Brebner F, et al. Pacific Health Dialog 2019; 21(3):166-168. DOI: 10.26635/phd.2019.609
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Perspective OPEN ACCESS Traditional Medicine and Western Medicine, Coexisting Systems and Practices. A Perspective on the way forward.
Frances BREBNER, Faafetai SOPOAGA
This article looks at Western Medicine and Traditional Medicine and explores the implications of these coexisting but very diverse systems of healthcare. We have sourced information from the World Health Organisations, Strategy and Guidelines in Traditional Medicine Use and, Guidelines for assessing quality of herbal medicines with reference to contaminates and residues and a Study on Traditional Medicine use in Dunedin by final year Otago University Medical students. We offer a perspective on the roles of academic institutions and Traditional Medicine/Traditional Healers in the provision of universal healthcare coverage in the Pacific.
The Pacific Health Dialogue recently published an article on Traditional Medicine use in the Pacific community in Dunedin, New Zealand (NZ). 1 This study was conducted by final year medical students at the University of Otago in 2017.
The article explores Pacific peoples’ access and perspectives regarding the use of Traditional Medicine. The article suggested that Pacific peoples consider Traditional Medicine to be an important part of the healing journey and overall wellbeing. Study participants perceptions of Traditional Medicine and Western Medicine as conveyed in the study medicine included:
• Traditional Medicine is holistic in its approach to healing and is inclusive of mental, physical and spiritual well-being,
• Traditional Medicine knowledge is handed down from ancestors and is spiritual in nature,
• Traditional Medicine is sourced mainly from plants and, the treatments prepared by someone known to the user while Western Medicine was manufactured and had unknown components,
The participants’ trusted often Traditional Medicine because the ingredients were familiar and they often knew the Traditional Healers who prepared the medications.
The researchers reported there were challenges related to accessing Traditional Healers and plants for traditional medicine in New Zealand.
They also found that Pacific people born in the islands were more inclined to use Traditional Medicine than those who were born NZ. For the elderly living in New Zealand, Traditional Medicine plays a role in supporting their own
health and wellbeing. Pacific communities contribute to the diversity of traditional practices in NZ, in addition to Traditional Medicine practices in the local indigenous population and other migrant communities.
At the global health level, the World Health Organization (WHO) has published a WHO Traditional Medicine Strategy 2014-2023. 2 This Strategy outlines global perceptions of Traditional Medicine, and recognises its contrition to universal health coverage and impact on health outcomes. The WHO has Guidelines for assessing quality of herbal medicines with reference to contaminates and residues. 3 This Guideline are for medicinal plants that have been used therapeutically around the world, and are important aspects of various Traditional Medicine systems.
Corresponding author: Frances Brebner [email protected], Pacific Regional Coordinator;
FS- Assoc Professor, Assoc Dean (Pacific), Head,
Va’a o Tautai, Division of Health Sciences. P.O. Box 913, Post Code 9054, University of Otago, Dunedin, New Zealand Received: 01.09.2018 Accepted: 02.02.2019 Published: 30.03.2019 Citation: Brebner F, et al. Traditional Medicine and Western Medicine, Coexisting Systems and Practices. A Perspective on the way forward. Pacific Health Dialog 2019; 21(3): 166- 168. DOI: 10.26635/phd.2019.609
Copyright: © 2019 Brebner F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Brebner F, et al. Pacific Health Dialog 2019; 21(3):166-168. DOI: 10.26635/phd.2019.609
167 It outlines that Traditional Medicine, although
based on different theoretical and cultural models, integrates phytotherapy (the use of plants and plant products for medicinal purposes), into their doctrine.
This Guideline recognises that in high-income countries, the widespread use of phytotherapy declined at the end of the first part of the twentieth century and that this was due to the development and production of synthetic medicines. However, it is noted that during the past few decades, phytotherapy had started to be increasingly used in industrialized countries.
The WHO recognition of Traditional Medicine in Health systems includes its consideration as contributing to achieving universal health coverage, especially in areas where access to a Western trained doctor or nurse is difficult due to isolation or other social, economic and geographic factors.
There is recognition that there is increasing parallel use of Traditional Medicine and Western medicine in most countries. WHO suggests that Traditional Medicine is an important and often underestimated part of health care and, that it is available in most countries and the demand for its services is increasing.
In the Traditional Medicine Strategy 2014-2023, WHO acknowledged that the use of TM as well as parallel use with Western Medicine, has encouraged many countries to recognize the need to develop cohesive and integrative approaches to health care that allows governments, health care practitioners and, most importantly, those who use health care services, to access Traditional Medicine in a safe, cost- efficient and effective manner.
However, this remains a challenge as these two systems or models of medicine have significant differences in the way they are taught and, the processes undertaken to measure efficacy of medicines used.
The world of western medicine is founded on the principles of safety and efficacy enabled through scientific methods and including principles of:
1. professional registration, 2. accountability and transparency, 3. evidence-based knowledge,
4. regulated and monitored drug trials These are essential components of a health system based on the Western Medicine model.
These methods and systems are challenging when applies to Traditional Medicine and the practice of this model of medicine.
A WHO a meeting in July 2018 held in Manila, 4 to review the WHO Strategy for the quality assurance of Traditional Medicines, further noted that ensuring the quality, safety and effectiveness of Traditional Medicines and promoting their safe and effective use, are essential to the integration of Traditional Medicine in national health-care systems. The meeting also revisited WHOs guidelines on quality assurance of Traditional Medicines.
The objectives of these (WHO) guidelines are to provide:
• guiding principles for assessing the quality in relation to the safety of herbal medicines, with specific reference to contaminants and residues;
• model criteria for use in identifying possible contaminants and residues; • examples of methods and techniques; and • examples of practical technical procedures for controlling the quality of finished herbal products.
A major concern highlighted by WHO in these Guidelines includes the parallel use of Traditional Medicine with western medicine and the need for the physician to “conduct a careful evaluation of the correlation of the efficacy and safety of the herbal medicine compared with the chemical medicines that are to be substituted by the herbal medicine”
The coexistence of these two very diverse models of medicine highlights the need for more exploration to ensure that health outcomes are strengthened. A multitude of questions is posed from this dilemma including: In support universal health coverage how can safety and efficacy be determined for Traditional Medicine ?.
How can Academic institutions based on the Western models of medicine train future health professionals about working effectively in the interface?
The WHO Guidelines for assessing quality of herbal medicines with reference to contaminates and residues, notes that contact between the two models of Medicine has raised the urgent need to compare the background of traditional knowledge with the scientific procedures of research and validation. The objectives being focusing on demonstrating the safety and efficacy of single or combined medicines.
The suggestion is made in this article that for Traditional Medicine practiced within Pacific communities the Academic Universities within the Pacific region may be best placed to support research initiatives. It is felt that the people of the Pacific Islands need to be involved and play key roles in the research into the practice and composition of traditional medicine, and how or
Brebner F, et al. Pacific Health Dialog 2019; 21(3):166-168. DOI: 10.26635/phd.2019.609
168 whether this can be assimilated into the western
context of medicine.
Research into the scientific composition of selected plants used in Traditional Medicine needs to explore not only the impacts of these on human health conditions but also the possible impacts when taken in parallel with Western Medicine for treatment
Suggestions for considerations to minimise risks associated with coexisting and parallel use of Traditional Medicine and Western Scientific models of health systems:
a. Research is conducted to investigate the effectiveness and safety of commonly used Traditional Medicines in the Pacific region b. Tertiary institutions include information
about Traditional Medicine in addition to Western Medicine in their curricula
c. The role of Traditional Healers/Traditional Medicine alongside Western Medicine is further explored to support universal healthcare coverage.
REFERENCES
1. Wilson E, et al, Traditional Medicine use in the Pacific community in Dunedin New Zealand, The Pacific Research Pacific Health Dialog 2018;21(1)
2. World Health Organisation 2013, Traditional Medicine Strategy 2014-2023, Hong Kong SAR China WHO 2013.
3. World Health Organisation, WHO guidelines for assessing quality of herbal medicines with reference to contaminates and residues, Spain WHO 2006
4. World Health Organisation. Forum : To review the WHO Strategy for the quality assurance of Traditional Medicines. July 2018. Manila
