Groesbeck Parham, M.D. A Member of the Global Community
Based on an interview with Dr. Parham conducted by CCNH’s Director of Herbal Studies Phyllis D. Light in conjunction with Tara N. Brown.
Groesbeck Parham, M.D., is a gynecological surgeon specializing in cancer at the world-renowned University of Alabama Medical Center, and a CCNH adjunct faculty member. Parham was also a presenter at the 2005 natural health conference, Educating the Leaders of Natural Health. CCNH invited him to speak at our 2007 conference, Building a Natural Health Community; however, we were not certain he would be able to join us this year because he has been working and living in Zambia, Africa, nine to ten months out of the year for the past 18 months. When we learned that Parham would be home for the holiday season, CCNH asked him to spend some time with us, and leave us with a message to bring to the conference attendees in case he could not attend in April. Not only did he grant us an interview, Parham also confirmed his participation in the spring conference.
A Marked Man
Groesbeck Parham, M.D., already felt a spiritual connection to Africa when his professional connection with the continent began 20 years ago as a medical student. While studying gynecological urology in London, England, in 1986, a Sudanese friend and fellow student told Parham that if he really wanted to understand female urology that he needed to travel to Sudan and see the work that a doctor named Abbo Hassan Abbo was doing to repair female genital mutilation, or forced female circumcision.
When Parham, married with two young children, asked his friend about the socio-economic context in which the doctor worked, his friend replied, “Well, you will see. My people in Sudan live as close to the earth as animals in the forest.”
Using an extended line of credit and with his family’s blessing, Parham purchased the least expensive flights to Sudan that he could find. Parham recalls the moment the reality of what he was about to undertake struck him, “As the plane was landing, I realized I really didn’t know anybody in Sudan, I felt like I was in a black hole. I had my wife and children with me, and I felt very responsible.
“But as we got off the plane that night, at the end of the ramp, a Sudanese man, a taxi driver, was holding a sign that read ‘Dr. Parham and family, Welcome to Sudan.’”
The driver took the family to their hotel, and the next morning Parham went to the hospital to work with Abbo. “Women would sometimes walk 300 to 400 miles to get to his clinic because they had no control of their urine,” says Parham.
“That experience moved me more probably than anything else has ever moved me in the field of medicine,” says Parham. “I saw someone make a fundamental difference just out of pure commitment. He had very little suture materials, very few medical supplies, but he was able to restore many women back to their normal lifestyles.”
Parham worked with Abbo for four months. “I remember the day that I left Sudan, he [Abbo] came to my hotel, and as we were standing on the street corner he said, ‘you need to come back to Africa one day, and bring some skills and make a difference in the lives of women,’ ” recalls Parham.
“So, he sort of marked me,” concludes Parham.
From that time Parham began traveling back and forth to Africa. As he advanced from general gynecologist to cancer specialist, Parham began establishing cervical cancer screening programs in the countries he traveled to, including South Africa, Uganda, and Tanzania. “Why cervical cancer?” Parham says as though he has previously been asked that question. “Cervical cancer is the number one cancer suffered by women in Sub-Saharan Africa and it is also the leader of cancerrelated deaths among women in Sub-Saharan Africa, primarily because there are no screening programs, no Pap tests.”
To raise the money to establish the clinics, Parham would teach young African medical students complex surgeries in the universities. Some of the money came from drug companies and research grants. “Most of the money, over the 10–15 years, came out of my back pocket, as my wife would tell you,” laughs Parham. “My wife is wonderful. We felt it was a commitment, something we needed to do.”
Drawn to Africa
While back at home in the states, Parham was working on a health project in Alabama’s Black Belt, which encompasses approximately 20 counties and is considered one of the poorest areas of the United States. Parham began to sense that doors around the project were closing. At the same time, about four years ago, Parham was lying on the sofa at his mother’s house and he found himself in prayer, “I asked God to put me in a place in the world where I could serve the most dispossessed women that I could possibly serve.”
Sometimes prayers are bolder than simply asking for guidance. Parham, being a risk-taker, vowed, “That if God would do this for me that I would commit my life to being a better man than I had been, spiritually,” says Parham. He adds with a smile, “So you can imagine what kind of man I had been.”
Also at the same time, Parham was developing a relationship with a young UAB doctor, Jeffrey Stringer, M.D., an obstetrician/gynecologist. Stringer was working on a research project in Zambia, Africa, to try to prevent the transmission of AIDS from pregnant women to their babies. Stringer invited Parham to visit Zambia and see his work.
Parham agreed to visit Zambia, and Stringer set up some lectures for him at the local university. While reading more about HIV, Parham realized that women usually die of HIV before they can develop cervical cancer. “However, as more antiretroviral drugs are given and the women stay alive longer, there would be a high cancer rate if women lived past the first 90 days,” Parham suggests.
“The body can’t clear the human papilloma (HP) virus that causes the cancer, so it progresses more rapidly, and it’s more difficult to cure in the setting of HIV,” explains Parham.
Parham went to Stringer and told him that they needed to set up a cervical cancer screening program there in Zambia. Stringer indicated that they were not seeing many instances of cancer in HIV-infected women. Parham explained to Stringer that the women were probably dying of HIV before they could develop cancer. “I told him that as he continued to give more of these HIV drugs and keep the women alive, that what he was winning on the one hand, he would be losing 10 to 15 years down the road as they develop cervical cancer if undetected through screening programs,” says Parham.
Stringer told Parham to “prove it.” Accepting the challenge, Parham presented his hypothesis to UAB. The university hospital awarded him a small grant to travel to Africa and conduct his research. “We screened 150 HIV-positive women participating in a program at the medical university to get HIV drugs,” says Parham. “Only six percent of the women had normal Paps, and of the 94 percent that were abnormal, 50 percent were seriously abnormal and 20 percent showed cervical cancer.
“‘You definitely need to start screening for cancer,’ is what Jeffrey [Stringer] said to me. So he was able to shift some money toward helping me set up cervical cancer screening clinics that target HIV-infected women, but deny no woman,” says Parham.
In the past one and a half years, Parham and his group have set up six cervical cancer screening clinics. The goal for 2007 is eight more clinics.
“The plan is to set up an entire public health cervical cancer screening program throughout the country, and if we can do that it will be the first that has ever occurred on the continent of Africa,” explains Parham. “Right now we think we are the only program that has set up free cervical cancer screening for HIV-positive women in Africa.
“That’s how I got drawn to Africa, by Dr. Abbo 20 years ago. Now I am back living there nine to ten months out of the year. So, he put a stamp on me, and there it is,” says Parham with a smile.
The Role of Nutrition
Unfortunately, HIV is stilled regarded as a social stigma, and it is often associated with perceived negative sexual behaviors. “No one wants to know they have the disease, so late diagnosis is a problem prevalent among Africans and people of African descent throughout the globe,” says Parham.
“With HIV, we see a lot of muscle wasting and low CD-4 counts, indicating a weakened immune system,” explains Parham. “They don’t get tested until they get sick because of the stigma in the African countries.”
In his work, Parham has discovered that the death rate for HIV positive people on antiretroviral drugs is extremely high, about 25 percent, in the first 90 days. But Parham also points out that, “If you can keep people alive for 90 days, by putting them on anti-retroviral drugs, then they do as well as the people at the 1917 Clinic [a UAB hospital HIV clinic]. The question then, is why is the death rate of Zambians so high in the first 90 days, and not only Zambians, but throughout the developing world,” continues Parham.
When looking at the information gathered in Zambia, Parham says that what jumped off the screen as a common element was low body mass index, which speaks to poor nutrition. Another one of Parham’s UAB colleagues, Doug Heinberger, M.D., a nutritionist, has joined the Zambia initiative. His team is researching the nutritional deficiencies in the HIV-infected population in order to appropriately supplement diets in the critical first 90 days of antiretroviral drug administration. It is the team’s hope that they may be able to keep more people alive with better nutrition.
A specific area of their research has led to the discovery of some evidence of HIV infected women being folate deficient. “If the women are folate deficient, this means that their bodies experience a more difficult time getting rid of the HP virus that causes cervical cancer,” explains Parham. “It may be that we can affect the cervical cancer rate, and decrease the cervical cancer rate, if we find that that’s the case. We can provide folate supplementation or tell people to eat more natural foods with naturally occurring folate,” he concludes.
General nutritional awareness is also a national concern for Zambia, as well as other African nations. Parham says, “According to the World Health Organization, the next big wave of diseases to hit the African population will be the American dietary diseases — type II diabetes, heart disease, high blood pressure, stroke, etc.” Zambia, like other African countries, is rapidly modernizing, and due to technological advances, more people are working at desk jobs, walking less, and eating convenience foods.
The young people of Zambia want to eat the convenient, Western fast foods that are moving into the market, as these foods are associated with a higher socio-economic status. “Fried chicken is equated with a rich man’s diet,” explains Parham. “While beans are equated with a poor man’s diet and considered low status,” he says of the healthier traditional African diet, based largely on beans and grains. He continues, “It’s going to take a lot of education to get people to understand that if they return to the way they used to eat in the villages they would be more healthy.
“We have to turn it around.”
Cancer and Spirit
Cancer is the number one killer disease in the United States. “Cancer is complex,” says Parham. “It’s not just the disease that must be considered. It is also the environment inside the body, the cancer in that environment. All those things interplay, the genetics, food, stress, emotions, and spirituality. They all play a role,” according to Parham.
“Once I was reading something where someone said that cancer was a wound that never healed,” says Parham. That notion led Parham to develop a talk 10 years ago that he still gives today, about how cancer is a physical manifestation of a wound that never healed, and that we must look at the person’s spirit as well.
Parham realized he could remove the physical manifestation of a spiritual process. “Just doing this, I was only half a doctor,” says Parham. “I was curing, but not healing when just dealing with the physical manifestation of the cancer.
“The other half of the solution was to deal with broken spirits. Broken spirits lead to broken bodies,” concludes Parham. That’s also the tentative title of the book he’s been working on for 10 years in between his time in Africa.
“A broken spirit can cause immuno-suppression, or cause one to live a lifestyle that is immuno suppressive: drinking, smoking, staying up too late, not caring about one’s self, low self-esteem, all these things can cause immuno-suppression, which can lead the body to be more susceptible to bacteria, viruses, and cancer-causing processes,” explains Parham.
“When I had that revelation, I started going back to my clinics and asking my patients this question: ‘When was your spirit broken?’ ” says Parham. “I have never asked that question to a patient who couldn’t go to the exact date, the time, the place and the circumstance.
“That experience led me out of conventional medicine,” explains Parham. “Because what I did was open up Pandora’s Box… and I was not equipped to deal with the psychological issues,” he admits. “I found it driving me to start doing some things that were harmful to me. ‘You better shut up until you are better equipped to deal with the spiritual issues,’ I said to myself,” he continues. “I needed to fortify myself as a person in order to deal with it. Now that I had opened that box, I had people asking me how I was going to help them.”
When Parham is Africa, he lives on a farm, a short distance outside the city. Living out on the farm has helped fortify himself for the spiritual aspect of his work. “When I first went to Zambia and was living out on the farm, it was interesting because at the end of the day I would go home, and I had all this negative chatter in my brain,” says Parham. “I really never knew how much negative chatter was going on in my brain, but out on the farm alone where there was no other noise, just a few birds and bees, the conversations in my brain were incredible,” he says.
One of Parham’s colleagues says that stress is what kills us and we can’t eliminate it, so it’s all in how well we deal with it. “All that negative chatter, all the time and I had no idea until I got out in the quiet of the farm. I realized I had to turn it off, and now I can turn it off like a radio,” he says with a relaxed smile.
Parham believes we must seek positive people and positive messages to build our spirits. It is easy to get bad news — newspapers, TV news, the Internet, magazines — it’s everywhere. We have to remind ourselves to seek out the positive in this world.
“I began asking God again, what could I do spiritually as a man, as a human being, what can I do for my patients,” he says. Parham now refers his patients to a person better suited to handle spiritual matters, be it a counselor or a religious person, he tries to find the right person to address the spirit.
“Mind, Body, Spirit all day long,” Parham says with a smile. He says it frequently, as though it were a mantra.
Global Community
People ask Parham why Africa, why doesn’t he stay here in Alabama and work in his own community. “Geographic boundaries are man made,” says Parham. “An African woman is as much my spiritual sister as you are.
“The music is different, the language is different, and their movements may be different from ours, but the longer I am there and the more I get to know the language and the people, the more I see that deep down inside we are all the same. We all want the same things,” asserts Parham. “We’ve got to lose these narrow and parochial definitions of the world.
“All cultures have deficits and biases. This is a global world, and there are lessons we can learn from other cultures and lessons they can learn from us,” he says. “If we begin to move as a global community, the communities become more whole, more holistic, and we become more complete as individuals.”
“Living out on a farm alone has been very healing, because of the solitude,” he says. “The farm provides me with the solitude to contemplate and to see myself as a citizen of the universe, a citizen of the world, as opposed to just seeing myself as an Alabamian, and even more so than just seeing myself as a black man. I am a spiritual being, just living in a body. “I think if we can take ourselves to that level, a lot of what we are experiencing in terms of conflicts, will disappear,” Parham says.
People also ask Parham about what will happen when his work in Africa is finished. Will he just be done and leave? “I am always there, forever. It’s a part of my neighborhood as much as Homewood or Fairfield [local cities]. It’s a 32 hour plane ride, but Africa is still part of my neighborhood,” he says with a smile.
Final Thoughts
Before the interview, Phyllis Light, director of herbal studies, gave Parham a sheet of paper with a set of questions to help guide the conversation. When Light asked Parham if he had any final thoughts before they wrapped up, he said he had been thinking about the excerpt from a poem that was on the sheet of paper with the questions. Parham reached into his coat pocket and pulled out a folded piece of paper.
“Somewhere ages and ages hence, Two roads diverged in a wood, And I took the one less traveled by; And that has made all the difference. Robert Frost,” reads Parham.
“That’s it right there. Where there is a closed door, look for an open one. Take a risk, go out on that growing edge, that’s where the secrets lie,” asserts Parham. “You’re going to get hurt, but it’s worth it,” he says with a knowing smile.
“Try to figure out why you are here, why you were put here, and then do that.”
Tara N. Brown
Photo credits: African Thorn Trees in Western Zambia & Canoe on Riverbank in Livingstone Zambia, ©iStockphoto.com/elbow-room (Julia Seal)
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