Could Homeopathy Hurt Haiti?

January 20th, 2010

Let’s get down to it. Haiti is the big story of the week, and I have a bit of a rant.

We could discuss the science of earthquakes, but we won’t. There is nothing we can do to stop earthquakes from ocurring. We could discuss the political issues at play. For instance, Pop. Mechanics reports that geologists warned the Haitian government that they were at extreme risk, and should take measures to reinforce response critical buildings like hospitals. Measures did not take place, and we see the aftermath. What I want to talk about is an interesting battle taking place on the field of disaster-response medicine that is based in science.

Doctors without Borders and the Red Cross are sending people by the hundreds to Haiti to respond to medical needs. They will be bringing with them scientifically proven treatments and supplies. And, they will need lots of supplies to treat all the wounded and sick. Interestingly, voices from the homeopathy camp are suggesting that Emergency Homeopathy kits and homeopaths should be sent to the frontlines to help. This is a very dangerous suggestion.

The successes that homeopathy boast seem to be based on the placebo effect - the fact that people think something is going to work seems to have a positive result - but, in all systematic reviews of the literature so far, it seems that which literature is included and why plays a major role in the study conclusions. Whether homeopathic treatments or placebos can be considered true protection or treatment is widely debated.

Simon Singh writes:

When critics point out to politicians or regulators that homeopathy is not backed by any good evidence and is just a placebo, one response is “What’s the harm?”. In other words, if the placebo effect is positive and the side effects are zero, then what’s wrong if people want to waste a bit of money on sugar pills? But is homeopathy really safe?

Unfortunately, homeopathy can have surprising and dangerous side-effects. These have nothing to do directly with any particular homeopathic remedy, but rather they are an indirect result of what happens when homeopaths replace doctors as sources of medical advice… For example, many homeopaths have a negative attitude towards immunization, so parents who are in regular contact with a homeopath may be less likely to immunize their child… Perhaps the greatest danger occurs when homeopathy replaces a conventional treatment…

… homeopaths failed to ask about the patient’s medical background and also failed to offer any general advice about bite prevention… homeopaths were willing to advise homeopathic protection against malaria instead of conventional treatment… [A] homeopath tried to explain the mechanism behind the remedies: ‘The remedies should lower your susceptibility; because what they do is they make it so your energy – your living energy – doesn’t have a kind of malaria-shaped hole in it. The malarial mosquitoes won’t come along and fill that in. The remedies sort it out.’

Science-based medicine brings up the concern that attitudes about vaccines could prove to be very detrimental to disaster scenarios.

One of the coming tragedies in Haiti will be widespread illness and death from vaccine-preventable diseases. A terrifying example is tetanus. Tetanus is a disease caused by the bacterium Clostridium tetani. These bacteria live in most soils, especially rich soils, and can easily infect small wounds. Once the infection takes hold, the bacteria produce a potent toxin responsible for most of the symptoms of the disease.  These symptoms include horrifying muscle spasms, including jaw spasms which give the disease its other name, “lock-jaw”. And it is a horrifying disease, affecting adults with even minor wounds, and babies, who can become infected at the site of their umbilical cord. The disease is frightening, causing uncontrollable muscle spasms resulting in death in nearly 100% of untreated cases. Even when treated, tetanus has a very high mortality rate, and given that tetanus tends to be more common in areas with less access to treatment, the impact is doubly felt. Neonatal tetanus is a dreadful disease, doubly so because it is so easily prevented. When mothers are vaccinated neonates are protected by passage of antibodies to the fetus in utero. Due mainly to political and economic conditions, tetanus vaccination rates in Haiti are low (about 50% in children). Previous similar disasters, such as the Kashmir earthquake and the Indian Ocean tsunami have showed us that tetanus is a special problem after natural disasters.

If anti-vaccination activists succeed in influencing the policies of the U.S. and other governments—as other fringe health activists have done—they may become morally complicit in the deaths of thousands of Haitians.

The bottom line here is: are we going to accept homeopathic and other unproven / unscientific remedies as part of medical disaster-response regimes when the lives of thousands are on the line?

If not there, then why accept them at all?

Think about it.

And, in the meantime, consider donating to the relief response in some way. Doctors without borders is one organization that can use some assistance. There are many ways to help that don’t directly involve money. It has come to my attention that airmiles can be transerred to other people, so if you have spare airmiles, they might help someone get to Haiti who can be of some help.