The People’s Pharmacy: Creating Grassroots Healthcare Systems
By David Crow
Harvesting Vetiver
The last century brought immense improvements in health and longevity to people in the US. Some of these benefits can be attributed to medical advances, but most were the result of better sanitation, nutrition, and overall quality of life. Now, many of the improvements that were gained are being lost, and new threats to individual and collective health are emerging. Instead of open sewers, we have ubiquitous environmental contamination; instead of malnutrition from inadequate intake of food, we have widespread nutrition-related illnesses caused by degradation of the food chain. While modern medicine has made great advances, iatrogenic illnesses are among the leading causes of morbidity and fatality, and preventable and treatable chronic degenerative diseases have reached epidemic levels.
The Root Causes of Illness
Most health problems in modern America can be attributed to five root causes. These are:
Nutrition
Environmental pollution
Socio economic stresses
Spiritual emptiness
Medical treatments and drug toxicity
Holistic medical systems, including Traditional Chinese Medicine, Ayurveda, and Naturopathic medicine, offer significant benefits in the treatment of symptoms arising from these root causes, especially those related to nutrition, environmental toxins, and iatrogenic illness. Every clinician, however, is well acquainted with the limitations of what natural medicine can do when these root causes are not adequately resolved in a patients life.
Over the years, my clinical work has evolved toward an increasingly personalized form of practice, which strives to uncover, understand, and remove the root causes of illness, while simultaneously treating its symptoms. As a result, I have become aware of the urgent need for a new form of medicine, one which raises the overall level of environmental, social, nutritional, and spiritual wellbeing. It would not be alternative, complementary, or integrated medicine, although it could be used in many cases as an alternative or complementary therapy, or integrated with other healthcare modalities. Rather, it would be a parallel system of medicinegrassroots, community-supported, cost-effective, plant-based healthcare, accessible to everyone. In other words, folk medicine: using medicinal and nutritive plants grown in our neighborhoods, according to common knowledge passed down within families and communities.
Community-Supported Plant-Based Healthcare
The revival of folk medicine and the creation of community-supported plant-based healthcare depends on many types of social, botanical, educational, and environmental projects and participants working together, including:
Community and urban gardens
School gardens
Eco-villages
Eco-preserves
Agro-forests
Nurseries and small herb farms
Botanical gardens
Seed banks
Practitioners and educators of herbal medicine
Community and urban gardens
Community gardens and urban gardening have a long history, and are now re-emerging as viable alternatives to both modern agribusiness and destructive traditional farming methods such as slash and burn. Community gardens come in all shapes and sizes: from tiny, inner city plots tended by homeless people, to entire neighborhoods planted with foods and medicines. These gardens can be as simple as potted plants on balconies and rooftops, and as innovative as edible parks. In developing countries, urban and community gardens are a primary source of nutrition and income for countless families.
Community gardens are the foundation of grassroots healthcare. Without a strong nutritional foundation from affordable, locally grown organic foods, it is difficult to improve the standards of health in society. When medicinal plants and foods are cultivated together, folk medicine becomes part of the community.
When neighborhoods are transformed into gardens, numerous social problems are resolved: crime decreases, community and family bonds are strengthened. Gardens are places of beauty and spiritual solace, which bring happiness to those suffering from stress and emotional difficulties. Prison gardens, for example, are now recognized as one of the best paths to genuine criminal rehabilitation. By transforming our cities into living pharmacies and sources of nourishment, the five root causes of sickness can all be alleviated.
School gardens
School gardens are a rapidly developing aspect of community and urban gardening. In outdoor classrooms students find more enjoyment in learning; thus attention difficulties and behavior problems are reduced. Emotional growth and social skills are enhanced when students observe the processes of nature at work and are given responsibility for caretaking plants and animals. The high quality nutrition provided by the gardens, along with the physical activity of gardening, improves the overall health of students and teachers alike.
School gardens are the seeds for a sustainable plant-based culture. Many of the academic studies that are encouraged in todays schools will become obsolete in the coming years, and many new fields will become important parts of public education, including organic gardening, natural medicine, permaculture, sustainable ecology, alternative energy, and non-toxic industries. As more students begin careers in these areas, society will be positively transformed.
Eco-preserves, agro-forests, botanical gardens, and seed banks
Extinction of plant and animal species is accelerating. It is estimated that 34,000 species of plants are currently facing extinction, including many important sources of food, medicine, fiber, oil, and fuel. There are only two solutions to this global problem: the preservation of existing habitats, and widespread cultivation of endangered plants. At this time, only a relatively small number of medicinal plants are in sustainable cultivation; the majority continue to be overharvested from dwindling wild sources.
Eco-preserves, agro-forests, botanical gardens, and seed banks are playing a critical role in caretaking the genetic base of the plant realm for future generations. As community gardens flourish and folk medicine takes root in more neighborhoods, more plants can be brought into greater cultivation, drawing on the resources preserved by these larger entities. An excellent example is the work of Paul Strauss and the many volunteers at the United Plant Savers Sanctuary, who have renovated a degraded forest area into a world-class botanical preserve for the major endangered medicinal plants of the US. Projects such as these hold the key to the continuation of herbal traditions throughout the world, and the return of medicinal plants to society.
Eco-villages
Eco-villages represent the synthesis of all the elements necessary for the creation of community-supported plant-based healthcare. Eco-villages are based on innovative paradigms of self-sufficiency and independence from the economic and ecological disasters of corporate globalization; grassroots medicine is an important part of this self-sufficiency. Larger eco-villages produce their own food and medicines; some produce medicinal products for income, and some have small clinics operated by trained herbalists. Some are involved in agro-forestry or are linked with eco-preserves. Many offer educational programs in a wide variety of ecological, spiritual, and healthcare topics.
Practitioners and educators of herbal medicine
The last decade has seen an astronomical increase in the use of herbs by the general public, stimulated by the health food and natural products industries, the spread of alternative and complementary therapies, and the urgent need for nontoxic medicine. In order for herbal medicine to be further integrated into society at the grassroots level so that these medicines are available in a cost-effective way for everyone, the knowledge of how to grow and use the plants must once again become part of family traditions. Those who have training and clinical expertise with herbs can play important roles in bringing phytotherapies to a broader level of acceptance and use by society, and in establishing herbal medicine as a viable grassroots healthcare system.
There are several ways that herbalists and other healthcare practitioners can support the revival of community-supported folk medicine. The most important is helping to create and maintain community and urban gardens. When community gardens have the active support and participation of knowledgeable herbalists, information about the propagation, cultivation, harvesting, and use of medicinal plants becomes an ongoing part of the collective learning experience. Another way is to encourage patients to grow their own medicines, specifically those needed for their health conditions. This can easily lead to the creation of a network of gardens in a neighborhood, where a wide variety of herbs are being grown by different people. When herbs are grown in communities, either collectively in community-supported gardens or in a network of neighborhood gardens, many teaching opportunities arise naturally. Hands-on medicine-making classes, horticultural workshops, and classes on the use of specific plants or the treatment of specific health concerns are an excellent way for herbal practitioners to support folk medicine; it is also one of the best ways to build a clinical practice.
The Need For Grassroots Healthcare
The need for grassroots community-supported plant-based healthcare is becoming more urgent. The reasons for this include:
High cost of healthcare
Lack of insurance coverage
Need for affordable nontoxic medicines
Loss of medicinal plant species
Loss of ethnobotanical knowledge
Need for fresh, high-quality, locally grown foods and medicines
Loss of communities and degradation of urban environments
High cost of healthcare and lack of insurance coverage
While having the worlds most expensive per capita medical system, the US ranks among the lowest of the developed countries for quality of healthcare. Almost fifty million people now lack any form of health insurance, and an almost equal number are inadequately insured. This combination of high medical costs and lack of basic health coverage is causing impoverishment on top of illness, while the domination of the medical profession by the insurance industry is placing tremendous strain on the integrity and functionality of modern medicine. Although there is an increasing demand for universal healthcare coverage, there is little political will to change the current conditions.
Need for affordable nontoxic medicines
Even if universal coverage became a reality, it would probably cover only the basics of modern allopathic medicine. The great limitation and deficiency of modern allopathic pharmaceutical drugs is their inability to increase immunity, enhance nutritional status, regenerate vitality, restore humoral and energetic homeostasis, or detoxify; in reality, the epidemic of iatrogenic illnesses can be attributed to the adverse effects of drugs on immunity, nutritional status, vitality, homeostasis, and detoxification processes. Only the phyto-nutrients and medicinal constituents of botanical plants can effectively perform these crucial functions. Unfortunately, high quality herbal preparations are becoming increasingly expensive, and many people cannot afford the out-of-pocket expenses necessary to treat chronic conditions.
Loss of medicinal plants
One of the primary reasons for the high cost of many herbal medicines is decreasing supplies of plant materials. Uncontrolled overharvesting has brought numerous important medicinal species to the brink of extinction. As global demand and need for herbal medicines increase, overharvesting accelerates. This depletes natural populations, which increases the value of the plant, which in turn stimulates more overharvesting. Unfortunately, many important medicines will be lost forever due to this destructive cycle, and other plants will become so rare that they will be affordable only as luxury items for the wealthy. The only way that many medicinal and nutritional plant species will be saved from this fate is through widespread cultivation, both as commercial products and in community gardens as folk medicines.
Loss of ethnobotanical knowledge
Medicinal plants, the habitats they come from, and the understanding of their uses are inseparable. As medicinal plants are lost and the habitats they come from vanish, the accumulated knowledge of age-old ethnobotanical traditions also perishes. Community-based healthcare again offers the hope of preserving this valuable heritage. When plants are brought into widespread local cultivation, the knowledge of their cultivation, harvesting, preparation, and use can once again be preserved within families.
Need for high-quality locally grown foods and medicine
Fossil fuels are a finite resource; our modern lifestyle and agricultural methods, which are largely based on fossil fuels, are therefore finite. It is likely that in the near future, instability of oil supplies, worsening economic conditions, and the cumulative hidden costs of destructive agribusiness practices will drive the cost of growing and transporting food higher; the result will be increased malnutrition and decreased immunity in the population. Cultivating foods and medicines in local communities will reduce dependency on agribusiness and fossil fuels, and increase the general level of nutritional status and resistance to illness.
Loss of communities and degradation of urban environments
For many people, urban environments and the stresses of modern culture are the primary sources of sickness and suffering. The current degraded and deteriorating condition of many urban and suburban areas is the result of shortsighted city planning, which has placed cars, business interests, and racial segregation above the interests of people, nature, and health. Unpleasant and unrewarding careers in unhealthy work environments, so common as to be accepted as normal, present a formidable challenge to those seeking to improve their wellbeing.
Cities do not have to be unpleasant, unhealthy, and stressful places to live and work, however. As many projects are proving, cities can be places where business thrives in car-free environments, homeless people grow their own food, smog and pollution are dramatically reduced, opportunities for right livelihood abound, and the general level of nutritional wellbeing is improved through community gardening.
Through the universal human need for plants, plant-based healthcare can be linked to the re-greening of urban environments, resulting in many fundamental improvements in public and environmental health. The collective work of tending community gardens helps restores community and family bonds. Ecological cities create numerous job opportunities in non-toxic industries, which provide alternatives to the stressful disease-causing careers of the modern corporate world. Training homeless people to cultivate organic foods and medicines in urban settings is potentially one of the best solutions to the increasingly serious social problems of urban environmental degradation. By replanting cities, both with community gardens and urban forests, they will become cleaner, quieter, and more beautiful.
Creating Grassroots Healthcare
Building a grassroots movement to grow and utilize medicinal and nutritive plants in a collective manner requires commitment and resources originating from individuals, neighborhoods, and communities. In order for this movement to quickly gain momentum and have long-term success, it must be embraced by city planners, have the cooperation of numerous professions and organizations, and receive funding from governments. While this seems unlikely under the current political climate, worsening environmental, social, and medical conditions are bringing about significant changes in cultural priorities. Historically, the more economies suffer, the more people work together at the grassroots level to provide for their needs. A striking example of this is Cuba: in response to economic and political isolation, it has become a leading model of self-sufficient urban gardening and government-sponsored, community-supported folk medicine.
Numerous models of sustainable community-based healthcare are well-established throughout the world. These projects comprise a network of various functions related to the preservation, propagation, and utilization of medicinal plants, and are therefore crucial for the building of a grassroots movement as the greater global need increases. When social, medical, and environmental priorities change, when political will is activated, and when government support becomes a reality, these projects will be the repositories of plants and knowledge from which sustainable cultures can be created.