Cuba: low- and high-technology
developments pertinent to family medicine. Journal of Family
Practice;45(3)250-258.
Resources
http://www.aussurvivalist.com/downloads/AM%20Final%202.pdf
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