Tribal Medicine in the Amazon Rainforest
Randall Green and the Yanomami

You can go home again if you're Randall Green. As the son of missionaries, he spent part of his childhood living in the Amazon rainforest, where he learned firsthand the tribal ways of the isolated Yanomami Indians, whose seclusion in the dense, tropical jungle kept them far removed from the outside world. Many years later, Green is now working as the director of Latin America business affairs for Rusch, Inc., a multinational medical device manufacturer, based in Duluth, Georgia, when he decided to form a non-profit organization with his sister, Tressa, to help bring much-needed medical help to the Yanonami. They called their foundation TOMA, which stands for Tribal Outreach Medical Assistance, and has become a health-care godsend for the disease-ravaged Yanonami who suffer from malaria, jungle parasites, and poor hygiene. Equipped with medicine and supplies, and assisted by volunteer doctors and dentists, TOMA's crew of modern-day Albert Schweitzers travel by bush planes to reach these grateful villagers, frequently landing on grass strips hacked out of the jungle. Here then is RailRiders interview with TOMA's co-founder and medical miracle-worker.

Q: What was it like growing up as the son of missionaries in the Amazon rainforest?

Randal Green: I spent three years living in Venezuela's Amazonas region, located in the southern jungle region near the Brazilian border. This is the home of several tribes, but the one that had the most impact on me as a child was the Yanomami. I have always considered their effect on my life as an inspiring force that provided insights and wisdom into jungle survival, though it should be noted that we, as a family, lived in Colombia for 18 years. Four of the six siblings lived in Venezuela and attended a boarding school located in the headwaters of the Orinoco. Most of time, we lived withother tribes in Colombia's rainforest, also part of the Amazon basin.

Q: Describe some of the Yanomami customs.

RG: They have a very animated nature, with intense emotion in their speech. They have a powerful culture dominated by aggressive males. The most powerful men in each village usually have multiple wives. Their customs and rituals were fascinating. A favorite custom is the way they broadcast news. Two visiting friends squat face-to-face in the middle of the shabono (round house built for communal living) and chant the news until the early morning light. Also, the Yanomami decorate themselves with ashes and red seeds. They wear body paint for every occasion: birth, death, war, party and welcoming guests. They are hunters and gatherers, though most have banana gardens in close proximity to their shabonos. They are warriors who pride themselves on being experts with a bow and arrow as well as being aggressive and tough. They always avenge a death.

Q: What is the purpose of their facial sticks?

RG: It has been explained to me as merely Yanomami makeup. It is used only by young girls and women who they think they look better with the sticks and flowers or palm in their ears. The sticks pierce the cheek to the inside of the mouth.

Q: The Yanomami have been described as "fierce warriors." Have you seen evidence of this? Local skirmishes?

RG: It appears true that the Yanomami have a tendency for violent behavior. Much of it is a reaction to events such as a death of a family member where the loss must be avenged or a woman having been stolen by another village. These are events that will bring about war raids where fights involving clubs, poles, machetes and occasionally guns are involved. The Yanomami enjoy competition where violence is the key activity. There are chest fights where each man is allowed to hit another as hard as they can on the chest. They alternate until one man falls and indicates he can not continue. There are offshoot contests to this involving poles and the flat side of a machete.

Q: What lessons or beliefs have you learned from the Yanomami that can benefit us in the West?

RG: The Yanomami are not afraid to show their emotions. Crying and wailing for a lost loved one often goes on for days. The women in mourning will mix tears and ashes and paint their cheeks. Their faces may be darkened for over a year.The Yanomami are not wasteful. They reuse and recycle everything possible. They are self-sufficient: they grow their own tobacco, cotton (equivalent), make hammocks from vines, bows from palm trees, arrows from reeds, andmake baskets from grass and reeds. Part of their value system is sharing with others. Being selfish or stingy is a major "sin" in their culture. Another interesting Darwinism worthy of note: in each village there is a group of what are called walidii. They are the physically and or mentally handicapped people that are not capable of contributing to the group. They are kept together and apart from the rest of the group. It is almost like they are the first ones to be sacrificed to the jaguar or anaconda. Being a wanidee has a stigma that carries a heavy negative position in the community.

Q: What has been the effect of the illegal influx of gold miners in the Yanomami region?

RG: The very nature of gold mining has a very negative impact on tribal communities. The chemicals that are used poison the water systems that provide a primary food source for the Yanomami. The impact on the supply of fish, alligators and other animals is devastating. Communicable diseases have been introduced through casual contact, and miners have brought resistant strains of malaria that have killed hundreds of Yanomami in the last twenty years. Many Yanomami have died from violent confrontations with miners who have killed them with shotguns.

Q: Does TOMA encounter any resistance by local shamans? What do they make of your supplies and treatments?

RG: While there are obvious differences in the techniques and treatments between us, but there has been a gracious tolerance for each other's work. During a recent trek deep into the jungle where an infant had tested positive for malaria, we provided traditional Western treatment, but the baby continued to cry throughout the night. The shaman chanted for hours, waving herbs and ashes over the infant, making sucking noises on the baby's chest until five in the morning. The next day the infant had no symptoms and was clearly in no pain. I view our relationship as that of mutual respect with both of us taking our share of the credit.

Q: How have the Yanomami survived for thousands of years in a stone-age culture in a region with such a high incidence of tropical diseases?

RG: That is a mystery, and I am sure that each expert has his theory. In my mind, it is clear that in recent years something has happened. The dynamics seemed to have changed. The Yanomami are less isolated and have more contact with the outside world. It only takes one person with a communicable disease to affect a large population. We have seen an alarming increase in the incidence of more virulent strains of malaria, yellow fever and dengue fever. These diseases are the killers in the jungle, much more dangerous than the snakes and jaguars.

Q: Some of the villages serviced by TOMA are in quite remote regions. What travel hardships have you and your group experienced?

RG: The TOMA team typically meet at the Miami or the Caracas airport in Venezuela. The next leg is an hour an half flight to Puerto Ayacucho, the principal town in the Amazonas region located on the Orinoco River. It is a bustling mix of local tribes, businessmen, military and supply buyers from all over the region. It is where we stage our final leg to the Yanomami villages, where the supplies are weighted, prioritized and sent out by bush plane to each village. These are small Cessnas equipped for short takeoffs and landings. The airstrips are hewed from the jungle by machete and ax and often provide challenging and precarious landings depending on the weather and strip conditions. On one trip we were asked to conduct a health survey of the Cobaliwa tribe near the Brazilian and Venezuelan border. We were to land on an airstrip that had been made years ago by the military though the bush pilots had never landed there before. The pilot, a guide and I decided to land first with very little weight since we were not sure of the length. The decision proved to be a good one as the strip was 200 meters too short. It was an abrupt landing, taking all the airstrip to land. The remaining team would arrive in three flights over a two-hour period. We immediately took our machetes and cut down an additional 100 meters from either side so that the bush planes could land with the supplies and additional team members.

Q: How do you communicate with Yanomami?

RG: Most of the core TOMA team have a basic vocabulary in Yanomami relating to medical issues and situations. As a rule, we always have a nurse or healthcare worker with the team that live year-round with Yanomami and are fluent in their language.

Q: When you arrive with supplies, what happens? Are there ceremonies? Tribal feasts? How long do you stay in each village?

RG: TOMA's principal villages of Coyowateri and Parima are isolated from the outside world as they are not accessible by river. When we arrive, the whole village ascends on the bush plane. There is a lot excitement. The Yanomami men and young boys carry the cases of medicine to the clinic. Typically there are no ceremonies or feasts, but all the sick people from the villages in the area arrive after having heard that medicine is available.

Q: Describe what it is like to live among the Yanomami.

RG: When TOMA arrives at the village, called shabono, we are immediately greeted by all the men and boys. We are given an area to set up our hammocks and mosquito netting as well as space to use for the clinic. Banana leaves are cut to cover the ground in attempt to keep our supplies clean. We are shown two trails: one to the creek for water and bathing the other that is used for the restroom area. We typically build our own fire for cooking and warmth. If meat is available —wild turkeys, armadillo, monkey, wild pig, alligator—it is shared with us as well as palm fruit, plantains, roasted termites and grub worms. A typical day in a Yanomami village(shabono) starts before dawn when several men will leave to hunt wild turkey or monkeys. As soon as it is light the women carry the water up from the creek for the morning meal. They then leave the shabono to gather palm fruit or work in their gardens.

Q: Have you ever gone hunting with them?

RG: I started hunting with the Yanomami at age 12. I was impressed with the accuracy with their arrows. My first memory is of a young boy shooting a hummingbird out the air. He wanted the bright beautiful breast feathers for his earrings. Each arrow tip is used for a different size and type of animal or fish. The tips are carried in bamboo quivers along with the poison, curare, wrapped in banana leaves for application to their tips. The monkey bone tip is best for fish, alligators and all water-based animals while the bamboo is great for monkey, wild pig and large rodents. All of the animal is eaten including entrails. The Yanomami go on wayumi, long hunting trips, prior to the arrival of visitors as meat is expected and needed to be a good host. The Yanomami have a word specifically used for the concept of being meat-hungry, that is, naiqui.

Q: What evidence have you witnessed of the destruction of the rainforest?

RG: There are more areas of clearing along rivers and streams where gardens have been built and then evidently abandoned. The large villages and small towns show the most damage. During the dry season, the sky is constantly filled with smoke as the slash and burn continues. Still, there are areas of jungle that are vast carpets of green with no sign of damage. These are remote jungle areas far from major rivers and even farther from any sign of civilization.

Q: Have you contracted malaria? What precautionary measures do you take?

RG: My first introduction to malaria was at age 12. It was an intense experience and one that I hoped never to relive. Unfortunately, by age 18, I had malaria another six times. Precautions include taking the preventative mefloquine (Larium), using plenty of repellent at dawn and dusk as well as always sleeping under mosquito netting.

Q: What are your hopes, short-term and long-term, for TOMA?

RG: Our goal is to establish an effective healthcare system for all 12,000 Yanomami living in the Amazonas region of Southern Venezuela, including on-site medical diagnosis and treatment, preventative health measures in strategically located clinics. By working in concert with local government health officials, the military and mission organizations, TOMA's objective is to develop a long- term presence in the region. The Yanomami, living in the remote and precarious jungles, are preyed upon by disease, parasites and the presence of gold miners who carry new diseases, yet maintain a lifestyle little changed for hundreds of years. Their most devastating health threat currently comes from malaria. TOMA has five main strategies to fulfill these objectives. Continue to provide year-round medical support to the Yanomami through local mission nurses and tribal healthcare workers with assistance from visiting tropical medicine and family practice physicians from the United States. Provide funds and support to train tribal healthcare workers in basic and preventative healthcare. Implementation of a malaria preventative program involving education, mosquito netting and fogging.

Development of a medical consultation communications network between villages, distant hospitals and experts in the U.S. This would involve real-time video link-up for face to face consultation of patient care issues. Development and implementation of community healthcare disease prevention projects that provide long term benefit, for example a Clean Water Project like the one in Parima, which is a remote valley in Southern Venezuela and inhabited by an estimated two thousand Yanomami. There has been a recurrent health problem for over a thousand villagers due to high-bacterial content streams where all washing, bathing and fishing are done. This is also their principal source for drinking water. Our plan is to divert uncontaminated water from a mountainside waterfall located three miles from the villages. This would involve the purchase of plastic tubing and materials to build a small reservoir. All supplies will be flown into the area as there is no other means of transportation.

Q: Any thoughts on the recent book attacking the famous anthropologist Napolean Chagnon, who lived among the Yanomami and might have introduced measles to the Yanomami through a measles-innoculation program that might have backfired?

RG: This issue of measles and the Yanomami is of particular interest to me as I lived in the area during the 1968 measles epidemic. As a young adolescent with Yanomami friends who died of the disease it was devastating experience. I recall seeing Chagnon in those days as his guide to the Yanomami villages was my best friend's older brother. I doubt whether he had anything to do with the introduction of measles to the Yanomami. My understanding has always been that a Yanomami visitor from Brazil unknowingly brought the disease that killed scores of natives in the Alto Orinoco region in 1968.

Q: How are the Yanomami viewed by other Venezuelans, especially by the government? Is there an effort to have them assimilated, left alone, or protected as an indigenous culture?

RG: I believe Venezuelans are proud of their country and the diversity of the indigeous populations. There is political revolution in the country which has created many changes. The Chavez government has made it a priority to include all tribal groups in the political process. This is a new and positive direction for the country. In the upper Orinoco region in the Amazonas region where all Venezuelan Yanomami live, the Las Esmeraldas Hospital will soon open. It is the first and only hospital in the Amazonas specifically designed with tribal needs considered. TOMA will support the hospital with equipment and supplies as needed. The Upper Orinoco region of the Amazonas is a protected biosphere, viewed as a restricted, enviromentally sensitive area. Permissions from local government officials must be obtained prior to entering the area. In my opinion, the Yanomami are treated as a protected culture.

Q: What is your job at Rusch?

RG: Rusch is about a 130-year old medical device manufacturer from Germany. In the late '80she company was bought by Teleflex Corporation, an American multinational company in the Philadelphia area. The product focus is anesthesia, urology and surgical disposable products. As director of Latin America, I am responsible for sales and marketing in each country through a network of distributors. Many of my customers in Venezuela as well as other Latin American countries, have contributed to TOMA's work among the Yanomami. Rusch is extremely generous with their support for TOMA. It would be very difficult, nearly impossible for me to manage TOMA without Rusch's spirit of generosity and the value placed on what TOMA is doing for global health.

Q: Finally, what do you think of RailRiders clothing?

RG: I have worn the X-treme Adventure Pants and the Weatherpants on the last three TOMA trips. They are without a doubt the best I have had for our type of trekking and conditions found in the jungle. Last year we spent five days walking from one village to the next, through streams and rivers, wading in waist deep water and mud, up and down mountainous jungle. The pants are still without a tear. Another feature that is of extreme importance is the lightweight fast-drying material. In our treks, we are constantly wet, or in the process of drying out.

Contact info for TOMA: 107 RR 620 South #21-D, Austin, Texas 78734; 512-699-TOMA; fax: 512-263-3645;