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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
www.giftsofhealth.org
WHO Global Atlas on Traditional &Complementary Medicine (Bodeker et al,2005)
Designed to record, analyze and map theDesigned to record, analyze and map thestatus of policy in the TCAM sector aroundthe world.
Three Key Areas for ESD Development
in
TK & Healthcare
1. Poverty Alleviation:Training in local means of preventing & treating illness
2. Priority Diseases: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
Poverty Alleviation
A key aspect of sustainable health development for the MDGs is poverty alleviation
Affordable, effective, local solutions to preventing & 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
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 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 12-15 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.
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 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.
EconomicsHealth 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 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.
SOUTH EAST ASIAN REFUGEES
An investigation of traditional health
practices among Southeast Asian refugees
in the United States found that 58% of 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).
GIFTS Programme – Burmese Refugees
Traditional medicine and refugee health
Herbalist trainings: 2001-2003
Creation of herbal clinics and networks: 2002-presentCreation of herbal clinics and networks: 2002-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
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 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?
Chronic Disease –
absent from MDGs
First NGO’s then WHO have proposed a new MDG for reducing deaths from new MDG for reducing deaths from chronic disease.
Focus is on prevention and control
ESD &TK can focus on those areas
Example of Chronic Disease:
CVD Globally
By the year 2020 healthcare projections suggest that ischaemic heart disease suggest that ischaemic heart disease will be the most important global cause of death and also disability
(Hobbs F, 2006).
YOGA
US reviews of studies suggest that yoga may
reduce many insulin-resistant syndrome related risk factors for CVD, 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).
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)
Diet & Nutrition
� Mediterranean diet: reduced cancer & CVD
� Indian diet: Alzheimer’s lower with turmericuse
� Japanese diet – fish, seaweed, tofu. Longevity.
� Need for ESD in traditional forms of nutrition
Tai Chi & Falling
Training in Tai Chi – most effective means of preventing falling in the elderly.elderly.
Wolf SL, O'Grady M, Easley KA, Guo Y, Kressig RW, Kutner M. (2006)
Choi JH, Moon JS, Song R. (2005)
TRADITIONAL KNOWLEDGE & SPAS
In the evolving spa world, indigenous themesindigenous 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.”
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 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.
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 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.
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 and
The Foundation for Restoring Thai
Traditional Medicine and
The College of Ayurvedic Medicine.
These have developed educational curricula
according to traditional standards
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.
PhilippinesTraditional 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 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,
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. and workforce for the spa.
Contributing to children’s education, local micro-enterprise activities and village development is part of the wider philosophy of ‘putting back’.
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).
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 volunteer part of their time to provide rural
healthcare services to low-income
communities in their vicinity & to train
local healthcare workers.
Four Key Areas for ESD Development
in TK & Healthcare1. 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 Deseases2. Priority DeseasesCommunicable 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.