Written by: Lauren Hardy
Edited by: Ratna Sharma, Zoee Drimmer, Apurva Oak
Illustrated by: Ena Selman-Housein
Growing up in a Caribbean household, “Kara” witnessed firsthand the stigma surrounding seeking medical attention in her community. Her family often turned to traditional remedies such as bush tea, a tea brewed using local plants with varying healing properties such as anti-oxidant and anti-inflammatory effects, to cure common ailments [1]. Kara remembered her grandmother always having a pot of bush tea on the stove, and they were encouraged to drink it for everything from a common cold to stomach pains.
However, there were times when these remedies were not enough, and they had to turn to more "modern" medicine. Kara remembers her mother's reluctance to take her to the doctor when she was younger, even when she was clearly sick. It was not until her condition worsened that they finally sought medical attention, and even then, her mother was hesitant to follow through with the prescribed treatment. She felt as if seeking medical attention was seen as a sign of weakness that brought shame to their family.
This story, told by Kara, displays the long lineage of traditional remedies deeply rooted in Caribbean countries and cultures. Bush tea is believed to have numerous health benefits, including lowering blood sugar levels, reducing inflammation, and even preventing cancer [2, 3]. Moreover, herbs such as cerasee are used to treat diabetes and hypertension, also known as high blood pressure, a condition in which blood flows through your arteries at a higher than normal pressure [2, 4-6].
The validity of these cultural remedies has been supported by numerous studies. For example, a study published in the Journal of Ethnopharmacology found that bitter melon, commonly used in Caribbean traditional medicine, has hypoglycemic, referring to lowering blood sugar levels and hypolipidemic, referring to lowering blood lipid levels effects and may be useful in treating diabetes and high cholesterol [7-9]. Elevated lipid levels are associated with an increased risk of heart disease, so hypolipidemic effects are often desirable for individuals with high cholesterol or other cardiovascular risk factors [10].The Journal of Ethnopharmacology also found in another study that aloe vera, a herbal remedy, has numerous health benefits such as wound healing, treating skin infections, and managing inflammatory disorders [11]. This is due to its antioxidant and antimicrobial properties [11]. Another study, published in the Caribbean Anthropology Quarterly, noted the importance of using traditional medicine in the Caribbean as it is often more affordable and accessible than Western medicine [12]. However, a key issue to be noted by Kara’s experience, is that there is an unspoken stigma associated with seeking Western medicinal treatment.
There is a deep-rooted distrust in Western medical treatment in Caribbean communities, and this article is an acknowledgement of these issues [13]. Due to a variety of factors, including a belief in natural remedies, concerns about side effects, and high healthcare costs, many Caribbean people’s lives have been cut short [14]. For example, according to the World Bank's data on life expectancy at birth by country, amongst the many other social and economic factors, lack of “formal,” or standardized medication and treatment has aided in Haiti having one of the lowest life expectancies in the Caribbean region [15]. In 2019, the life expectancy at birth in Haiti was 65 years, which is significantly lower than the regional West Indian average of 73 years. Furthermore, many Caribbean immigrants may not have access to healthcare and/or may not understand how the healthcare system works in their new country, so they rely solely on cultural remedies and avoiding formal medical treatment altogether, which have proven to render severe health consequences [15].
To gain a deeper understanding of this phenomenon, I spoke with several individuals about their experiences with formal medical treatment. They ranged from Caribbean communities in different New York City neighborhoods, such as East Flatbush, Canarsie, Bed Stuy, my neighborhood Crown Heights, and the neighborhood Columbia resides in, Harlem/Morningside. One common theme that emerged from these conversations was the belief that Western medicine is too invasive and reliant on medication. Many of the people I interviewed also expressed concern about the potential side effects of these medications and their impact on overall health:
"I've seen too many people in my community become dependent on prescription medication, and it's concerning. I believe in the power of traditional remedies, and while I recognize a need for Western medicine, it’s a bit difficult to trust a system that has continued to take advantage of my community.” - Interviewee from Canarsie
"I think there's a misconception that Caribbean people are resistant to Western medicine, but it's really about finding a balance. I want to be able to trust my doctor, but I also want to feel like my voice is being heard and my concerns are being taken seriously." - Interviewee from Bed Stuy
"I have been living in Harlem my whole life and have family members who have lived here for decades and I've seen firsthand the impact that cultural beliefs can have on healthcare decisions within my neighborhood. It's important for healthcare providers to understand and respect these beliefs in order to provide the best possible care." - Interviewee from Harlem
Healthcare in Caribbean communities has long been a complex issue as illustrated by these quotes, as a mixture of historical, political, and economic factors has contributed to the failing state of healthcare in these countries [16]. Despite recent efforts, such as donations for better funding by organizations like The Caribbean Public Health Agency (CARPHA) to improve the quality of healthcare in the region, many Caribbean countries still face a number of challenges in terms of affordable and accessible healthcare [17].
One of the biggest medical issues that affects Caribbean people is non-communicable diseases (NCDs) [18]. According to the Pan American Health Organization, the term NCDs refers to a group of conditions that are not mainly caused by an acute infection, resulting in long-term health consequences which creates a need for long-term treatment and care [19]. NCDs such as heart disease, hypertension, diabetes, and cancer are responsible for a significant portion of deaths in the Caribbean, and the prevalence of these diseases is on the rise [18]. According to the World Health Organization, NCDs account for over 70% of deaths in the Caribbean, and this figure is expected to increase in the coming years [20]. In addition to NCDs, infectious diseases such as HIV/AIDS, tuberculosis, and malaria also pose a significant threat to public health in the Caribbean. In many cases, these diseases disproportionately affect marginalized populations such as sex workers, LGBTQIA+ individuals, and people in impoverished communities and is further exacerbated by the lack of trust in the healthcare system [20].
Historically, Caribbean countries have struggled with these NCD’s as a result of the legacy of colonialism and slavery, which left many Caribbean countries without proper infrastructure or resources to build strong healthcare systems [21]. The reliance on natural remedies and traditional healing methods in the region can also be attributed to the fact that many enslaved Africans brought with them knowledge of traditional healing practices from their home countries, and this knowledge has been passed down through generations [22].
Despite these challenges, there have been efforts to improve the quality of care in the region. The CARPHA organization was established in 2011 to provide regional leadership in public health for the voices of those unheard in Caribbean countries to be heard, and as aforementioned made efforts in improving the quality of healthcare through donations [21]. In New York City, there are many organizations that work towards mitigating health disparities in the NYC Caribbean community like the Caribbean Equality Project (CEP), which provides resources, guidance, emotional support, and material aid to Caribbean LGBTQIA+ immigrants [23].The Caribbean Women’s Health Association also works to improve the capacity, organizational development, governance, management, ethical behavior, accountability, efficiency and effectiveness of grass-roots and faith-based organizations [23]. All of these organizations make an active contribution to helping further migrant communities in NYC, as well as the Caribbean communities in the West Indies.
It is also important to note that Caribbean people are not opposed to "modern" medicine; rather, they are familiar and comfortable with their traditional medicinal systems and home remedies. However, both Western and Caribbean medicinal practices and treatment can be used in conjunction with modern medicine to enhance the effectiveness of treatment. For example, a patient with diabetes can use bush tea to help manage their blood sugar levels in addition to taking insulin or other medications prescribed by a doctor [1]. By recognizing the value and benefits of both cultural and Western medicinal practices, medical organizations can begin to gain the trust of the Caribbean community and create a healthcare environment that prioritizes the well-being of Caribbean people that promotes a holistic understanding of health.
References
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