Diabetic dilemma: Traditional or Western medicine?

By Joan Black
Windspeaker Contributor

Although there is no cure for diabetes, people who have it can improve their chances of living an almost normal life by taking responsibility for their health. The trouble is, by the time you notice the symptoms and are worried enough to see a doctor, you may already be very sick.

Maybe you've heard there are herbal remedies or "natural" medicines around. Somebody wants to put you in touch with a medicine man or woman. Or maybe you have already put your faith in Indian medicine and have been feeling all right. Now suddenly you're having complications, and your family wants you to see "a real doctor." Is it safe to keep taking your herbs along with insulin?

Windspeaker talked to three traditional medicine people, as well as to representatives of the Canadian Diabetes Association, the Aboriginal Diabetes Association, the Aboriginal Diabetes Wellness Centre at the Royal Alexandra Hospital site in Edmonton, and others who counsel diabetic clients.

They all said diabetes is a serious disease with no cure and no single plan of treatment to fit everybody. But most observed a degree of caution in expressing their opinions for publication in areas they know are controversial. There is a gulf of misunderstanding and, in some instances, misrepresentation of the aims and methods of "the other side", whether Western or traditional. All those who would go on record, however, were unanimous in saying that diabetic clients on pills or insulin should never, ever change or stop taking their medication without a doctor's advice.

Maryann Hopkins, a nurse who works in Ottawa, spoke about herbal remedies at a diabetes conference in Calgary last October. She says until that time, "I was not familiar with the Aboriginal approach to wellness and I did not understand it."

Hopkins said she considers complementary medicines to be exercise and diet. She sees only a minor role for "herbals," and says some of the "alternative" products can be classified as "traditional herbs" if they have gone through a rigorous process of certification, but even then "the indication has to be for something minor."

Hopkins said the reason for this is that there are a lot of "fly by night" companies, and said she knows of one example where blue-green algae was being sold as an anti-oxidant and health promoting product, when it had high toxin levels in it. In addition, she said there may be five different brands of a herbal on health store shelves, but there is no quality assurance or "checking" of the stores or origins of the products.

Hopkins said that in Canada, products which "fall under the rules" can display a DIN number allocated by the Health Protection Branch, which means "someone is looking at the information provided by companies and is doing post-marketing surveillance." The fact that Health Protection Branch has been publicly criticized for what prominent scientists who formerly worked there say is improper approval of some drugs doesn't sway Hopkins.

"Normally, by the time Type 2 diabetes is diagnosed, usually the eyes are affected. [These people] can't be helped by herbals," Hopkins said.

This attitude frustrates 49-year-old Russell Willier, a Cree healer from northern Alberta, who has been treating a variety of ailments with herbal treatments for 20 years. On the one hand, Willier wants recognition for the value of what he and others like him do, yet he does not keep written records of his treatments. Similar to most other traditional medicine people, he will not reveal the exact ingredients in his herbal "combinations," either.

In the mid-1980s, Willier participated in a research project with anthropologists from the University of Alberta to show that Indian medicine works. David Young, who is retiring as head of Anthropology at the university, said there is no doubt in his mind that Willier is able to help some people. He said he has seen patients respond very well to Willier's treatment of leg ulcers, for instance.

That the medical profession was not persuaded that the healer's methods work may be because of the limitations of the research project itself. They kept one foot in the boat throughout: the test was only designed to treat psoriasis, a chronic and sometimes serious skin disease, which sometimes affects diabetic patients. Skin ulcers resulting from impaired circulation, on the other hand, which are a frequent complication of diabetes, were deemed too dangerous to allow Willier to treat in a controlled setting.

In addition, Willier stresses the component of belief and respect for the teachings that accompany the use of plants is as important as their medical benefit. That view is central to the teaching of the other medicine people too. Yet Willier was unable to get any Aboriginal people to volunteer for the project. All 13 were non-Natives. Two were test cases; of the main sample of 11 people, one dropped out at the beginning. The anthropologists' reports indicate that many, if not all the subjects, stopped using all their topical medicines some of the time because of the bad smell. In addition, treatments were conducted in Edmonton instead of in Willier's home, which curtailed his normal way of doing things and in some instances probably shortened the treatment he could offer. In addition, the sweat lodge ceremony was delayed. In the end, the anthropologists' report said six people benefited from treatment to varying degrees.

Willier once hoped to get a healing centre started, so he could have others handle the paperwork while he doctored full time. That dream is all but gone now; his letter sent out to all of Alberta's chiefs and councils did not elicit one reply, he said. Still, he treats about 40 people a year all over Alberta, British Columbia, the Northwest Territories and Yukon. In 1997, he was invited to explain Aboriginal medicine at Queen's University in Kingston, Ont. In addition, Willier has taught apprentices from the Alexander reserve in Alberta and from Isle la Crosse in Saskatchewan. But most of the time, he finds himself "working around the doctors," even when family members ask him to visit their relatives in hospital. Sometimes patients ask him for his herbal drink, which he says has regulated blood sugar when Western medicine has failed.

Willier's main complaint is with the approach of Western doctors. He suggests they are not prepared to put the time into healing obstinate chronic conditions.

"They want to cut [legs off] to prevent gangrene spreading or when ulcerative conditions are almost at the gangrene stage," he said.

Other than to say they use "a traditional approach," nobody at Edmonton's Diabetes Wellness Centre wanted to talk about the traditional medicine. Spokespeople there said it was "political," and deferred to the Elders on staff, who they said might or might not want to talk to the press.

One did. Madge McCree, from Slave Lake, looks after the spiritual aspects and leaves the doctoring to others. She said circles are held at the wellness centre, where people can express themselves, and prayer is part of each day.

"We teach them - we plant the seed to take responsibility for themselves," McCree explained. "We start by awakening the spirit, then the mind works." The difference is that the centre" [doesn't] teach fear-based, AKA Western, medicine," she said. Instead they "work on the seven grandfathers" to create the balance she said is missing from people's lives.

McCree said some Elders think diabetes among Aboriginal people is caused by "a lot of things in the past - grieving," from a lot of the hurt they have been through since the Europeans got here. Still, she leaves the choice about whether or not to take Indian medicine up to the individual, and "we never tell them not to take [insulin]" she said.

Sometimes, McCree added, if they see clients before they become insulin-dependent, traditional medicines can help them avoid it.

"We advise them if they take traditional medicine, check their sugar more often." The healers have consensus on this point, as all said that traditional medicines often lessen the need for insulin or Western oral medications.
The big difference between her approach and that of Western herbalists, McCree added, is prayer. She said she has seen that even if someone takes the same medicines Aboriginal people use, that they obtained commercially, more success occurs where "protocol - the offering of tobacco - is observed and the client "wants something from the heart.

"If the sacredness is gone, healing stops," McCree concluded.

That is the view of Derrick Pitawanakwat of Manitoulin Island in Ontario, too. He also relies on the seven grandfathers to treat illness. But Pitawanakwat seems to have the respect of the doctors, dietitians and others with whom he works on the island and who sometimes give him referrals. There he is welcomed to treat in the hospital when Aboriginal patients request it. Like Willier, he uses internal and external medicines.

His brew to help cardiovascular complications does not remove plaque in arteries, he said, but it prevents clots and permits better blood flow. He also treats psoriasis and other skin conditions with four herbs in an external application. The past five years, Pitawanakwat said, he has restricted his medicine to the treatment of diabetes and has 152 clients whom he sees regularly. He only treats Aboriginal people and thinks genetics is the main cause of diabetes among them.

Unlike Hopkins, Pitawanakwat does not see proper diet and exercise as "complementary" aids to diabetes treatment, but an essential component of it. Like Willier, he said "Western doctors' only solution to gangrene is to cut the leg off."

Pitawanakwat took training for more than a year as a diabetes educator at a community college in Ontario, and has adapted that knowledge to suit the ways Aboriginal people learn. The 61-year-old healer has taught about 80 students and currently has eight, he said. He has a proposal before the minister of health to hire nurses and do more teaching and follow-up.

"If I can get them to understand they need to change their lifestyle, even tough cases will respond," Pitiawanakwat said of his methods. Like McCree and Willier, he stresses , that belief and the proper respect for the gifts from the Creator make all the difference.

Irene Csotonyi, who operates a herbal remedy store in Edmonton, disputes the statement of many doctors, nurses and pharmacists that most natural medicines are sold by uninformed lay people who may put your health at risk. She stresses that people need to take the responsibility to research and learn and ask questions before deciding on herbal remedies. Like the other interviewees, Csotonyi said there is no "quick fix" for diabetes and no one remedy for everybody. Although she does not work with physicians, Csotonyi said she was trained as a medical doctor in her Native Hungary and has taken training in natural medicines by correspondence and other means here in Canada.

Csotonyi described in detail several products that she can offer to help regulate blood sugar, reduce the need for insulin, boost the immune system and increase energy. Still, she said "Diet is the most important thing. Look at diet first.

"Self-diagnosis is out," Csotonyi added; "I always recommend they see a doctor first."

The businesswoman adds that she is not opposed to government getting involved to better regulate natural products, provided "they hire people in the Health Protection Branch who have had training in and understanding of natural medicines."