Sunday, October 11, 2009

Shaman-Based Triage for Telemedicine

In many parts of the world, large segments of the population still fervently believe in the powers of supernatural healers, a shaman, witch doctors and the like. This causes problems when modern medicine starts to be introduced into a culture with a history of such beliefs. In remarks at a recent meeting in Cartagena, Colombia, ATALACC President Silvio Vega recounted a story where telemedicine ran up against such a case in the indigenous community of Hato Chami in Panama. The town is too small and impoverished to afford a physician on site so a small office was set up with a video phone and a few other telemedicine devices and connected to a rural hospital in another part of the country. This provided a stark contrast between the traditional and the new, making it even harder to gain acceptance by the residents of modern healthcare.

Wary of modern technology, the town’s Ngobe-Bugle Shaman was provided a free office next door to the telemedicine office. Often the Shaman is the first one to see a patient and is a major opinion leader in the community. When a patient sees the Shaman and has a mild problem, not requiring advanced medical attention, he takes action and “heals” the afflicted. In more serious cases he can refer the case to the telemedicine office. Of course, that is especially true if the case involves a lethal snake bite or other problems that may end up being fatal! This implied endorsement by the local, trusted healer has enabled many people to accept the ways of modern technology. In this manner, the Shaman also maintains a good record with his followers.

If you have other stories of telemedicine blending the old with the new feel free to share them in the comments section.

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