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

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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.

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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.

Assessment

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

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

Rural villages –

remote from health services

Herbal clinic at Noe Poe

Discussion of database with

master herbalists/monks

Herbal Book – Training in Use

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2. PRIORITY DISEASES:

Communicable Diseases

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Communicable Diseases

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?

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2. PRIORITY DISEASES:

Chronic Conditions

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Chronic Conditions

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)

3. TK & Wellness: Bridging the Gap

between

Affluence & Poverty

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Affluence & Poverty

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.”

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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.

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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.

UNESCO Heritage Listing

‘

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.

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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.

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THANK YOUTHANK YOU

www.giftsofhealth.org