Visits to other worlds

Over the years I've had the opportunity to travel-- whether out of an exploratory yearning mixed with a desire to contribute, or in response to requests to consult on specific medical projects-- to odd locations around the world. Among them have been central Mexico, Kashmir, Afghanistan, India, and a part of Eastern Tibet, "The Kingdom of Kham," as it was once known.

In the Fall of 1995 I worked with a remarkable small NGO in Jalalabad, run entirely by Afghans, (with the exception of its founder, Howard Williams, a San Francisco bicycle messenger at the time). ABRAAR worked with amputees by providing them with bicycles, and teaching them to alter, maintain, and ride them, along with basic literacy and first aid. My work was in part to help train Ali, a nurse who ran a small clinic there, and to see whoever showed up-with malaria, tuberculosis, shattered limbs, and/or depression. The photo above shows us, along with a hired guard, travelling across the famous bandit-ridden Khyber Pass back into Afghanistan after a survey trip to Peshawar, Pakistan.

During a further survey, I flew with two Afghan friends to Herat, which had just been taken over by the Taleban militia. We met the Taleban commander, who gave us blanket permission to look into whatever was necessary for our purpose. By the following year, Jalalabad also fell to the Taleban, who took over the NGO with unfortunate consequences.

In 1999 I undertook a survey of the medical situation in a remote valley of Kham. The photo shows me with Jamyang Singye, and a local monk. Singye was our interpreter, and also one of a very few traditionally trained master Thangka painters in the world today. In the photo he is critiquing a local Thangka, the production of which has suffered from obstruction of the teachings of Tibet Buddhist traditions. Traditional medicine, which is a crucial part of any practical health care there, has also been badly adulterated in local practice by the invasion of western medicines inappropriately used.

This experience taught me that the usual "do-gooder" approach of starting medical clinics based on Western models is not always the best thing to do. Such approaches are liable to unintentionally create an even more dependent group of disadvantaged people. It is much better to strengthen weakened positive traditions (with or without relation to what we define as "health"), to help people gain mastery and confidence in their own lives. The same principle can be applied in medical practice in my own country, in that people can be given the understanding and tools to take charge of their own situation, rather than putting the doctors, insurance companies, and drug companies in control of everything.

In another part of Kham, I followed a monk down the mountain from the upper retreat center, towards the main Palpung Monastery building. Virtually destroyed in the 1959 Chinese cultural revolution, it is slowly being restored. Palpung is the head monastery in the Kadyu school and the source of Singye's Thangka tradition. A series of documentaries is in production, one of which chronicles this first return to his origins, and his encounters with what remains of the art of Thangka painting.

These, and other engagements with differing cultures, have left me with a broadened sense of the role of medicine and healing in our world. The vast differences in practice and need around the world leave much more open the questions about what is appropriate for any given person. And medical practice seems as much about questions as about answers. Unfortunately, in modern Western systems of medicine, there is little time to engage the questions properly with each patient. My work with the Alternative Medicine Foundation is an effort to correct this a little at a time.

J. Ladd Bauer MD