Rural Women's Health Conference Summary Report Summary Report  (PDF File, 1.82 Mb) August 13 -15, 2007 Omni Shoreham Hotel, Washington DC

Plenary Session

Native American Medicine: A Model for Creating Healing Environments

Keynote speaker Lori Arviso Alvord, M.D., Associate Dean of Student and Multicultural Affairs at Dartmouth- Hitchcock Medical Center, opened her presentation by reading a passage from the book she co-authored titled, Native American Medicine: Ancient Wisdom for Modern Times. The passage was from the chapter called "Ceremony Medicine." It is the story of a woman with breast cancer whom Dr. Alvord tried to convince to have a Native-American ceremony before trying surgery. The ceremony is called the Night Chant.

Dr. Alvord continued by explaining that to talk about Navajo healing, we need to consider work at the Massachusetts Institute of Technology on "systems thinking," which is a way of understanding complex systems. She went on to explain that "systems thinking" is useful when thinking about large systems like ecosystems or healthcare systems. Some of the components of the system are almost invisible until you point them out.

Dr. Alvord went on to explain that a systems approach to illness and wellness would look at all levels of a human being's environment. She stated that body, mind, and spirit are part of a family; which, in turn, is part of a work environment. The work environment is part of a community, which, in turn, is part of a global environment. Dr. Alvord noted that illness can occur at any of these levels—body, mind, spirit, family, work environment, community, or global environment. Navajo Diné (people) say illness can occur at any point in life, and when it occurs, it is because of a lack of balance. Illness affects the body and the mind, as well as relationships with other human beings and animals.

Dr. Alvord then explained more about Navajo ceremonies. She said it is hard to describe a Navajo ceremony and do it justice in a limited amount of time, but if there is one concept that is at the heart of the ceremony, it is "hózho."

Dr. Alvord said that hózho is defined as a mixture of beauty, harmony, balance, and peace. It is a state of being and a way of being. It is a part of a larger phrase, "Sa'a Naghai Bike'e Hózho," that translates to "moving along the life path with spiritual balance and harmony." She explained that hózho is similar to yin and yang. It is the name of the force in the universe that created all things. The concept is that the creator created all things and is also in all things. As a result, she said, separateness is an illusion. In contrast, it is hard to think of the American concept of the individual. If you believe that everything and everyone around you are part of you, then you want everything and everyone to be well, and to do well, too. It is like a prism. She said that in ceremony, the word "energy" is the closest word that can be used to describe the concept.

Dr. Alvord explained that Navajo ceremonies teach people to think. Words have great power—Navajo Diné believe that it is possible to speak or think something into existence. She said there is evidence of this concept in American culture, too. Research has shown that athletes who envision success often perform better. They are thinking something into existence. She noted that corporations do the same thing through mission statements and strategic planning.

Dr. Alvord went on to explain that in American medicine, psychoneuroimmunology is a blossoming field. She reported that Dr. Herbert Benson, Emeritus of the Benson-Henry Institute for Mind-Body Medicine and Assistant Professor at Harvard Medical School, has found that various mind states do influence the body, including the body's ability to fight infection and cancer. However, the majority of systems have not yet adopted this way of thinking.

Dr. Alvord noted that there is, however, a movement called guided imagery, which is used to calm a person before a surgical procedure. It has been shown to significantly reduce anxiety, pain, and the narcotic requirements of surgery, and to increase patient satisfaction. In Navajo culture, ceremonies, sand paintings, and dancing are elaborate forms of guided imagery. It is, therefore, ironic that the Navajo concepts have been called primitive, while guided imagery is considered progressive. Dr. Alvord also noted that when considering the concept of guided imagery, it is important to consider the reverse—how images that people are receiving from the news, television, and video games can have negative effects.

Dr. Alvord explained how in traditional Navajo culture, if you wanted to survive, you had to do it yourself. If you wanted to eat, you had to hunt or grow your food, or make something that could be traded. She noted it was a very vigorous physical lifestyle, but it was a lifestyle that ensured bodies were active and strong. She said issues like osteoporosis were nonexistent. She went on to explain that human beings were meant to use their bodies. Modern machines, such as lawnmowers, microwaves, and cars, promote not using the body. She noted that obesity is now one of the top medical issues in our country today. Obesity affects almost every other illness. Becoming a couch potato culture promotes illness.

Dr. Alvord stated that traditional Navajo diets were based on grains, vegetables, fish, and meat, and were high in fiber. She said this diet is better suited to a healthy lifestyle, and asserted that simply returning to traditional diets, to what we used to eat, may reduce health disparities, including obesity.

Dr. Alvord then explained that Navajo Diné believe that human beings are part of all things in the universe, including the winds. Our breath is part of this wind. Health is the well-being of all things in the universe. The universe has a consciousness, and we are a part of that. Spirituality, as practiced through ceremony, strengthens the bonds between human beings, families, communities, animals, and the environment. She explained how Navajo's view the natural world as sacred and refer to it as a family. The earth is a mother, the sky is a father, and the bear is a brother. The things that we seek to protect are those that we consider family. By assigning this value to the animal world and natural world, we become protective of them. She went on to explain that this is a concept of interconnectivity. She noted that we are seeing the effects of not thinking this way—toxic water, toxic earth, and global warming. Change is needed quickly.

Dr. Alvord reported that America represents 5 percent of the world's population, but it consumes more than 25 percent of the world's resources. For some reason, she said, there is no dialogue about living in balance and drawing too much from our natural world. Dr. Alvord asserted that what we need is a systems approach—if we want to be healthy as human beings, we need clean air, clean water, and a clean earth.

Dr. Alvord explained how through ceremonies, people develop mental wellness, which helps promote physical wellness. Spiritual wellness influences family, community, and planetary wellness. She noted that ceremonies also are said to energize the healers, which is something not built into modern medicine.

Dr. Alvord then discussed how these concepts can help us form a new way of thinking about health care. She said if you consider a systems approach, if mind-states matter, if you can influence the minds of patients, you may be able to influence their care. She noted that one important part of this concept is using the power of all of the senses to promote healing. She said there have been numerous studies on this concept. There was the study on guided imagery. There was also a study on the power of touch—babies who were not held did not survive. She suggested the same may go for elders. Yet another study showed the power of music therapy in getting patients off ventilators by listening to music.

Dr. Alvord noted that pet therapy and art therapy are also powerful healing tools. Animals can often reach people when others cannot. They have been used with people with mental illness and children with autism. She said animal contact results in decreased loneliness, improved morale, and increased social interaction. Animals can produce higher levels of relaxation among patients and can play a role in promoting optimal holistic health. She explained that art may also help the mind become relaxed, energized, or happy. It may reduce stress, and therefore, augment the immune system to help fight disease. She noted that art is woven throughout Native culture and medicine and used extensively in Navajo ceremonies.

Dr. Alvord then described how another powerful healing tool can be the beauty of the environment. She said that in health care, the environment around us should be beautiful too—we should be surrounded by things that calm patients. She emphasized that it is important to think about things from the patient's perspective. We should use art, color, and lighting to create patient spaces whenever we can.

Dr. Alvord went on to describe how the model goes beyond patients to medical teams. In order to provide good medical care, medical staff must be happy. She said the system should reward teams that practice this. Mistakes happen when teams have low morale. It is a domino effect. Sleep deprivation is part of this, as is family. Work must include family, too. She explained that people function best in their work environments when they are able to take family considerations into account. She suggested that some approaches might include onsite daycare, flexible work schedules, and including families in events.

Dr. Alvord concluded by stating, "The ideal hospital would not smell like a hospital—nor would it necessarily look like a hospital. Perhaps it would have adobe walls and natural smells. It would be filled with light and warm, with generous and comfortable seating for relatives. The windows would not be square and chrome but rather round or arched. There would be porches, flowers, and gardens. In addition to state-of-the-art operating rooms and equipment, there would be a ceremonial space for use by anyone who felt the need for it. Most important, when patients entered, they would feel that every person they encountered was committed to their comfort and participating in their healing process."

Current as of October 17, 2008