ELENA AVILA, a psychiatric nurse, donned a headband to join a ceremonial procession with Mayan healers in colorful embroidered dresses and Aztec dancers wearing brightly feathered headdresses.
The procession opened the 12th International Congress of Traditional and Indigenous Medicine here last month, where conventional medicine intersected, sometimes awkwardly, with alternative forms of treatment.
''I practice medicine and spiritual healing simultaneously,'' said Ms. Avila, who treats patients privately and works with doctors. She earned a master's degree in psychiatric nursing at the University of Texas at El Paso, and has called herself a ''curandera,'' Spanish for healer, for the past 20 years.
In the Southwest, this combination is not unusual. Hispanic people and American Indians, who respectively make up 38 percent and 9 percent of the population of New Mexico, often rely on a heritage of herbs, spiritual healing and other folk practices.
In cities like Albuquerque, some pharmacies devote shelves to Hispanic medicinal herbs, and doctors are accustomed to patients' using traditional therapies, like Native American healing ceremonies. In some remote communities, traditional medicine may be the only kind available.
But the use of traditional medicine is not always a function of lack of access to regular health care, said Kim Kinsey, the program manager of primary care planning in rural health programs for New Mexico. For many, it is an alternative. ''People may choose Western medicine,'' Ms. Kinsey said.
''They may also choose to see the curandera or medicine people at the same time,'' she said, referring to traditional Hispanic and Native American healers.
Ms. Kinsey said that the Indian Health Service, for instance, sets aside rooms in its hospitals for medicine people to see patients along with a Western doctor.
According to a report in Archives of Family Medicine in March, 38 percent of patients surveyed at an Indian Health Service clinic in Milwaukee said they had seen a healer and 86 percent said they would consider seeing one.
The weeklong meeting, at the University of New Mexico, coincided with evidence of increasing public interest in complementary medicine, therapies that lie outside the realm of conventional, mainstream medicine.
A report published this month in The Journal of the American Medical Association showed that one in three American adults uses complementary therapies, like chiropractic, acupuncture, homeopathy, herbs and folk remedies.
The report also said that more than half the nation's medical schools offer courses in alternative medical practices, and patients are looking for doctors familiar with complementary as well as mainstream medicine.
''My patients come in with their own remedies, from a community healer or organized or nonorganized traditional healing,'' said Dr. Christopher Urbina, vice chairman of the Department of Family Practice and Community Medicine at the University of New Mexico's School of Medicine.
The remedies brought to Dr. Urbina by his patients include a mixture of alcohol and avocado seeds that patients rub over their joints and poultices, usually of aloe vera and other herbs, for skin conditions.
Traditional medicine was part of Dr. Urbina's own childhood. ''I grew up in a Mexican-American family,'' he said. ''My mother gave me multiple remedies when I was growing up. We always did things before we went to the physician.'' He recalled remedies from the ordinary (drinking chamomile tea to settle the stomach) to the strange (placing sliced potatoes on the head to alleviate fever).
At the medical school, traditional and other alternative therapies are integrated into the curriculum in the context of patient care, in classes and in grand rounds, Dr. Urbina said. Students can attend seminars with alternative healers to develop sensitivity to cultural beliefs of various populations, and patients who ask for healers or traditional therapies are supported, he said.
But patients who avoid conventional medicine can find themselves in trouble. Dr. Jeffrey Sollins, an Albuquerque internist who supplements conventional medicine with complementary therapies, said that patients who used unproved alternative treatments exclusively were taking serious risks.
Dr. Sollins cited the example of parents who reject conventional medicine and refuse to have their children vaccinated. They are putting their children at risk for serious, avoidable diseases, said Dr. Sollins, who is director of an organization called Bridges in Medicine Health Care Inc.
But he added that ''the indigenous practitioners I've met often recognize when they're past their limit.''
As increasing numbers of scientists explore the effectiveness of alternative therapies, doctors may begin to feel more comfortable discussing them with their patients and finding ways of incorporating them into their practices.
Dr. Helmut Wiedenfeld, a chemist at the University of Bonn in Germany, described his research with traditional healers and diabetes in rural Mexico. The World Health Organization estimates that 8 percent of Mexico's population will have Type 2 diabetes by 2005 and this sometimes deadly disease is rampant among Mexican Indians. (In the United States, the rate of Type 2 diabetes among Indians is more than double that of the general population.) A high fat and carbohydrate diet plays a part, and although most rural areas of Mexico are far from fast food outlets, virtually every village has a stand that sells sugary soft drinks, Dr. Wiedenfeld said.
His field work in three Indian villages in Mexico left Dr. Wiedenfeld with considerable respect for traditional healers. Even without the training or equipment to detect levels of blood glucose, the healers could identify the classic symptoms of diabetes, and they treated the disease with an herbal tea brewed from ''cola de caballo'' (equisetum myriochaetum), he said.
In field trials, Dr. Wiedenfeld and his colleagues found that the herbal tea helped stabilize blood sugar levels in female patients who took part in a study.
Dr. Wiedenfeld believes that both the successes and failures of alternative medicine can be quantified.
And, Dr. Urbina added, ''How we live our lives is a balance between the scientific evidence, our understanding of the evidence and our own cultural beliefs,'' he said.
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