CUBA AND AMERICA: ONE YEAR ANNIVERSARY 17 DECEMBER 2015

The greatest victory of the accord of 17 dec 2014 between Obama and Castro, USA and Cuba is that Americans have flocked to the country in their thousands and seen the reality and not fallen for the unrelenting propaganda of the Miami Cubans and their press peons about harsh conditions, political oppression etc.
My american friends who have visited the island have uniformly fallen in love with the Island.
More great news, USA and Cuba announced today that up to 100 flights daily might be authorized!

Throughout the country, even in smaller towns, an area or streets have been designated for WI FI access. Along the Rampa in Havana it is not unusual to see a thousand people accessing the Internet with phones, tablets or laptops! There are apps to be downloaded such as IMO with which the Cubans can videotalk to their loved ones abroad, anywhere in the world!

The entrepreneurial spirit of the Cubans is something to marvel at. Twenty somethings like those above, own this patisserie, where under air conditioned comfort one can indulge in all sorts of cafe and cakes and salads!

Cakes and Coffee at La Arca de Noe at La Rampa and D , you can check them out at Tripadvisor!

The body oriented culture of Cuba is so wonderful to watch. These students as can be seen are fit as fiddles, no overweight or obesity among them! Their unashamed embrace of the physical pleasures is something some of the richer countries could follow!

The young and the restless gather to exchange notes about 
technology, Internet, websites, ways to download music and videos (a flourishing market for pirated tech exists)

With such innovation and enthusiasm, along with the fundamentals of a society that is egalitarian and helpful to one another, I have no fear for the future of Cuba..
It is as bright as a Cuban  Day....

AN UMONHON NOZHITHI'A EN OLYMPIA, WASHINGTON

Little Mr  D whom I met for the first time, is the son of Mitexi, my niece in the UmonHon Tradition. Olympia, the capital of the State of Washington is not a place for a family encounter of this sort, but that is where I could meet this Buffalo Clan member! Time was too short, so we briefly reminisced about other times in the UmonHon reservation as well as the time she went to Cambodia as a budding Occupational therapist to help the Cambodian Diabetes Association.

When I met his grandmother at the Indian village of Walthill, she reminded me that while the Buffalo Clan is his heritage from the UmonHon tribe, his father is a Yurok, belonging to the Eagle Clan, to which he would belong!

WHY ARE EDUCATED IMMIGRANTS FROM INDIA SO ATTRACTED TO FRAUD IN THE USA ? THE CASE OF DOCTORS

FROM THE ECONOMIST
AND TO QUOTE
Some criminals are switching from cocaine trafficking to prescription-drug fraud because the risk-adjusted rewards are higher: the money is still good, the work safer and the penalties lighter. Medicare gumshoes in Florida regularly find stockpiles of weapons when making arrests. The gangs are often bound by ethnic ties: Russians in New York, Cubans in Miami, Nigerians in Houston and so on.
I remember reading this in 2014, Miami becoming a capital of "legal" defrauding of the Government if such an anomaly existed.
I was at the Blue House among the UmonHon, reading the issue of JAMA Internal Medicine which had arrived (Dec 2015 volume 175  number 12, pages 1955-1959

Being an Anthropologist, news items with cultural overlays hold interest to me. The article I am reading is titled
Physicians and Insider trading
What interested me was not whether or not Insider trading happened among Doctors , that would like asking how many of the Professors speaking at International Diabetes Federation congresses have received large amounts of money to promote drugs. We know it happens. We don't pay any attention to the talks but at times eat the delicious food provided and sneak away!
It is only natural for an anthropologist to be aware of a persons culture, nationality, origin and education in a country such as USA where there is a very large percentage of immigrant population.
What struck me was that most of these insider trading and some worth millions were done by doctors from India or of Indian origin.
People in India like to boast how well their emigrants to USA have done but they never talk about the similar number of people indicted for fraud of one sort or another.
An average reader may not make a connection between India and these insider trading (they are good at software arent they?) but an anthropologist would, by looking at their name and by googling where thy were educated.
Cubans are a very innovative people and some of these innovations have crossed the line of legality when they arrive in the USA. The innovative spirit is what makes them thrive, most of them legally as is the case of Indian migrants, but sometimes this instinct is overcome by greed. 
From Bloomberg News
Health care has become America’s sweet spot for insider traders like Skowron. Among researchers, physicians, government officials and corporate executives, the lure of easy money in health-care insider trading has become epidemic. Since 2008, about 400 people were sued by regulators or charged with insider trading; of those, at least 94 passed or received tips involving pharmaceutical, biotechnology or other health-care stocks.
So something shifts these doctors, almost all of them immigrants, almost all of them in private practice, to stray into the realm of the third world mentality, Let me see if I can get away with it.
Neither India nor Cuba is to be blamed but the frailty of these human beings who saw an opportunity which was not quite legal. There was a connection which was little elaborated. while most of the immigrants tend to be Democrats in their political leanings, many of these indicted were Republicans, including one who raised millions of dollars for both brothers Bush!  Something to think about... all these nebulous connections.
It is the very same republicans who are avowing to keep the immigrants like those contributed millions to their reelections away from the American Shore!
Greed is your nationality here, not the colour of your skin, your singsong accent or the language of Cervantes that you speak..

Canadian Prime Minister Justin Trudeau welcoming the first of the 25000 syrian refugees flown at his Governments expense to Canada.
Think of the humanitarian gulf between him and similarly aged American Cubans vying for Presidency of the United States!
May Allah save the ordinary people from them..

FRACTURED MEDICAL CARE IN TIME OF ARROGANCE OF BIOMEDICINE

FRACTURED MEDICAL CARE IN THE TIME OF TECHNOLOGY

There is a shortage of Primary Care Providers so the burden has been shared with not so well prepared Doctor’s Assistant and Nurse Practitioners. Unfortunately both of these para professionals, they are called mid-level for a reason, are modelled after the broken metaphor of a dominant male biomedical model of Disease care.

Biomedicine has deviated so far away from the social aspects of the suffering of the patients that these mid-level professionals have become much like car mechanics. Attending to the problem, but with the added prejudices of objectification and depersonalization as if the body is a machine and that no one actually lives in it.

I had one such experience today at a hospital and ER clinic catering for a poor community of American Indians in a remote part of USA.

Mr. E had come to see me, I have known him for a while. He has type 2 Diabetes but his life is complicated by the fact that he is at the end of a failed surgery for his back and is in constant pain and in fear of a second surgery. He had gone to the dentist the day before and had one of his molars pulled out, adding to his pain and discomfort.

When I saw him this morning, his Blood sugar was elevated and clinically I could determine that he was a little dehydrated. I sent him to the ER attached to the clinic where I consult, requesting that he be given one litre of fluids with some insulin.

When the drive through (temporary) mid-level saw him, he began accusing the patient of not taking his insulin and began victimizing him.

This poor man, in his sixties had gone to get some relief but was being abused by someone who had no knowledge of his social circumstances and the medical history of what was taking place except the fact that he had high blood sugar.

He looks at the paper, the end product but does not have the intelligence to look at what has made that blood sugar high. It was a very unpleasant experience for the patient who does not wish to see the drive through temporary mid-level provider again.

They are very bad copies of the bio medically oriented medical doctors

It reminded me of what that wonderful poet of the beat generation of Americans had written

Ah,

You’re just a copy

Of all the candy bars

I've ever eaten.

Richard Brautigan

This is yet another form of colonialism, continuing from an earlier sort, but with the same dire consequences.

My Meskwaki teacher had taught me

Each patient must be treated with respect, regardless of age and how they are dressed. If you respect them and love them a little you will never go wrong

This has been my motto during all these years of working with Indians of USA

Let them leave the consulting rooms happier than they came in and we must do everything to meet that objective.

“I learned a long time ago that I can't control the challenges the creator sends my way, but I can control the way I think about them and deal with them” 
― Wilma Mankiller, Ex-Chief of the Cherokee Nation of Oklahoma 

Lessons for Health Care Providers

Try to have a relationship with the patient. Learn a little bit about him.

As Dalai Lama has said: if you want to make another person happy, be compassionate.

To be truly compassionate, you need to walk in their moccasins, you must feel something for what they are going through, you must cultivate empathy.

Empathy is respectful and soothing

I am so fortunate to work with MS, who is probably the best Diabetes Nurse Educator in the world, with compassion towards all and assertion of how to achieve a better health status for them.

MY SISTER FRIEND FROM GRAYLAND, WASHINGTON

For a person who was not fortunate enough to spend a lot of time with those related by blood to me, I have been extraordinarily grateful for the many members of my family all over the world: mainly in the USA CUBA and among the INDIANS of USA..
I have two sisters, one lives in Miami, an English lady, brought up in Jamaica, married to a Jamaican of Syrian/Cuban ancestry.
The other sister is an Omaha, an Indian tribe located in Nebraska, USA. Her grandmother was one of the first Omaha to be educated in the American system and had written a book on the life of the Indian during her time, (I have a copy of this book)
In Cuba friendships are so strong that it is altogether in another level. So I coined the term Sister Friend, that is more than a friend and much like a sister but not able to share the geography. 
In the USA, I can count on two wonderful caring nurses, both of whom work with Indians, as my sister friends. DBSG works with Yakama Indians and MS works with HoCank Indians.
I try my best to be with Dar at least once a year and in the past we had shared a nice medical humanitarian trip to Cambodia with a stop over in Malaysia.
When I told her that I would be in Vancouver and that I would like to see her, she managed to get a four day weekend and promised to pick me up at the Seattle International Airport. I did not know where we were going, she just told me that we are going to the wild coast of the Washington State, an area that I had never visited. 
She had made all the arrangements, in a small town called Westport, where she had spent her childhood summer holidays. She also introduced me to a pair of innovative artistic humanistic level headed couples who had retreated from the competitive and destructive nature of the American workplace.
I did not mind the rain, the winds that lash at this coast, but the evergreens stood as guardians of this earth, we had enough to eat, we could buy coffee and wine and there was always something to talk about.

I explained to her Lea's Law of Mindfulness
My sisters, my close friends in Cuba (LL AA MM BF CG AL JP YC and my Cuban mother as well as my colleagues, esp RMLG), my sister friends are always in my consciousness, they are not memories.
Memories can be forgotten but if a person is present in your consciousness, they don't disappear, and you don't long for them, but look forward to the next reunion.
I wont say goodbye to my sister friend D, but wish to express my gratitude for this weekend of humility and learning, to know that wild coasts are not dangerous if you approach them properly, and will Hasta Luego  See You Later  Ate Logo A bientot

WESTPORT, WASHINGTON USA AN ENTHUSIASTIC RETURN TO AMERICANA

Westport, Washington: A report from what used to be the Salmon Capital of the World

Going towards the Pacific coast, skirting the Puget Sound, once you pass an indistinct town of Aberdeen, the atmosphere and the evergreen trees remind you that you are in for a time travel treat. You are headed towards Grays Harbour Area, discovered by a certain Capt. Gray in the early 1700s. Of course Indians had always lived here.

Səʔ notsʔ Tí.

Our tribe was formed in 1866 incorporating members of Lower Chehalis, Shoalwater Bay and Chinookan people. As a small but strong tribe, we strive to keep our language, culture and economic health active and viable. While very connected to our past, Shoalwater Bay tribal members work to expand our influence and increase awareness of our tribal culture while improving our health and way of life.

This part of Willapa Bay has sustained our ancestors since the beginning. It continues to sustain our people and enables us to reach out to the greater community. Throughout this area, visitors, travelers and residents receive the benefit of the vision, infrastructure and development directed and managed by the Shoalwater Bay Tribe.

You’re Welcome. Hiyu maśi (many thanks). (From the tribe’s website)

If you look at the map, you can see why this sense of exhilarated isolation sets in. If you had taken the north road, you would have ended up in the modern, all facilities available, no comfort spared, community of Ocean Shores.

But you have left Aberdeen and its non-descript façade and driven south, into a sparseness, which has cultivated the men who live here, given them strength, sturdy fisherman, people who made this region their home, windswept and tsunami prone, giving them an unique character. The people who live here, who have always lived here or moved here in recent years, rejecting the comfort levels of the capitalist coercion, are uniformly friendly.

As a foreigner, but a person with a fondness for USA, I can say this: I was charmed by the Americana of the city, which has remained unchanged from its 1950s architecture, with the kinds of businesses which are simple and straightforward that honest people do, to pass time and to say hello to others but not with the intention of accumulating wealth, which may not be a possibility in this sparsely populated region. It used to be called the Salmon Capital of the World, that is long gone, but since the 1960s it seems that they have become experts at Crab (it can’t be crab fishing or crab catching, there must an English word for it, crab pots are lowered down to the sea and the crabs enticed into it for their last supper, crab fishing I am told if you go on a boat, crabbing if you do it manually on the beach?)

The town is neither prosperous nor poor, there is a tranquility about it. One thing for sure, it is not pretentious, as defined by its people who are not pretentious.

I had been crisscrossing the continents in the month prior, so my good sister friend wanted me to enjoy the tranquility of this lovely village. Because of the currents the temperature is about 5 degrees higher and the wind and the spumes are bearable under coats and jackets.

More importantly, I had the pleasure of meeting some genuine people. They are trying to leave as little carbon foot print as possible on this earth. They are young people who had left the hectic life of the cities and wanted to live in harmony with nature and build a community of likeminded people, while indulging in their artistic sides.

For me, in a way, in this little village of an Americana that had not been paved upon by concrete, these people were also reminiscent of the times of American Innocence and adventure and at the same time, the American hospitality and generosity of time and efforts and solidarity with the neighbours and friends and visitors. I wish them well and they seemed to be in balance in mind and body. Only when you are not balanced in the mind that you are afraid of the Other, fear of the future and seek security in goods and things known to you.

For me this visit to Westport, Grayland, North Cove, Tokeland (and the Indian reservation of Shoalwater Bay) has had the effect of reinforcing my eternal optimistic attitude about human beings and their good nature and that we can accept each other, love each other, respect each other and allow us our own space and time, while sharing what you have, including the happiness generated by living in such an ambience.

THE LUCKY ENDOCRINOLOGIST OF HAVANA..OUR ANTHROPOLOGIST IN CUBA

I am writing this in a hotel room in Westport in the State of Washington in the USA. I can hear the ocean in the distance and i can see it through the hotel window.
Yesterday I was at the Intenational Conference on Diabetes, and had made a slew of new friends.. and had the satisfaction that our philosophy in the remote corners of Nebraska with HoCank and Omaha Indian nations had resonated with the indigenous people asking for change in the management of their own health.
I met the Panamanian delegate who said, you are so cuban that is why you are so different from your friend DAG. I said, he chose the capitalist route and has big house in Paitilla in Panama City and I took the socialist route to help people in various parts of the world, but I have to tell you, I am very happy and have a diverse life.
Last week, I had given a talk to a large group of enthusiastic Cuban doctors on a topic of medical anthropological interest which was well received.
The week before traveling in the chilly weather in a clinic bus to remote parts of Cheyenne River Sioux Reservation. A week of work with the Omaha Indian friends. Nowhere did I feel stressed, everyone treated me well, most of the work I did had nothing to do with the western medicine, but mostly applied forms of medical anthropology.
Since all of us are looking at what makes the health of our patients better, our own individual welfare and income takes a back seat. In the poor community of UmonHon Indians, the enthusiastic nurse was able to arrange a few to have continuous glucose monitoring and pump therapy for the 7 who need them. It is a luxury not even the rich white americans can afford because we do not have to commercialize something as good as continuous glucose monitoring.
I am looking forward to complete relaxation over this weekend, in this very isolated spot in Olympic Peninsula. A good sister friend is with me and we are planning various humanitarian programmes in the years to come.
Few more days with the Indians, eating well and being fed well, and it is time to take the Qatar Airways flight, in an indirect fashion, to Europe and the village by the sea in Brittany..
You need only a few friends, and a thousand acquaintances will not do..