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

CULTURAL KNOWLEDGE CAN SAVE LIVES ...RESPECT INDIGENOUS KNOWLEDGE

Early on in my association with the Indigenous North Americans, they reminded me, We know the answers but no one asks them. Also the well meaning, Euro-Americans come to the Indian Reservations, with plans and projects, without taking into consideration, that the local people who have lived in this land for thousands of years have maintained their own systems of belief and knowledge.
This translates well into medical care as well. Even educated American Indians are treated by most doctors especially those with no knowledge about Indigenous cultures (even if they are living close by), as if they are ignorant and have no knowledge.
In my conferences, I like to give the example of the Leader of the Indigenous people of Andaman Islands, who on 24th December 2004, noticed that the big animals and birds were seeking shelter higher up in the land. He exhorted his people to follow the animals for he was taught that the animals and birds can sense something the new comers to the islands from India could not, including meteorologists! His indigenous wisdom saved his people, none of whom perished, but thousands of Immigrants from India to Andaman Islands perished. While the so called enlightened governments call for assimilation of indigenous people, it is always in the terms of the outsiders and not of the insiders! The assimilated tribe of Andamanese who lived among the Immigrants also perished!

so it was good to read a story on this day of the tenth anniversary of the Tsunami of 2004 when thousands perished in the epicenter of the tsunami, Bandar Aceh. But the islanders with the knowledge of changes in the ocean were all spared!



Awareness of the warning signs saved many lives on Simeulue, an island off the west coast of Aceh - just seven people died there in the tsunami compared to 167,000 on Aceh itself.

The hilly geography of the island helped, but the islanders also knew what to do thanks to a local storytelling tradition called smong. According to a Unesco report, smong stories told to children often ended with a warning: "If a strong tremor occurs, and if the sea withdraws soon after, run to the hills, for the sea will soon rush ashore."

TO MOTIVATE PEOPLE TO CHANGE THEIR WAYS OF LIFE, ESPECIALLY IN THESE DAYS OF GALLOPING OBESITY AND OVERCONSUMPTION OF UNHEALTHY FOOD,
RESPECT LOCAL KNOWLEDGE

 

YALDA IN IRAN, ISRAEL LOVES IRAN, STONEHENGE, CARNAC, CHICHEN ITZA, DZIBILCHALTUN ANDהילדה הקטנה שלי

December 21st, 2014, it would be the night of YALDA, celebrated in most of the Persian Speaking Middle East and Central Asia, also spilling into the Indian Subcontinent.
But one usually associates YALDA with Iran. It is the longest night and it also signifies new life and optimism, and symbolically escaping from Darkness (of time and thinking or narrow-mindedness as you want to interpret)
It is also the Winter Solstice
It is an universal phenomenon, observable from all parts of this planet and obviously there would be celebrations or suspicions or superstitions on the parts of the descendants of the indigenous people. Also the "modern man" may have incorporated some of these ancient beliefs into the modern symbolism, Yalda is one of them. Most people celebrate Christmas as the day of the birth of Jesus, but it is a symbolic incorporation of pre Christian European celebration of the birthday of a God, into the Christian Europe. Its proximity to 21st, itself an ancient celebration of the symbolic arrival of light is significant.

Pomegranate, Watermelon and the Colour Red are all symbolic, perhaps of the redness of the rising sun? Whilst the ancient Iranians noted the occurrence of the Solstice the Zoroastrians may not have celebrated it because of the Length of the Night signified for them the longer presence of Evils to be afraid of.
The association of Night with Bad Spirits is seen in many cultures. I see this significance of it among my medical practice with the HoCank, UmonHon and Lakota Indians. They tend to finish their dinner very early and are very reluctant to eat at night. When asked, an elder told me: In the darkness, you do not know who are you are eating with, since you do not know who is present.
While there are fewer archeological remnants of the builders of ancient north America, some are well preserved, such as in this serpent, which signifies the passage of sun through heavens on solstice and equinox

 A very well known Road Man of the Native American Church, a Hocank, playfully referred to himself as Your Humble Serpent. He authored a book by that same name, which is a good introduction to the Hocank ways of thinking. ( a good anthropological description of Hocank is by the Jewish anthropologist, Radin written nearly 100 years ago)

I was told of this phenomenon whilst visiting Chichen Itza, from Miami ( a short plane ride) during my university days. I have always remembered the story on my repeated visits. Lately it has become a social phenomenon with thousands of people congregating on Dec 21st the KukulCan temple (The Castle or El Castillo) at Chichen Itza

 
The ancient structure is so constructed that on the day of Solstice the shadow of a Serpent appears on one of its sides.
The prehistoric sites of Stonehenge has also an alignment to the Sun and attracts visitors on these special days.

The archeological site at Carnac in France is older than Stonehenge but I don't know about the alignment with the sun, even though the parallel rows of stones stretch out for miles.
( I hope to be there in a few days time, passing by, on my way to Quiberon)

Whilst the one at Chichen Itza was impressive enough, the smaller archeological ruins at Dzibilchaltun left a more lasting impression. (thanks to Nicte-Ha currently of Cologne, for accompanying me there). There was a heavy spiritual connection to the world around here, as one could feel the subterranean waters of the Yucatan peninsula bubbling a few meters away.

While some of these ancient customs have been trivialized by modern day travelers, the seriousness of Yalda in Iran has never faded. The Diwan Hafez, the beautiful poems of Hafez, which most Iranians read on a regular basis and there are no houses in Iran without a copy, will be present while the various sweets and food are tasted in the company of family and friends.

Yalda is of Syriac, proto Aramaic origin, thus it is a foreign word to Farsi. Interestingly enough in Hebrew, Yalda, means a girl but also means birth, or giving birth.
I am including here a link to a site called Israel loves Iran, which lets the citizens of each of the countries to communicate peacefully with each other. I thought it is good to remember these souls on the spirit of Yalda.

A symbolic message to all those who harbour any sort of hatred towards other groups because of differences in belief, ideology, religion or politics: The True Morning will not come until this Yalda Night of Darkness has gone!

when I sent this message to an Iranian friend, this was the reply:
Yes, we believe that days becoming longer than nights is a sign that the life becomes better.

https://www.facebook.com/israellovesiran/photos/a.401026863258378.107525.400704776623920/556351894392540/

Today is 20 December 2014
This is how I plan to celebrate YALDA
First of all, read Yoga Sutra of Patanjali, take the book given to me by my yoga teacher, YMC in KL, and adivinate by reading a page at random and trying to absorb the meaning. This is what many Iranians do with the book of Hafez. But one must not do it more than thrice, lest you make the Master angry!
Since Yalda also means food and celebrations, but with whom else but my dearest friends in Miami, Mordecai and G, an Italian resto has been chosen and at least two of us would settle for a Sauvignon Blanc from Marlborough.

These notes on Yalda are dedicated to מאמר זה מוקדש לילדה הקטנה של.
 ייתכן שהיא תגדל להעריך את

 

התרבות של איראן וכמובן ישראל

 

HAPPY HANUKKAH, A MIRACLE FROM CUBA, MAZELTOV TO OBAMA, CASTRO AND ALAN GROSS

Today, more than ever, I am proud to say, Soy de Cuba, I am from Vedado! in La Havana. The above collage is from my neighbourhood of Vedado in Havana.

a house in Vedado.

Today is the first day of Chanukkah 2015, a festival of Miracles, and a miracle did happen today. I am not the same person that i woke up to hear the historic news, the courageous decision taken by President Barack Obama to normalize relations with Cuba. 

and that Alan Gross, would return home after five years of captivity in Cuba. In the spirit of Chanukkah, he had this to say: The majority of the Cubans have great hearts and I support the President.

In fact, the entire world supports the President in this courageous action, except some clever politicians who have something personal to gain, by hiding behind democracy and human rights (as they do when it comes to Gun Control, for example)

I congratulate President Raul Castro who is trying to negotiate a difficult path, in face of the Globalized economy, the best chance for the Cubans, and at the same time be generous with Cuba's gift to the health of the poor in many countries. As Obama mentioned: Cuba and USA can cooperate when it comes to the World Health, as seen with the Ebola epidemic.

I am happy for the Jewish Community of Cuba.

What does this mean to me, at a personal level. First of all, I would be more than ever closer to my Cuban friends. Whilst i have had no trouble travelling between Cuba and USA ever, now the processes would be even easier.

It is amazing, this world of capitalism. Within hours of Obama's announcement, I heard that Airlines executives are already in conference about flights to Cuba! in 2015, I would imagine, hourly flights to Havana from Miami. I look forward to showing my Cuban friends, the sights of Miami and also the plight of American Indians! And certainly, my good friends from Dept of Psychology, some of whom can be seen below, would help me with my work with the Indians. Now I can invite them to come!

amigas de meu coracao 1

amigas de meu coracao 2

Two Cubans, one A Cross Cultural Endocrinologist and the other in the first year of her studies to become an Endocrinologist. She also happens to be my daughter. She is at the National Institute of Endocrinology INEN in La Habana

Medical Students in Havana 

I will not forget this Chanukkah. Mazeltov to Alan Gross, Barack Obama and Raul Castro.

If you can come to La habana, let us go to this Persian Resto, in Vedado.

I want to remind my brother no 1 in Portland above, and 

Brother no 2, also in Portland, that it has been a full 3 years since we have had a Sabbath meal together!

What about Freedom and its responsibility, mayn mischpochah?

My brother at a famous monument in Rio de Janeiro, Brasil

I am very grateful to Papa Francisco for the role he played not only in the release of Alan Gross but also in the normalization process (the negotiation) between the two republics. Whilst it was not reported widely in the US media, both Chile and Canada also helped, as the secret meetings were held in Canada. It is very significant and symbolic that a Catholic Pope helped free a Jewish American from a Communist island on this day of Fiesta de los luces, Chanukkah

So, if you want to find me, 

look for me amidst the elegant buildings with memories

in san cristobal de la habana

in the island which is a moveable feast!

Every minute I am away from La Habana, I miss the tenderness and genuine affections without strings attached

I will wait for you, my dear friends and family. with the winds from the ocean touching gently those elegant buildings with memories

which can teach you the meaning of the word tenderness.

Hasta La Victoria Siempre..

This note arrived from the younger Endocrinologist in la Habana.

ESTOY REALMENTE MUY FELIZ!!! HOY ES UN DÍA HISTÓRICO PARA NOSOTROS LOS CUBANOS, CON LA LLEGADA DE NUESTROS HEROES A LA ISLA TAMBIEN HA LLEGADO UNA LUZ DE ESPERANZA PARA NUESTRO PAÍS. YA ERA HORA DE PONER FIN AL BLOQUEO ECONÓMICO, YA ERA HORA DE PONER FIN A TANTO RENCOR SIN SENTIDO, YA ERA HORA DE BUENAS NUEVAS PARA CUBA. ESTE 2015 SERÁ SIN DUDAS UN AÑO PROMETEDOR!!! FELICIDADES A TODOS LOS QUE COMO YO, HOY SE SIENTEN MÁS QUE EUFÓRICOS POR ESTA NOTICIA, A LOS QUE NOS SENTIMOS ORGULLOSOS DE HABER NACIDO EN ESTA TIERRA Y A LOS QUE SIN NACER EN ELLA SE SIENTEN IGUAL DE CUBANOS. VIVA!!!

GREETINGS TO MY MALAYSIAN, INDONESIAN, AMERICAN INDIAN FRIENDS AND FAMILY, ALSO TO MUSLIMS EVERYWHERE IN THE WORLD

DEAR FRIENDS

I send these greetings to you because I consider my relationship with you to be important.

This long winded thoughts put down on paper is my way of wishing you a 

MERRY CHRISTMAS, BEST WISHES FOR THE SEASON, AND FOR MEMBERS OF MY TRIBE, HAPPY CHANUCCAH. FELIZ ANO NUEVO 2015 BONNE ANNEE FELIZ ANO NOVO

GOOD WISHES TO CHRISTIANS, MOSLEMS, HINDUS, BUDDHISTS AND JEWS

MERRY CHRISTMAS. HAPPY NEW YEAR  HAPPY CHANUCCAH

TO MY GOOD FRIEND JOE; THE BUDDHA OF BOGOR, GRATITUDE AND THANKS FOR YOUR FRIENDSHIP

Peace in the world, in our villages, at our work, in our families, begins with us. What works?

Whatever works to free the soul from suffering?

Whatever works to allow the heart to have compassion?

What works to awaken our minds from ignorance?

Love Compassion Peace

In all the ancient philosophies, Compassion is repeatedly mentioned as the source of Happiness, compassion towards others, compassion towards oneself.

When I was in Burma, I repeatedly heard the word Mitta, which is the Pali word Metta or the Sanskrit word, Maitri meaning  Loving Kindness.

Attitude of Friendliness

Good Will

Generosity of Heart

   My good friend Joe from Bogor with his friends.

Who does personify better than our own Joe, the loving kindness of a human being?

Our wish, to take it from Joe: May all beings be happy.

I asked him when I met, on a flight from Omaha to Los Angeles in the USA, why are you doing these things for your workers? Is it to increase their productivity?

No, sir, he said emphatically, I do it because I want them to be happy. If they are happy their families are happy and their villages are happy.

May all being be happy.

American Indians would include in ALL: not only human beings but also Animals and Birds and Trees and all living things

They would wish: May all living beings be happy.

Yoga sutra would speak of a love that does not seek self benefit.

In the business circles, whether Asian or European, networking is an artificial show of affection in which self benefit is sought. It is much more prevalent among Asians than Europeans.

Whereas, unusual individuals like Joe in Bogor, or enlightened Europeans would not seek self benefit in their actions. I have witnessed this personally among the Native Americans, for whom, networking means, what can I do for you, rather than what can you do for me?

If I were to say to Joe, I will be in Singapore early February 2015, he would ask: What can I do for you?

Loving kindness arises from the purity of the heart not associated with anything harmful.

Let us wish, May you be happy, now and in times to come

Issa, the Japanese poet had said:

In the cherry Blossom’s shade, there is no such thing as a stranger.

This is very reminiscent of what Joe would say:

Smiling is a must.

On that misty early morning at OMA airport, I saw this oriental gentleman smiling at me and I returned the smile. Just that exchange ended up in such a good friendship.

If we consider other people as strangers, then we can hide our prejudices. If we smile at them, it is difficult to have inferior feelings about them. You can try this when you are at the Abu Dhabi or Dubai or Doha airports, full of indentured workers from all over the world, and give a bit of yourself by smiling at them. They would be happy you smiled at them, so would you be.

I was thinking of the Buddhist concept of Mitta, loving kindness towards others, when I entered the Inipi ceremony of the Indians, where you subject your body to very high temperatures and at the moment of extreme suffering you pray for the welfare of others, without sacrifice of some sort, one cannot wish successfully for the good of others, just thinking about it alone is not sufficient.

Recently at the SFO airport, I wanted to experiment on myself how I would feel if I were to ignore every one that was present there. I realized then, shamefully, that I do not wish to have “neutral” feelings towards people around me, even if I don’t know them. When I do that, I feel that somehow I am denying them their status as human beings, as if I am insulting their presence by ignoring them.

How we feel about other people, whether at Sentul City or at the crowded airport in Doha, full of indentured labourers going home with huge bags, depends upon us.

A smile is full of good will and you reassure your heart that your heart does not harbor ill feelings about the humanity so removed from your daily life.

In our lives we have noticed that love with attachment or desire can turn into ill will or anger or irritation. But loving kindness does not fill our hearts with ill will or anger or irritation, exactly opposite.

What are the moments of distress in our lives?

Each of us has different sources of distress.

As Kahlil Gibran had famously said: the source of sorrow was once the source of pleasure.

How can you deal with distress? If a loved one is causing this distress in you?

See the situation that caused it in the larger context.

Remember, before you condemn anyone, that they have 10 000 reasons to behave the way they did, and we don’t know all the 10 000 reasons and until we do, we shouldn’t react in a negative fashion.

See the difficult people in our lives including our enemies as human beings. With loving kindness you expect to have Peace, to find happiness and not to suffer, in the same way they too have their claim to the very same things in their lives. They also have the right not to suffer, they also have the right to find happiness.

The third insight also reminds me very much of my friend Joe, it is about humility. While many Chinese businessmen around that part of the world, parade their wealth or accomplishments, our humble friend from Bogor, is exactly the opposite. You could easily mistake him for anything you wish to mistake him for when you see him at the airport but very quickly his true self would be revealed to you, if you take the time, if you decrease your own pride. Pride leads to a sense of self importance and that creates suffering for others which would end up as your own suffering.

(Just this week, the daughter of the CEO of the Korean Air, sitting in First Class, wanted the Chief Flight Attendant off the aircraft because he did not serve the macadamia nuts to her in a plate! Think of all the sufferings caused, to the poor soul as well as other passengers as well as her father, her company and in fact, she cast a bad light on all Korean people, behaving in such a way of entitlement)

Get rid of self-righteousness! This is truly a bad characteristic to have and I am amazed, whether educated or not, how prevalent it is in our societies whether it is Asian or American or European. No one race seems to be harbor this characteristic any less than the other. I have seen this in all continents where I have travelled, much less so among the Indigenous peoples of all continents.

(The best example of this self righteousness, Cornell West, a Black Academic in the USA, calling Barack Obama all sorts of names, very insulting, saying he is righteously indignant at Barack Obama because of Obama’s lack of courage.)

Hatred never ceases through hatred, it ceases only in response to love.

You can apply this in your own lives or in the conflicts, big and small in the geo political arena.

Native American Indians have a concept of Harmony and Balance, which are related. Your mind is in balance when there is harmony in your life as well as you live in harmony with your environment, connected with the universe.

You can do that only with humility, with an open heart towards to all not only those you know but also strangers. Once you consider all living things as part of your large family, your own self importance would decrease. Man is not the superior creation of the Great Spirit, Indians would say, but only one fo the superior creations of the Great Spirit.

Yoga Sutra of Patanjali lists

Five structural defects of the mind, which needs to be under control if one has to lead a happy, philosophically content, spiritually fulfilled life. He stresses the importance of ignorance which aggravates our need to be Egoistic, and the other defects such as attachment, fear of change and aversion to things or people.

As you can see, all the above philosophies concur on  what needs to be done to be happy. It does not matter whether you are a Buddhist, Hindu or Yogic or American Indian, all the ancient cultures thousands of years old stress these essentials facts about life of happiness, without suffering and in peace.

In Tibetan Buddhism, this concept is Bodhi Chitta , an awakened heart, to awaken from the depths of ignorance.

Dalai Lama says: I cannot pretend I always practice Bodhi Chitta but it gives me tremendous impetus. His thoughts on this are explained by Tsoknyi Rinpoche.

“Bodhicitta is your acting, your thinking, your selfless thinking for others,” says Tsoknyi Rinpoche.

As His Holiness the Dalai Lama always says, promote human values: love, compassion, tolerance. We have human intelligence. Use that intelligence inside as well, not always outside. Make it happy and healthy. And then within that intelligence, then you operate or connect with the outside world.

Individuals or countries as a whole can be involved in lessening the suffering of others. Medicins sans Frontiers is an organization intent on lessening suffering. Cuba is a country which is devoted to decreasing the physical suffering of millions of people, they were the first country to send doctors and medical personal to fight Ebola in West Africa. We as individuals can do our bit to alleviate suffering; that impulse comes from Compassion.

The Cuban born Polish Jewish Communist told me soon after my arrival in Cuba, if you are primarily interested in yourself, then USA would be a good choice as a place to live; but if you are interested in helping others, you have arrived in the paradise, here in Cuba. His prophetic words turned out very true for me, as I consider my years in Cuba to be the golden epoch, which by the way is still continuing.

Look around our fast paced societies, you would see everything that creates suffering, the list is long enough. Just because you live in USA or Indonesia, you don’t have to be a part of it.

Here is a partial list:

Anger

Hatred

Fear

Anxiety

Boredom

Loneliness

Greed,

All of which can lead to suffering.

What can we do as individuals?

When we feel a person suffering physically, we don’t feel smug that we are not suffering physically but we try to do something to lessen that suffering.

In this situation of suffering, from causes outlined above,  in our societies where we suffer as individuals and collectives, what should we do?

Be mindful of the presence of suffering.

I was sitting on a bench at the ferry terminal at Bremerton in Washington State. I looked around and believe it or not, it was a panorama of human suffering. There were mentally ill, homeless, poor, neglected people, hanging around the pier or the bus stop. Appropriately, a warning from the nearby café stated: Please remove your hoods, your bandanas and face coverings before you enter this shop.

You have to be mindful of these suffering human beings, not to feel righteous (about those neglected or abandoned by the society) but to be aware that these are human beings, they too deserve a shot at happiness and peace and lack of suffering.

Be mindful of your feelings

Of when you see a homeless person or a mentally ill person, hanging around aimlessly in our big cities (I am proud that in Cuba there are no homeless in the streets! Even with such a scarcity of abodes in Cuba), be mindful of their presence, acknowledge them as human beings.

If any of the following feelings arise: (in any situation)

Greed, envy, jealousy, fear, enmity, hatred

Look at them with mindfulness

Remember these feelings within you cause suffering for yourself and our duty is to relieve suffering in others as well as ourselves. If we are not at peace within ourselves when  we are full of these ill feelings, no action based on them would be beneficial,  would not lead to the lessening of suffering of any one and also the peace of anyone concerned.

Instead of feeling superior in these situations, we have to acknowledge our own vulnerability, of mind, body and spirit, only then we can connect as human beings. With those people who surround us, we can connect to each other with our hearts.

It is our hearts we see, how often we have heard that, from Antoine San Exupery of The Little Prince to many of my Indian teachers, it is with the heart we take care of others and not with our minds. Those in the caring and healing and curing professions might want to take note of that, with the heart one never fails but with the minds, we may make errors.

This is what Jiddu Krishnamurthy, the Indian Philosopher had to say:

When one gives one's heart, it is a total action. And when you give your mind, it is a fragmentary action. And most of us give our minds to so many things. That is why we live a fragmentary life, thinking one thing and doing another; and we are torn, contradictory. To understand something, one must give not only one's mind but one's heart to it.

Having a series of pleasant feelings one after another may not contribute to genuine happiness, however good it may feel.

This was brought to my attention one at the clinic when my teacher came to see me as a patient. He is an UmonHon Indian.

Did you see the clear sky? On your way over here to the clinic? Did you see the lone eagle?

Doctor, he continued in his soft voice, Be happy with all the things we have, and don’t be unhappy with things we don’t have.

How often I have read about these words, from Dalai Lama to European philosophers, but here is, an Indian, sitting in front of me, at the small consulting room at an isolated Indian reservation telling me that.

I have never forgotten that.

   The Indian on the upper left is an UmonHon from Nebraska

Material things do not bring happiness. They may make your life comfortable.

Only Relationships brighten your life, of all the things, the relationships with others, in all forms, is the essence of happiness. And pay attention to those relationships and nurture them, without relationships, a human becomes sole and lonely, abandoned by all, in one way or another, now or at some other time, eventually.

This is what Black Elk of the Lakota Indians had to say about relationships:

"Peace... comes within the souls of men when they realize their relationship, their oneness, with the universe and all its powers, and when they realize that at the center of the Universe dwells Wakan-Tanka, and that this center is really everywhere, it is within each of us."

-- Black Elk (Hehaka Sapa) OGLALA SIOUX When people ask me to define spirituality, I would tell them, remembering what the American Indians have taught me and what great Indian leaders like Black Elk had taught: It is your connection with the Universe. That is why  rupture in  any close relationships bring us sadness. It is sad to loose a friend. Do you remember the paragraph from The Little Prince? For I do not want any one to read my book carelessly. I have suffered too much grief in setting down these memories. Six years have already passed since my friend went away from me, with his sheep. If I try to describe him here, it is to make sure that I shall not forget him. To forget a friend is sad. Not every one has had a friend. And if I forget him, I may become like the grown-ups who are no longer interested in anything but figures . . .

While I was writing this my friend, the Buddha of Bogor, the humble man called me from Terminal 3 of CGK, Soekarno Hatta airport in Jakarta. He was only his way to Johor via Singapore and then on to HoChiMinh city and back home via Singapore.. He will be home for dinner the next day, it was early morning in Indonesia.

His conversation showed his concern for others, he never mentioned about himself or his business or his personal problems but all questions related to his relationships with others that we knew in common.

I made up my mind, to fulfil and demonstrate the great value I place over this friendship with this very humble man, I will make every attempt to spend a week with him in between work and travels in the new year, before the busy lives of others interrupt the travel universe, before the Chinese New Year on 19 February 2015 sets in.

more than once I have stood at this very spot, remembered my UmonHon Indian Family and Friends. We are UmonHon Indians, said the two sisters, one of whom played at a playground of tepees and kayaks at this very same site.