Round the World Endocrinogist Medical Anthropologist

It was France, USA, India and Oman in January and I have just finished my second trip for the year 2012
CDG-SIN-KCH-KUL-PNH-ICN-LAX-IAH-OMA-IAH-SAT-EAGLE PASS-SAT-IAH-CDG

 I can use Food as a Metaphor for my journey into USA. On the photo above it shows the food served on Asiana flight from Phnom Penh to Seoul to Los Angeles. Arriving at Los Angeles Airport after the ultramodern ICN airport at Seoul reminded one of the rising economic power of the Asians. Below is the food served on the flight from Houston to Paris. The food, the service and the wines, none of which could compare to the Asiana Airlines. 

Even the aircrafts, Asiana flew a 747 400 and United flew an old 767-200. No wonder the US based airlines have good Frequent Flier programmes, to attract the frequent fliers without offering true comforts. Sometime in the future, Asian Airlines would begin a local subsidiary in the USA and then you can see the decline of the American Aviation Industry.
The hostesses on my flight to Paris were close to retirement and they have seen it all, so the service was spotty and not at all comforting. It felt more like an official function!
Still I will continue to fly the new United and the old Continental (I will miss them when the disappear).. because of their Frequent Flier programmes, excellent service on the ground and Lounges in US domestic airports.
On this trip, the lounges visited
CDG  terminal 2E  excellent 
PNH  International   okay
ICN  Business Class lounge Excellent 
LAX  United Club  okay
IAH  United Club   Good( three times)
SAT  United Club  very friendly
In exactly two weeks, another RTW but this time going west: France USA Malaysia Cambodia France
I am always grateful for this opportunity to do what I like doing while traveling to other parts of the world..

welcome to Eagle Pass America.. 97% Spanish Speakers

Welcome to Eagle Pass. Texas and the Hairstylist Olguita, from Mexico  and the Pedi/Manicurist Heidi(Phuong) from Soc Trang, Vietnam.

When you are working with Indians, you have to travel to places that are not exactly on the tourist route. But you may come across cities and towns, which are very interesting from an anthropological point of view.

Imagine, a town in USA

Where Spanish is the predominant Language (97% Spanish speakers)

There is neither a newspaper nor a Café.

The biggest employers are Wal-Mart and Lucky Eagle Casino.

The latter is owned by the tribe that is close to my heart, so that is why I come here.

Tacos and Tex Mex cuisine

Just a short walk to MEXICO. Eagle Pass lies right on the Rio Bravo/Grande that defines the USA Mexico Border.  In fact one can see the huge flag flying over Mexican territory as if it is over the American Air Space!

The ubiquitous “Chinese” Buffet.

Low cost of living. Tacos run about a dollar, Chinese Buffet about 8 dollars, a hair cut at 15 dollars, Pedi/Mani with massage for 35 usd.

A Library where one can access free Internet is situated in a very nice building downtown and in fact it was featured in the movie Like Water for Chocolate.

An eclectic downtown where many shops are owned by newly arrived Chinese and Korean merchants, much like border towns on the South American continent.

Hardly any blacks, even though I could spot one or two black and perhaps one of them even African. In fact one of the local doctors is from Africa, I think. The ever-present East Indian doctor also is here but you don't see any East Indians about, possibly they are in San Antonio, 130 miles away?

Mexico, Mexican, Mexican Spanish. Moustachioed men who look like they have walked out of movie sets, sombreros of the cowboy type, even little boys and girls dressed up as cowboys and cowgirls. Spanish everywhere.  In this corner of USA, one sees the good and the bad of immigration, the desires and hopes and frustrations, the friendliness and lack of transparency.

Amidst all this confusion, the Indian walk around without any worry, calm and elegant. In the forty years they had decided to make Eagle Pass their home, their permanent home is in Mexico, they have truly advanced. Modern buildings, clinics, schools and Police and new houses for every one. Excellent management by the current tribal administration and Tribal Council. A real pleasure to see and experience.

It takes about 3 hours by car along a nice wide highway and then a state highway to reach this town from San Antonio. SAT is well connected by air to other parts of the USA and to parts of Mexico. Before the violence in Mexico, it was not unusual for people to go over to Mexico for Lunch! Definitely the food used to be better on that side of the border. Now the attraction to the Mexicans on the other side of the border are the two large employers here, not for a job provided, but services provided: Wal-Mart offers goods at a cheaper rate than the shops in Piedras Negras on the other side and the Casino attracts people wanting to spend their time and money in a congenial and safe atmosphere.

I had my nails done by Heidi (Phuong) from Soc Trang whose family has moved to Dallas but she maintains her job and residence here for most of the month. A chatty Vietnamese, and good at work, my feet felt good, especially since I was missing my regular Pedicurist, GS at A Cut Above in Bangsar, Kuala Lumpur. Also, Fei Wen is no longer easily available to me, he who of KL, so Olguita from Mexico did a reasonable job of making me look presentable as I prepare to leave for that mecca of fashion, Paris.

WELCOME TO THE BLUE HOUSE AMONG THE OMAHA INDIANS

Just imagine, tonight is Monday, and on Friday night past I was having a Khmer/French dinner at Le Rits’ Boutique Hotel in Phnom Penh. Today I am in Walthill, in the land of UmonHon Indians, Population 881 (882 including the baby born two months ago!). As Yogic Philosophy would teach us, it is the perception that gives you the false impression. I am very glad to be here in this quiet village of Indians, in this blue house. I have time to think, to reflect and occasionally receive a visitor.

Todays’ visitor was none other than Little Miss R, who dropped in with her mother. It was a sheer pleasure to have R here, her presence lighted up this old house. As Cuban ambassador’s wife reminded me: these are precious moments, enjoy them to the fullest. Yes I did, it was good to have R here…

It was Pierre, a relative of R who reminded me one day: All the beautiful things in life are free. It becomes unreal when you begin to chase the unreal lie.

One such great gift is the smile of R. Indians are well known for their hearty laughter and you can see this little one, not yet 2 years old, has already begun to spread happiness by the gift of being herself.

You are always welcome at the Blue House, Miss R with your mother!

"Let the person I serve express his thanks according to his own bringing up and his sense of humor."

-- Charles A. Eastman (Ohiyesa), SANTEE SIOUX

"It is better to give than receive." But it doesn't really matter if we are giving or receiving. There is an identical feeling associated with both. We get this feeling every time we receive. We can't control when we receive gifts but we can control when we give gifts. Therefore, the more we give, the better we feel. When we are given gifts, or someone does something for us, it is the Indian way to honor this person.” I have always felt that the Great Spirit has given me an eternal Gift because of this association with his earliest creation among men, the Indians who live in this land they call The Turtle Island. I return that honour to each and every Indian who enters my life. Even if they are not yet 2 years old!

AMERICAN INDIANS DO NOT LIVE IN TIPIS OR WEAR FEATHER BONNETS

My Kickapoo sister recently moved into her new home, provided by the tribe. Not a handout mind you, but reward for the good management by the tribal elders and the administrators of their income. Theirs is an incredible story.. From abject poverty living under the international bridge to relative modern affluence in just under 40 years. While maintaining their deep cultural connections! They are the most traditional tribe that I work with in North America.. most of whom speak Kickapoo.
Before she moved into her new house, she asked me for some advice. I told her, please decorate with mild colours, do not clutter up the place, with walls full of ancient photographs and buy all new cutlery 
When I arrived she had just finished preparing the welcome dinner: home made tortillas the way her mother used to make; potato soup of the Kickapoo with small pieces of meat, Frijoles with no pork products (she is very considerate to this wandering Jew), specially prepared condiment to satisfy my desire for hot food.. As I had noted elsewhere, the native people, like the Iban of Borneo whose hospitality I recently enjoyed, do not spice up their food.
I was amazed at the house, how it was set up and it looked like a home in any affluent suburb of the USA! looking out you see the natural beauty of the region ..and since the house was situated in land away from the main settlement, it was incredibly quiet and good place to observe the moon and the planets and other stars..
It is a lesson for people to learn, Indian dont wish to be poor, they had been kept poor by oppression and racism by the recent immigrants.. Believe it or not, it was not long ago, that the Indians of this town were discriminated by the Mexicans who were just recent comers to this land. That reminded of the way the Herrero maltreated the San/Bushmen of Namibia and the same in Botswana.. So discrimination and oppression is not limited to just Europeans, the others do it when given the chance, just go to Kerala and enquire at the Adivasi Centre!
But the Kickapoo has overcome all that. A new Health Clinic will be built to care for them, they are free of the burdens of dependence on the Federal Government (as did their cousins the Meskwakia who drove out the federal agencies handing out food and other poisons and dependencies to them).
Those who work with Native People ( I mean to say Indigenous people, nowadays every one is claiming to be Native) would soon know the concept of Social Responsibility. You are your brothers keeper or she ain't heavy, she is my sister, as popularized in songs. and the famous dictum of Chou En Lai, the PM under Mao Tse Dong: Let China get ahead, but not at the expense of its own people , let all the Chinese get ahead.
Among the Kickapoo, it is not just a small minority who have done well, each and every one has done well; as the fruits of well managed labour is equally distributed.
Congratulations to your tribe, Sister Mena..

HEROES OF OUR TIMES

I left Phnom Penh, Cambodia at around midnight last Friday and I am writing this at around midnight on this Friday, seven days later, in Eagle Pass, Texas, from the house of my Indian sister Mena, which lies just about 500 metres from Rio Bravo separating USA from Mexico.
These 7 days also included a very comfortable flight on Asiana Airlines from PNH to ICN and then on to LAX. Continental took me to IAH and then OMA, few days later OMA to IAH to SAT, a rent a car, a drive of 2 1/2 hours to Corpus Christi (Corpulent Christi as my good friend Ian would call it), then a five hour drive along pretty desperate scenery to Eagle Pass.

(from left to right: arriving in Phnom Penh; Heritage petrol station in Winnebago, Nebraska;the sunset on the drive to Eagle Pass, Texas; the ultramodern Inchon airport in Seoul, Korea; my newest friend RSS from Walthill, Nebraska; standing on the shores of Rio Bravo/Rio Grande looking at the mexican town of Piedras Negras, Coahuila; The good doctor from Mexico and her husband visiting my kickapoo sister. centre: the shoreline boulevard at Corpus Christi, Texas)
I wanted to thank the people who had illuminated my soul during these 7 days.
Maurits vp, www.mopotsyo.org in Phnom Penh
Dr Jim and his wife Gena, who were on the same flight to Omaha, coming back from a vacation to Key West. also included was looking for a place to eat at midnight in Omaha and the neighbouring towns.. Drinking Yes, but Eating, No  said a tavern owner in the Old Market.
My Colleague at Hocank Diabetes Programme, M who is a Nurse Educator.
My Indian colleagues at the tribe.
VS, her daughter MS and her granddaughter RSS, for pleasant times after work
My esteemed colleague in Global Health Dr IBB and his wife VM.
My Kicakpoo sister M who had gone to lengths to prepare her house for my stay
The most holistic General Doctor that I know, Dra. ERG who drove over from Mexico, just across the border, for a late night chat, with her very patient husband.
One week is a short period of time, but each of these people contributed an entire universe to me.
What a melange!
A dutch lawyer in Cambodia, who had worked in Mocambique and many other places who speaks Khmer
American Indians, my patients and my friends and teachers
Christian, Jewish, Animist and Hindou
All in professions taking care of other people
A Gujerati-Ugandan-British studying to be an Occupational Therapist
Mexican
Represents a good chunk of this world.. Two Stars from the French Skies are always present.
These are my heroes! their every day life gives me strength to gon on in my chosen direction with a great speed given by them.
Thinking about each of them, as the night has chilled the air in this town which lies quite close to the northern desert of Mexico, I thought how each of them help me bring down the Structural Defects, Kleishas, as detailed by Patanjali in his Yoga Sutra.. Two and half millennia ago!
IGNORANCE
you cant remain ignorant of this world with friends such as this. Dr IBB regales you with details of his travels, one moment he is Mae Sot with the Burmese Shan Doctor and the next he is telling me a Yiddische joke!
ATTACHMENT  it is so good to practice dis-attachment, even from your loved ones. To see the sufferings at close quarters of GK and IBB/VM, makes you realize that attachment can make your suffering worse.
FEAR OF CHANGE  You will not accomplish much if you are afraid of change. A graduate degree in International Law and this dutch humanitarian is helping hundreds of sufferers in Cambodia.
EGO There are bigger things in this life, bigger than you and there are people who sacrifice to a much greater degree. Both Dr JK and VM, how much they sacrifice for their partners .. so humbling and something to look up to ..
AVERSION  using this technique, there is nothing to hate and nothing to love, the objects are there.. I immensely enjoyed my visit to Singapour, having arrived there from Paris and left for Phnom Penh.


Nothing is permanent, but I am so glad that I can be there for these friends, and I will make every attempt to travel to them, support them morally ..
Our world needs more people like this.. My Kickapoo sister who is so unselfish when it comes to helping members of her tribe, the inredible Dra ERG, who would go out of the way to be with a patient and at times would travel hundreds of miles on her own dime and time... unselfish, sacrificing and a healer..
I will quote from the two books I am reading now:
Murakami Haruki  1Q84
When granted hope, a person uses it as fuel, as a guidepost to life. It is impossible to live without hope
Erin Morgenstern  The Night Circus
People see what they wish to see, and in most cases what they are told that they see.


Thank you my dear friends, my mentors and my inspirations and my two stars in Paris .. and also my newest little friend from Walthill.. each of you fills my heart ...

I AM HAPPY TO BE A PHYSICIAN ANTHROPOLOGIST TO NATIVE AMERICANS

CHOOSE A CAREER TO SUIT YOUR PERSONALITY, NOT YOUR INCOME

Thank God for the Indians (Los Indios de America)

I had done particularly well in the latter years of my medical education that many of my mentors wanted me to follow them in their speciality: Cardiology, Gastroenterology, and General Surgery, None of which suited my personality. I was in my second year of post medical school training, when I met the Professor Endocrinology and we had a nice chat, I knew that Endocrinology and Endocrinologists were my type of people, as it fit well with my personality.

For me, having a father and a grandfather before me who had been very altruistic about their actions and humanitarian efforts, it was already clear that I would follow them. Never once had I thought of practising Medicine for money, not do I have high opinion about it.

Meeting the Indians of North America (the first tribe was the Meskwakia) settled the question: Think of others, put others first, bring some comfort to others before your own.

I have had such an excellent day at the last day of the clinic (I come regularly once a month to this clinic) that filled my heart with such contentment, I felt so grateful to the people I work with and I realized that each and every patient of mine, Indians of various tribes, leave something or other with me.

As is my custom, during a consultation with the Indians, I bring the conversation around Spiritual and emotional aspects of their lives, this is a great treasury for me, since each one of them gives me something. Reminds me of the Buddhist monks, silently standing in front of people’s homes or shops, silently receiving what is given to them, with gratitude.

My first patient was a Hidatsa man, an acquaintance of many years. I was talking to him about the importance of meditation and also of pranayama, he said we have similar things, in my country people go to sweat lodge, and when you put the sage o n those hot stones, the lungs are cleared and you are taking deep breaths.

Do you sweat here in this reservation? Sweat is the term used as in do you go to a sweat lodge.

No, he answered, to my surprise.

Men and women enter the sweat lodge here together and where I come from, women and men separately. I wondered loudly about this gender distinction.

He took a deep breath and went on to explain to me in detail the reason, which took most part of my consultation on this Hidatsa Indian who had come to see me about controlling his Blood Sugar.

We consider women to be very pure and men not so pure and we don't wish to pollute their purity with our presence.

Vow!

Among our tribe, it was men’s duty to provide and protect, but it was women who were in charge of the day-to-day affairs of the tribe and take care of the tribe. In a way, they were the government and we were the soldiers.

Why are women purer than men?

The Great Spirit creates a new human being, it is created as a woman, and when it is known that it contains some impurity it is turned into a male,

When we have sweat lodge ceremony, we, the men go away from the lodge, quite a distance and wait for the signal. Women go in first to the lodge and do their ceremony and once they are finished, the head lady would send us a message and we wait yet another hour and go to the sweat lodge. By the time we arrive there are no signs of their presence. And we continue with our ceremonies.

So, you can understand why it is difficult for me to go to the sweat lodge ceremonies here in this reservation. In fact, I have never done those ceremonies outside my reservation.

He continued telling me a story told him by his grandmother. My grandmother told me, he continued, that your hair contains your story, the longer it is, longer you have lived and experienced more and it carries the story within itself. I didn't understand when she was telling me that, but years later when I was a Federal Officer, DNA studies of the hair strands were used and from the DNA of the hair they could tell a whole lot about the person, including the kinds of food they ate. My people knew about that long before the science proved them right, he beamed.

As he was preparing to leave, after I had finished the mundane parts of the consultation, such as refilling his medications, and talking about stress at work (more important than the medications), I was happy to be working with the American Indians, the earliest inhabitants of this continent.

SAME CURRY, DIFFERENT PLACES AND COMPANIONS AND AN AMERICAN TRAGEDY

LE RITS boutique Hotel and Resto, Phnom Penh, Cambodia, Thai Curry

Dining Companion Friday Last, Maurice VP, who conducts an NGO on how to take care of Diabetics at a very cheap cost, and good outcome

 Four days Later, I am having Panang Curry at the Thai Resto in South Sioux City, a nondescript city by the river Missouri. But this time my dining companion was none other than the winsome Omaha and her mother and her grandmother!

The Lao lady who with her husband owns this resto, was in Thailand and then came over here. Her children help her now and then and I noticed that while she has remained thin, her children and relatives have become fat or obese,, the reason may be found in the folowing picture.

There is something very dominant about american Culture that it can make humble lao-cambodians..whether they are born in the country or not,they yield to sickness quickly.. not only Lao or Cambodian or Thai but just about any nationality...
KFC in Phnom Penh
Starbucks in Bombay
Dunkin Donuts in Kuala lumpur...


You dont see French or UK fast restos spread all the place,, is it an inferiority complex of the colonized people?

Blue House among the UmonHon Indians

Just imagine, tonight is Monday, and on Friday night past I was having a Khmer/French dinner at Le Rits’ Boutique Hotel in Phnom Penh. Today I am in Walthill, in the land of UmonHon Indians, Population 881 (882 including the baby born two months ago!).. As Yogic Philosophy would teach us, it is the perception that gives you the false impression. I am very glad to be here in this quiet village of Indians, in this blue house. I have time to think, ro reflect and occasionally receive a visitor.

Todays’ visitor was none other than  Little Miss R, who dropped in with her mother. It was a sheer pleasure to have R here, her presence lighted up this old house. As Cuban ambassador’s wife reminded me: these are precious moments, enjoy them to the fullest. Yes I did, it was good to have R here…

It was Pierre, a relative of R who reminded me one day: All the beautiful things in life are free. It becomes unreal when  you begin to chase the unreal lie.

One such great gift is the smile of R.. Indians are well known for their hearty laughter and you can see this little one, not yet 2 years old, has already begun to spread happiness by the gift of being herself.

You are always welcome at the Blue House, Miss R with your mother!

"Let the person I serve express his thanks according to his own bringing up and his sense of humor."

-- Charles A. Eastman (Ohiyesa), SANTEE SIOUX

"It is better to give than receive." But it doesn't really matter if we are giving or receiving. There is an identical feeling associated with both. We get this feeling every time we receive. We can't control when we receive gifts but we can control when we give gifts. Therefore, the more we give, the better we feel. When we are given gifts, or someone does something for us, it is the Indian way to honor this person.” I have always felt that the Great Spirit has given me an eternal Gift because of this association with his earliest creation among men, the Indians who live in this land they call The Turtle Island. I return that honour to each and every Indian who enters my life. Even if they are not yet 2 years old!

                                                                    

A day in the Life of a Medical Anthropologist

What do Medical Anthropologists do anyway? I dont know about others, This is one day, more than 24 hours.. but felt like one day.

Early out of bed from the nice boutique hotel run by Nyemo NGO in Phnom Penh, A friend comes with a car, he is a important part of the NGO MoPoTsyo and we pick up the Director, MvP off we go to Takeo, stopping at a town nearby to have some breakfast (strong coffee for me), then to the Peer to Peer Diabetes Clinic to watch the operations; then visiting an Eye Clinic at Takeo and it is now lunch time, but have to hurry back to Phnom Penh. A chicken noodle lunch at Sydney, more like a Food Court and then back to the Hotel to await a call from the Cuban Embassy, where I spent few lovely hours. It is truly the country that I love! Packing my bags and a nice khmer/french dinner at the Hotel and off to the airport to catch a very late night flight to Seoul, Korea. Six hours and interrupted sleep, long wait at the Lounge of Asiana airlines n Seoul and a 10 hour very pleasant flight to Los Angeles. I think it would have been better to break the journey here and rest and continue the next day..On to Houston, another three hours on the plane , fatigue creeping in and a delayed flight arrives in Omaha close to midnight.. in fact 44 hours earlier I had left the Hotel in Phnom Penh to go to the airport..
But the tiredness vanished when the unexpected pleasure of meeting two close friends who were coming back from KeyWest...
Life is full of unexpected pleasures, that is what a day in the Life of a Medical Anthropologist is like..

MEDICAL ANTHROPOLOGY AND YOGA

MEDICAL ANTHROPOLOGY: QUALITATIVE VS QUANTITATIVE

Being Both a Physician and an Anthropologist, I can see the mechanism of problem solving among Physicians: mainly quantitative. But apart from some neurotic nationalities, most people and all anthropologists are qualitative.

I used to be horrified when well-educated Nutritionists would advice that you can fit in a McDo on a diet plan as long as you took care of the Calories and Carbohydrates and Fat!

It is the difference between WHY and WHAT. Doctors would ask   WHAT? When a patient presents with tummy ache, he tries to figure out WHAT is happening, acidity of the stomach, causes and treatment. Whereas an Anthropologist would ask WHY does it happen? People who migrate from UK to NZ, have a higher rate of Peptic Ulcer Disease, WHY?

So it was good to read the following article:

Neuhouser, M. et al: “ A low glycaemic load diet reduces serum C-reactive Protein and modestly increases adenopectin in overweight and obese adults” Journal of Nutrition 2012, DOI:10.3945/jn 111.149807

First of all to look at who funded the study. American Nutrition Association has McDo and company as their sponsors, so we have to be initially careful of the purpose behind the study. I was sad to hear that at the recent well-organized International Diabetes Federation meeting in Dubai, the stars of the show were Coca Cola and many Drugs, which generate Billion dollars or more each year. Of course studies showing the efficacy and appropriateness of these drugs do not come into discussion. (Such as the necessity to use Statin drugs in every body with slightly increased cholesterol).

I was happy to see that the study was supported by grants from the National cancer Institute. Research like it used to be!  I have lost faith in professor-peons (the new drug pusher) and do not wish to read what they write or listen to them at conferences regardless of the University they are from. (Sad also to see that the main benefactors of Malaysian Diabetes Federation are also Drug companies!)

In summary of the article: the researchers interpret the study findings to suggest that low glycaemic load diets influence two critical mechanisms linked to adverse health outcomes: inflammation and synthesis of adipose derived peptides.

Majority of the current day chronic diseases which are non communicative are results of Inflammation in the body.

One of the best ways to deal with Inflammation in the body is not to take Medications, but to practice the philosophy of Raja Yoga! I honestly feel that those who need to loose weight and who are pre diabetic, could use the above nutritional advice and also incorporate a Yoga Way of Life as well find a Lifestyle Coach who would introduce you to this ancient science. I do not recommend yoga classes or deviant forms of Yoga such as Hot Yoga.

Like the American Indians say: Every thing is related. So you can see that a science that was developed by thinkers over 2500 years now can be proved by modern measurements!

Here is some more science for those who want further confirmation:

 Novices’ serum interleukin (IL)-6 levels were 41% higher than those of experts across sessions, and the odds of a novice having detectable C-reactive protein (CRP) were 4.75 times as high as that of an expert. Differences in stress responses between experts and novices provided one plausible mechanism for their divergent serum IL-6 data; experts produced less lipopolysaccharide-stimulated IL-6 in response to the stressor than novices, and IL-6 promotes CRP production.

Psychosom Med. 2010 Feb;72(2):113-21. Epub 2010 Jan 11.

Stress, inflammation, and yoga practice.

From Ohio State University, USA.

 The ability to minimize inflammatory responses to stressful encounters influences the burden that stressors place on an individual. If yoga dampens or limits stress-related changes, then regular practice could have substantial health benefits.

It is recommended that we try to reduce our every day life related inflammation in our bodies, we can do that by choosing our food well, having a lifestyle coach that you would listen to. And being active rather than sitting in front of TV or Computer…I have managed the first two and trying to wean myself from the computer, but just to write this blog, I had to read few articles from the Internet on my COMPUTER!