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  Today Online 1 Sep 06
Barefoot doc who went native

SOME doctors like the familiarity of their own clinics and a regular pool of patients. Dr Aldo Lo Curto prefers to rough it out in the wild, lending his skills to indigenous people. Every six months, the 1993 Rolex laureate will take off from his family clinic in Italy, and spend the next half year travelling, healing and living among people without modern technology. He has done that for the past 20 years--in almost 40 countries.

Dr Lo Curto tells Sampoorna Dasgupta why technology has "killed" communication between doctors and patients, and why Western medicine--despite its attractions--should never replace traditional culture.

Why become a "volunteer travelling doctor"?

I felt that my profession was a limited resource in developing countries. There are no native Indian doctors in Brazil and the modern doctors do not go to the countryside because their salary would be too low.

So, in 1978, I decided to work for six months in Italy, save some money and fund my humanitarian trips. I gave up my salary in the second half of the year, and offered my medical services for free where there is no doctor.

I provided help for short but intense periods in more than 40 countries to gain experience. Finally, I selected one country in each continent: Brazilian Amazonia (South America), Benin (West Africa), Mongolia (Asia), Solomon Islands (Oceania) and...Italy!

In my country, the relationship between doctor and patient is in crisis because of the high level of technology which has killed communication.

But in these countries, I found strong environmental energy, shamanism, and the medical use of plants, animals and minerals. I also had the possibility of healing by cooperating with the local shaman, complementing both medical cultures.

What happens when you visit a particular community?

I go to indigenous communities only when invited. When I go to an area where there are no doctors, I locate and work with at least one local health centre, and get the help of at least a nurse, a midwife or a traditional healer.

My services serve to supplement the work of the existing healthcare workers, who also act as my "cultural interpreters". The community would not be left in the lurch were I not around.

The villages normally have 150 to 300 people, so I might be the only doctor. I have, though, invited other doctors, dentists or nurses, especially when the village is bigger (1,000 inhabitants).

Very few come, and those who do only stay for a short period (two to three weeks).

In general, I try to avoid big projects and prefer to do smaller projects really well. I want to respect the local culture, without creating dependency or paternalism.

Which indigenous group has had the most impact on your life?

The Amazonian Indians of Brazil, because they were only contacted very recently, so, most of their culture and spirituality is still intact.

Living with them, I have learned to respect nature, children and old people. The shamans taught me that treating one part of the sick body is good, but treating and encouraging the patient as well is better.

Any memorable incidents to tell your grandchildren about?

There were many (such as travelling by jeep, by boat, horse, buffalo), but the most impactful was the first time I had to treat two children with pneumonia, and they were dying.

Unfortunately I only had antibiotics for one of them. It was terrible. I had to treat one first (and managed to save him), but I stayed with the second child the whole time and prayed, massaged him and was with him until he died. His mother was content.

What lessons do you take away from each trip?

Indigenous people are attracted to modern technology, but the risk is that they may forget their traditional culture.

The ideal situation would be their complete isolation.

However, I suggest they become bicultural, but very slowly (over 30 to 50 years) so when they reach this stage, they can decide what they want to be--a traditional, bicultural or modern society. This is called "auto determination".

Tell us more.

Being bicultural means to speak a Western language without forgetting your own native language; to hunt using a gun without forgetting the correct use of bows and arrows; to use a torch without forgetting how to start a fire with two wooden sticks; and to listen to modern music without forgetting how to appreciate traditional music.

Auto determination means that we, as non-locals, have no right to interfere with the locals' decision about their own culture and society. We can only show them the possibilities and impact (pros and cons) of our capitalistic society.

Perhaps after two or three generations, they would have learned to be bicultural--which means they know how to manage the good (better living conditions, higher mobility, more advanced society, etc) and the bad (social vices, e.g. alcoholism, drugs, etc) effects.

Why are you critical about how modern doctors treat their patients?

Some doctors use very sophisticated and technical terms to explain the patients' condition. He/she may say "gastritis" instead of "inflammation of the stomach". He/she may say "therapy" instead of "treatment".

Most doctors call patients by their allocated numbers instead of by name--this loses the personal touch. I do not reject modern technology, you can be human with the patient while using the most sophisticated technology.

What is your next project?

After the illustrated health books for Amazonian people (for which I received the Rolex Awards for Enterprise in 1993), and for the African people, I am drawing up a new one for the nomadic people of Mongolia.

The last book will be for the Melanesian people (Solomon Islands). As with the previous books, they will not be for sale, out of respect for the indigenous intellectual property rights.
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