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“Where There Is No Doctor” With Author David Werner – Episode 163

doctorOur guest this week has written three books and co-authored two more about self-reliance and how to get by when there is no doctor available. His book “Where There Is No Doctor” is used by groups like UNICEF and the Peace Corps and has been translated to over 90 different languages.

Werner has worked in more than 50 countries helping to facilitate health workshops and training programs, and has been a consultant for UNICEF, WHO, UNDP, and the Peace Corps. He has received awards and/or fellowships from the World Health Organization, the American Pediatric Association, the American Medical Writers Association, and the MacArthur Foundation.

Listen to how he got involved with this work in the first place and what changed his outlook on the availability of healthcare.

Off The Grid Radio
Ep163
Released: June 28, 2013

Welcome to Off the Grid radio, better ideas to bust you and your family out of today’s global control grid.  Now here’s today’s show.

Bill: Hey everybody, it’s Bill Heid here with Off the Grid radio and thank you so much for spending time with us, we really do appreciate.  You know, it takes time to listen to our show but we hopefully will be offering you tremendous content today.  We’ve got an amazing guest.  We have with us David Werner and David is the author of the book, Where There Is No Doctor.  And this book has been out for a number of years.  It’s a fabulous book.  It’s been written originally to use – I think David was in Mexico for a while and this was a grassroots book written from the ground up which is what we’re all about.  It’s an off the grid medicine book and it’s fabulous and you really need to get it and we’re going to tell you how to get it absolutely free.  It’s over 400 pages long.  It’s a labor of love that David and some friends have spent their lives working on and we want to avail that book to you today so at the end of the broadcast, we’ll tell you how to get that book for free so welcome to you David Werner.

David: Thank you.

Bill: Thanks so much for being with us.

David: Well, you’re very welcome, it’s my pleasure.

Bill: Now you’re a biologist and an educator by training.  I think you’ve worked in small villages, how many years has id been 40 or 45 years?

David: It’s been over 45 years since I began yes.

Bill: And I mentioned to you before we went on the air that I had a copy of your book and I loaned it to somebody that I think went on the mission field and I never got it back but I have the PDF in front of me and let’s talk a little bit about why you wrote the book originally and who helped with it, the cost of the book.  Just tell me – give us some background about where you were in Mexico and why you came up with the idea of writing a book called Where There Is No Doctor.

David: Well back in 1965, I was a teacher in a small alternative high school in California and a teacher of eco-biology course, a course which tried to sort of connect the human relationship with nature, with the world and this sort of thing and I, rather than starting with books, we would go on field trips and take the kids to make their own observations and interesting ecological zones and areas and I was always interested in a new area to take the kids to so one time, in a Christmas vacation, I went down into Western Mexico and just to sort of random, picked a road headed back up into the Sierra Madre Occidental, the mountain range of western Mexico and interested in the biology and in finding a possible place to take a group of students, but when I got further back into the mountains, what most impressed me was the people because they were so friendly and so helpful.

I began to get the feeling that gee these people live more like human beings ought to than most of them do.  They welcomed me into their homes, they fed me often better than they were eating themselves even though they were very poor and had very slim picking.  But in the process, I stayed in one little hut way off on the mountain side where the family had some big health problems.  One little boy had a fallen foot with pus running out of it.  I asked what had happened and the father said he’d stepped on a thorn 3 months before and something clicked in my mind.  Gee 3 months, taken with this small injury and now it’s become a bad infection and with proper attention, it could have been cured or a lot of the problems prevented much easier.  And that sort of clicked something in my mind and I saw a couple of the other even younger children which had big swellings on their neck, on their throat and realized they were goiters caused by iodine deficiency because the people don’t use the iodine salt in that area.  They pick their own salt out of the rocks and because it’s high in the mountain, it doesn’t have the iodine and they developed goiter from low iodine problems and that can also cause cretinism and other problems.

So seeing one thing and another as a biologist although I didn’t have training in medicine, I began to get the idea that well maybe something with a little more knowledge, a little more interpretation of basic medical information in the simple language the people could understand could be a help.  Well this whole process led first to taking a group of my high school students down into the area where the focus on healthcare rather than just biology and ecology and that experience was so fruitful that I decided to take a year off from my teaching and go back into the mountains to see what I might be able to do in developing sort of a small healthcare project mainly with the interpretation of basic medical information into a language that the local people could understand. And when that year was over, I was sold on it, I resigned from my teaching in California and involved in this mountain area with healthcare and then later with disability work.

Bill: So one of the things again that I like about your work and your perspective is that you went there and this is a very bottom up oriented thing.  You didn’t start with a government grant with millions of dollars.  You started, you saw a need in a community, you saw something that people that had less than you did and your ability to reach out and it started small and now you have, without all this help from top down, you’re a bottom up guy, now you have all these organizations coming to you.  You have World Health coming to you, you have United Nations, you have government agencies coming to you for help. It’s an amazing thing what can happen in someone who will just look around and wants to help their fellow man.

David: Well, I think that one of the reasons that Where There is no Doctor has been accepted and had the impact it has is that it did grow out of this direct relationship with people in need and I was learning along with the people, better approaches to meeting local problems.

Bill: But it’s not a typical family health book obviously or even a first aid book. What would you say would be the differentiating idea behind it? I mean this is kind of an emergency – you’re living in the bush and you’re treating people at a very simple level but in some cases, kind of an advanced level too I think.

David: Well the difference between the first aid book and Where There Is No Doctor is that a first aid book is generally information as to what to do when the doctor until the doctor arrived and Where There Is No Doctoris a book about what to do when the doctor is not going to arrive for people who live in situations or in distant locations where there is simply not that access to standard medical care.

Bill: Which is an important thing for the listeners of this show –  you know, what happens when you don’t have a doctor and I think being able to you don’t want to self-diagnose will make that little caveat right now, really in this show that if you can get to a doctor, get to your doctor.  You don’t want to use this book to go solo as it were and try to figure as a self-diagnosis book and a self-prognosis book.

What you want to use this book for is in an emergency, it’s good for helping other people helping yourself, helping your family, helping people at church or in your community when if there’s a crisis in this country and you couldn’t get to a doctor, maybe the clinics are all full.  What do you do? And I guess I’m curious too, David, we’ve got a minute here before the break, why did you get so much resistance early on from the big guys, the big medical establishment, UN.  I’m saying people came to you later but why at the beginning, why would they fight you so much?

David: Well, I think that medicine as a whole has become kind of a monopoly in the hands of an elite group that tend to sort of hold on to their knowledge rather than share it and also to price it out of reach for a lot of the people who can’t afford it. And this has created a huge problem today with over 10 million children under 5 dying every year largely for preventable disease or diseases that could be easily treated but they don’t get the access to the healthcare because they don’t have the resources or the money or they live too far away from the centers and this kind of thing.

So I think that some of the resistance arose from the medical establishment because they really don’t like often to let go of their knowledge and share information and open it up with the village health workers we work with.  One of our basic ideas with the share of a knowledge they gain with as many people they can primarily mothers.  We consider the real primary healthcare workers in the world are mothers or should be mothers and if the healthcare process could help mothers gain more knowledge about what to do in an emergency situation and when a problem comes up, and to know what they can do to themselves and when they need to look for more expert help.  This would make a big advance in getting a healthier world.

Bill: Well thank you David, we’re going to take a short break here and we’ll be right back.  We got a lot more to talk about with author, David Werner, who wrote the book Where There Is No Doctor.  We’ll be right back.

Bill: Hey, we are back. This is Bill Heid talking with David Werner, author of the book, Where There Is No Doctor, and we’re going to tell you again how to get this book absolutely free in PDF form at the end of this talk so stay tuned.  But right now, David, how many languages is this book in now?

David: Well there’s over 90 languages that we know of but it may be more because the book has an open copyright policy where any people in any country or situation are welcome to translate it, to distribute it without permission from the publisher or author so sometimes, the translations done that we don’t even know about.  One time, when I went to India, I found out that there were three translations that I wasn’t aware of when I was visiting villages and different parts of the country.

Bill: Well, again, let’s go back to your resistance a little bit before you move on.  You had a lot of resistance from the government, whoever, the powers that be, when did they kind to start? When was the tipping point where they kind of started to come around and take notice and said, look, this guy is helping more than he is hurting?  Has that been just recently or was that?

David: No, it happened slowly over a period of time, but mainly in the 70s and early 80s when the idea of community-based healthcare and primary healthcare began to arrive in the late 70s when the idea of primary healthcare arose.  People began realizing that the standard western approach to healthcare which was hospital-based and doctor-based just was not reaching the vast majority of the poor people in the world and in the rural areas and the remote areas.

So the World Health Organization, UNICEF and other groups began to look for alternative and fortunately, there were examples of alternatives in different part of the worlds, communities that had begun to train community health workers and develop a strategy for meeting healthcare at the community level and with community people and building on and better training some of the traditional healers and this kind of thing.

So there was a gradual shift and Where There Is No Doctor, people began to look at it and say hey, this is something that has a lot of these kind of ideas that we’re trying to move toward and so little by little, it was wider accepted until UNICEF for instance, I think has paid for 7 or 8 different translations in different parts of the world.

Bill: Well how many copies you do you think that there are if you were take a guess.  I mean this is one of the, you know, people brag about largest selling copy of this or that in New York Times bookseller’s list.  This is a guy that gives away his stuff so we can’t measure this but how many copies would you say are out there?

David: Well it’s difficult to know.  Maybe 10 years or so ago, we figured that there were at least 3 million out and today it maybe double that.

Bill: With the PDF, I would guess that on the internet, things travel pretty quickly so you’re probably maybe between 6 and 10 million if, maybe that would be a good number.

David: I think that would, I think that would be the, in the ball park.  And also the people going to the web are – there’s a lot of people around the world.  It’s interesting now on our own website where we have it available; we get more hits in Spanish than in English because we have the book up in Spanish which is of course the language it was originally written in.

Bill: Sure and it’s used by the Peace Corps and as I said, a lot of missionaries around the world use this book to help where there is no doctor.  Talk a little bit; what’s the UK equivalent of the Peace Corps?

David: It’s called Volunteers Oversees and they’ve been using the book for I think over 20 years to, giving it to all of their overseas volunteer just as the US has been giving it to Peace Corps volunteers for over 20 years.

Bill: Sure and we’re talking about the book itself, talk a little bit about the cover.  You do a lot of the art in this book, do you not?

David: Yes, I practically all the drawings I’ve done myself and a lot of the photos I’ve taken and the cover is an interesting story.  That’s the cover of the edition, the main edition here in the United States.  Different countries have different covers but that cover shows a man being carried by a group of people on a stretcher crossing the river and the stretcher looks like a covered wagon a little bit because it has arch sticks over it with a sheet over it that protects from the sun.

But that photo – I actually took when I was coming out of the mountains trying to get to a hospital with a man whose whole family had been washed down the river in a flash flood.  And he was very much injured and he had gangrene in one of his legs where a stick had been sort of run under it.  He was being whirled down the river and the curious thing is that when we finally got him to the hospital, it was so costly and they said that he didn’t have a chance for survival and we actually ended up taking back to our little village clinic and opening up the wound and cleaning it out and the fellow survived.  So it was an example of what can be done with a lot of people pulling together.

Bill: Wow, that’s a great example and things like that can happen in any kind of a crisis in this country, abroad, anywhere.  But I’m also interested in, I was looking through the pictures and I also noticed, being a little cute here, David, you have the audacity to suggest that mothers ought to use their own breast milk to feed their children and that when large corporations would love to sell formula and I think for a while, the UN told everybody not to dare use their own breast milk, it was bad for their children, but instead they should use formula.  What’s the philosophy behind your ground up? I mean I love your approach to this because you want to use resources that are available and sometimes there’s great resources available very close to us.

David: Well this is very true and I think your honing in on the example of breast milk is very good because certainly it’s one of the areas where if people would turn away from the infant formula and back to breast milk, particularly in difficult situations and in poverty situations it could make a huge difference.  UNICEF has calculated that a million and a half babies die because of the use of – because of not breast feeding and using baby bottles and formulas.

Bill: And I think that they were groomed by big corporations.  One of the things I know philosophically, we make share on some level, their approach may be a little bit different that we make sure the idea that so much of the world’s wealth is owned by just such a small percentage of people and I’m not here bashing, I’m the principio arch catalyst.  I love free enterprise but we’re not talking about is for enterprise, we’re talking about a large gaggle of folks that have money and power and use it for their own advantage and the small people end up getting hurt.  We’ll be right back.  We’re going to take a short break.  We’ll be right back with author David Werner.

Bill: We are back with author, David Werner, on Off The Grid radio and we’re talking about the consolidation of money and power not through fair trade, we’re talking about the consolidation of money and power and how that affects the poor.  And David, do you have some comments that you’d like to make on that as well?

David: Yes, well I mentioned that UNICEF tried to take a stand promoting breastfeeding and really putting a lot of emphasis on the dangers of bottle-feeding but they were actually threatened by the US State Department at one point that if they continued to put too much emphasis on breastfeeding and the risk of bottle feeding that the United States government would cut off the funding for UNICEF and so UNICEF was sort of forced to tone down its campaign.  And there are many, many different examples of where the big corporate interest gets in the way of the best and the need of the people and for maintaining health.

Bill: And I think it’s usually, it’s where the middle class today is being squeezed but especially in these other countries, it’s the very poor and the people, it’s the people, David that you’ve worked with that get punished the worst. And these are simple people in many cases and your book was written for them but it’s so comprehensive because it’s just ground up and as you look at the introduction of this book, folks, you know it just starts out with hygiene and taking a look at community and things like that, and it is just so broad based and there’s so much depth to it but why the simple language and why did you feel the need to start at the ground up?

David: Well, a lot of the people in the Sierra Madre where I began to work in community healthcare don’t have much education.  Illiteracy rate is still very high particularly in the very remote villages and a lot of the traditional healers are older persons particularly women who can’t read and write.  Sometimes we find with examples where a traditional healer who gets a copy of Where There Is No Doctor and can’t read will have her daughter or school child actually read the text while she looks at the pictures and together, they sort of figure out what’s to be done, so the simplicity of language and the use of a lot of illustrative pictures which help explain things is very, very important at this level.

Bill: Well this could come handy to anybody.  Once you see this book folks, you realize just the scope and nature of it. But the other thing that I wanted to talk about a little bit is and I love the idea.  We’ve had a lot of guests on the show before we have talked about sort of intertwining the idea of western medicine and traditional medicines.  Now, there’s a reason for traditional medicines and we may not have the potencies in some cases that we have in a clinic if you want to go to antibiotic but there’s a reason that these medicines have existed and continued to exist for hundreds if not thousands of years and some of these medicine men and healers, they’ve had information passed down to them from generation to generation sometimes orally, sometimes written.  But David, speak a little bit about the reason for addressing both Western medicine and the native traditional cures that may be being used in a particular area.

David: Well it’s important to keep in mind that traditional forms of healing because when you don’t have access to western medicines, it can be even more important but also, some of the traditional forms of healing although they may be quite simple, sometimes work as well or better and may be less dangerous than western medicines.  The medical textbooks all say that Alexander Fleming discovered the first antibiotic for instance.  But in fact, the indigenous peoples of the Sierra Madre in Mexico were using the underground fungus gardens of leaf-cutting ants to brew into a tea for post partum infection and for other infections long before Fleming ever discovered penicillin.

Bill: Well what do you think, let’s before we run on because I’m fascinated with you know, fermented things and healers. We had Deborah SaintClaire on with us a while back and we talked about, she does work with indigenous populations and she found one thing that’s very interesting.  She found, in terms of longevity, wherever she goes, whether it’s in the Himalayas or you know, in Northern India or she’s not working with the Karo people in Peru, they’re always drinking fermented drinks and they’re always doing things just like you just mentioned with the ants, with this making these potions. Go back to the ants and talk about that a little bit, that’s fascinating.  What do you think it is there?

David: Well I think they actually brew into the tea the fungus that the ants grow underground and then from leaves that they cut from the trees and then the ants eat the fungus.  But of course, penicillin is a fungus and it’s very likely that whatever this fungus happens to be, it’s been used as an antibiotic has similar antibiotic antimicrobial effects very similar to modern antibiotics.

Bill: Maybe 20 or 50 years from now, there’s some folks researching that and they will come up with the reasons why and then they will patent that and take it away from the Indians or whoever is it that’s using it and they won’t be able to use it.  It will be against the law to talk about it on the radio or use it or anything to so learn these things folks. When you get this book, you’re going to learn about all kinds of things like that.  If you learn it, no one can take it away from you.  You get it in your mind, you pass it on to your kids orally, if nothing else, and you’ve made a tremendous mark.  But how do you think to that your book has contributed to demystifying medicine?

David: Well, it provides a great deal of information that is ordinarily not shared with most people and uses a language which avoids the technical complicated medical terminology, puts things into simple words and it tries to relate medical concepts to experiences the people already have.  For instance, this is an example that we – this training of village health workers.  Villagers know how to measure how much kerosene is in a drum for instance by tapping on it starting at the bottom and going up and it starts with a dull sort of thud, thud, thud until it reaches the air area not the liquid area, it goes ting, ting, ting, ting, it changes sounds. So if somebody is going to percuss or tap on the chest of somebody to find if there’s fluid in the lungs, they do the same thing.  Tapping on the chest and then you can hear the difference in sound as you go up.  So in the teaching, they have a drum of kerosene and then they have somebody standing beside it and they tap on both so the people can get to hear the difference and build on the knowledge that they already have about tapping on a drum and it’s building on previous knowledge is a way to demystify concepts which may be new for people otherwise.

Bill: So it’s kind of a bridge in a way to no matter where you’re at from where is I said it starts out in a very simple way talking about things like being clean and keeping things clean and it works its way into every almost every variety of situation that you can imagine things caused by heat, how to control bleeding from a wound, how to stop nosebleeds, cuts and scrapes, what to do with cuts and scrapes, infections, bullet wounds, appendicitis, burns, and I’m just looking at one little part of one chapter, it goes on and on and on.  Matter of fact, I think it might go on so much that you told so much about medicine, we got another minute here.  Tell us about you’ve got some countries where this book – you actually can’t get this book where it’s been banned.  Why can’t you get it? Why has it been banned?

David: Well it’s been banned I think in countries like Guatemala during the military dictatorship, in Chile during the military dictatorship because it encourages people to get together to look at their problems and to work together to improve their situation and for people who are oppressed or held down by powerful forces, it’s a threat to them to have a book which advocates on something so basic as healthcare, people working together, analyzing their reality and collectively trying to work for a better situation, a healthier more equal situation.

Bill: Imagine that government that actually wants to suppress people and what they know and how they can help themselves.  We’ll be right back.  We are going to take another short break here and we’ll be right back for the final segment of Off The Grid radio news with author, David Werner. We’ll be right back.

Bill: Back again with off the grid news radio. I’m Bill Heid and I have again with me David Werner.  David, we’re talking a little bit about oppressive governments of all things and you were talking a little bit about at the break off radio about what happen example of maybe why and how it was kept from the people, how this book was kept from the people in Guatemala.

David: Yes in Guatemala village health workers were often targeted by the government as organizers of communities and sometimes persecuted sometimes killed.  And a program in Wey Wey Tonango is highland Indians, when they would give their village health workers a copy of Where There is No Doctor, they’d also give them a small knife and the knife was to be used when the health workers were riding on buses and the buses would be stopped by the military and searched as soon as the bus would stop, the health worker was instructed to slit the material on the seat of the bus and stuff the copy of their book under the cover of the seat to hide it because if they were found with the copy of the book, they could be arrested or disappeared or killed or that sort of thing.  And in fact in a sequel book to Where There is No Doctor which is called Helping Health Workers Learn, in the Spanish edition of it, the cover picture is of a health worker teaching nutrition to a group of indigenous health worker group of women, very pretty picture, but the village where that place was actually burned and destroyed by the military in their onslaught in the highlands.

Bill: Wow, that was a dangerous, dangerous book if they are – but I guess when you think about it does empower people and when greedy people, when power hungry forces see a rival it’s basically a slash and burn, it’s like Sherman going through Atlanta, it’s just search out and destroy.

David: Yeah, I’m sort of proud to say that in Chile where, Where there is no Doctor was banned by the 0:45:31.1 dictatorship that the publisher there took it to court and it’s the only book where the military order to ban the book was reversed and so the book was then distributed in spite of the ban was reversed because of the popular demand.

Bill: Well, that’s remarkable, I want again just take people through, we’ll talk about some examples but I’ll just a break and tell people a little bit about what’s in the book, just all the stuffs that it covers as I peruse on my laptop, just some of the stuff that’s in there. Ladies and gentlemen, it’s, you know how to analyze any situation, it’s fever, like how to deal with someone drowning, how to stop a nosebleed, how to apply bandages, diets to use, harmful ideas about diet, worms, tapeworms, hookworms, dealing with things like dehydration and diarrhea and dysentery. I imagine that diarrhea and dysentery are pretty big problems in some of the areas. Let’s say in Pakistan, right now we’re knowing that those folks are going through floods, I’ll bet they could use a copy of this because what all do you get when you get flooding like that, don’t you have tremendous amount maybe typhoid or ..

David: One is a cholera, it’s a huge problem.

Bill: Cholera, okay yeah.

David: Well cholera is causing diarrhea.

Bill: Okay, so have you experienced a lot of that in some of the areas that you’ve been through where people need help just with simple things? I mean it may seem like simple things but they’re life threatening things at some point.

David: Oh very much so and of course the biggest cause of death of children under 5 in the world today is diarrhea and it’s a combination of malnutrition and diarrhea really is a sort of vicious cycle.  But a lot of those cases of diarrhea can be controlled by the use of oral rehydration giving the children lots to drink with either a little bit of sugar and salt or cereal and salt in them.  And you had mentioned before the way that fermented drink and materials are being used in a lot of places by people and you can say fermentation is the poor man’s refrigerator because by fermenting grains and this kind of thing it preserves them a gruel used for baby food for instance can be often kept three or four days without spoiling if it’s fermented.

And there’s an interesting example in Northern Africa, the people were using fermented gruels or cereals and drinks as a weaning food and Western nutritionists went in and said, oh this smells too bad and taught to people not to use it and the death rate of children went up because the foods were spoiling or because they weren’t fermented.  And also, it was found that in terms of a rehydration drink for diarrhea, that the fermented gruels that were being given to the children were the ideal drink because the fermentation liquefies and pre-digests the cereals and also the bacteria in the fermentation actually combat the harmful organisms that cause the diarrhea, so there’s a lot of things like that, again growing out of people’s traditions that can be built on and learned.

Bill: Another reason why when go in the indigenous areas that we can help with western medicine, of course but why we are to be listeners as well as teachers because there is so much that we need to learn from people all around the world, that have a history of healing and I’d read from this part of your book about cereals and I was fascinated. We used to think sugar water, a lot of sports drinks in this country are used as re-hydrators but I’ve noticed in your book the update you’ve got now that cereals in this case these fermented gruels we’re talking about is maybe being preferable.

David: Absolutely, there is no question that not only are they preferable in terms of rehydrating against diarrhea or other dehydration problems, but they can get more calories into the person and they actually, and the fermented drinks will last longer without spoiling.

Bill: Well, David maybe someday we’ll see some of today’s largest sports celebrities on TV parading around drinking fermented gruels instead of the latest money-making sports drink, I’m not sure if that will ever happen but let’s talk about, we’ve got a minute left, let’s talk about some of your other books and then why don’t you tell us where they can get these books, we waited the whole time, but where can we get this book Where There Is No Doctor as well as some of the other very wonderful books that you’ve done, books designed to help communities, designed to help disabled people in emergencies.  Where can we get these books?

David: They can get them by writing to our or by opening our website, they can get them free.  All the books are available on www.healthwrights.org.

Bill: And they can download this book as a PDF as well as some of the other books that you’ve got.  What’s your, real quickly, you’ve got a few more seconds, what’s your favorite other book that you’ve got, that you think if someone could only get two books, they grab this one, what will be the other one that you would say get it?

David: Well, it’s sort of a split between Helping Health Workers Learn which has a lot of sort of the what we call liberated approach to learning about health needs and community needs.  And the other book that your readers might be interested in is called Questioning the Solution: The Politics of Primary Health Care and Child Survival.

Bill: Well, those are great suggestions and David, I just want to say thank you so much for your time. Thanks for being with us, in addition to that, thank you so much for a life well spent, we respect you here, we love your work and just keep up the good work, run that good race man.

David: Well, thank you very much and I’ve enjoyed talking with you.

Bill: Thank you very much. As always thanks for listening to us here at Off the Grid Radio and be sure to email us with any questions or comments and send that email to [email protected].  You can follow us on Twitter by going to twitter.com/. Thank you again for listening.

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