Low-tech Medical Care

Economic necessity may force many people to stop relying on expensive problem focused health care. How do people take care of themselves in a culture where self-reliance is not emphasized in mainstream health information? Many of the approaches that are used in "Where There is No Doctor" or older editions of "Our Bodies Ourselves" offer health care approaches that are practical and incorporate looking at the social causes of ill health. These approaches can be used to explain the causes and treatments for the rising incidence of chronic, non-infectious health problems that people in the US have. This information needs to be directed to the user public, not to policy makers, academics or a highly educated elite. Information must be practical and presented within a historical and political context.

The use of the book, "Where There Is No Doctor" (1) is widespread internationally. It provides a useful tool where no other is really available, for people living in areas where acute, infectious processes are more common. In the US, this approach needs to be adapted to treat diabetes, asthma and COPD. Instead of explaining the causes of diarrhea as in the picture above, a scenario can be created showing how typically American lifestyle choices create ill health. Paulo Freire calls this learning process Transformative Literacy. "Codification" is an element of this process that begins with a photograph or picture from a scene of the learner's life. "Codification represents a given dimension of reality as individuals live it, and this dimension is proposed for their analysis in a context other than that in which they live it.” “ The learners, rather than receive information about this or that fact, analyze aspects of their own existential experience represented in the codification.” (2)
The Internet or other abstract forms of information sources may not be the best place for people to access this information. For this level of complex information, an impersonal source like the Internet, will not establish the trust and dialog needed for people to understand it. Examples of information sources that might be better suited for this level of information exchange are lay health workers. In Detroit, community members are trained to help families deal with asthma prevention and lead poisoning. Low cost techniques that help children control their asthma are taught to family caregivers. These techniques include learning about housing conditions that are harmful, procuring vacuum cleaners and smoking cessation.

A critical awareness must be raised to move people away from being dependent on a medical system they cannot access. They must develop new behaviors based on an independent viewpoint that will maintain health.