FRIENDSHIPS IN MIAMI

Who else do you need in Miami, asked my sister, you have me and my husband and also your good friends M and G and all of us like to eat good food. So do your work and eat well and talk well.
There are words in Yiddish which cannot be translated adequately. these words are all lived in experiences. My good friends M and G and I have what we call schmooze sessions. we spend hours with each other talking about a thousand things, and also about things which are close to our heart and which we share an interest in.
The last two schmooze sessions with M and G lasted six and four hours each, always accompanied by good food and good wine. It has become a ritual for me, each time I come to Miami, get together for a schmooze with my friends  M and G.
In 2015, I hope our geographies change a little, I want to show them La Habana before it is overrun by curious Americans, share the beauty of Angkor Wat and acting as their guide! wonderful it would be if L/M can join us too!  I hope to see my sister and her family in Venice and London in July of this year... to return the favour of their hospitality in foreign lands!
Look forward to our next schmooze!

Soyka and Villagio Restaurants
Chinese New Year Celebrations
Boat ride on Biscayne Bay

MULTIPLE NATIONALITIES, DISTINCT IDENTITIES BUT SIMILAR ASPIRATIONS: MULTIINDIVIDUALISM?

MULTIPLE NATIONALITIES, DISTINCT IDENTITIES  BUT SIMILAR ASPIRATIONS

I was at a Shopping Mall near my sister’s house on this sunny but breezy day.

At the Apple Store, a young man (born in USA of Nicaraguan parents), interested in Ecology sold me the iPhone 6. We talked not about the Apple products but about income inequalities in Latin America, Cuba’s role in providing medical care to the poor in Latin America and Nicaraguan Politics. I told him: Emigration is a very personal choice but I feel sad that so many educated professionals especially Doctors leave Nicaragua, Ecuador and other developing countries.

Walking into the L’Occitane store just to savour the perfumes and creams, the young lady inn attendance turned out to be chirpy and very pleasant. She was born in Brooklyn of Dominican parents. We had a nice chat about her dreams and aspirations. She had an innocence about her which was very attractive. She is a credit to the company she works for (she loves her job) and the other hobby cum job in the PR field. Good Luck!

On the way to the café, I saw the T mobile store and went inside to say Thank you for the excellent service provided by T mobile to this traveller. I was talking to an agent, a young man, born in Texas of Colombian parents. We talked about the recent upsurge in tourism to Colombia and reminisced about the beauty of his parental country.

All three of them are Americans, well integrated into the society. All born in the USA spoke English like americans (naturally) but when I broke into Spanish, they replied, without shame, in perfect Spanish with sonorous accents. They were not ashamed of their origins, they knew about the countries of their parents, had spent time there and all the three of them, wanted to return and do something for their countries.

This is in sharp contrast with some of the immigrants to Europe, where such integration is hardly seen and there is a shame about who they are or where they are from.

Perhaps, in the words of Marc Auge, this is the advent of Multiindividualism.

We had something in common but at the same time, we were individualistic. One was interested in Ecology, the other two in bettering the conditions of their parental countries. These young men and woman indeed deserve our respect and not our scorn as “immigrants”. It is such people who made this country, the USA, one of the more livable countries in this planet, where your aspirations are limited only by yourself: not by your school, not by an elite system of education at tertiary level or blockades erected against your colour or parental nationality.

I settled down for a cup of coffee (I missed the cortadito of Cuban cafes and any day give me a Cortadito from a Cuban café, Starbucks  never can compete for my taste!). Without even thinking, I ordered my coffee in Spanish.

The American born young lady had no problem understanding me. Her parents had come here from El Salvador!

Bienvenidos a Miami!

MARC AUGE AND MULTIINDIVIDUALISM AND DIVERSITY: CUBA AND UNITED STATES

Well known French Ethnologist was asked about Identity and this was one of his answers:

Actualmente predominan en la vida social las tendencias provenientes de la defensa del multiculturalismo, posturas que despiertan ciertas sensibilidades sin duda necesarias, pero que también dan lugar a nuevos conflictos. ¿Cómo ve la convivencia entre lo “políticamente correcto” y esas otras costumbres largamente arraigadas?

Creo que hay que llevar a cabo algo más que el multiculturalismo para crear otro tipo de diversidad, lo más importante es el multi-individualismo. Tengo siempre una dificultad cuando me preguntan por mis orígenes, ya que mis abuelos eran de Bretaña, Cataluña y Burdeos; de la misma forma, en Francia 1 de cada 4 personas tiene al menos un abuelo que es de fuera del país. Es decir, personalmente conozco algo de Bretaña, pero no puedo decir que mi cultura adquiera su significación de ahí, mi cultura tampoco es parisina, aunque he vivido siempre en París, también he vivido en África, por lo que también tengo elementos de cultura africana. Lo que quiero decir es que cada individuo tiene experiencias culturales de vida diferentes y no tiene por que ser encerrado en una cultura, incluso una cultura que corresponde a su país natal, aunque está claro que puede reivindicarla si quiere. Pero al nivel de una organización, mi preferencia es que tenemos que tratar con individuos, no con culturas, porque las culturas también pueden ser un instrumento de opresión. Podríamos tener todo un debate sobre las nociones de tolerancia, de relativismo, que son nociones ambiguas, pero ¿qué es la tolerancia? Que yo piense que tú tienes derecho a equivocarte y que esto es recíproco. En realidad, no pienso como tú, pero creo que tengo razón, claro que también puedo equivocarme. Sin embargo, no puedo decir que se puede pensar cualquier cosa y no tengo respeto hacia ciertos aspectos de algunas “culturas”, ya que, por ejemplo, para mí una mujer es exactamente igual que un hombre, a nivel teórico no tengo ningún respeto intelectual por las posiciones que dicen que hombres y mujeres tienen su puesto. Está claro que no voy a hacer la guerra, pero podemos pensar que tenemos que hacer un esfuerzo. En este sentido me siento más cercano al siglo XVIII que al siglo actual. Mañana la moda intelectual puede cambiar y lo importante me parece el individuo. La cultura se puede reivindicar por parte de los individuos, diría mejor “las culturas”, en esa mezcla que hay siempre, pero no hay que partir de la cultura, sino que hay que tomar al individuo como punto de referencia».

Trends in defense of multiculturalism currently dominate social life pose certain sensitivities certainly necessary, but they also give rise to new conflicts. How does the coexistence of "political correctness" and those other long-established customs?

I think we should carry out more than multiculturalism to create another kind of diversity, the most important is the multi-individualism. I always have a difficulty when asked about my origins, because my grandparents were from Brittany, Catalunya  and Bordeaux; in the same way, in France 1 in 4 people having at least one grandparent who was born outside France. That is, I personally know some of Brittany but I can not say that my culture acquires its significance there, my culture is not Paris, but have always lived in Paris, I also lived in Africa, so also I have elements of African culture . What I mean is that each individual has different cultural experiences of life and not have to be locked in a culture, even a culture that corresponds to his native country, although it clearly can claim it if you want. But the level of an organization, my preference is that we have to deal with individuals, not with cultures because cultures can also be an instrument of oppression. We could have a whole debate on the notions of tolerance, relativism, which are ambiguous notions, but what is tolerance? I think you have a right to be wrong and that this is reciprocated. Actually, I do not think like you, but I think I'm right, I can also be clearly wrong. However, I can not say that you can think of anything and have no respect for certain aspects of some "cultures", since, for example, for me a woman is just like a man, theoretically have no intellectual respect for positions that say that men and women have their place. Clearly not going to make war, but we think we have to make an effort. In this sense I feel closer to the eighteenth century than to the present century. Tomorrow intellectual fashion can change and how important we think the individual is. The culture can be claimed by individuals, better to say cultures in the mélange we already have but it must be based on culture, but you have to take the individual as a reference point. "

I have just left Cuba and arrived in Miami. It is an interesting trip, in that in the short distance and the minutes it takes to cover by air travel (39 minutes), one sees clearly and understands what Marc Auge was talking about.

In Cuba, there are three distinct racial groups and a false one (Tainos who do not exist culturally): White, Black and Mulatto.

Everyone  identifies as Cuban and speak the same language, share very similar food and drinks throughout the island. Cubans are mostly secular but if religious they either follow Catholicism or Santeria: one from Europe and the other from Africa, regardless of their racial identification. There are minor Christian denominations introduced by American Missionaries. Religion does not play an important part in the life of an ordinary Cuban. Interestingly enough, the DNA studies show that an average Cuban, if he is white, has chances of having African DNA and vice versa. It is where one can say that DNA does not prove ones culture. The False Tainos of Baracoa and other “Indians” of Cuba may well have Black, White or Indian DNA but that does not prove anything, from a cultural point of view. Like their Puerto Rican and Dominican counterparts, they are mainly mulatto or Black in their culture.  There is a very high amount of mixing of the races in Cuba, much more so since the Triumph of the Cuban Revolution.

Just crossing the brief Straits of Water, one arrives in Miami, where the population is predominantly White Cuban, but here they have another identity they can mark: Hispanic

It is an interesting nomenclature which has no cultural meaning at all. Here is the definition:

The U.S. Department of Transportation defines Hispanic as, "persons ofMexican, Puerto Rican, Cuban, Dominican, Central or South American, or other Spanish or Portuguese culture or origin, regardless of race."

I can assure you that Cubans who are in Miami are predominantly White, Mexicans who are in Texas or California are predominantly of Indian origin, Puerto Ricans and Dominicans have a fair share of African Blood. Argentines, Chileans are mostly White, Guatemalans, Peruvians and Bolivians are predominantly Indian.

So the term HISPANIC is an insult to the idea of “cross culturalism” or multiculturalism ( a concept which is in the throes of its disappearance), instead of diversity, they want to unite diverse group into an unifying nomenclature.

While doing research for lectures on Identiy, it was interesting to discover this: A Black Cuban is Cuban first and Black second in Cuba but if he migrates to USA, especially to MIAMI ( the USA officials in La Habana advises of potential black Cuban migrants about this and recommend that they go to some place like Nevada!), he is Black first and Cuban second!

USA is a very large country and it is the most diverse country on earth. I am told of one particular street in Queens, where more than 130 languages are spoken. There are language communities large enough to support their own newspapers!

But there is a huge difference between USA and say Europe or Great Britain. In this regard USA resembles closer to Australia or New Zealand than to Britain.

In the USA, you are welcome to join the  Nationality Club. Legally anyone can become American but there is no pressure to do so.

While in France, the diversity is disguised into French and Non French, and recent lessons learned have showed them that this lack of division is probably an insult to the culture of the multitude of races which  inhabit France.

In the UK on the other hand, one can aquire a British Nationality but can never become English, Welsh, northern Irish or Scottish. So we have Black British but never Black English or Black Scottish.  Jacques Derrida would have had a field day deconstructing these nomenclatures behind which we hide our intolerance, racism and phobias.

Marc Auge is futuristic in his vision. Travelling frequently between Cuba and the USA, I see the importance and significance as well as importance placed on  Individualism in the USA and solidarity with the society in Cuba. (solidaridad) with less emphasis on the individual.

What Marc Auge proposes can be accomplished by a combination of both the above, which never happened to the Cuban immigrants to Miami, where they quickly became individualistic and were forced to adopt and construct an universe of anti-cubanism, just for survival or monetary gain.

The future would be something like this, if you have a Spanish surname;

Surname  Spanish origin

Race  White   Black  Asian   ( Cuban White,  Africans from Equatorial Guinea,  Filipinos ) or  Mostly Native Indian (Mexico, Central or South America)

The diversity would be furthered even more, when children of Bosnian Roma immigrants to Argentina begin to migrate to the USA!

If any country has a chance to fulfill the futuristic notion of Multi Individualistic Diversity with loyalty to the country of residence, it would be USA. Australia and NZ also stand a good chance of coming ahead in this race. (no pun intended)

Cuban Faces

an american may look like any of the below

MARCEL MAUSS, THE CONCEPT OF THE GIFT AND THE CURRENT DAY CUBAN SOCIETY

THE GIFT

MARCEL MAUSS AND HIS LESSONS FOR CURRENT DAY CUBA

Marcel Mauss, considered the Father of Modern Ethnology was the nephew of Emile Durkheim, considered the Father of Modern and French Sociology. His book, The Gift, published in 1925 remains one of standard texts in Social Anthropology and the theories have had a long standing impact.

I had been impressed with the idea of his, the archaic forms of exchange and I see that on everyday life of American Indians, despite their Americanization and incorporation into the modern market economy. But their ancient forms of prestations, still direct their lives, incorporating rituals and social connections.

While living in Paris, I noticed the way they give gifts to each other, in an almost elaborate ritualistic fashion and suddenly occurred to me that, as Marcel Mauss had mentioned nearly a hundred years earlier: it is a diluted form of the archaic form of exchange in which the gift giver obligates the recipient to an equal form of reciprocity. Unlike in the archaic societies no status declaration is involved. It is slightly different in the USA where gifts do carry a status, and puts the gift giver in a superior position in relation to the recipient.

From the concept of obligation and social coherence in the archaic societies without a market economy, the concept of Networking in the modern societies may have risen.

With a gift, in the modern societies, the question asked is; what can you do for me?

In archaic societies, the question asked is: What can I do for you?

Here is an example of Solidarity, Archaic Exchange and reciprocacity shown in a Gift, among the INUIT of Alaska.

Cuba is a society which has gone an experiment in Socialism in the past 50 plus years after the triumph of the Revolution led by Jefe Comandante Fidel Castro. It was a classical revolution in the sense of overthrowing an unjust, illegal, oppressive, tyrannical regime by an uprising of the people. Che Guevara, a Doctor turned Revolutionary, had outlined some of the ideas for a future society in his book: Socialism and Man

It is very often heard, in a derogatory sense, that Cubans make only very little as paid out as salaries. It is an individualistic concept in that Cuba takes care of so much for each and every man in the society, does not leave any one out. Why is that no one in Miami ever mentions the fact that Cuba does not have homeless people or people sleeping under bridges? You don’t see children or adolescents wandering around streets during the day because they are in school! (as Fidel explained to Rigoberto Menchu, when she asked the Comandante why there were no children on the streets) And that there is medical attention to everyone and anyone at any time of the day or night, within reach ? The idea is that Cuba tries to make sure that every one is looked after in society, not just certain members of the society ( as Republicans in the USA proclaim in their actions, taking care of just the rich of the society)

The capitalistic, oppressive, manipulative, fraudulent elements of the society who thought more about themselves than the value of the society or the people in general did migrate to Miami (where they continue to commit these crimes. The Economist recently named Miami as the Capital of Fraud in America! Thanks to these Cuban Immigrants and their descendants)

While the loss of a class of skilled people was a blow to Cuba, they soon recuperated from it, by educating the population and within a few years reached the status of the most educated society in the Americas including USA.

But the economic realities of a socialist state confronted by an enemy in the North, people had to make do with a system of communal good put before individual gain. This to me, this solidarity, is one of the principle strong characteristic of the Cuban society today.

And it fits well with the Concept of The Gift and the archaic form of exchange as outlined by Marcel Mauss.

People familiar with Cuba would know that it is rare that a person goes hungry in Cuba, thanks to the forms of sharing, at the governmental and social levels.

Instead of griping that Cuban professionals are paid only limited amounts of Cash, it might be good to look at what they do with that cash.

Here is an example:

A doctor in training at a hospital gets 1200 Cuban Peso (think of it as 1200 dollars, as the official exchange rate is 1 to 1)

She gives 500 to her mother, so that her retired mother who lives with her grandparents, both of whom are alive, can live in comfort in the village where she was born in the eastern part of the island. She gives another 300 to a caretaker who looks after the sister of her grandfather, as a token of appreciation.

Yes she is left with very little money for herself but what about the satisfaction? Even though she is young, the years of education in the socialist society of Cuba has left her with deep ideals of GIFT. She makes herself member of the greater society of Cubans, not by thinking of migrating to Miami, but thinking of becoming a member of an International Team of Cuban Doctors who go to all parts of the world to offer humanitarian medical missions. She wishes to serve her country by being part of its future, not serve herself by migrating thus becoming part of its past

Some ignorant people in Miami talk about Democracy (of their definition) as a precondition for lifting of the Economic Blockade of Cuba. What if Cuba insisted that they would have relationship with USA only if USA adopted a more human approach to the population as current in Cuba? What if the Cubans demanded that there be no people sleeping under the bridges in Miami? That everyone in America can have access to good health care and education without facing financial ruin?

The words of Prof Jose Altshuler ring in my ears:

If you are interested in the welfare of yourself over the welfare of others, I recommend you go to the USA, where you would be amply rewarded. If you are concerned about others, and willing to give and take, you have come to paradise, it is Cuba.

It was Paris for Hemingway, the moveable feast.

For me, the moveable feast of emotions and affections remains La Habana and Cuba.

WHY I LOVE CUBA SO VERY MUCH

Just twenty four hours ago, I left the crowded, unruly Terminal 2 of the Jose Marti International Airport in La Habana to arrive in the crowded, unruly but more diverse but still Spanish speaking terminal at Miami airport.. the flight lasted just 39 minutes.

I was wearing the same shirt as you see me in this photo with my good friend AA who is a specialist Psychologist. (taken at Restaurant near Cine Riviera at La Rampa and H in Vedado)

Leaving Havana is never easy for me. it is just another world and the technically superior, less humanistic world I would enter in just a few minutes (but thank you for wifi) fills me with an anxiety, transmitted by the people around me, including the Cuban immigrants who seem to be carrying some trauma in their faces.
So I am usually silent when I check in, was given a good seat and then paid the 25 dollars tax and on to the Immigration. Usually a pleasant chat and I request that my passport be stamped so that I have a souvenir of my travels.
When I put my carry on luggage and passed through the security, the alarm went off and the security officer with his electronic wand came towards me.
Is this shirt from Arabia? or India? he asked. Big difference, I joked with him.
and then he surprised me with a statement which I would never expect from a  TSA agent in USA: Of course you are familiar with Krishnamurty?
I was taken back. Cuba is the most educated country in this hemisphere (including the USA) but a philosophical discussion is not what you expect when you go through the security at an airport, especially at a terminal where the flights are leaving for a country with which until recently you had no relationship, and had always had a tense atmosphere.
Believe or not, for the next 15 minutes he and I talked about the philosophy of Jiddu Krishnamurty, the Indian Philosopher who is very popular with intellectuals in the west. I told him I would send him some articles I had written which have Krishnamurty's philosophies about the necessity for lack of attachment. Then I said Good Bye to him, leaving him to check other passengers.
This confirmed something I have always believed in. If you are in Cuba to pursue intellectual subjects or enjoy the human warmth special to the Cubans or enjoy the humanitarian nature of Cuban Socialism or the unselfishness brought on by years of thoughtful leadership, you will never be disappointed. But if you are here with any hidden agenda, or part of a scheme to make money or enjoy the benefits of individuality that is contrary to this society, you are better off in a country like the USA, you would not enjoy Cuba.
My life in Cuba is full of human warmth, great long conversations on Philosophy, Psychology and Anthropology, along with sharing of simple pleasures of lives of ordinary Cubans.
I miss it. I always miss Cuba when I am away from there.

MEDICAL CONSULTATION IN AN AMERICAN INDIAN DIABETES CLINIC

MEDICAL CONSULTATION IN THE INDIAN COUNTRY

I am proud to be a Physician to some Native American Indian tribes.  On this day, this 54 year old Indian came to see me regarding his uncontrolled Diabetes.

To get to the Clinic, he has to walk to the collection point for free transport offered by the hospital and Clinic. It is offered twice daily. The town he lives in is 35 miles north of the Clinic. The winters can be brutal in this part of the world, but he very seldom misses an appointment.

He was born in the Indian village where the clinic is located. He attended an Indian boarding school and then joined his mother who had moved to the town where he still lives. That was in 1975.

He had last worked in 1993, 22 years ago. Alcohol abuse had been a part of his life. He was sentenced to 5 years in prison for domestic violence (he was drunk). He sobered up, like they say, on 13 April 2003 (nearly 12 years ago)

His current “income” is $194 per month in food subsidies provided by the US Government. When he can get a ride, he would shop at Wal-Mart. Otherwise he is forced to buy food at the neighbourhood petrol station (junk Food at higher prices). He lives in a duplex in a poor section of the town, rented by his sister, owned by a Mexican Immigrant. His sister, unemployed, suffers from the complications of Diabetes , with one below Knee Amputation and she is on Dialysis, three times a week. Her boyfriend, also unemployed, takes care of her, helping her reach the Dialysis centre three times a week, using public transport. A nephew who is disabled with a hip injury is also unemployed, 42 years old  also lives at the house. Two nieces also call this small apartment home, one of them is currently incarcerated, the other, also unemployed, leads an itinerant life style, alcohol features predominantly in her life.

No one owns a car. The nearby Church provides clothing donated by charities. He wears XXL shirts and 38 waist pants.

This patient uses his 194 dollars food allowance to buy the following: Eggs, White bread, Cottage Cheese, potted meat, Diet pop, Crystal light powder to make sugary drinks.

Do you eat at Fast Food Restaurants, like McDonalds?

No Way, he laughs, I cant afford it, since I have no money.

I know I should eat better, but I have only 194 dollars in Food allowance to last me one month.

Pleasant gentleman, no resentment towards any one, no gripes, honest, not jealous towards those who has more than him, goes to extra trouble to come to the clinic, with both of us knowing that it is the availability of human warmth that he seeks here, that brings him here. We reciprocate what he gives us and do whatever we can do for him. The least we can do for him, is to make sure that he has enough medications, make sure that his feet are without any dangerous signals of impending ulcers, that his eyes are checked and also to make sure that he gets home safe on the hospital transport.

Why doesn’t his Diabetes come under control? The society has cornered him, he has no access to food, only chemically laden processed food. Medications can combat the effects of Food on his Diabetes but cannot deal with the chemical’s effects on his Diabetes.

He reaches out to us, the nurse educator and the doctor at the Diabetes Clinic, the Family Physician who cares for him in the hospital clinic, he gets to visit some people  he may know at the clinic/hospital, and a day is pleasantly spent, before going back to his lodging, in a city where he garners no value or respect, an alien city with an alien culture.

As he was preparing to leave, something compelled me to take out my wallet, empty it and give the money to him. Believe it or not, he was reluctant to accept but I could see he was happy to have some cash, not food stamps issued by the US Government. He smiled broadly and hurried to catch the hospital transport home.

I thought of 3 women in my life, all three sisters in one way or another who have influenced me and also watch over me.

The Diabetes Educator Nurse puts the welfare of the people like this patient and many many others like him in this isolated, poor country. To me, she personifies what I would call ‘christian” values of the western civilization, non judgmental, all done in the sense of service, with thoughts of relief from pain and suffering in these marginalized original inhabitants of this land.

My Indian sister, an extremely efficient administrator, many years ago , by her actions taught me what it means to be a relative, to the people you work with, the people you come across in your every day life in this poor community of Indians. She also believes that we must have a head to toe approach to our patients, that we must provide the best quality care we are able to provide to each and every Indian who comes to the clinic.

I have to reiterate that these unfortunate souls may be poor in material things but they are not poor in spirits and generosity of themselves.

My British-Jamaican sister has a big heart and as I write this, aboard a flight to Miami, it is she that I am going to see. I am certain she would have prepared some dishes that I like. She knows that I had been in a food desert for the past one week. (PS . I enjoyed the Curried Goat she had prepared, with rice, she has already prepared the breakfast for tomorrow of Jamaican fish fritters and avocado, and always good strong British Brooks Bond Tea)

This past week, Consultation of this sort took place, over and over again. Patients had travelled from far and mostly from the village, most of them wanted to talk, some had problems (not medical but social) which took hours to negotiate with the authorities. As my Indian sister would say: Let us take care of them, head to toe.

The role of Medicine/Medical Care Provider is not limited to diagnosis and treatment but also alleviation of their suffering, not just physical but social, cultural and spiritual.

I am proud to be a Physician to the Indian, the native people of America.

As I pulled into the drive through window of the small bank, the only one in a thirty mile radius, I realized it had closed for the day. So here I was, metaphorically without any money in my person, beginning a pleasant journey to my Miami and Cuban homes and hearts.

May my Mezhinga be blessed with the good spirits of these ancient people.

SUCCESSFUL SOCIAL AND CULTURAL RESEARCH IN HEALTH, ILLNESS AND DISEASE

SUCCESSFUL SOCIAL AND CULTURAL RESEARCH IN HEALTH, ILLNESS AND DISEASE

You have to tip your hats off to molecular scientists who concentrate on a minute aspect of metabolism. But it is that concentration that produces revelations, those results converted down the line into treatments for common and rare disorders.

As a Medical Anthropologist, is there an equivalent to that kind of concentration on small components of everyday life, in our field of observation and research?

Yes!

Observe, participate, assist and share the lives of the same groups of people over a long period of time

When you are thinking of the welfare of a group of people, rather than an individual in a group or working on an instrument or a pharmaceutical drug, the worldview has to be a selfless one. A purity of intentions usually fires the enthusiasm when working for the welfare of a group of people. A Community is not a collection of individuals living in proximity to each other, brought there because of external parameters, such as wealth or education.

I am lucky to be working with American Indians, henceforth referred to as Indians, who have not only a shared culture, history and many a times, a language and a religion but also a collective unconscious, which Carl Gustav Jung was able to codify while watching them.

By describing their lived in experiences and explanatory models of their illnesses, it was evident that the aetiology of their diseases did not and does not fit into the commonly accepted physiological and biochemical explanations.

One has to be a Medical Anthropologist if you wish to understand fully the suffering of a community, regardless of which country they live, Canada or USA or Australia or Aotearoa; only by understanding can you assist in some meaningful help to alleviate that suffering a little bit.

The Cartesian dichotomy of Mind and Body has had a strong influence in the Western Medical thinking, it often asks, What is happening?

And looks for an explanation by objecitivising the symptoms of suffering of the person into physiological dysfunction with a name, Disease: to be measured, treated and followed up, in a strict Quantitative fashion.

An anthropologist may ask a different approach, about the same phenomenon: Why is this happening? Why is this happening now? What alleviates this suffering? What can be done?

Two observations stand out in the context of my first contact with the Indians.

a.     The tribe which once used to be healthy and lean, are now overweight, obese. At the time of contact the white men wondered about the excellent health of the natives. In 300 years, their social, cultural and economic as well as physical situation had deteriorated.

b.     Fortunately enough during my travels among other indigenous peoples of the American Continent, it was curious to observe that these afflictions were rare among the other Indians, who are related to the North American Indians. The Kuna of the Panama had no Diabetes, were not overweight, had no change in Blood Pressure with age.  Many other tribes, in Mexico, Guatemala, Ecuador and Peru, were strangers to the afflictions and suffering of their brothers and sisters to the North.

Obviously then it was not a genetic phenomenon, perhaps an epigenetic phenomenon, even though the concept was not popularized until recent times.

For a social scientist, it was probable that the sufferings of Indians of North America, including Canadian First nation people as well as Australian Aboriginals and Maori of Aotearoa, were the results of social dysfunction caused by maladjustment to another society, culture and not to mention an inferior food product (which was to become clear in the analysis in the new century). It exhibited as Obesity, Diabetes and Hypertension in the body as well as other chronic metabolic problems.

It is interesting to look at the history of these diseases among the Indians. Hrdlicka in his book published in 1908 had mentioned that pathological obesity did not exist among any of the Indian tribes he had encountered. Doctors working with the Navajo exclaimed that they never saw a patient suffering from High Blood Pressure. Even the doyen of Diabetes in America, Dr Joslin, conducing a large number of measurements appropriate for the day, in 1920s, declared that American Indians are free of Diabetes. Records indicated that it was rare for an inpatient at an Indian Hospital to carry a Diagnosis of Diabetes.

Why this dramatic change? In less than fifty years, ninety per cent of the American Indians were overweight or Obese (paradoxically enough the percentage of Obese Indians is greater than Overweight Indians, rather than the other way around, once again challenging the physiological thinking).

It was clear, at least to me, that something was coming from outside: social, cultural and chemical that was the cause of this sudden change in a short period of time. When I mentioned these ideas to my colleagues in the USA, it was ridiculed. (except Dr Mark W who was not practicing Medicine for financial security but out of a desire to be of help to people)

The postgraduate education in Medical Anthropology in London which I definitely needed to acquire tools to understand what was happening to the Indians in the USA, helped me a great deal, allowing me to see the socio cultural aspects of their suffering.

The chemical aspect, something that is inflaming, was that a possibility?

In 2002, I was wandering around the streets of Johor Bahru in Malaysia, after a delicious south Indian meal while being on a stopover in Singapore.

A temple in the centre of town advertised a book fair was in progress. I entered the sacred grounds with no expectations. Instead of a cacophony of religious ministrations and philosophical outpourings it was surprising to find all sorts of books on sale. In one corner, a stall had lots of booklets, the kind that would fit into a shirt pocket but their titles were tantalizing.

American Indians would say: things happen for a reason, it is just we are not smart enough to figure out why.

Toxics in Plastics, exclaimed one booklet which I began reading. It was an eye opener, explaining the various ingredients used in various types of plastics that we use in everyday life and their ill effects.

Reading extensively on the already available medical literature, it became clear that,

a.     The knowledge that outside chemicals in the form of plastics causing damage to the body was not something new

b.     While it was not suppressed, it was not being publicized or released for mass consumption for the media. A generation of babies were being exposed to BPA in their feed bottles!

The conclusion, now more than ten years ago,

a.     Chemicals enter the body usually in the form of some additive in “food”

b.     Their chemical composition or metabolism was not discussed, but quantitative biological measures, such as Protein, Fat, Carbohydrate content were being used to hide the chemical nature.

The best example was High Fructose Corn Syrup. With an excess of corn to get rid of, with biological alteration of molecules, HFCS was created, touted as the healthy alternative to Table Sugar, while having very similar content of Fructose and Sucrose.

Here is a conversation with my erudite colleague, Dr Mark W

On 6 January 2015 , "So we speculate that the different sugars could favor different microbes in the guts of mice. Other research has shown differences in bacterial communities in the gut to be associated with metabolic diseases in rodents and humans. It's possible one form of sugar causes more bacteria to get across your gut than another."

The difference between high-fructose corn syrup and sucrose

While high-fructose corn syrup and sucrose contain around the same amounts of fructose and glucose, there is a difference in how they are arranged molecularly.

In corn syrup, fructose and glucose are separate molecules, known as monosaccharides, whereas in sucrose the two sugars bond chemically to form a disaccharide compound

Dr Mark W

Interesting. I wonder if the absorption of the monosaccharides in corn syrup is faster and more likely to produce an insulin spike then the absorption of the sugars from sucrose once the molecule has been cleaved?

Do you have any facts or opinions on this?

Dr Sudah Yehuda KS:

my gut feeling is, pardon the pun, corn syrup acts in a different way than the physiological way that  table sugars are metabolized. I am sure you are able to find some information on that since you can understand it better. (biochemically)

25 % of obese people have no metabolic abnormality. And when they are fed a McDonalds diet, nothing bad happens to them, but in those obese people with metabolic abnormalities the same diet makes everything worse

a susceptibility as well, then.

For example, American Indians as a whole are susceptible to obesity with the kind of diet , so far different than their genetic diet.

When i hear now about a new combination medication for diabetes it does not interest me since the physiology of the diabetes and many inflammatory diseases is what we are after and not the age old physiology which may have been correct as an end product but not as an aetiology.. like they taught us that in  type 2 diabetes the insulin is not effective..in the medical school.

c.     Inflammatory molecules produced directly or indirectly (directly: reaction in the cells on contact or metabolism; Indirectly: secondarily by increasing fat cells or other cells which then produce inflammatory molecules), can give rise to :

Abdominal fat deposition

Fat storage elsewhere  such as the Liver

Act as Endocrine Disrupting chemicals, interfere with the action of the various hormones, such as Insulin, Cortisol, Testosterone and Oestrogen, among others.

The latest addition to this knowledge is the research published just two days ago from Dr Moynagh and colleagues from Maynooth University. My hats off to them.

They have discovered a protein called PELLINO 3 that may block obesity driven inflammation

inflammation and thus prevent insulin resistance and diabetes. According to the researchers, there is a direct correlation between low levels of Pellino 3 in obese individuals. This low level of Pellino 3  is associated with the production of a critically important pro-inflammatory protein called IL-1 that drives inflammation and ultimately Diabetes.

So, as you can see, consistent social observation of the same group of people over a period of time can lead to a good understanding of their suffering and arrive at conclusions later on validated by science.

This can be used to tailor the education, couched in cultural terms and historical information. Indians have a great respect for their ancestors, and of course the ancestral diet is not the one that made them sick.

I am convinced that Medical Anthropology or an Anthropological education is necessary to people who are suffering from maladies of maladaptation in everyday life.

I wish to thank my Indian teachers  Pat B of Meskwakia, Pierre M of the UmonHon and my colleagues, especially the PHNs I have worked with over the years at the various Indian Clinics in the USA.

And to  Dr Mark W