URL: http://www.amazonteam.org/index.php/240/Integrated_Healthcare_Suriname
Integrated Healthcare: Suriname
Traditional Medicine Clinics
In the forests of southern Suriname, ACT has constructed four working models of integrated healthcare centers based on traditional medical systems. In each case, the traditional clinics are operated by tribal healers and their senior apprentices, and receive thousands of patient visits annually. Each indigenous clinic is constructed adjacent to a village outpost facility of the Medische Zending Suriname, the principal primary care provider to the Suriname interior. Traditional healers and primary care providers cooperate and share responsibility, referring patients to each other for consultation and treatment; the two are complementary rather than competitive.
The clinics empower indigenous participants to maintain control over their own health and healthcare, and establish a replicable model to improve healthcare in remote indigenous communities throughout the world. They also represent a significant contribution to the preservation of the tribes' cultural heritage as they are run and maintained by shamans and their apprentices supported by ACT's Shamans and Apprentices program.
ACT's traditional medicine preservation and advancement initiative in the Suriname interior was recognized by UNESCO/NUFFIC as a Best Practice for Indigenous Knowledge in 2002, and was a 2003 winner of the World Bank Development Marketplace competition.
Services
Patients may seek treatment for a broad variety of conditions ranging from traumatic injuries to respiratory conditions to parasitic infections. The state facility health workers refer patients to the clinics for the treatment of several conditions, including leishmaniasis. Likewise, shamans refer patients with fever and suspected malaria to the primary care health outpost to obtain a malaria smear in addition to the botanical therapies they provide to the patient. Follow-up care of the patients is co-managed by both traditional healers and village health workers.
A recent emphasis has been on cross-training, with the western doctors gaining a better sense of which rainforest plants have curative properties against common diseases, and the traditional healers observing the benefits of specific hygiene protocols. Each clinic provides a facility for apprentices to directly observe the shamans actively practicing their medicine with opportunities for graduated clinical responsibility, enabling the transmission and preservation of clinical skills and rituals through generations. Apprentices are trained to complete record forms that document the incidence of conditions and treatments utilized for each patient at the clinics.
ACT staff and clinic healers also hold regular community workshops to discuss specific health problems; health practices, diet, and hygiene; and the various medicines and/or treatments used by the healers. Topics have included prevention and treatment of malaria and gastrointestinal diseases, two important morbidities in the interior communities. Workshops are often attended by the state-sponsored facility's staff members, reinforcing the efficacy and importance of integrating traditional and western healthcare systems in the village. Efforts are made to involve the school-age members of the community in these classes.
Low Environmental Footprint
To maintain a low environmental impact, the traditional clinics use solar-powered refrigerators to preserve fresh medicinal plant preparations and protect against over-collection of forest species. In addition, materials for the buildings are constructed using local materials, and solar-powered radios are used to maintain communication with other clinics and with ACT field personnel.