Post by Okwes on Jul 15, 2006 21:40:22 GMT -5
Traditional American Indian Treatment of Diabetes
Jul 12, 2006 / Community
All Islands, Kauai
by Dr. Jane Ely
American Indian Heritage Month, Nov. 2005
Diabetes Awareness Day
Authors: Jane Ely, Ph. D., and Sam Beeler, Ph. D.
Presented by Jane Ely, Nov. 19, 2005
Copyright © 2005 Dr. Jane Ely
Let me begin by thanking the sponsors and coordinators of this event, the Hawaiian Health Guide, Katie Fisher and Michael Saiz; the Kahuna Valley Peace Project; HMSA; the Hawaiian Tourism Authority; Wilcox Health; and the Radisson Beach Hotel.
Also, I would like to acknowledge and thank the Hawaiian Nation, the spirits and ancestors of this land upon which we reside; and my ancestral American Indian elders who have walked before me— I give gratitude, and thanks for all you have taught through your living-wisdom ways, and by example in ‘walking the talk’. I would also like to offer this paper in support of health, healing and a returning to the teachings of traditional indigenous wisdom, knowledge, and application for our children, the generations who will follow in our footsteps.
Introduction: This paper is in two parts; the first aspect outlines facts, and statistics that are very rarely shared on the epidemic of diabetes in the American Indian, Alaskan Native and Native Hawaiian populations. The second half of the paper explores Traditional Healing Approaches from my American Indian background as a healer, counselor and practitioner. I have also included resources, references and sources for further reading and study for those who are interested, at the conclusion of this paper.
Facts and Statistics:
Diabetes is the 5th deadliest disease in the United States
In 2002, direct medical costs associated with diabetes totaled $92 Billion
Indirect costs totaled an additional $40 Billion [in disability, premature mortality, work loss]
18.2 M or 6.3% of the U.S. population are diagnosed with diabetes. This rate is one of the highest in the world, from one of the richest countries with the highest medical advantages in the world. [National Association for Diabetes, 2002]
Estimated 13 M or 5.2% or the U.S. population are undiagnosed [ibid]
1 out of every 400 children and adolescents suffers from type 1 diabetes [ibid]
In ages 20 and over, 8.7% have diabetes [ibid]
In ages of 60 and over, 18.3% have diabetes [ibid]
There are 2.7 Million full blood American Indians and Alaska Natives according to 2003 Census, and another 4.3 Million of mixed ancestry = 7 Million or 1.5% of the total U.S. population
2.1% of the American Indian population lives in Hawaii [approx. 33,000] [ibid]
American Indians are the highest ethnic group serving in the military; and 47% of the farms in Hawaii are operated by American Indians. [Natural Resources Conservation Services, 2002]
27% of American Indian adults over 35 years of age suffer from Type 2 diabetes.
In Hawaii the mortality rate is 70-90% of the Native Hawaiian population that are diagnosed with Type 2 diabetes.
American Indian mortality rate is 90%, including complications arising from Type 2 diabetes.
American Indians, Alaska Natives have the lowest life expectancy of all ethnic groups.
American Indians and Alaska Natives are 2.6 times more likely to have diabetes than any other ethnic group.
The major prevalence of Type 2 diabetes is in urban/off reservation American Indians. In areas where traditional foods are grown, hunted and fished, regional diabetes goes down from 14.5% of the American Indian/Alaska Native population to 6.8%, which is below the national U.S. diagnosed statistics. In regions where our ethnic population are in urban settings, the diabetes rate is 27% or higher.
Complications from Diabetes are heart disease, 65% of deaths amongst diabetics are due to heart disease. American Indians have 5 times more heart disease as a result of diabetes than any other ethnic group. Strokes, congestive heat disease are 2-4 times greater in American Indians. Kidney disease and renal failure is 6 times higher; amputation rates 3-4 times higher and retinal disease from diabetic complications are 24.4% amongst American Indian population. Over 73% of American Indians are diagnosed with high blood pressure arising from complications of diabetes.
History and Contributing Health Factors
Some historical facts on diabetes in American Indian population coincide with several governmental policies perpetrated upon our people. One example of which is the increase in and awareness of diabetes as a “killer” amongst American Indians was first noticed when our children were forcibly removed from our tribal lands and sent to governmental schools. This provided the first opportunity for the dominant culture’s medical field to “study” us an ethnic group. This removal policy began in the 1890’s in North America. The last governmental school was closed in British Columbia, Canada in 1998, over one hundred years later. Not only did this cause diseases relating to Post Colonial Stress Disorder amongst our entire population, the European diet children were raised upon and the dramatic health consequences of diabetes onset were first noticed by attending physicians to the schools.
Coinciding with this was the continued removal of and displacement of American Indians from ancestral homelands, causing a loss of traditional food sources, culture, language, traditions, tribal unit and ceremonial spiritual practices—to name only a few factors relating to complicating health factors amongst our population. Five hundred + years Post Contact, our population has come back from the brink of extinction. I will discuss this remarkable regeneration later in the paper.
Not until 1997 did the Congress establish a special diabetes program for American Indians. Under the auspices of the Indian Health Services, a governmental agency, the short-term program aims its focus on prevention education and treatment services. Both aspects of the program are only funded until 2008.
The Indian Health Service system has only 12 facilities to serve 7 Million American Indians and Alaska Natives. Most of these are located near reservations. The majority of health care and educational benefits are erroneously based upon American Indians living on or in American Indian Homeland Territory [ie. on reservation land]. Although the IHS is purportedly set-up to serve all enrolled American Indians. Over 50% of our population lives off-reservation. The urban work program sponsored by the federal government again relocated Indian people into major metropolitan areas, thereby dispersing us into urbanized cities, further contributing to the breakdown of tribal culture and traditional life-style. Many American Indians participated in the urbanization project to escape poverty, alcoholism, no work, suicide and infant mortality rates that plague all reservations. American Indian Health Services are focused on the geographical location of reservations, [versus the Canadian Indian Health system that follows the individual Indian]! If an American Indian moves off the rez., we forfeit health care. This policy does not meet governmental treaty obligations.
The increase in diabetes is historically marked by medical studies that begin in the 1940’s, and also post WWII, with the introduction of fast foods. Needless to say, the urbanization of our population contributed to a major shift in diet, which is a direct cause of Type 2 diabetes. It is Type 2 diabetes that is the majority of diagnosed cases in American Indians and Alaska Natives.
Interestingly, the Federal Government has a history of sponsoring health care pilot programs that knowingly and intentionally promote adverse health conditions amongst certain segments of the population. Three documented examples are the Tuskegee Project, the Sterilization Project, and Commodity Foods. The Tuskegee Project was a scientific study by Public Health Services to study the spread of syphilis and other sexually transmitted diseases in the African American rural south and to study the results in the population.
The Sterilization Project is a federal Indian health services program of involuntary sterilization of pre-teen and teenage American Indian women in an effort to “control” and reduce the American Indian population. This is known in other countries as genocide.
The third program that has more bearing on what we are here to discuss today is the Commodity Foods project. It has long been known that American Indians develop serious health issues, (of which diabetes is one) as a result of improper diets. Commodity foods were introduced by the federal government to all reservations under the auspices of alleviating dire hunger and starvation conditions. Commodity foods are: white flour, sugar, lard, soda pop, high fructose juices, and dairy products. The ubiquitous “fry bread” that you see offered at Pow Wow’s is an Indian mother’s answer to starvation utilizing lard, white flour, and sugar. It is not traditional food at all. It is nutritional genocide.
Almost all American Indians are type o+ blood, which means we all have an allergy to dairy products and alcohol. Nutritional genocide has been deliberately practiced since the loss of our traditional way of life. And it has caused millions of deaths.
Being overweight was rare among American Indians prior to 1940. Very few of our population had diabetes. Research indicates many factors contribute to the epidemic increase such as commodity foods, poverty—causing poor nutrition, urbanization, lack of health care, depression, alcoholism, and a sedentary lifestyle to name only a few causes.
Changes in nutrition documenting the history of food consumption by American Indians [Jackson, 1994, Native American Research and Training Center, Arizona], estimates that fat content was 17% prior to European contact and has risen to 38% in the current diet. The Euro-diet is high in calories and fat and low in fiber.
Diabetes in American Indian and Alaska Native Population:
There are three main forms of diabetes:
Type 1 is characterized by destruction of the beta cells of the pancreas, requiring insulin daily. This form is rare in Native Americans and Alaska Natives.
Type 2 is most common form among our population. Patients diagnosed with this form of the disease can control the diabetes through diet and exercise [and traditional forms of medicine that we will explore later in the paper]. Some patients may require insulin if the disease is advanced upon diagnosis. Symptoms in Type 2 are subtle and may not be apparent to a patient. As a result half the population with Type 2 are unaware of the disease until secondary complications such as heart disease, high blood pressure, stroke, kidney failure, loss of sensation in hands or feet, glaucoma and other eye problems have occurred. Type 2 also includes a family history of diabetes, gestational diabetic birth, being overweight, being sedentary, and eating an improper diet.
The third type is Gestational Diabetes Mellitus (GDM) a form of diabetes occurring in some expectant mothers only during pregnancy. Note: Mothers and babies are more subject to develop Type 2 later in life.
The Medical Approach to Diabetes
Medical studies, treatment and pharmaceutical products on the current market are all geared to treat male, Caucasians. The effect of ethnicity, ethnic biological differences, cultural diversity, spiritual and social structure and traditional orientation are all missing from current medical treatment of diabetes. In the 1950-70’s, American Indian tribes were approached by drug companies to study the effect of some types of drugs on our population. The tribes that volunteered were used as biomedical research guinea pigs. Theses tribes did not receive any benefit from the research. The results of the research were never published or shared with the tribes who participated. [Mind and Culture, June 29, 2005, Washington Post series of articles]. This knowledge has lead many tribal governments to turn towards our traditional healing practices, to renew our knowledge of herbal medicines, spiritual understandings about diseases, and to practice ceremonial ways of coming back into balance for our health and for our very survival.
Traditional Healing Approaches to Diabetes from an American Indian Perspective
To begin this section of the paper, I will need to give you an overview of American Indian approaches to all illness and disease, whether it is an illness of the physical body, or of the emotional kind, or a spirit sickness, we approach all ‘dis-ease’ in a multifaceted way. We include the body, mind, spirit, and emotions in all diagnosis and treatments. Today, the term used for this approach is Holistic Health. American Indians know this approach as traditional medicine. It is because we have certain people in our tribes who have never forgotten the balanced, harmonious traditional ways that we have survived to the present. So the term, “traditional medicine” for the purposes of this paper relates to and reflects American Indian values, wisdom and time honored traditions that work for us.
We know that all illness arises from four root causes: fear, hatred, jealousy and grief.
Fact: All American Indians in today’s culture are suffering from Post Colonial Stress Disorder. This condition has been brought on by the four root causes of illness. All illness in our diagnosis process begins with this understanding but is not limited to this knowledge. We know ourselves to be many layered. Being an American Indian in the 21st Century requires us to understand our past and practice principles of health and life in the present. We know all illness has an outer cause and an inner cause. When we are ill, it is because we are out of balance in some way, shape or form. We focus on both the outer illness as it is being manifested as well as the inner causes. When we become ill we know it is because we are out of balance both in the outer world and the inner world.
Returning to traditional values in diagnosis and treatment does not exclude the use of some types of drugs. The dosage however, may need to be more closely monitored and regulated to suit American Indian biology. The principles of healing we incorporate into all treatment plans are:
The inner and outer causes of illness, body, mental, spiritual and emotional.
Where does harmony need to be restored? How in what way?
Diet and nutrition—a return to American Indian foods
Cleansing and purification [sweating, bathing, detoxifying, fasting]
Herbs and remedies to bring the balance back
Rest, relaxation and no stress
Community/tribal support through the illness
Counsel Practice for emotional balance, talk with an elder or trusted friend
Spiritual practices such as prayer, meditation, healing ceremonies
Dreams and creative projects manifest healing insights and direction
Once an illness passes or is balanced, we in turn become in service for others who have the same or similar life experiences.
American Indians do not view death as failure as a result of a disease. We view it as a natural, organic growth of our spirit.
Traditional American Indian Treatment Protocol for Type 2 Diabetes:
Traditionally we go to an elder, a medicine man or woman to explore the inner and outer causes of an illness or disease. When we become ill, we recognize this is a time for inner exploration, for personal transformation and change, to look at other problems effecting our life and spiritual matters. “Dis-ease” is a call for deep change from our perspective. The power of telling our story to an elder or a medicine man or woman is the first act of healing. Storytelling is a healing way. . For example: We know and understand that part of the illness of diabetes is due to anxiety, poverty, and extreme emotional conditions. Working with a medicine person would bring these inner states into account with the overall illness of diabetes.
When a patient understands and accepts the causes, the next step is to purify, cleanse and detoxify. This includes bathing, scrubbing the skin with sand, salt, sponges, soaking in minerals and mineral springs, sweat lodges, and fasting—taking liquids such as broths and teas to help unload the system from the heaviness of the illness.
Cleansing can also mean taking on a more serious fast that includes herbal remedies to clean the colon and intestinal tracts. In addition a tincture of black walnut and dandelion, and other herbs are taken for 45 days after the fast is completed to clean the system of parasites and parasite eggs. This is done under supervision with the medicine elder that makes the herbal formula according to the illness. The detoxing process brings the entire system, inner and outer into a state of receptivity and homeostasis. It also give the digestive system time to REST. Fasting, taking special herbs teas, being quiet as the body is unloading old stuff, all aid the patient in going inward. Self reflection, rest, sleep and silence are part of fasting and detoxification.
A purposeful spiritual cleanse would lead the patient into a Vision Fast [also known as a Vision Quest]. This is another topic we will explore later in another article.
Next, the diet needs to be corrected and brought into balance. Traditional foods must be sought out and reincorporated into a daily routine and diet. These foods are: corn, peas, beans, leafy greens such as wild water cress, dandelion, ferns in the spring, root, ramps, and garlic, cabbage, root vegetables such as sweet potatoes, potatoes, burdock, squash and nuts specific to the region. Such as acorn nuts which are ground and used as flour or to thicken soups or stews. Vegetables are eaten according to the season in which they flourish and are harvested naturally. The same goes for fruits and berries. There are over 50 varieties of blueberry in North America. Roots, leaves, and berries are dried and reserved for winter months, and are also pounded into meat as a preservative, ie. Pemmican. Peppers are used to flavor foods; hot peppers have restorative value for the heart in diabetes and heart ailments, such as cayenne.
Meat and fish are eaten in small portions and are hunted from the wild, such as turkey, buffalo, deer, elk, moose, duck, goose, lobster, local fishes, rabbit, grouse, etc. Meats are flavored with peppers, roots and natural sea salt.
There is no wheat, dairy, white flour, processed foods, sugar or iodized salt in the diet. There are no trans-fats. The only fat that is used is fat from the meat.
Fresh water is drunk; teas such as sassafras, dandelion, mint, and osha teas are blood cleansers and digestives. The change over to this diet alone causes many American Indian patients with Type 2 diabetes to come into balance and regain health. Complicating health factors such as high cholesterol, high blood pressure, circulation problems, overweight problems also diminish and in some cases disappear. Researchers have found that anyone following a traditional American Indian diet will reduce and in many cases heal hypoglycemia and hyperglycemia, control blood glucose levels and regulate metabolism. Foods rich in vitamin B such as cabbage, nettles, peas, spinach, sweet potatoes will stabilize the metabolism that is crucial in regulating diabetes.
Herbal Formulas such as a tea of wild carrot and devil’s club are drunk as a tea to specifically rebalance the pancreas, the blood glucose and the endocrine system. Another tea we have used with time honored effectiveness in treating diabetes is American Ginseng Root. It does not have high blood pressure side effects that other ginseng roots have and it regulates the blood sugar levels in Type 2 diabetes and is an energy booster.
There are many valued herbal teas in every American Indian culture that deal specifically with diabetes. The herbal formulas relate specifically to what is grown regionally. It should be noted that the use of herbal formulas as “medical cures” should be avoided as a “fix-it” method. All American Indian herbs are used in conjunction with a complete healing program.
Blueberry fruit and leaves are used as a herbal formula to treat long-term diabetic damage to the small blood vessels in the eyes, kidneys and extremities. A well known diabetic tea from the blueberry leaf lowers blood sugar in diabetics. Blueberries aid in regeneration of macular eye vessels and keeps the blood vessels subtle and flexible. One cup of blueberries a day will do this.
The use of wild grape seeds also produces the same effect.
For cases that involve heart illness as a complicating aspect of prolonged diabetes, a drink of hawthorn berry tea will balance the heart and support it in recovery. The hawthorn berries can also be eaten with the same effectiveness. The same is practiced for strokes.
The patient begins an exercise program of walking, stretching, biking, swimming, etc. according to need and preference. The exercise program is done outdoors in nature and with the natural elements all around.
A spiritual process is suggested and supervised by the elder to support the person in coming back into balance. It is through our spirituality that all healing flows, and that the body, mind, emotions will follow. This can include some ceremonies, prayer, and meditation. How we bring our inner world in balance with our outer world is crucial to the healing process.
Life changes are discussed in counsel and the person is supported in making these changes gradually. For example: Cigarettes all have addictive additives in them. Cutting out smoking is important to healing from diabetes. We do this in a ceremonial way that helps the person detoxify and shift from the addictive dependency to a more spiritually centered lifestyle. The power of ceremony to heal is fundamental to our beliefs. Daily routine is put aside to enter into the healing aspect of some ceremonies. In other ceremonies the patient is encouraged to make spiritual practice part of daily conscious life. Spirit work and healing work are the same thing.
Rest, more sleep, and relaxation such as fun activities are integral to the healing process of diabetes. Sometimes a patient needs to retreat from life to get the insights, rest and perspective he/she needs and the wisdom being offered by the illness. Often the diabetes recedes when stress and anxieties are shifted in a patient’s life. If the system is in a state of exhaustion from years of having the condition, rest may become a more serious and primary factor in recovering balance.
Finally, illness does not invariably lead to death, and a person does not have to be ill to die. Sickness and death are not necessarily related. “Curing” may not make a person get better from an illness. There is a difference between healing and curing. Healing may result in a death or it may not. Curing may be a short-term outer fix that covers over many other aspects of deeper inner illness.
“We are born into this world as two legged animals. Our responsibility is to become real human beings” … grandfather, 1989
References and Sources
Remembering the Ancestral Soul: Soul Loss and Recovery, by Jane Ely, Ph. D., D. Min – see interview with Dr. Sam Beeler, Keetoowah elder
Coyote Medicine, by Lewis Mehl-Madrona, M.D., Ph. D.
Native American Research and Training Center, University of Arizona
American Diabetes Association: National Diabetes Fact Sheet, 2002
Indian Health Services
National Indian Health Board
Center for Chronic Diseases (CDC)
Education Commission of the States (ECS)
Article on: Education Policy Issues: American Indian/Alaska Native/Hawaiian
US Dept. of Natural Resources Conservation Services [search for about indians in 2004-2005 report]
US Census Bureau
The Actor’s Fund of America—Health Resource Center, Article on Minority Health liason programs
Hawaiian State Diabetes Prevention and Control Program
Native American Post Colonial Psychology, Eduardo Duran, Bonnie Duran
State University of New York Press, Albany, 1995
Jul 12, 2006 / Community
All Islands, Kauai
by Dr. Jane Ely
American Indian Heritage Month, Nov. 2005
Diabetes Awareness Day
Authors: Jane Ely, Ph. D., and Sam Beeler, Ph. D.
Presented by Jane Ely, Nov. 19, 2005
Copyright © 2005 Dr. Jane Ely
Let me begin by thanking the sponsors and coordinators of this event, the Hawaiian Health Guide, Katie Fisher and Michael Saiz; the Kahuna Valley Peace Project; HMSA; the Hawaiian Tourism Authority; Wilcox Health; and the Radisson Beach Hotel.
Also, I would like to acknowledge and thank the Hawaiian Nation, the spirits and ancestors of this land upon which we reside; and my ancestral American Indian elders who have walked before me— I give gratitude, and thanks for all you have taught through your living-wisdom ways, and by example in ‘walking the talk’. I would also like to offer this paper in support of health, healing and a returning to the teachings of traditional indigenous wisdom, knowledge, and application for our children, the generations who will follow in our footsteps.
Introduction: This paper is in two parts; the first aspect outlines facts, and statistics that are very rarely shared on the epidemic of diabetes in the American Indian, Alaskan Native and Native Hawaiian populations. The second half of the paper explores Traditional Healing Approaches from my American Indian background as a healer, counselor and practitioner. I have also included resources, references and sources for further reading and study for those who are interested, at the conclusion of this paper.
Facts and Statistics:
Diabetes is the 5th deadliest disease in the United States
In 2002, direct medical costs associated with diabetes totaled $92 Billion
Indirect costs totaled an additional $40 Billion [in disability, premature mortality, work loss]
18.2 M or 6.3% of the U.S. population are diagnosed with diabetes. This rate is one of the highest in the world, from one of the richest countries with the highest medical advantages in the world. [National Association for Diabetes, 2002]
Estimated 13 M or 5.2% or the U.S. population are undiagnosed [ibid]
1 out of every 400 children and adolescents suffers from type 1 diabetes [ibid]
In ages 20 and over, 8.7% have diabetes [ibid]
In ages of 60 and over, 18.3% have diabetes [ibid]
There are 2.7 Million full blood American Indians and Alaska Natives according to 2003 Census, and another 4.3 Million of mixed ancestry = 7 Million or 1.5% of the total U.S. population
2.1% of the American Indian population lives in Hawaii [approx. 33,000] [ibid]
American Indians are the highest ethnic group serving in the military; and 47% of the farms in Hawaii are operated by American Indians. [Natural Resources Conservation Services, 2002]
27% of American Indian adults over 35 years of age suffer from Type 2 diabetes.
In Hawaii the mortality rate is 70-90% of the Native Hawaiian population that are diagnosed with Type 2 diabetes.
American Indian mortality rate is 90%, including complications arising from Type 2 diabetes.
American Indians, Alaska Natives have the lowest life expectancy of all ethnic groups.
American Indians and Alaska Natives are 2.6 times more likely to have diabetes than any other ethnic group.
The major prevalence of Type 2 diabetes is in urban/off reservation American Indians. In areas where traditional foods are grown, hunted and fished, regional diabetes goes down from 14.5% of the American Indian/Alaska Native population to 6.8%, which is below the national U.S. diagnosed statistics. In regions where our ethnic population are in urban settings, the diabetes rate is 27% or higher.
Complications from Diabetes are heart disease, 65% of deaths amongst diabetics are due to heart disease. American Indians have 5 times more heart disease as a result of diabetes than any other ethnic group. Strokes, congestive heat disease are 2-4 times greater in American Indians. Kidney disease and renal failure is 6 times higher; amputation rates 3-4 times higher and retinal disease from diabetic complications are 24.4% amongst American Indian population. Over 73% of American Indians are diagnosed with high blood pressure arising from complications of diabetes.
History and Contributing Health Factors
Some historical facts on diabetes in American Indian population coincide with several governmental policies perpetrated upon our people. One example of which is the increase in and awareness of diabetes as a “killer” amongst American Indians was first noticed when our children were forcibly removed from our tribal lands and sent to governmental schools. This provided the first opportunity for the dominant culture’s medical field to “study” us an ethnic group. This removal policy began in the 1890’s in North America. The last governmental school was closed in British Columbia, Canada in 1998, over one hundred years later. Not only did this cause diseases relating to Post Colonial Stress Disorder amongst our entire population, the European diet children were raised upon and the dramatic health consequences of diabetes onset were first noticed by attending physicians to the schools.
Coinciding with this was the continued removal of and displacement of American Indians from ancestral homelands, causing a loss of traditional food sources, culture, language, traditions, tribal unit and ceremonial spiritual practices—to name only a few factors relating to complicating health factors amongst our population. Five hundred + years Post Contact, our population has come back from the brink of extinction. I will discuss this remarkable regeneration later in the paper.
Not until 1997 did the Congress establish a special diabetes program for American Indians. Under the auspices of the Indian Health Services, a governmental agency, the short-term program aims its focus on prevention education and treatment services. Both aspects of the program are only funded until 2008.
The Indian Health Service system has only 12 facilities to serve 7 Million American Indians and Alaska Natives. Most of these are located near reservations. The majority of health care and educational benefits are erroneously based upon American Indians living on or in American Indian Homeland Territory [ie. on reservation land]. Although the IHS is purportedly set-up to serve all enrolled American Indians. Over 50% of our population lives off-reservation. The urban work program sponsored by the federal government again relocated Indian people into major metropolitan areas, thereby dispersing us into urbanized cities, further contributing to the breakdown of tribal culture and traditional life-style. Many American Indians participated in the urbanization project to escape poverty, alcoholism, no work, suicide and infant mortality rates that plague all reservations. American Indian Health Services are focused on the geographical location of reservations, [versus the Canadian Indian Health system that follows the individual Indian]! If an American Indian moves off the rez., we forfeit health care. This policy does not meet governmental treaty obligations.
The increase in diabetes is historically marked by medical studies that begin in the 1940’s, and also post WWII, with the introduction of fast foods. Needless to say, the urbanization of our population contributed to a major shift in diet, which is a direct cause of Type 2 diabetes. It is Type 2 diabetes that is the majority of diagnosed cases in American Indians and Alaska Natives.
Interestingly, the Federal Government has a history of sponsoring health care pilot programs that knowingly and intentionally promote adverse health conditions amongst certain segments of the population. Three documented examples are the Tuskegee Project, the Sterilization Project, and Commodity Foods. The Tuskegee Project was a scientific study by Public Health Services to study the spread of syphilis and other sexually transmitted diseases in the African American rural south and to study the results in the population.
The Sterilization Project is a federal Indian health services program of involuntary sterilization of pre-teen and teenage American Indian women in an effort to “control” and reduce the American Indian population. This is known in other countries as genocide.
The third program that has more bearing on what we are here to discuss today is the Commodity Foods project. It has long been known that American Indians develop serious health issues, (of which diabetes is one) as a result of improper diets. Commodity foods were introduced by the federal government to all reservations under the auspices of alleviating dire hunger and starvation conditions. Commodity foods are: white flour, sugar, lard, soda pop, high fructose juices, and dairy products. The ubiquitous “fry bread” that you see offered at Pow Wow’s is an Indian mother’s answer to starvation utilizing lard, white flour, and sugar. It is not traditional food at all. It is nutritional genocide.
Almost all American Indians are type o+ blood, which means we all have an allergy to dairy products and alcohol. Nutritional genocide has been deliberately practiced since the loss of our traditional way of life. And it has caused millions of deaths.
Being overweight was rare among American Indians prior to 1940. Very few of our population had diabetes. Research indicates many factors contribute to the epidemic increase such as commodity foods, poverty—causing poor nutrition, urbanization, lack of health care, depression, alcoholism, and a sedentary lifestyle to name only a few causes.
Changes in nutrition documenting the history of food consumption by American Indians [Jackson, 1994, Native American Research and Training Center, Arizona], estimates that fat content was 17% prior to European contact and has risen to 38% in the current diet. The Euro-diet is high in calories and fat and low in fiber.
Diabetes in American Indian and Alaska Native Population:
There are three main forms of diabetes:
Type 1 is characterized by destruction of the beta cells of the pancreas, requiring insulin daily. This form is rare in Native Americans and Alaska Natives.
Type 2 is most common form among our population. Patients diagnosed with this form of the disease can control the diabetes through diet and exercise [and traditional forms of medicine that we will explore later in the paper]. Some patients may require insulin if the disease is advanced upon diagnosis. Symptoms in Type 2 are subtle and may not be apparent to a patient. As a result half the population with Type 2 are unaware of the disease until secondary complications such as heart disease, high blood pressure, stroke, kidney failure, loss of sensation in hands or feet, glaucoma and other eye problems have occurred. Type 2 also includes a family history of diabetes, gestational diabetic birth, being overweight, being sedentary, and eating an improper diet.
The third type is Gestational Diabetes Mellitus (GDM) a form of diabetes occurring in some expectant mothers only during pregnancy. Note: Mothers and babies are more subject to develop Type 2 later in life.
The Medical Approach to Diabetes
Medical studies, treatment and pharmaceutical products on the current market are all geared to treat male, Caucasians. The effect of ethnicity, ethnic biological differences, cultural diversity, spiritual and social structure and traditional orientation are all missing from current medical treatment of diabetes. In the 1950-70’s, American Indian tribes were approached by drug companies to study the effect of some types of drugs on our population. The tribes that volunteered were used as biomedical research guinea pigs. Theses tribes did not receive any benefit from the research. The results of the research were never published or shared with the tribes who participated. [Mind and Culture, June 29, 2005, Washington Post series of articles]. This knowledge has lead many tribal governments to turn towards our traditional healing practices, to renew our knowledge of herbal medicines, spiritual understandings about diseases, and to practice ceremonial ways of coming back into balance for our health and for our very survival.
Traditional Healing Approaches to Diabetes from an American Indian Perspective
To begin this section of the paper, I will need to give you an overview of American Indian approaches to all illness and disease, whether it is an illness of the physical body, or of the emotional kind, or a spirit sickness, we approach all ‘dis-ease’ in a multifaceted way. We include the body, mind, spirit, and emotions in all diagnosis and treatments. Today, the term used for this approach is Holistic Health. American Indians know this approach as traditional medicine. It is because we have certain people in our tribes who have never forgotten the balanced, harmonious traditional ways that we have survived to the present. So the term, “traditional medicine” for the purposes of this paper relates to and reflects American Indian values, wisdom and time honored traditions that work for us.
We know that all illness arises from four root causes: fear, hatred, jealousy and grief.
Fact: All American Indians in today’s culture are suffering from Post Colonial Stress Disorder. This condition has been brought on by the four root causes of illness. All illness in our diagnosis process begins with this understanding but is not limited to this knowledge. We know ourselves to be many layered. Being an American Indian in the 21st Century requires us to understand our past and practice principles of health and life in the present. We know all illness has an outer cause and an inner cause. When we are ill, it is because we are out of balance in some way, shape or form. We focus on both the outer illness as it is being manifested as well as the inner causes. When we become ill we know it is because we are out of balance both in the outer world and the inner world.
Returning to traditional values in diagnosis and treatment does not exclude the use of some types of drugs. The dosage however, may need to be more closely monitored and regulated to suit American Indian biology. The principles of healing we incorporate into all treatment plans are:
The inner and outer causes of illness, body, mental, spiritual and emotional.
Where does harmony need to be restored? How in what way?
Diet and nutrition—a return to American Indian foods
Cleansing and purification [sweating, bathing, detoxifying, fasting]
Herbs and remedies to bring the balance back
Rest, relaxation and no stress
Community/tribal support through the illness
Counsel Practice for emotional balance, talk with an elder or trusted friend
Spiritual practices such as prayer, meditation, healing ceremonies
Dreams and creative projects manifest healing insights and direction
Once an illness passes or is balanced, we in turn become in service for others who have the same or similar life experiences.
American Indians do not view death as failure as a result of a disease. We view it as a natural, organic growth of our spirit.
Traditional American Indian Treatment Protocol for Type 2 Diabetes:
Traditionally we go to an elder, a medicine man or woman to explore the inner and outer causes of an illness or disease. When we become ill, we recognize this is a time for inner exploration, for personal transformation and change, to look at other problems effecting our life and spiritual matters. “Dis-ease” is a call for deep change from our perspective. The power of telling our story to an elder or a medicine man or woman is the first act of healing. Storytelling is a healing way. . For example: We know and understand that part of the illness of diabetes is due to anxiety, poverty, and extreme emotional conditions. Working with a medicine person would bring these inner states into account with the overall illness of diabetes.
When a patient understands and accepts the causes, the next step is to purify, cleanse and detoxify. This includes bathing, scrubbing the skin with sand, salt, sponges, soaking in minerals and mineral springs, sweat lodges, and fasting—taking liquids such as broths and teas to help unload the system from the heaviness of the illness.
Cleansing can also mean taking on a more serious fast that includes herbal remedies to clean the colon and intestinal tracts. In addition a tincture of black walnut and dandelion, and other herbs are taken for 45 days after the fast is completed to clean the system of parasites and parasite eggs. This is done under supervision with the medicine elder that makes the herbal formula according to the illness. The detoxing process brings the entire system, inner and outer into a state of receptivity and homeostasis. It also give the digestive system time to REST. Fasting, taking special herbs teas, being quiet as the body is unloading old stuff, all aid the patient in going inward. Self reflection, rest, sleep and silence are part of fasting and detoxification.
A purposeful spiritual cleanse would lead the patient into a Vision Fast [also known as a Vision Quest]. This is another topic we will explore later in another article.
Next, the diet needs to be corrected and brought into balance. Traditional foods must be sought out and reincorporated into a daily routine and diet. These foods are: corn, peas, beans, leafy greens such as wild water cress, dandelion, ferns in the spring, root, ramps, and garlic, cabbage, root vegetables such as sweet potatoes, potatoes, burdock, squash and nuts specific to the region. Such as acorn nuts which are ground and used as flour or to thicken soups or stews. Vegetables are eaten according to the season in which they flourish and are harvested naturally. The same goes for fruits and berries. There are over 50 varieties of blueberry in North America. Roots, leaves, and berries are dried and reserved for winter months, and are also pounded into meat as a preservative, ie. Pemmican. Peppers are used to flavor foods; hot peppers have restorative value for the heart in diabetes and heart ailments, such as cayenne.
Meat and fish are eaten in small portions and are hunted from the wild, such as turkey, buffalo, deer, elk, moose, duck, goose, lobster, local fishes, rabbit, grouse, etc. Meats are flavored with peppers, roots and natural sea salt.
There is no wheat, dairy, white flour, processed foods, sugar or iodized salt in the diet. There are no trans-fats. The only fat that is used is fat from the meat.
Fresh water is drunk; teas such as sassafras, dandelion, mint, and osha teas are blood cleansers and digestives. The change over to this diet alone causes many American Indian patients with Type 2 diabetes to come into balance and regain health. Complicating health factors such as high cholesterol, high blood pressure, circulation problems, overweight problems also diminish and in some cases disappear. Researchers have found that anyone following a traditional American Indian diet will reduce and in many cases heal hypoglycemia and hyperglycemia, control blood glucose levels and regulate metabolism. Foods rich in vitamin B such as cabbage, nettles, peas, spinach, sweet potatoes will stabilize the metabolism that is crucial in regulating diabetes.
Herbal Formulas such as a tea of wild carrot and devil’s club are drunk as a tea to specifically rebalance the pancreas, the blood glucose and the endocrine system. Another tea we have used with time honored effectiveness in treating diabetes is American Ginseng Root. It does not have high blood pressure side effects that other ginseng roots have and it regulates the blood sugar levels in Type 2 diabetes and is an energy booster.
There are many valued herbal teas in every American Indian culture that deal specifically with diabetes. The herbal formulas relate specifically to what is grown regionally. It should be noted that the use of herbal formulas as “medical cures” should be avoided as a “fix-it” method. All American Indian herbs are used in conjunction with a complete healing program.
Blueberry fruit and leaves are used as a herbal formula to treat long-term diabetic damage to the small blood vessels in the eyes, kidneys and extremities. A well known diabetic tea from the blueberry leaf lowers blood sugar in diabetics. Blueberries aid in regeneration of macular eye vessels and keeps the blood vessels subtle and flexible. One cup of blueberries a day will do this.
The use of wild grape seeds also produces the same effect.
For cases that involve heart illness as a complicating aspect of prolonged diabetes, a drink of hawthorn berry tea will balance the heart and support it in recovery. The hawthorn berries can also be eaten with the same effectiveness. The same is practiced for strokes.
The patient begins an exercise program of walking, stretching, biking, swimming, etc. according to need and preference. The exercise program is done outdoors in nature and with the natural elements all around.
A spiritual process is suggested and supervised by the elder to support the person in coming back into balance. It is through our spirituality that all healing flows, and that the body, mind, emotions will follow. This can include some ceremonies, prayer, and meditation. How we bring our inner world in balance with our outer world is crucial to the healing process.
Life changes are discussed in counsel and the person is supported in making these changes gradually. For example: Cigarettes all have addictive additives in them. Cutting out smoking is important to healing from diabetes. We do this in a ceremonial way that helps the person detoxify and shift from the addictive dependency to a more spiritually centered lifestyle. The power of ceremony to heal is fundamental to our beliefs. Daily routine is put aside to enter into the healing aspect of some ceremonies. In other ceremonies the patient is encouraged to make spiritual practice part of daily conscious life. Spirit work and healing work are the same thing.
Rest, more sleep, and relaxation such as fun activities are integral to the healing process of diabetes. Sometimes a patient needs to retreat from life to get the insights, rest and perspective he/she needs and the wisdom being offered by the illness. Often the diabetes recedes when stress and anxieties are shifted in a patient’s life. If the system is in a state of exhaustion from years of having the condition, rest may become a more serious and primary factor in recovering balance.
Finally, illness does not invariably lead to death, and a person does not have to be ill to die. Sickness and death are not necessarily related. “Curing” may not make a person get better from an illness. There is a difference between healing and curing. Healing may result in a death or it may not. Curing may be a short-term outer fix that covers over many other aspects of deeper inner illness.
“We are born into this world as two legged animals. Our responsibility is to become real human beings” … grandfather, 1989
References and Sources
Remembering the Ancestral Soul: Soul Loss and Recovery, by Jane Ely, Ph. D., D. Min – see interview with Dr. Sam Beeler, Keetoowah elder
Coyote Medicine, by Lewis Mehl-Madrona, M.D., Ph. D.
Native American Research and Training Center, University of Arizona
American Diabetes Association: National Diabetes Fact Sheet, 2002
Indian Health Services
National Indian Health Board
Center for Chronic Diseases (CDC)
Education Commission of the States (ECS)
Article on: Education Policy Issues: American Indian/Alaska Native/Hawaiian
US Dept. of Natural Resources Conservation Services [search for about indians in 2004-2005 report]
US Census Bureau
The Actor’s Fund of America—Health Resource Center, Article on Minority Health liason programs
Hawaiian State Diabetes Prevention and Control Program
Native American Post Colonial Psychology, Eduardo Duran, Bonnie Duran
State University of New York Press, Albany, 1995