Lithuanian patients have a hard time letting go of the past

[Read the story as published in Lithuanian in Draugas: The Lithuanian World-wide Daily as a collaboration with Immigrant Connect]

Lietuvele, or the “Little Lithuanian Store,” is a small mom-and-pop business selling Lithuanian household items from movies to chocolate. Though Lietuvele claims to stock its shelves with everything immigrants need to maintain cultural connections, its selection of medications is sparse. When immigrants cannot find their preferred remedies at any of the Eastern European stores scattered throughout the Chicago area, they may look as far as the Old Country to meet their needs.

Today Migle Linga, who immigrated to the United States from Lithuania 20 years ago, is browsing Liutevele’s movie selection. “You won’t find much medicine here,” she says. “I get my medicine from friends and relatives back home. I ask them to send me what I need.”

Linga relies on both Eastern European naturopathic remedies and modern commercial drugs in her approach to personal health.

“In Europe, everybody uses these traditional remedies, as there are fewer restrictions on them,” she says. “I have a colleague in London who can buy all remedies from the Old Country in London. You just can’t get traditional remedies from American stories.”

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This story is part of a unique collaboration with nine Chicago area ethnic news media exploring some of the health care options and risks for immigrants who live here. The stories were released in June 2011 by Extra (Hispanic), Reflejos (Hispanic),  Pinoy Newsmagazine (Filipino), Al Moustaqbal – Future newspaper (Arab), India Tribune, Korea Daily News, Draugas – The Lituanian World-wide Daily, Reklama (Russian) and the Urdu Times (Pakistani). Click here to access the other stories: Tobacco repackaged: Paan Parag and hookah and their unappreciated risks, Seeking closure after Chernobyl, Medical tourism lures Korean immigrants home, Lithuanian patients have a hard time letting go of the past, The silence of diabetes threatening the health of the African community, Promoting healthy eating from the ground up in Little Village’s Hispanic community, Community programs needed to fight obesity among Latinos, Filipino elders find “family” in caretakers, A look into the complexities of refugee and immigrant health care coverage, and Is the South Asian vegetarian diet bad for the immigrant heart?

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Linga explains that reasons for using natural medicines vary from individual to individual. “Personally I tend to use these homeopathic remedies for skin problems but everybody has his own reason. Usually, the remedies are in the form of herbs. You can make tea out of them and drink them that way. Names most often match flowers or leaves from which the remedies are produced.”

Dr. Rasa Kazlauskaite, endocrinology specialist at the Rush University Prevention Center in Chicago and a Lithuanian immigrant, agrees with Linga’s assessment of the lack of traditional medicine available in the Chicago area.

“I would love to have these commercially available herbal pharmacies that I could rely on. For symptom management, some of those Lithuanian herbal medicines I think were very good,” says Kazlauskaite. “If I knew that the herbs were fresh and that they were formulated by a pharmacist, I’d recommend them to my Lithuanian patients, but in the U.S. I don’t have this option.”

Kazlauskaite has been trained in both naturopathic medicine and modern Western medicine and is generally unconcerned by her older Lithuanian patients’ use of herbal remedies. She does, however, worry about where they are getting their medicine.

“What is happening is that Lithuanians in the Chicago community are getting drugs, even controlled substances, from their country. That’s what makes me much more nervous than herbal remedies,” she says. “For example they might get antibiotics from their home county and they are cheaper, but they might be outdated and even dangerous.”

Kazlauskaite sometimes struggles to convince older Lithuanian patients to switch from ineffective herbal remedies to pharmacological remedies or to not take drugs shipped from Lithuania if they are expired or interfere with other drugs the patients are taking. This struggle is part of a larger lack of trust that immigrants who experienced healthcare in Soviet Lithuania feel toward doctors.

“Essentially, under the Soviets, you had to be your own doctor,” explains Kazlauskaite. Patients felt obligated to bring overworked, underpaid doctors gifts and bribes in order to ensure they received good care, and these habits have lingered. Lithuanian immigrant patients of Kazlauskaite and her colleagues continue to bring boxes of candy or bottles of whiskey to their appointments. Kazlauskaite tells instances in which patients have slipped surgeons cash – up to $100 or $200 – on top of what surgeons were already being paid for procedures.

Establishing a trusting, collaborative doctor-patient relationship, Kazlauskaite asserts, is much more of a challenge with immigrants than most other demographics. This has definite implications for the health of the immigrants, such as when a patient continues to take a drug against the advice of her doctor or neglects to mention symptoms, especially symptoms of mental ill health that the patient believes a doctor will be unwilling or ill-equipped to treat.

“They’ll take a mountain of herbs, but I have to convince and cajole them with my best speeches to take a blood pressure or cholesterol medicine,” says Dr. Andrius Kudirka, a second-generation Lithuanian practicing family care at the Palos Community Hospital in southwest suburban Orland Park. His clinic frequently treats Lithuanian immigrant families and he sees similar distrust among his patients.

Kudirka also cites Soviet-era healthcare as the cause of Lithuanian immigrants’ preference for alternative medicine. “Many of these immigrants are distrustful of doctors or they want to try and heal themselves first before seeking further help. Usually when my patients come to me, it is after they have spent a long time healing themselves with alternative methods,” he says. “Most of these methods are not dangerous, but cannot cure things like pneumonia.”

Lack of medical coverage is another reason for partiality to alternative medicine. “A lot of immigrants are uninsured and because of this, they cannot afford a lot of medications,” says Kudirka. “We try to help them out, but you can get herbal remedies from stores like Lietuvele for low cost and without prescriptions.”

Lithuanian immigrants also prefer to use herbal remedies like Valerian Root and St. John’s Wort to treat anxiety and depression rather than see a psychiatrist or take anti-depressants.

“They move here expecting the American Dream and end up working very hard to make ends meet. Many of them left behind family, friends, and even spouses or kids to try to get work in America. They often feel isolated and overwhelmed,” says Kudirka. “There’s a lot of anxiety, depression and psychosomatic illness, which can be tough to treat because they distrust psychiatry and are a culture that does not like to share their problems with other family members or friends.”

According to Kudirka, even if herbal remedies are not actually curing them, they are familiar and trusted. Immigrants are more apt to use a natural remedy to treat depression-driven ailments.

Lithuanian immigrants want to continue to follow the health trends of Lithuania and herbal remedies are continually becoming more and more prevalent overseas, according to Dr. Kastytis Karvelis, a second-generation Lithuanian and physician at the Henry Ford Hospital in Detroit.

“There is widespread use of herbal remedies in Lithuania currently. Most of these do not need prescriptions, but some do.  Doctors and pharmacists routinely recommend and prescribe these in Lithuania,” Karvelis says. “I just met a pharmacist last week who is the head of a couple of pharmacies, who gave me some herbal medications to take – unsolicited.  She insisted that they were wonderful.”

Akvile Kaminskyte, who emigrated to the U.S. from Lithuania 11 years ago, echoes this faith in natural remedies. “Here I can’t buy the remedies we use back home, but I do like to use them. They come in different forms – I use them for pain relief. My friends and I, we go to Whole Foods and look at their vitamins and supplements and try to find the closest thing to European medicines.”

Only when Kaminskyte returns to visit her family in Lithuania does she access authentic Eastern European medications. “They’re not Lithuanian remedies, exactly, in that they’re usually made in Russia or Germany and then sold in Lithuania. I try to go home to Lithuania once a year for about three weeks as all my family still lives there, and when I’m home my mom will buy natural remedies for me. I use modern drugs though too of course – whatever my doctor here prescribes me, I’ll get.“

As a younger, more recent immigrant to the states, Kaminskyte does not share the same mistrust of doctors cited by Kazlauskaite or Kudirka. She is happy to listen to her doctors’ advice, and in fact prefers health care in America to health care in Lithuania.

“But this is because I have insurance,” she clarifies. “Not all immigrants I know have it – so they wait to go back to Lithuania to have all the doctors’ appointments they need. In Lithuania, health care is cheaper, but you have to wait longer for services and there is not as much choice. Doctors might say, we can give you this service for free, but you have to wait two or three months for it.”

And even beyond a firm belief that herbal remedies are effective, Lithuanian immigrants have another reason to continue to seek out Eastern European medicines – nostalgia. Maintaining links to the Old Country is undeniably among immigrants’ motivations for taking naturopathic remedies. Indeed, Linga harbors a certain soft spot for medical care in Lithuania.

“Because in Lithuania doctors are not paid like here, they deliver their work from their hearts,” she insists. “Here in America, doctors’ work depends on their pay. So you can make your own conclusion.”

Whatever you can say about the efficacy of certain natural remedies or the differences between Lithuanian and American medical care, Lithuanian immigrants fondly remember their homeland, and taking a dose of familiar medicine may be the perfect way to do so.

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Popular Herbal Remedies

Lithuanians use herbal and natural remedies as cures for ailments from wrinkled skin to headaches. Some commonly purchased medications are:

5-NOK = Mild “antibiotic” for urinary infections

Aktyvoji Anglis = Activated charcoal. Emergency Rooms use this for certain overdoses. Lithuanians use it “to cleanse themselves of toxins”

Biseptol = Antibiotic for urinary tract infections

Kamparo aliejus = Camphor oil. Natural cough med, treats muscle aches

Godebeliu = Hawthorne tincture. Lowers blood pressure and strengthens the heart

Kalio permanganatas = Potassium permanganate, an antiseptic that treats wounds and abscesses

Karsil = Milk thistle, for liver health