12 Sep 2010, The Kathmandu Post
Two weeks ago, I wrote an article titled “Guava Cure.” In it, I discussed the soaring costs of allopathic healthcare, and suggested traditional medicine (TM) may provide an alternative to hospital and doctor care.
That evening, I got two responses. The first one said: “You are an incurable romantic! A believer in magic! All those leaves and herbs that you believe in—I know I can’t convince you that there is a reason why science is science, and has led to the incredible advance of human knowledge. Magic can’t do that. Those stories of so-and-so being cured of this or that with special leaves, herbs, potions, etc., are just observational, which means they are not grounded on real, solid evidence. They are just anecdotes. All the leaves and herbs in the world cannot cure a person with a serious bacterial infection, like TB, for example. It’s like those religious fanatics in the US (Christian Scientists, usually, and the like), who refuse to allow their sick children to get medical treatment, because they believe that their sick kids can be cured by prayer. The kids always die, unless the government intervenes and takes over the care of the sick child. Treat a kid who has TB with Tibetan or ayurvedic medicine, and you’ll end up with a dead kid.”
I agree with my friend on one level. I was not suggesting allopathic medicine be abandoned completely. Allopathic and traditional medicine should work in tandem, with traditional medicine acting as a complement, rather than a replacement. Undoubtedly many diseases are only cured by scientifically tested medicine.
The second response was from a Nepali friend who expressed displeasure at my article. In his own personal life, ayurveda was causing havoc. He reeled off the names of 11 medicines his father was taking—all from Divya Pharmacy, Ram Dev’s pharmaceutical company. His father consulted ayurvedic practitioners and kept adding medication. One was to reduce blood pressure, one to control diabetes, one to reduce stress. The maid was made to grow wheatgrass in a flowerpot, and prepare wheatgrass juice. In addition, he was ingesting tite karela (bitter gourd), Louka juice, and aloe vera juice—simultaneously! My friend was, understandably, distraught about his father’s health.
Ayurveda (the science of longevity or life) is based on one central tenet—balance. Balance in food, medication, physical and mental equilibrium. Vata (wind), pitta (fire, bile) and kapha (water and earth, phlegm) must be in equilibrium. When these are out of balance, they bring disease. How did this message get lost for one of Ramdev’s followers? And are there many like him, putting their health in danger by extreme consumption of traditional medicines?
The question must be asked: is complementary medication dangerous to one’s health, without the proper labels, the proper laboratory testings, and the patient’s non-willingness to follow the regime? Should ayurvedic doctors also be required to go through “medical school”, and be licensed, and held liable in the same way allopathic doctors are for malpractice? Or, as my first respondent suggested, should all traditional medicine be outlawed because they have no scientific verifiability?
The World Health Organisation’s factsheet on traditional medicine says:
• In some Asian and African countries, 80 percent of the population depend on traditional medicine for primary health care.
• Herbal medicines are the most lucrative form of traditional medicine, generating billions of dollars in revenue.
• Traditional medicine can treat various infectious and chronic conditions: new antimalarial drugs were developed from the discovery and isolation of artemisinin from Artemisia annua L., a plant used in China for almost 2000 years.
• Counterfeit, poor quality, or adulterated herbal products in international markets are serious patient safety threats.
• More than 100 countries have regulations for herbal medicines. According to the same factsheet, about 70 to 80 percent of the population in the developed countries have used some form of complementary alternative medicine (CAM).
The WHO Traditional Medicine Strategy says world expenditure on TM is growing rapidly—In Malaysia alone, US $500 million was spent on TM, while only US $300 million was spent on allopathic care. Americans spent an estimated US $ 2700 million on CAM—out of pocket. Canadians spend an estimated US $2400 million, and the English are not far behind with US $2300 million.
The issue then is not that traditional medicine is only used by the poor. Clearly, its usage is rising everywhere. The issue, it appears, is a greater need for research and development on effects and contraindications of traditional medicine. National policies to regulate products must come info effect. TM practitioners must go through a period of training, and become licensed.
Traditional medicine practitioners like amchis, who serve the population in the Himalayas (ie: Dolpo and Mustang), have requested time and again to have their system of healing recognised. They also require support for academic centres where such medicine can be studied. Despite repeated requests to the government, amchis remain un-licensed. Their system of medicine is not recognised.
In countries like Indonesia and Thailand, the government has policies regarding TM. It encourages the growth and practice of such knowledge and regulates quality of medicine. In Indonesia, a widely used traditional medicine is known as jamu. Jamu makers are both licensed and unlicensed (depending upon whether they can pay the government fees.) The Thai government has started a Thai massage school in Wat Po.
It is surprising that Nepal, which prides itself on its herbal wealth, has no national policy on traditional medicine. So far, foreign companies seem to have carte blanche to come and take whatever they want from forests—no questions asked. Perhaps our great leaders should stop fighting long enough to take stock of their biological wealth, put a custom officer at Nepalgunj, inspect each truck that goes through, and charge a tax on these “leaves and herbs”. They can reinvest the tax into TM training institutions. Businesses also must give back to local communities a percentage of their billion-dollar profits.
Situated at the crossroad of India and China, two countries in which traditional and complementary medicine remain extremely advanced, Nepal could turn into a new Visit Nepal destination by tapping into the large and lucrative field of alternative healing tourism. Unfortunately, it seems our leaders are themselves in need of medication (perhaps a Himalayan herb might make their minds alert to the problems at hand, or failing that, a magic potion to instill ethical leadership skills) before they can govern the country. firstname.lastname@example.org