Linking Traditional Knowledge With Modern Medicine & Healthcare

Transcription

1 Linking Traditional Knowledge With Modern Medicine & Healthcare Gerard Bodeker, Nuffield Dept of Medicine, Division of Medical Sciences, University of Oxford, Oxford, UK & Dept of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA. Chair, Global Initiative For Traditional Systems (GIFTS) of Health, Oxford, UK

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3 WHO Global Atlas on Traditional & Complementary Medicine (Bodeker et al, 2005) Designed to record, analyze and map the Designed to record, analyze and map the status of policy in the TCAM sector around the world.

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6 Three Key Areas for ESD Development in TK & Healthcare 1. Poverty Alleviation: Training in local means of preventing & treating illness 2. Priority Diseases: Communicable Disease: Training for Prevention & Research Chronic Illness: Training for Prevention & Disease Management 3. TK & Wellness: Bridging the Gap between Affluence & Poverty

7 Poverty Alleviation A key aspect of sustainable health development for the MDGs is poverty alleviation Affordable, effective, local solutions to preventing & managing common illness can contribute to reducing poverty. 2 Examples from Asia: Rural Poor in India Burmese refugees in Thailand

8 Herbal Home Gardens In India, more than 80% of the need for healthcare is in rural areas, yet only 25% of existing services are rural. In a programme covering 6,000 rural villages and comprising 150,000 HHG s, herbal home garden seedlings of a set of 20 medicinal plants from species that are useful for common ailments were grown and sold to rural households by Women Self- Help Groups in the FRLHT network. These groups were trained by FRLHT in raising, distributing and demonstrating the use of the plants for the conditions. Through participatory rural appraisal a list was developed of plants specific to each of the regions in which the project was conducted.

9 Assessment The herbal home garden programme was adopted by the poorest of the poor

10 Beneficiaries Herbal home garden programme mainly benefited women & children in poor communities as a first response to common conditions such as cold, cough and fever. Rural women with gynaecological problems such as leucorrhoea and dysmenorrhoea benefited as they were otherwise reluctant to approach male doctors at Primary Healthcare Centres. Herbal home garden products were shared by not only the family members throughout the year but by friends and neighbours as well. HHG s served as an important means to alleviate poverty due to health expenditure and the associated indebtedness of the rural poor.

11 Economics Health expenditure incurred by non-hhg households was approximately 5 times greater than that of adopters. HHG adopters spend Rs. 92 on an average in 3 months towards their family s primary healthcare while the non-adopters spend Rs. 478 in that time. The village resource persons/trainers earned at least Rs. 500 (US$11.11) per month through the sale of seedlings & training households in growing and using the plants, thereby promoting income generation for local women.

12 SOUTH EAST ASIAN REFUGEES An investigation of traditional health practices among Southeast Asian refugees in the United States found that 58% of Cambodian, Lao, Mien, and ethnic Chinese patients had recently used one or more traditional health practices (Buchwald et al. 1992).

13 GIFTS Programme Burmese Refugees Traditional medicine and refugee health Herbalist trainings: Creation of herbal clinics and networks: present Survey research on refugee knowledge and use of traditional medicine: 2002 Medicinal plants database and field manual production: 2002-present Ongoing awareness building and advocacy: 2001-present

14 Rural villages remote from health services

15 Herbal clinic at Noe Poe

16 Discussion of database with master herbalists/monks

17 Herbal Book Training in Use

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19 . 2. PRIORITY DISEASES: Communicable Diseases

20 2. Communicable Disease: Training for Prevention & Research HIV/AIDS, TB & Malaria are top priorities for WHO MALARIA: Research on Natural Products, drawn from traditional medicine knowledge, has already yielded leading anti-malarials. ESD can include training for researchers in high malaria regions to use appropriate methods to study local plants against malaria. HIV: One programme in South Africa trained 1,510 THPs to give an HIV prevention message. During the first 10 months of the programme, > 845,600 of their clients were reached with AIDS/STD prevention messages. India alone has several million THPs how many can they reach with an HIV prevention message?

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22 . 2. PRIORITY DISEASES: Chronic Conditions

23 Chronic Disease absent from MDGs First NGO s then WHO have proposed a new MDG for reducing deaths from chronic disease. Focus is on prevention and control ESD &TK can focus on those areas

24 Example of Chronic Disease: CVD Globally By the year 2020 healthcare projections suggest that ischaemic heart disease will be the most important global cause of death and also disability (Hobbs F, 2006).

25 YOGA US reviews of studies suggest that yoga may reduce many insulin-resistant syndrome related risk factors for CVD, improve clinical outcomes may aid in the management of CVD (Innes et al 2005). Reduce age related deterioration in cardiovascular functions (Bharshankar et al 2003).

26 Meditation NIH funded study on 202 S s using meditation (TM), mean age 71 years. Meditation group had a significant reduction in: the rate of death from cardiovascular disease- 30%, death from cancer - 49% reduced risk factors for heart disease overall reduction of 23%C in the rate of death from all causes was found. Schneider et al (2006)

27 Diet & Nutrition Mediterranean diet: reduced cancer & CVD Indian diet: Alzheimer s lower with turmeric use Japanese diet fish, seaweed, tofu. Longevity. Need for ESD in traditional forms of nutrition

28 Tai Chi & Falling Training in Tai Chi most effective means of preventing falling in the elderly. Wolf SL, O'Grady M, Easley KA, Guo Y, Kressig RW, Kutner M. (2006) Choi JH, Moon JS, Song R. (2005)

29 . 3. TK & Wellness: Bridging the Gap between Affluence & Poverty

30 TRADITIONAL KNOWLEDGE & SPAS In the evolving spa world, indigenous themes have emerged as a significant trend, especially in destination spas and in rural and regional settings where traditions are strong and local health knowledge is lively. SpaFinder noted in its Ten Spa Trends to Watch for in 2007 : Spa guests are rewarding a spa's efforts to incorporate authentic indigenous treatments, hire local staff, and contribute to the community. They're also welcoming education about local cultures and healing traditions.

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32 Japan - Onsen The Japanese Onsen tradition is centred around hot springs in this volcanically active country. Traditionally used for public bathing, Onsen have become major features of Japan s tourism industry. Purity of water, mineral richness and heat are key features of the Onsen experience. Reflecting the globalization of Asian health cultures, Onsen are found in spa settings in many different parts of the world.

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34 Thai Traditional Massage Drawing on basic principles of the Wat Pho tradition of Thai massage and the Lana traditions of Northern Thailand, Thai spas draw on local as well as generic national concepts and products to integrate into their treatment regimens. Wat Pho, the Temple of the Reclining Buddha, in Bangkok, adjoins the Grand Palace and is known as the birthplace of traditional Thai massage. In the era before the temple was established, the site was a centre for training in traditional Thai Medicine, which in turn has it roots in Ayurveda.

35 UNESCO Heritage Listing

36 Thai Traditional Massage Conservation efforts in Thailand have resulted in such initiatives as: Thai Massage Restoration Project which has revised the texts of Thai traditional massage and The Foundation for Restoring Thai Traditional Medicine and The College of Ayurvedic Medicine. These have developed educational curricula according to traditional standards

37 Traditions of the Malay Kingdoms The indigenous health traditions of Malaysia and Indonesia have also been the source of a unique set of spa programmes and ambiances. These have taken village or kampung traditions, as well as those from royal courts, and placed them within a spa and wellness setting.

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39 Philippines Traditional Philippine medicine has its roots in the many ethnic groups of the Philippine islands. The traditional massage system of the Philippines, known as hilot, is equally diverse in practice and tradition. Now hilot is becoming standardized. It is also incorporated into contemporary spa programmes in the Philippines,

40 TK & Ethics: Acting Locally: Thailand In Thailand, the Six Senses Spa, Hua Hin, has a commitment to investing back into local village communities that provide the herbs, local produce and workforce for the spa. Contributing to children s education, local microenterprise activities and village development is part of the wider philosophy of putting back.

41 Acting locally - Malaysia Sembunyi Spa at Cyberview Lodge Resort & Spa in Malaysia is currently working with people from a nearby village or kampung - "kampung Dengkil". The management & spa team are working with a Single Mothers Group in the kampung to cultivate & supply the resort with some traditional spa ingredients (Ginger, Lime, Pegaga, Serai & Kunyit), with batik material, and with Mengkuang weave for room compendiums, Kampung folk music (Gamelan).

42 Acting locally: The Philippines Doctors at award winning medical spa, The Farm at San Benito, in the Philippines volunteer part of their time to provide rural healthcare services to low-income communities in their vicinity & to train local healthcare workers.

43 Four Key Areas for ESD Development in TK & Healthcare 1. Poverty Alleviation: Training in local means of preventing & treating illness. Documenting local knowledge; training resource people in herbal home garden development; training rural communities, including refugees, in herbal management of common illness. Curriculum & educational evaluation are needed 2. Priority Deseases Communicable Diseases: Training for Prevention & Research. Train researchers in appropriate methods of evaluating of traditional medicines for preventing & managing communicable diseases. Train THP s in giving disease prevention messages. Chronic Illness: Curriculum in evidence-based traditional approaches to preventing & managing chronic illness, including traditional diet. 3. TK & Wellness: Bridging the Gap between Affluence & Poverty. Culturally acceptable training in TK for wellness programmes, along with ethics in TK use & development.

44 . THANK YOU