Just returned from Panama. I joined a group of family physicians from the University of Ottawa who have been on several short-term medical missions to different parts of the Central American nation since 2005. I was glad to be involved, because third world medicine combines many of the things I love most about being a doctor.

This trip was to a little village named Kankintu, several miles from the mouth of the Cricamola River, at the far western tip of the Caribbean coast of Panama. From Panama city, it was a twelve hour drive to the tiny harbour of Chiriqui Grande. The road into town had been beaten and battered by recent flooding, with uprooted trees taking asphalt with them as they fell and mudslides spilling out onto parts of the highway. The four-hour motorboat trip down the river brought us to the village in the early afternoon, the hot sun a far cry from the snowstorm we had left behind.

We knew what to expect because some of us had been there before. The biggest problems by far were diarrhea and malnutrition. We saw scores of infants and children, brought in by their mothers and grandmothers. Some lived in the village, but many had walked several hours to see the Canadian doctors. They were barefoot and tired, but always very grateful and sincere.

We saw many of the same problems that we would see back home – diabetes, high blood pressure, arthritis and back pain – but almost everyone was treated for parasites. Poor sanitation and dirty water are the cause, making the subject of worms a running joke during the trip. One older lady chuckled when I asked about them. “Of course I have worms”, she said. “Everyone has worms.” Reminded us all that the miracle of modern medicine might be more about flushing toilets and treated water.

There were definitely problems with the trip. Only a few of us spoke Spanish, which was a second language for these indigenous people whose native tongue is Ngobe Bugle. A few people got sick with amoebas or fever, but they are all fine now. We almost got stuck in the village as rainstorms grounded the boats, and then almost got stuck in New York as a snowstorm grounded the planes. The living was simple, the facilities sparse. But we swam in the river, we sang at night, and we gazed at stars like young children. It was a delight.

I spent my off-hours poking around the village asking about medicinal plants. They are generally wary of strangers and not keen to share their ‘secrets’ but one of the medicine men in town worked for the clinic, so we had a few exchanges. Like many of the others I have known, he got his knowledge in his dreams. They do not have a strong tradition of shared knowledge of plants – like the Chinese, Indian and Tibetan systems. In the end, the best contact I made was with Dr. Mahabir Gupta, a professor of Pharmacy at the University of Panama who specializes in rainforest plants. We will discuss a collaboration on a future visit.

It is ironic that in the first world, ‘alternative medicine’ tends to be the medicine of the rich. These people tend to be more educated, open-minded ‘seekers’ who have the time and money to invest in their health and think about things like prevention and holistic health. In Panama and many of the other parts of the world, plants are the medicine of the poor. Over 80% of the world’s people cannot afford pharmaceutical drugs. They use plants because they are available. They have local ‘doctors’ because their people do not go to university. Their knowledge is often oral because they cannot read or write. And yet they have managed to find medicines that our richest, most well-endowed institutions have not. Medicines that work.

If medicine is to truly serve mankind, it cannot limit itself to medicines that only the rich can afford. After spending years working and traveling with medicine men in developing countries, I brought their teachings home. Strange to find myself only able to offer them to people with money to spare. Strange indeed.

Did you enjoy this post? Share it with others.