cam malaysia handbook
TRANSCRIPT
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AH
andb
ooko
f Traditional andComplementary
Medicine Programme inMalaysia
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This handbook was crafted through generous mentoring and
encouragement. Special acknowledgement is due to Dato Dr.
Maimunah bt A. Hamid, Deputy Director General of Health
(Research and Technical Support), Ministr y of Health Malaysia, for
sparking the idea. Similarly, special acknowledgement is given to
Dr. Ramli bin Abd. Ghani, Director of the Traditional and
Complementary Medicine Division, Ministry of Health Malaysia, for
his continuous support and endless encouragement.
Also, the Traditional and Complementary Medicine Division greatly
appreciates the valuable work of every individual who contributed
to the success in the preparation of this handbook.
Last but not least, special appreciation to the reviewers for their
valuable comments and input.
Editorial Committee
Traditional & Complementar y Me dicine Division
October 2011
Acknowledgement
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Medicine is in the new e ra. In the past century, the health care
system has seen major changes not only within the modern
medicine but also, the integration of traditional and
complementary medicine into the modern medical system.
Th is is du e to th e fa ct th at th e wo rl d po pu la ti on is
increasingly seeking natural or drugless remedies or
solutions to their health problems. Realising this, Malaysia
strives to achieve a balanced and safe use of both modern
and traditional and complementary medicine.
Thi s han dbook is a reect ion of what trans pire d, what was
planned and achieved by the Government of Malaysia in
realising the dream of integrating both types of medical
systems. The contents of this handbook have been carefully
selected and organised in such a way that it delivers muc h of the
needed information to the public as well as the professionals
involved.
I would like to convey my deepest appreciation to the editorial
committee who have worked hard to put together this
remarkable book for the benet of the people of Malaysia.
Foreword
Dato Dr. Maimunah bt A. Hamid
Deputy Director General of Health
(Research and Technical Support)
Ministry of Health Malaysia
October 2011
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Preface
Dr. Ramli bin Abd. Ghani
Director
Tra dition al and Compl eme nta ry Med ic in e D ivi sio n
Ministry of Health Malaysia
October 2011
Today, Traditiona l and Com plement ar y Medici ne (T&CM) is an
important component of the healthcare system. It co-exists with
modern medicine to improve health and the quality of life.
T&C M plays a cr ucial role in the aspect of pr event ion, hea lth
promotion and healing. In the local community, traditional
remedies are commonly sought after to accelerate the process
of healing and in maintaining health after treatment or
diagnosis from an allopathic medical practitioner.
Thi s han dbook mar ks our r st att empt to pr ovi de a general
overview of the practice of T&CM in a localised setting whilst
promoting public awareness towards i ts safety and quality.
The idea of thi s han dbook came fr om Dat o Dr. Mai munah bt A.
Hamid, Deputy Director General of Health (Research and
Tech nical Support), Ministry of Hea lth Mala ysia . The informati on
and facts in this handbook are intended for the people of
Malaysia from all walks of life who care about the society they
live in and the people whom they share their lives with.
I would like to thank the editorial committee for devoting their
time with genuine interest and enthusiasm to ensure the
realisation of this book.
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CHAPTER 1
Introducing... Traditional & Complementary Medicine 1 6
Overview
Denitions
Classications of T&CM in Malaysia
Roles and Functions of T&CMD
CHAPTER 2
Development of T&CM Globally and Locally 7 19
Global Development
International Collaboration in Traditional &Complementary Medicine
Development of T&CM Programme in MalaysiaT&CM Practice s Ava ilable at the Int egrative Hospitals
T&CM Uni ts at the Integ rative Hospitals
CHAPTER 3
Modalities in T&CM 20 23
The rapeut ic Ver sus We lln es s Con cept
Home-grown Modalities
The Scope of Pra ct ice of T&C M Modalities
CHAPTER 4
EBP in Supporting Development of T&CM Practices 24 28
EBP Evidence-based Practice
Steps involved in the EBP Process
Use of EBP in Developing T&CM Guidelines
CHAPTER 5
Education & Training 29 32
CHAPTER 6
Research in T&CM 33 35
CHAPTER 7
Promotional, Enforcement & Public Education Activities 36 44
Promotional Activities
Inspection Activities
Public Education
GLOSSARY 45 49
EDITORIAL COMMITTEE50
Contents
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Traditiona l Medici ne (TM) is an anc ient medical pr actice which
existed in human societies before the application of modern
science to health. It has evolved to reect dierent
philosophical backgrounds and cultural origins. The practice of
modern medicine may be widespread but the use of traditional
medicine is still practiced in many countries although it is not
always included as a part of the healthcare system recognised
by the government. It is one of many types of non-standardisedhealth care services which involve varying levels of tr aining and
eciency.
TM/ CAM (Co mplemen tar y & Alt er nat ive Med ic ine) has be en
widely utilised by the world population for decades. In some
Asian and African countries, 80% of the population depend on
traditional medicine for primary health care purposes. In many
developed countries, 70% to 80% of the population have usedsome form of complementary or alternative medicine, with
herbal treatments being the most popular form of TM.
In the West, the umbrella term CAM is widely accepted as
including both TM and other recent forms of non-standardised
medicine. In Malaysia, the term Traditional and Complementary
Medicine (T&CM) is used to denote a practice of medicine that is
other than the practice of medicine or dental practices utilised
by registered medical or dental practitioners.
In accordance with the World Health Organization (WHO)
Trad it ional Medicine Strateg y 200 2 20051, member countries
are:-
To deve lop a policy that pr omotes the int egr ati on of TM/ CAMinto the national health care system.
To pr omo te saf ety, ecacy, and qual it y of TM/ CAM serv ices
and products.
To i ncre ase the ava ilabil ity and aordabil it y of TM/CAM and
To p romote rationale use of TM/ CAM.
The se senti ments wer e repeated in the Beij ing Declarat ion
20082
, in which WHO states that participating countries should,in accordance with national capacities, priorities, relevant
legislation and circumstances:
a) Respect, preserve, protect and communicate widely and
appropriately the knowledge of traditional medicine,
treatments and practices;
Chapter 1 Introducing... Traditional & Complementary Medicine
Overview
1
1
1.
2.
3.
4.
1World Health Organisation (2002) WHO Traditional Medicine Strategy. Geneva: WHO2Anon. (2011) Beijing Declaration 2008 [Online]. Switzerland: WHO. Retrieved from: http://www.who.int/medicines/areas/traditional/congress/beijing_declaration/en/index.html[Accessed 14th February 2011
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b) Governments should formulate national policies, regulations
and standards to ensure appropriate, safe and eective use
of traditional medicine,
c) To integrate traditional medicine into national health systems,
d) To further develop traditional medicine based on research
and innovation,
e) To establish systems for qualication, accreditation or
licensing of traditional medicine practitioners,
f ) To strengthen the communication between conventional
and traditional medicine providers.
Trad it ional medicine has made a signi cant contribution to the
health care of the Malaysian community. It continues to be
patronised by our people in their bid to seek treatment for
diseases and in maintaining health. In a recent study by Z.M Siti
et al. published in the Journal of Complementary Therapy in
Medicine in November 2009, it is found that the prevalence of
use of T&CM amongst Malaysians in their lifetime was 69.4%
(67.671.2%) and 55.6% (53.857.4%) within the last period of12 months of the study3. Realising this, the Ministry of Health
took a positive and proactive approach in nurturing traditional
and complementary medicine to ensure the quality and safety
of practices and products of T&CM. The National Policy of
Traditiona l and Complem entar y Medicine 2007 states tha t:
Traditional/complementary medicine (T&CM) system shall be an
important component of the healthcare system. It will co-exist
with modern medicine and contributes towards enhancing the
health and quality of life of all Malaysians.
The gover nme nt wi ll faci litate the devel opmen t of T&C M in the
country and ensure the quality and safety of practices and
products of T&CM. It will support the identication of its health,
economic and social benets.
Thus, the Traditional and Complementary Medicine Unit was born
in 1996 and later upgraded to the Traditional and ComplementaryMedicine Division (T&CMD) in the Ministry of Health in 2004.
Denitions
Malaysian perspective
Currently, there is no universally
agreed denition for Traditional
Medicine and/or Complementary
Medicine. However, the denition
below shall be the basis of the
Malaysian Governments approac h
to the development of T&CM.
2
3Z.M. Siti, A. Tahir, A. Ida Farah, S.M. Ami Fazlin, S. Sondi, A.H. Azman, A.H. Maimunah, M.A. Haniza, M.D. Siti Haslinda, A.K. Zulkarnain, I. Zakiah, W.C. Wan Zaleha (2009) Use of traditional andcomplementary medicine in Malaysia: a baseline study', Complementary Therapies in Medicine, Vol. 17, No. 5, pp. 292-299.
4Anon. (2007) The National Policy of Traditional and Complementary Medicine . 2nd ed. Kuala Lumpur: Traditional and Complementary Medicine Division.
Figure 1.1: National Policy of Traditional and
Complementary Medicine (Second Revision, 2007)
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Traditional and Complementary Medicine is a form of
health-related practice designed to prevent, treat, and/or manageillnesses and/or preserve the mental and physical well-being of
individuals and includes practices such as traditional Malay
medicine, Islamic medical practice, traditional Chinese medicine,
traditional Indian medicine, homeopathy, and complementary
therapies, and excludes medical or dental practices utilised by
registered medical or dental practitioners.
National Policy of Traditional & Complementary Medicine
Ministry of Health Malaysia (2007)
Globally
a. WHO
Traditional medicine is dened as diverse health practices,
approaches, knowledge and beliefs incorporating plant,
animal, and/or mineral based medicines, spiritual therapies,
manual techniques and exercises applied singularly or in
combination to maintain well-being, as well as to treat,
diagnose or prevent illness.
WHO Traditional Medicine Strategy 2002-2005
Complementary medicine, in practice refers to a wide range
of health interventions originating from dierent cultures
across thousands of years of history.
Scottish Oce Department of Health, Complementary Medicineand the National Health Services (London, November 1996)
b. USA
Complementary and Alternative Medicine (CAM) as dened
by the National Center for Complementary and Alternative
Medicine (NCCAM) is a group of diverse medical and health
care systems, practices, and products that are not generally
considered part of conventional medicine.
NCCAM, USA (2007)
c. UK
Complementary and Alternative Medicine (CAM) is a title
used to refer to a diverse group of health-related therapies
and disciplines which are not considered to be a part of
mainstream medical care. Other terms sometimes used to
describe them include 'natural medicine', 'non-conventional
medicine' and 'holistic medicine'.
House of Lords, Parliament, U.K (November 2000)
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Classications of T&CM in Malaysia
In Malaysia, Traditional and Complementary Medicine
are classied into si x major groups. They are:
1. Traditional Malay Medicine
2. Traditional Chinese Medicine
3. Traditional Indian Medicine
4. Homeopathy
5. Complementary Medicine
6. Islamic Medical Practice
Roles and functions of Traditional and
Complementary Medicine Division (T&CMD),
Ministry of Health Malaysia1. To regulate the practice of T&CM practitioners through
T&CM Bo dies us in g a phas ed appr oach, fr om
self-regulation to statutory regulations.
2. To facilitate the development of T&CM practices and its
integration into the national healthcare system.
3. To establish a registry of all T&CM practitioners.
4. To ensure all T&CM practitioners undergo a formalised
system of education and training.
5. To facilitate the developme nt of standards and criteria
in T&CM, regulation and monitoring of accredited
learning centres, setting the quality and standards of
T& CM pr og ra mm es, an d to ev al ua te th ei r ee ct iv en es s.
6 . To faci l itate and as a col laborator in research and
scientic evaluation of T&CM modalities; towards
promoting evidence-based medicine.
The T&CM Division is situated at Jalan Cenderasari,
Kuala Lumpur, with ve T&CM branch oces to
date located in Pulau Pinang, Terengganu, Johor,
Sarawak dan Sabah (Figures 1.2 and 1.3).
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T&CMD Headquarter and Branch Oces
TRADITIONAL AND
COMPLEMENTARY MEDICINE DIVISION
MINISTRY OF HEALTH MALAYSIA
BLOK E, JALAN CENDERASARI,
50590 KUALA LUMPUR
Tel No. : 0 3-2 69 85077
Fax No.: 03-26911259
http://tcm.moh.gov.my/
Figure 1.2: Contact details of the Traditional & Complementary Medicine Division Headquarter,
Ministry of Health Malaysia
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Figure1. 3: Contact details of T&CM Branch Oces.
6 Contact details of T&CM Branch Oces
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The use of tr adit ional and complem ent ar y medicine is incr eas ing wor ldwide. In low - and middle -income count ries, up to 80% of the
population may rely on T&CM for their primary health care needs. In many high-income countries, CAM utilisation is becoming
increasingly popular, with up to 65% of the pop ulation reporting that they have used this form of medicine (Figure 2.1).
Chapter 2 Development of T&CM - Globally and Locally
Global Development
60% 60%
70% 70% 70%
90%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Uganda Tanzania Benin Rwanda India Ethiopia
Use of Traditional Medicine to Help Meet Primary Health Care Needs in Developing Countries
Figure 2.1: Percentage of use of T&CM amongst the populations of developing countries.
Source: WHO Traditional Medicine Strategy: 2002 2005
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Figure 2.2: Percentage of Populations in Developed Countries who have used
CAM at least once.
Source: WHO Traditional Medicine Strategy: 2002-2005
48% 50%42%
75%
0%
20%
40%
60%
80%
100%
Populations in developed countries who have used CAM
at least once
40%
Belgium
Australia
Canada
USA
France
8
Figure 2.3: Percentage of CAM use in USA.Credit: National Center for Complementary and AlternativeMedicine, NIH, DHHS
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Table 2 .1: Use of C AM f rom a pra ctit ion er (all t herap ies) in t he
past 12 months by geographical region in Britain (2004)
Source: Thomas K, Coleman P. Use of CAMs in a General Population in
Great Britain. Journal of Public Health 2004 Vol. 26, No. 2, pp. 152157.
Region Received CAM % 95% CI n = 100%
Frequency
England 152 10.0 8.611.7 1513
Wales 10 10.0 5.517.4 100
Scotland 17 9.8 2.315.1 174
North 20 4.3 2.86.5 469Midlands and East Anglia 67 14.4 11.517.9 464
London 12 7.4 4.312.5 162
South East 32 12.5 9.017.1 256
South West 21 13.0 8.619.0 162
Figure 2.4: Percentage of CAM use by Race/Ethnicity among adults in US 2007.
Credit: National Center for Complementary and Alternative Medicine, NIH, DH HS
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International Collaboration in Traditional &Complementary Medicine
Togethe r with the World Healt h Org ani sation (WHO ), Malay siahas made a signicant number of collaborations with many
ASEAN countries, India and China in an eort to strengthen the
base for traditional and complementary medicine in the
country. An example is the Memorandum of Understanding
(MOU) signed between Malaysia and the Peoples Republic of
China in 2005 regarding cooperation on policy-making,
regulation and promotion of traditional medicine. Five years
later, Malaysia signed its second memorandum with India on thetraditional system of Indian Medicine.
In 2008, Dr. Ramli Abd. Ghani, Director of T&CM Division was
appointed as WHO temporary consultant for Interventional
Regulatory Conference for Harmonisation (IRCH) on TM,
marking a milestone for Malaysia in being recognised as a
signicant contributor in T&CM. He subsequently attended IRCH
meetings held in Montreal (2009) and Dubai (2010). Thereafter,
several other bilateral meetings in T&CM were conductedbetween Malaysia and Thailand, Brunei and Indonesia.
In 2009, Malaysia and WHO successfully organised a workshop
on the Development of Harmonized Policy and Standards of
Integrative Medicine amongst ASEAN countries. In 2010, at
the 2nd ASEAN Traditional Medicine Conference in Vietnam,
the separation of pharmaceutical products from traditional
Source: Nahin, RL, Barnes PM, Stussman BJ, and Bloom B. Costs of
Complementary and Alternative Medicine (CAM) and Frequency of
Visits to CAM Practitioners: United States, 2007.
National Health Statistics Reports; No. 18. Hyattsville,
MD: National Centre for Health Statistics. 2009.
Figure 2.5
* Self care costs includes CAM products, classes and material.
Relaxation techniques include relaxation, guided imagery, progressiverelaxation and deep breathing exercises.
10
Yoga, Tai Chi, Qi Gong
classes $4.1 billion(12.0%)
Homeopathic Medicine
$2.9 billion (8.6%)
Relaxation Techniques
$0.2 billion (0.6%)
CAM Out-of-Pocket Spending: Self-care* vs. Practitoner Costs
Nonvitamin, Nonmineral, Natural
Products $14.8 billion (43.7%)
Practitioner Costs $11.9 billion
(35.2%)
Total Self-care Costs$22.0 billion (64.8%)
Total Practitioner Costs$11.9 billion (35.2%)
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medicine was decided upon. In addition to that, two Malaysian
representatives namely Dr. Shamsaini Binti Shamsuddin from the
Traditiona l & Com plement ar y Medicine Division and Dr. Zakiah
Ismail from the Institute for Medical Research were appointed as
focal points of the TM Section in ASEAN countries.
From time to time, Malaysia has aggressively pursued
opportunities for cooperation whilst strengthening ties with
both ASEAN and non-ASEAN countries through ocial visits,
international conferences, seminars and attachment
programmes to nurture the grounds of T&CM in Malaysia .
Development of Traditional and ComplementaryMedicine Programme in Malaysia
Before the 15th century, indigenous or traditional native medicine
is the type of medicine practised by the Orang Asli of the Malay
Peninsular and the Pribumi of Sabah and Sarawak. During this
period, traditional Malay medicine was strongly inuenced by the
animistic culture of Hindu-Buddhism, which ori ginated from India.
Subsequently, with the introduction of Islam and with the
arrival of the Chinese, the practice of medicine began to change,
incorporating these new set of values. At about the same time,
Traditional Chinese Medicine practices were intr oduc ed and
Traditional Indian Medicine too began to take root in the soils of
Malaya.
At the end of the 19th century, modern medicine was br ought
in by the British and was taken up quickly due to its ease of
practice and eectiveness. During this period, complementary
medicine also started to appear in the country.
By the 20th century, modern medicine was the mainstream
medicine practised i n Malaysia, with T&CM treatments available
as a complement.
Figure 2.6 (next page), demonstrates the chronology of events
of development of T&CM in Malaysia. Subsequent pages show
the T&CM Units at various hospitals and the services they
provide.
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Figure 2.6 : Timeline depicting the development of T&CM in Malaysia.
2001
Launch of NationalPolicy on T&CM
1987
Preparation ofproposal for
research in
alternative medicine
1998
Establishment of theT&CM Standing
Committee
1996
Formation of theTraditional &
Complementary
Medicine (T&CM)
Unit under theFamily Health
Develoment
Division
2000
Launch of HerbalMedicine Research
Centre
1999
Formation of veUmbrella Bodies for
T&CM
2002
Establishment ofGlobal Information
Hub and National
Committee in R&D
on Herbal Medicine
2004
Establishment of theT&CM Division in
Ministry of Health
(MOH)
2007
Establishment of therst Integrated
Hospital in Kepala
Batas, Pulau Pinang
2008
Establishment ofT&CM services in
Putrajaya Hospital,
Putrajaya and
Sultan Ismail
Hospital, Johor
2009
Establishment ofregional T&CM
oces in MOH:
oNorthern region Pulau Pinang
oSouthern region Johor Bahru
oEastern region Kuala Terengganu
oSabah KotaKinabalu
oSarawak -Kuching
2009
Establishment ofT&CM Units at
Sultanah Nur
Zahirah Hospital in
Kuala Terengganu,Duchess of Kent
Hospital in
Sandakan, Sabah
and Sarawak
General Hospital
2011
Establishment ofT&CM Unit in
Sultanah Hajah
Kalsom Hospital,
Cameron Highlands,Pahang
2010
Establishment ofT&CM Units in Port
Dickson Hospital,
Negeri Sembilan
and Sultanah
Bahiyah Hospital in
Alor Setar, Kedah
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13T&CM Units at Integrated Hospitals in the Ministry of Health (2011)
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Figure2.7: T&CM Units at Integrated Hospitals in the Ministry of Health (2011)
13T&CM Units at Integrated Hospitals in the Ministry of Health (2011)
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Acupuncture
Putrajaya Hospital
Sultan Ismail Hospital
Kepala Batas Hospital
Sultanah Nur ZahirahHospital
Duchess of Kent Hospital
Sarawak Public Hospital
Port Dickson Hospital
Sultanah Bahiyah Hospital
Sultanah Hajah KalsomHospital
Malay
Massage
Putrajaya Hospital
Sultan Ismail Hospital
Kepala Batas Hospital
Sultanah Nur ZahirahHospital
Duchess of Kent Hospital
Sarawak Public Hospital
Port Dickson Hospital
Sultanah Bahiyah Hospital
Sultanah Hajah KalsomHospital
Herbal Therapy as
an Adjunct
Treatment for
Cancer Patients
Hospital Umum Sarawak
Kepala Batas Hospital
Sultan Ismail Hospital
Putrajaya Hospital
Hospital Umum Sarawak
Sultan Ismail Hospital
Putrajaya Hospital
Malay
Postnatal
Treatment
T&CM Practices Available at the Integrated Hospitals
Table 2 .2: T&CM Prac tice s ava ilabl e at the I ntegrated Hosp itals
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T&CM Units at the Integrated HospitalsT&CM Units at the Integrated Hospi
T&CM Unit
Kepala Batas Hospital
Jalan Bertam 2
13200 Kepala Batas
Pulau Pinang
Tel: 604- 5793333, ext 113
Fax: 604-5791088
Email: [email protected]
T&CM Unit
Putrajaya Hospital
Ground FloorPutrajaya Hospital
Precinct 7, 62250 Putrajaya
Tel: 603- 83124200
Fax: 603-88880137
Email: [email protected]
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T&CM Units at the Integrated Hospitals&CM Units at the Int
T&CM Unit
Sultan Ismail Hospital
Jalan Persiaran Mutiara Emas Utama
Taman Moun t Austi n
81100 Johor Bahru Johor
Tel: 607- 3565000
Fax: 607-3565034
T&CM Unit
Sultanah Nur Zahirah Hospital
Jalan Sultan Mahmud
20400 Kuala Terengganu
Terengganu
Tel: 609- 6212121, ext: 2394
Fax: 609-6221820/ 609-6227139
Email: [email protected]
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T&CM Units at the Integrated HospitalsT&CM Units at the Integrated Hos
T&CM Unit
Duchess Of Kent HospitalKM 3.2 Jalan Utara
90000 Sandakan
Sabah
Tel: 6089-212111
Fax: 6089-219359
Email: [email protected]
T&CM Unit
Sarawak General Hospital
Jalan Tun Ahmad
Zaidi Adruce,93586, Kuching,
Sarawak
Tel: 6082-276666, ext 51 50
Fax: 6082-276703
Email: [email protected]
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T&CM Unit
Port Dickson Hospital
KM 11, Jalan Pantai 71050 Si Rusa
Port Dickson
Negeri Sembilan
Tel: 606- 66263 33
Fax: 606-6625003
Email: [email protected]
T&CM Unit
Hospital Sultanah Hajah Kalsom
Jln Persiaran
Dayang Endah
39000 Tanah Rata
Pahang
Tel: 05 49119 66
Fax: 05 4913355
T&CM Units at the Integrated Hospitals
Unit
Port Dickson Hospital
KM 11, Jalan Pantai 7
Port Dick
&CM Units at the Int d
Tel: 05 49119 66
Fax: 05 4913355
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T&CM Unit
Sultanah Bahiyah Hospital
Blok T
Sultanah Bahiyah Hospital
Lebuhraya Darulaman
Alor Setar
Kedah
Tel: 04-740 6233
Fax: 04-735 0232
T&CM Units at the Integrated Hospitals
T&
Sult
Blok
Sul
Leb
Alor
Ked
Tel:
ax:
osp ta s
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Chapter 3 Modalities in T&CM
The modern med ical syste m intr oduces fou r
main concepts that are curative, therapeutic,
and palliative or wellness. However, T&CM a
adopts the concept of therapeutic and wellness
only only (Table 3.1).
The rapeutic conce pt refer s to hea ling, such as a
form of medicine or therapy that has the
capability to help in treating a disease or
disability. It is used for either physical and
mental health, which may be a drug, substance
or an activity that supports the healing of one's
mental or emotional health.
On the other hand, wellness concept refers to
modalities that assist in balancing positivehealth in an individual as exemplied by quality
of life and a sense of well-being.
Therapeutic Versus Wellness ConceptTreatment conceptType of practice
Therapeutic Wellness
Islamic Medical
Practice
Islamic Medical Practice
(Ruqyah)
Traditional Malay
Medicine
Herbal Medicine
Urut Melayu (Malay Massage)
Indigenous Massage
Bekam (Cupping)
Urut Melayu
(Malay Massage)
Indigenous Massage
Traditional
Chinese Medicine
Herbal Medicine
Acupuncture andMoxibustion
Tuinalogy
Cupping
Qi Gong
Tabl e 3 .1: Modal it ies in T&C M Pra ct ic es.
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The re are a number of modalities estab lished by
Malaysians which creatively infuses dierent
knowledge and techniques into a new,
combined form of therapy. Colour Vibration
The rapy and Aur a Metaphy sic are examp les of
home-grown modalities.
Home-grown ModalitiesTreatment conceptType of practice
Therapeutic Wellness
Traditional Indian
Medicine
Ayurveda
Siddha
Unani
Yoga
Homeopathy Homeopathy
Complementary
Medicine
Chiropractor
Naturopathy
Osteopathy
Nutritional therapy
Hypnotherapy
Psychotherapy
Therapeutic Massage
Spa Therapy
Reexology
Aromatherapy
Thai massage
Swedish massage
Balinese/Javanese massage
Shiatsu massage
Colour Vibration TherapyCrystal Healing
Reiki
Aura metaphysic
Raoha
Ozone Therapy
Chelation Therapy
Note: Please refer the Glossary, for description of each modality.
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The pr actitione r must exe rt pr ofe ssional ism at
all times especially during consultation sessions
with the client and should follow the rules and
regulations as stipulated in the Code of Ethicsand Conduct of T&CM Practitioners. Listed below
is a guide to what a practitioner is allowed and
not allowed to practice for a particular modality.
The Scope of Practice of T&CM Modalities
Permitted Practices Prohibited PracticesType of practice
Islamic Medical
Practice
Islamic Medical Practice
(Ruqyah)- Based on Al-Quran
Misuse of the Holy Quran (physically and
Quranic verses) Bedah batin (virtual surgery)
Use ofazimat(amulet), tangkal(talisman), susuk(charm needles)
Use of black magic
Traditional Malay
Medicine
Herbal Medicine Misuse of the Holy Quran (physically andQuranic verses)
Bedah batin (virtual surgery)
Use ofazimat(amulet), tangkal(talisman), susuk(charm needles)
Use of black magic
Traditional
Chinese Medicine
Urut Melayu(Malay Massage),Indigenous Massage
Tabl e 3.2 : Wh at is all owed or not a llo we d t o be pra cti ced for eac h T&CM modal ity. List
of permitted practices for each T&CM modality.
Bekam (Cupping) Bekam lintah (Leech Therapy)
Acupuncture using gadgets
TraditionalIndian Medicine
AyurvedaSiddhaUnaniYoga
Yoga cannot be practised by Muslim as it isprohibited by the religion (refer to Fatwa
Majlis Kebangsaan Bagi Hal Ehwal Ugama
Islam Malaysia Kali Ke-83)
Homeopathy Homeopathy
Acupuncture andMoxibustion
Herbal Medicine
Tuinalogy
Cupping
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All T&CM Practitoners are required to adhere to
guideline for ethical conduct, as outlined in the
Code of Ethics and Code of Practice for
Traditiona l and Complemen tar y MedicinePractitioners (Figure 3.1) at all times during the
provision of services to the public.
Figure 3.1: Code of Ethics & Code Of Practice for T&CM Practitioners.Note: Claims of treating acute conditions are prohibited
Permitted PracticesSubgroupType of practice
Complementary
Medicine
Manipulative therapy Chiropractic
Reexology
Osteopathy
Massage:
Therapeutic
Swedish
Thai
Balinese/Javanese
Shiatsu
Energy medicine Reiki
Aura metaphysics
Colour vibration therapy
Crystal healing
Bach ower
Raoha
Biological based Aromatherapy
Nutritional therapy
Mind-body therapy Hypnotherapy
Meditation
Psychotherapy
Others Chelation & Ozone Therapy is only for
practitioners with a medical degree(allopathic medicine)
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Chapter 4 EBP in Supporting Development of T&CM Practices
EBP Evidence-Based Practice
EBP is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual
patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research5.
Evolution of the denition:
EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient
care. Clinical expertise r efers to the clinician's c umulated experience, education and clinical skills. The patient brings to the encounter
his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant
research that has been conducted using sound methodology6.
Evidence-based Medicine
Evidence-based medicine (EBM)
is the conscientious, explicit and
judicious use of current best
evidence in making decisions
about the care of individual
patients
Evidence-based Healthcare
Evidence-based health care
(EBH) is the conscientious use of
current best evidence in making
decisions about the care of
groups of individuals or the
delivery of health services
Evidence-based Practice
Evidence-based practice (EBP) is
the application of such principles
across the broad field of health
care, including policy making,
education, practice management
and health economics
5Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS (1996) Evidence based medicine: what it is and what it isn't [Online]. US: BMJ Publishing Group Ltd. Retrieved from: http://www.bmj.com/content/312/7023/71.full [Accessed 1st February 2011].
6Anon. (2010) Introduction to Evidence-Based Practice [Online]. US: Duke University Medical Center Library and Jill Mayer University of North Carolina at Chapel Hill Health Sciences Library. Retrievedfrom: http://www.hsl.unc.edu/services/tutorials/ebm/index.htm [Accessed 1st February 2011].
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The evidence does not mak e a decision but it ca n hel p
to support the patient care process. Integration of these
three components into clinical decisions enhances the
opportunity for optimal clinical outcomes and patients
quality of life. The practice of EBP are usually attemps at
answering questions about the eects of therapy, utility
of diagnostic tests, prognosis of diseases, or the
etiology of disorders triggered by patient encounter.
Evidence-Based Practice requires a clinician to obtain
new skills such as ecient literature searching and
evaluation of the clinical literature by applying formal
rules of evidence.
Even though EBP has evolved over the years based on
allopathic medicine, there should be no barriers in
applying the process to T&CM practices.
Steps involved in the EBP Process
ASSESS
the patient
1. Start with the patient a clinical problem
or question that arises form care of thepatient
ASK
the question
1. Construct a well built clinical question
derived from the case
ACQUIRE
the evidence
3. Select the appropriate resource(s) and
conduct a search APPRAISE
APPRAISE
the evidence
4. Appraise that evidence for its validity
(closeness to the truth) and applicability
(usefulness in clinical practice)
APPLY:talk with thepatient
5. Return to the patient integrate thatevidence with clinical expertise, patient
preferences and apply it to practice
Self-
evaluation
6. Evaluate your performance with this
patient
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Use of EBP in Developing T&CM Guidelines
An immediate attraction of EBP is that it integrates medical
education and clinical practice. It has the potential of improving
continuity and uniformity of care through the common
approaches and guidelines developed by its practitioners. It
provides common framework for problem solving and helps
providers make use of limited resources by enabling them to
evaluate clinical eectiveness of treatments and services, whilst
eliminating unsound and unsafe practices.
Upon approval of the proposal to set up an Integrative Medical
Programme by the Malaysian Cabinet in January 2006, severalguidelines that are supported by EBP were developed to
support the T&CM services provided at selected government
hospitals. The Integrative Medical Programme aims to
incorporate selected T&CM practices into the mainstream
healthcare system, and the hospitals involved are termed as
Integrated Hospitals. Incorporating T&CM practices into the
mainstream healthcare system does not only achieve a holistic
approach towards enhancing health and improving quality oflife, but also enables the protection and preservation of
valuable traditional knowledge.
To suppor t the impleme ntati on of T&CM in the countr y, T&C M
Division produces two types of guidelines, aiming at two
dierent categories of practitioners;
At the time of publication of this book, T&CM Division has
published the following guidelines (Table 4.1a and 4.1b) which
have been used in integrating T&CM practices into the mainstream
healthcare system.
PracticeGuideline
For the use of practitioners in theIntegrated Hospitals
Good PracticeGuidelines
Consensus guidelines forpractitioners practicing in Malaysia
Tabl e 4. 1a: Gui de lin es dev elo ped by T &CM D iv is ion.27
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Old Publication (2007) Revised Publication (2009)
Developed Guidelines
(2007)
Reviewed Guidelines
Guideline on Herbal Therapy as an
Adjunct Treatment for Cancer
Standard Operating Procedures
for T&CM Unit
Standard Operating Procedures
for T&CM Unit
Gui deline on Malay Postnatal Care Guideli ne on Malay Massage Gui deli ne o n Malay Massage
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Work in progress is directed towardsthe following guidelines;
1. Practice Guideline on Shirodhara
2. Practice Guideline on Homeopathy
3. Practice Guideline on Chiropractic
4. Garis Panduan Pengubatan Islam (Practice
Guideline on Islamic Medical Practice)
Tabl e 4 .1b: Gui de lin es dev elo ped by T &CM Divis ion.
Old Publication (2007) Revised Publication (2009)
Reviewed Guidelines
Good Practice Guidelines (2010)
Guideline on Acupuncture Guideline on Acupuncture
Good Practice Guideline
on Malay Massage
Good Practice Guideline
on Acupuncture
Good Practice Guidelines (2011)
Good Practice Guideline
on Reexology
Garis Panduan Perkhidmatan Spa
(Spa Services Guideline)
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Chapter 5 Education & Training
Thr oug h colla borations between the T&C M Division with
various governmental agencies, several education and trainingprogrammes were developed for the various T&CM modalities.
The aim of the se pr ogramme s wer e to ens ur e tha t all T&C M
practitioners acquire standardised and internationally accepted
knowledge and skills through means of formal education to
ensure the delivery of T&CM servic es of the highest quality.
In Malaysia, the education pathway is compri sed of three higher
educational sectors, as outlined by the Malaysian Qualications
Framework (MQF) in Figure 5.1. They are the skills, vocational
and technical and academic (university) sector. Each sector is
supported by lifelong education pathways and is dierentiated
by learning outcomes, credit hours and student learning time.
In total, there are eight levels of qualications. Levels 1 to 3 are
Skills Certicates awarded by the Skills Sector. Academic and
Vocational and Technical Certicates are at Level 3. Meanwhile,
Diploma and Advanced Diploma are at Levels 4 and 5. BachelorDegree is at Level 6, Masters Degree at Level 7 and for the
Doctorates, Level 87.
T&C M Division classie s the level of education and training
programmes for each T&CM modality based on the therapeuticor wellness concept (as discussed in Chapter 3). Modalities that
fall under the therapeutic concept are to follow the academic
pathway whilst those in the wellness concept are to be obtained
through the certicate training programme (or the skills sector).
For the academic sector, thirteen standards and criterias for
diploma and bachelor degree have been developed to support
the provision of education programmes by both the public and
private centres of higher education. To date, seven bachelor
degree programmes and six programmes for diploma, as
outlined in Table 5.1, have been established and the courses are
presently being oered by the local institutions listed in Table
5.2.
In addition, the Malaysian Public Service Department has
recognised three universities from the Peoples Republic of
China to award the degree programmes listed in Table 5.3.
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Figure 5.1: Malaysian Qualifications Framework.
* Further information can be obtained from the Malaysian Qualications Agency (MQA) at www.mqa.gov.my.
Bachelor Educational Programme
Bachelor of Traditional Chinese Medicine (Acupuncture)
Bachelor of Traditional Chinese Medicine
Bachelor of Complementary Medicine (Natural Medicine)
Bachelor of Homeopathy
Bachelor of Malay Medicine
Bachelor of Ayurveda Medicine
Bachelor of Chiropractic
Diploma Training Programme
Diploma in Malay Massage
Diploma in Traditional Chinese Medicine (Acupuncture)
Diploma in Natural Medicine
Diploma in Aromatherapy
Diploma in Islamic Medicine
Diploma in Reflexology
Tabl e 5 .1: Bac hel or s a nd di plo ma educa tion al pro gr amm es de vel ope d by MQA.
The ed cational pr ogramme s be lo are pr esentl being pr o ided b the follo ing p bl ic and pr i ate ins ti t tions
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Source: Public Sector Department of Malaysia (http://pengiktirafan.jpa.gov.my)
Tabl e 5.3 : T&CM de gre e c ou rse s and uni ver si ties fro m Peop les Rep ubl ic of Ch ina whi ch are rec ognised by the Mal ays ian Pub lic Sec tor Dep ar tme nt .
Tabl e 5.2 : I nst itut ions pro viding T &CM cou rse s in Ma lay sia.
The educational pr ogramme s be low are pr esently being pr ovided by the follo wing publ ic and pr ivate ins ti tutions :
InstitutionsNo.
1. Southern College, Skudai University Foundation For Degree Programme (Traditional
Chinese Medicine)
Bachelor Degree of Traditional Chinese Medicine 4+1 incollaboration with Xiamen University, China
2. Tunku Abdul Rahman University (Sungai Long Campus) Bachelor of Traditional Chinese Medicine (Hons)
3. INTI International University College Bachelor of Traditional Chinese Medicine (Hons)
4. Cyberjaya University College of Medical Sciences (CUCMS) Bachelor of Homeopathy (Hons)
5. Management and Science University (MSU) Bachelor in Traditional Chinese Medicine (Hons)
Diploma in Traditional Chinese Medicine
6. International Medical University (IMU)
Bachelor of Science (Hons) Chinese Medicine Bachelor of Science (Hons) Chiropractic
7. Malacca College of Complementary Medicine Diploma in Natural Medicine
Courses Oered
To date , three univer sities fr om the Peo ples R epublic of China hav e been re cogni sed by the Pub lic Sect or Dep ar tme nt of Mal ays ia
to provide the following education programmes:
InstitutionsNo.
1. Beijing University of Chinese Medicine (BUCM) Bachelor of Chinese Medicine
2. Nanjing University of Chinese Medicine (NUCM) Bachelor of Chinese Medicine (Clinical Medicine)
3. Shanghai University of Traditional Chinese Medicine (SHUTCM) Bachelor of Medicine (Traditional Chinese Medicine)
Courses Oered
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Currently, T&CM Division together with the Ministry of Higher
Education and the Malaysian Accreditation Agency (MQA) have
introduced an Advanced Diploma for Urut Melayu as a Training
of Trainers programme. It is a one-o, one year programme at
the Sultan Salahuddin Abdul Aziz Shah Polytechnic, Shah Alam.
The rst batch o f students will be graduat ing in August 201 1.
In the skills sector, the standards and criteria for the issuance of
a skills certicate are dened in the National Occu pational Skills
Standard (NOSS). NOSS is a specication of the competencies
expected of a skilled wor ker, who wishes to gain employment in
Malaysia for an occupational area and level.
Development of NOSS involves the participation of industrial
experts from the Department of Skills Development (DSD),
under the auspices of the Ministry of Human Resources. NOSS is
used by DSD accredited training centres to oer skills training
for the specied modalities. Individuals who have completed
their training under the skills programme will be awarded the
Skills Certicate by DSD, which is a formal recognition to
individuals who has shown capabilities and competencies to
carry out the specied modality. These skills training
programme are being oered by the government in Malaysia,
and not by a Non-Governmental Organisation as practiced in
other countries.
As of 2010, six T&CM modalities have been developed under the
Malaysian Skills Qualications. This includes reexology,
aromatherapy, massage, manual lymph drainage, crystal
healing and spa. These NOSSs are part of the eort to promote
lifelong training and development, upgrading the competen-
cies and enhancing the competitiveness of Malaysians involved
in the industry. More Malaysian Skills Qualications will be
developed for T&CM modalities in the near future. More
information on NOSS can be obtained from the Department of
Skills Development at www.dsd.gov.my.
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Chapter 6 Research in T&CM
T&CM is curr ently consi dere d an im port ant component of the
healthcare system. Its co-existence with modern medicinecontributes towards enhancing the health and quality of life of
Malaysians. In support of the Malaysian National Policy on
T&CM, especiall y in ensuri ng the quali ty and saf e use of T&CM
products and practices, Research and Development (R&D)
Section was formalised in T&CM Division in August 2008.
The objectives of this section are:
1. To prioritise, encourage, facilitate and conduct research
on T&CM practices and products
2. To establish methods and technologies for quality
control, safety and ecacy of herbal medicines and
traditional remedies
3. To set up T&CM information database to support
information needs for healthcare providers, consumers,
manufacturers and other related agencies
The intr oduction of T&C M mod al it ie s in integ rated hospit als in
Malaysia opens the opportunity for more T&CM research in
clinical practice.
Current research eorts carried out by the R&D section focuses
on integrative medicine such as urut Melayu, acupuncture and
use of herbal medicine as an adjunct therapy in oncology.
Presently, the studies conducted uses case reports, surveys andqualitative techniques. Future studies will look into areas of
eectiveness of these modalities.
The T&C M R& D sect ion colla bora tes closely with the National
Institutes of Health (NIH), Ministry of Health in the conduct of its
research. This section participates actively in presentations at
scientic meetings and conferences.
The r st ar ticle on urut Melayu was published in the Journal ofAlternative and Complementary Medicine (JACM), November
2010 edition and more publications shall be pursued.
One of the activities to promote research on herbal medicines
was the annual workshops conducted in collaboration with the
National Conference for Clinical Research (NCCR). Currently,
eorts are being made for product development under the
National Key Economic Areas (NKEA) based on ve selected
herbs such as Tongkat Ali, Kacip Fatimah, Misai Kucing,
Hempedu Bumi and Dukung Anak. It is a crucial step to ensure
the availability of raw products as Malaysia strives to become
the leader in the production of nutraceuticals and botanical
drugs8.
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Another initiative by the Malaysian government in promoting
integrative medicine is through the development of a portal for
information sharing: Global Information Hub on Integrated
Medicine (GLOBINMED) at www.globinmed.com.
Apart from conducting researches, T&CM R&D section provides
consultation for interested parties to conduct researches on
T&CM modalities, in a bid to incr ease the availab il it y of
evidences, thus promoting evidence based practice.
For those interested to conduct research on T&CM in the
Ministry of Health institutions and facilities, the NIH Guidelines
for Conducting Research in the MOH Institutions and Facilities,
provides the guide and it can be downloaded from the NIHwebsite at www.nih.gov.my.
The gui deline re quir es:
1. Registration of all research that involves MOH personnel or
that is to be conducted in MOH facilities or to be funded by
MOH research grants
2. Review and approval of the research by a designated entity
to whom authority has been delegated for the purpose
3. Research involving human subjects requires prior review and
approval by the MOH Research and Ethics Committee (MREC)
4. Approval from the Director General of Health for all research
publications, whether in the form of research report, journal
article or conference proceeding, by the NIH initially and
thereafter by the Director General of MOH
Figure 6.1: GLOBINMEDs homepage
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A Qualitative Study On Urut Melayu The Traditional Malay Massage
8th Ministry of Health Malaysia Academy of Medicine of Malaysia Scientic Meeting 2009
Urut Melayu for Post-Stroke Patients: A Qualitative Study
Asia-Pacic Primary Care Research Conference 2009
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Chapter 7 Promotional, Enforcement & Public Education Activities
Promotional Activities
In order to increase consumer knowledge and awareness aboutT&C M serv ices in Malay sia, T&C M Division has condu ct ed
numerous promotional activities through road shows,
exhibitions and public talks, including television and radio talks
since the year 2007. These activities involve the participation of
various parties such as government agencies, practitioner
bodies and non-governmental organisations (NGOs).
Apart from that, the T&CM Division regularly organise ContinuingMedical Education (CME) and Continuing Professional Development
(CPD) activities for sta members of the Ministry of Health as well
as conferences, workshops and public forums for the general public.
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T& CMD B ull eti n Vol ume 1
(Sept Dec 2006)
T&C MD Bul let in Vo lum e 2
(Jan Jun 2007)
T& CMD Bul let in Vo lum e 3
(Jun Dec 2007)
T&C MD Bul let in Vo lum e 4
(2008)
T& CMD Bul let in Vo lum e 5
(Jan Jun 2009)
T&C MD Bul let in Vo lum e 6
(Jun Dec 2009)
T& CMD Bul let in Vo lum e 7
(Jan Jun 2010)
T&C MD Bul let in Vo lum e 8
(July Dec 2010)
During the course of these promotional activities, we have distributed various pamphlets, posters, books and bulletins to stimulate
public awareness towards the various typ es and benets of T&CM modalities.
Tabl e 7 .1 : T &CM Divis ion Bul let in s.
Tabl e 7 2: Pos ter s by T &CM Divis ion
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Traditional Malay Massage:
A Qualitative Study
Traditional Malay Massage for Post
Stroke Patients: A Qualitative Study
Haram Practices in
Trad it io nal Med ic in e
Services in T&CM Units in
Integrated Hospitals
T&C MD Ann ual Rep or t 2007 T& CMD An nua l R epo rt 2008 T&C MD Ann ual Rep or t 2009 T& CMD A nnu al Rep or t 2010
Tabl e 7. 2: Pos ter s by T &CM Divis ion.
Tabl e 7. 3: Ann ual Re por ts.
Table 7 4 : P amp hle ts
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Table 7.4 : P amp hle ts.
Traditional Malay Practices in Post Natal CareAcupuncture Traditional Malay Massage
Common Mistakes Found in the Practice of T&CMPhilosophy and Function of T&CMD
Promotion of T&CM Modalities
Public Education
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e-Pengamal Registration forTraditional & Complementary Medicine Practitioners
Guidelines Before SeekingTraditional & Complementary Services in Malaysia
8 Registered Practitioner BodiesIn Malaysia
Public Education
Inspection Activities
The Inspectorate and Enforceme nt Se ct ion (I&E) of T&CM
Division have successfully carried out enforcement activities
such as mapping and inspection of premises as well as
consumer/ public education throughout Malaysia. The I&E
section have collaborated with other governmental agencies
such as the Pharmacy Enforcement Division, Immigration
Department, Private Practice & Medical Control Section (CKAPS)
and City & Local Government Councils in carr ying out integrated
enforcement activities. In addition, I&E section also contri buted
to the development of the Traditional and Complementary
Medicine Bill which is planned to be tabled in the Parliament
late 2011. Once gazetted, surveillance of T&CM services in
strengthened will be strengthened whereby only qualied
T&CM pr acti tioners ar e eli gible to re giste r with the Ministry of
Health and be allowed to practice.
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Public Education
Consumer education is the best way to ensure public safety.
T&CM Division actively or gan ises consu mer edu cation activities
and publications that primarily educates the public on variousT&C M mod al it ie s, the impleme nta tion, safet y and ecacy of
T&C M serv ices in Malay sia as wel l the re quirement for
registration for all T&CM practitioners of traditional and
complementary medicine.
Some examples on the messages for the public are highlighted
below:
You might ask #2
I chanced upon an advertisement which featured a new
concept in alternative medicine (previously unheard of)
and was deemed capable of treating various diseases. Can
I believe this statement?
Our answer to you: Understand the newtreatment concept
Dear consumer, do not be deceived by new treatment
concepts with miraculous claims. All treatment types, be it
modern, traditional or complementary should be
supported with existing proles of quality, safety and
ecacy. Each treatment has to be subjected to a battery
of clinical trials over a period of time before it can be
safely introduced to the public. Do not try any of these
treatments if you are not condent of its safety and
eectiveness and check with the Ministry of Health if you
have any doubts.
You might ask #1
There are adver tisements that provide statements such as
scientically proven, proven eective, based on Western
technological advancement, acknowledged by the Ministry
of Health and many more. Are these statements for real?
Our answer to You: Questionable statements
and testimonials
Advertisements that provide statements such as scientically
proven, proven eective, based on Western technological
advancement, acknowledged by the Ministry of Health etc
should be conrmed before one places condence or believes in
a particular treatment. When in doubt, do not hesitate in seeking
advice from a doctor or a Ministry of Health representative.
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What should you do rst?
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1. Ask the practitioner for his valid certicate. Why?
Practicing certicates are issued by Practitioner Bodies appointed by the Ministry of Health
Malaysia. This certicate will indicate that the practitioner is qualied. Cant identify which
certicate is the genuine one? These are the logos of the currently appointed Practitioner
Bodies.
Federation of Chinese Physicians
& Acupuncturists
Association of Malaysia
(FCPAAM)
Pertubuhan
Perubatan Tradisional
India Malaysia
(PEPTIM)
Federation of Chinese Physicians
and Medicine-Dealers
Associations of Malaysia
(FCPMDAM)
The Federation of Complementary
& Natural Medicine
Association Malaysia
(FCNMAM)
Malaysian
Chinese Medical Association
(MCMA)
Persatuan Kebajikan
dan Pengubatan
Islam Darussyifa
Majlis Perubatan
Homeopathy Malaysia
(MPHM)
Gabungan Pertubuhan Pengamal
Perubatan Tradisional
Melayu Malaysia
(GAPERA)
1.
ra
Ma
cer
o
Fed
The
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2. Do nt be ea si ly in uen ced by the fron t title Dr. Why?
Besides the Doctor of Philosophy (PhD), only those registered with
the Malaysian Medical Council, under the Medical Act 1971, can
use the title Dr. Otherwise, it is ag ainst the Act. Do be alert on this
when you enter any traditional or complementary medicine centre.
3. Ask the practitioner whether he has been registered
with a Practitioner Body or the MOH. Why?
Registration with a Practitioner Body will conrm his qualication
to practice. Normally they will be given a practicing certicate by
the Practitioner Body. MOH has begun its registration on all
pra ct it ione rs si nc e Novem ber 2008 . To ch ec k, pl ease emai l us at
[email protected] call us at 03-26985077.
4. Ensure that the health products or herbal medicines
supplied are registered with MOH. Why?
In ou r mar k e t s u r v e y , 12% of T& CM p r ac t i t i one r s we r e f ou nd
supplying unregistered products to their customers. How do
y ou c he ck ? S im pl e, j us t l ook fo r t he pr odu c t re gi s tr at i on nu
mb e r ( e . g. : MAL 05051150TC) and t he Mi ni s t r y of He al t h
( MO H) hol ogr am s t i c k e r . S t i l l i n d ou b t ? Che c k onl i ne at
ht t p : //p or t al . b p f k. gov . my /pr od u c t _ s e ar ch. c f m
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5. If you are a woman, please do not be alone with any
T&CM male practitioners during treatment. Why?
There have been incidences of molestation, pederasty and rape
reported when women were found alone with T&CM male
pra cti ti oners .
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Glossary
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Glossary
Description of Traditional & Complementary Medicine Modalities
TYPE OF PRACTICE TYPE OF MODALITY
Islamic Medical Practice Islamic Medical The eort at seeking treatment for physical and spiritual ailments; done by a Muslim who is
Practice knowledgeable and skilled in treatment methods using Quranic verses, Hadith, the practices
of the pious and righteous scholars, and of the venerated religious teacher; and also skilled
with the use of methods or materials permitted by the Islamic law.
Traditional Malay Malay Herbs The herbs are used as a complement to various physical diseases/conditions or for wellness
Medicine based on Malay community beliefs
Urut Melayu Massage is the use of hands, or mechanical means, to manipulate the soft tissues of the body,
(Malay Massage) particularly muscle. It can be used for relaxation, stimulation or rehabilitation of the whole
body or part of it. It promotes suppleness of the muscle, improves circulation and reduces stress.
Bekam (Cupping) Bekam (cupping) is a form of traditional medicine practice found in many cultures worldwide.
It involves placing cups containing reduced air or pressure (creating suction or a relative
vacuum) on the skin. It is known in other languages as badkesh, bahnkes, nuhang, bantusa,
kuyukaku, gak hoi, hijamah and many other names.
Traditional Chinese Acupuncture & Technique of inserting and manipulating ne liform needles into specic points on the body
Medicine Moxibustion to relieve pain or for therapeutic purposes associated with or without moxibustion that
involves the burning of mugwort, a small, spongy herb, to facilitate healing.
Chinese Herbs The herbs are used as a complement to various physical diseases/conditions or for wellness
based on Chinese community beliefs and based on the Chinese Materia Medica.
DESCRIPTION
Spa Therapy The term spa is associated with water treatment which is also known as balneotherapy.
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Therapy for the promotion of water-based treatments which include body wraps, body
scrubs, baths, etc. Whose main services consist of water based applications.
Reexology Is the practice of massaging, squeezing, or pushing on parts of the feet, or sometimes the
hands and ears, with the goal of encouraging a benecial eect on other parts of the body, or
to improve general health and well being.
Thai Massage Incorporates elements of mindfulness, gentle rocking, deep stretching, and rhythmic
compression to create a singular healing experience
Swedish Massage Refers to a variety of techniques specically designed to relax muscles by applying pressure
to them, and rubbing in the same direction as the ow of blood returning to the heart.
Balinese/Javanese Positioned above the client, the Balinese/Javanese massage therapist performs a
Massage combination of kneading strokes, skin rolling, and foot massage. Treatment is followed by an
application of coconut oil infused with spices.
Shiatsu Massage Also known as acupressure massage. The therapist applies pressure with his thumbs, nger,
and palms to specic areas of the client's body that have been determined during an
assessment period prior to the massage session.
Aromatherapy Uses volatile liquid plant materials, known as essential oils (EOs), and other aromatic
Massage compounds from plants for the purpose of aecting a person's mood or health.
Aromatherapy massage combines the therapeutic benets of using essential oils with
Swedish massage techniques.
Colour Vibration Colour vibration therapy utilizes the aromatherapy concept as a nutrient for the brain/mind.
Therapy The aromatherapy - called 'Essential Nutrition' will calm those who inhale it. The white rose is
the most essential element in the aroma vibration oil.
Crystal Healing Crystal healing is the use of crystals to bring about healing and positive changes in the mind
and body
Complementary Medicine(Energy Medicine)Deals with energy eldsof two types: Veritable, which can be
measured Putative, which have
yet to be measured
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Homeopathy Homeopathy A system for treating disease based on the administration of minute doses of a drug that in
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massive amounts produces symptoms in healthy individuals similar to those of the disease
itself.
Nutritional A system of healing based on the belief that food provides the medicine we need to obtain
Therapy and maintain a state of health: our food is our medicine and our medicine is our food.
Naturopathy Emphasizes the body's intrinsic ability to heal and maintain itself. Natural remedies such as
herbs and foods are used.
Chelation Therapy Chelation therapy is an intravenous treatment designed to bind heavy metals in the body in
order to treat heavy metal toxicity. Proponents claim it also treats coronary artery disease and
other illnesses that may be linked to damage from free radicals (reactive molecules).
Ozone Therapy Ozone is known to eliminate microorganisms such as fungus, viruses, bacteria, etc. and also
helps oxidize toxins such as heavy metals, pesticides, hydrocarbons and other environmental
pollutants.
Chiropractic A health care approach that emphasises diagnosis, treatment and prevention of mechanical
disorders of the musculoskeletal system, especially the spine, under the hypothesis that
these disorders aect general health via the nervous system.
Osteopathy Treatment of the musculoskeletal system (bones, muscles and joints) facilitates the
recuperative powers of the body.
Therapeutic Therapeutic massage involves the manipulation of the soft tissue structures of the body to
Massage prevent and alleviate pain, discomfort, muscle spasm, and stress; and, to promote health and
wellness.
ComplementaryMedicine (Biologicalbased Practice)The domain includes,but is not limited to,botanicals, animal-derived extracts,vitamins, minerals, fattyacids, amino acids,proteins, prebiotics andprobiotics, whole diets,
and functional foods.
ComplementaryMedicine (Manipulativebased Practices)Focus on the structuresand systems of thebody, including thebones and joints, softtissues, circulatory andlymphatic systems.
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Reiki The belief is that the energy will ow through the practitioner's hands whenever the hands
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are placed on, or held near a potential recipient, who can be clothed
Aura Metaphysic The combination of three parts of knowledge which is Aura, Meta, and Physic. Aura is a wave
energy or bioelectromagnetic frequency while meta is something that crosses the
expectations and physics means natural or nature. Thus, combination of these can be
dened as a philosophy or knowledge of unusual or unexpected natural law that exist in ourlife
Roaha Therapy for optimize the oxygenation of cell via alkaline water through detoxication and
increase body immunity
Bach Flower They gently restore the balance between mind and body by casting out negative emotions,
such as, fear, worry, hatred and indecision which interfere with the equilibrium of the being
as a whole.
The Remedies allow peace and happiness to return to the suerer so that the body is free to
heal itself
Phytobiophysics Utilization of the innite energy of owers and plants to harmonize and balance the
disturbances of humanity on all levels of consciousness: Spiritual, Mental, Emotional and
Physical
Hypnotherapy Often applied in order to modify a subject's behaviour, emotional content, and attitudes, as
well as a wide range of conditions including dysfunctional habits, anxiety, stress-related
illness, pain management, and personal development.
Psychotherapy Intentional interpersonal relationship used by trained psychotherapists to aid a client in
problems of living.
Aims to increase the individual's sense of well-being and reduce their subjective sense of
discomfort.
Complementary Medicine(Mind Body Soul Therapy)Focuses on theinteractions among thebrain, mind, body, andbehaviour, and on thepowerful ways in whichemotional, mental,
social, spiritual, andbehavioural factors candirectly aect health.
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Editorial Committee
INTERNAL REVIEWER
DR. RAMLI ABD GHANI
MR. JAAFAR LASSA
EXTERNAL REVIEWER
PROF. DR. SYED MOHSIN SAHIL JAMALULLAIL
PROF. DR. ABD RASHID ABD RAHMAN
DR. ZAKIAH ISMAIL
ADVISOR
DATO DR. MAIMUNAH BT A. HAMID
CHIEF EDITOR
DR. SHAMSAINI SHAMSUDDIN
EDITORS
DR. AIDATUL AZURA ABD RANI
DR. MARIA SAFURA MOHAMAD
DR. NUR HIDAYATI ABDUL HALIM
MR. MOHD HADI MOHD ZIN
MDM. WONG WEI CHYI
MDM. ASMIRAH MD REDZUAN
MDM. NUR HAZIRAH KAMARUDIN
MS. NG ANGELINE
Copyright 2011 Ministry of Health Malaysia
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Copyright 2011, Ministry of Health Malaysia.
All rights reserved. No part of this book may be reproduced,
stored, or transmitted in any form or by any means, electronic
or otherwise, including photocopying, recording, internet
or any storage and retrieval system without prior writtenpermission from the publisher.
Published by:
Traditional and Complementary Medicine Division
Ministry of Health Malaysia
ISBN 978-967-10715-0-2
Designed by GNG Signature Sdn Bhd
Printed by Pencetakan Alfa Gemilang Sdn Bhd
Notes
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Notes
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Traditional and Complementary Medicine DivisionMinistry of Health, Malaysia
Block E, Cenderasari Road,50590 Kuala LumpurTel: 603 2698 5077Fax: 603 2691 1259
Email: [email protected]: http://tcm.moh.gov.my