Traditional Medicine Program of the Philippines

Josephine Carnate, MD, MPH

Topic Outline:

1. Introduction: Definition of terms

2. CAM forms

3. Reasons for use of TM/CAM

4. Issues in TM/CAM

5. The Philippine Traditional Medicine Program

Introduction

Primary health care principles– Equity/bias for the poor– Focus on prevention– Multi-sectoral approach– Community participation– Appropriate technology

Introduction

Primary health care principles– Appropriate technology

Scientifically sound Can be adapted Acceptable Affordable

ComplementaryAlternativeTraditional Medicine

Introduction

ComplementaryAlternativeTraditional Medicine

Primary health care elements/activities• Education• Locally- endemic disease control• Expanded program on immunization• Maternal and child health • Essential drugs• Nutrition• Treatment of common diseases• Safe water and sanitation

Complementary and Alternative Medicine Complementary and Alternative Medicine (CAM)(CAM)

“is a group of diverse medical and health systems, practices, and products that are not presently considered as part of conventional medicine.”

-National Center for Complementary and Alternative Medicine, NIH, US

Definition of Terms

Definition of Terms

Conventional MedicineConventional Medicine

“Medicine practiced by holders of MD degreesand allied health professionals (physical

therapists, psychologists, registered nurses),DO degrees.”

-National Center for Complementary and Alternative Medicine, NIH, US

Allopathy, Western, mainstream, orthodox, regular, biomedicine, scientific

Definition of Terms

Complementary and Alternative Medicine Complementary and Alternative Medicine (CAM)(CAM)

Complementary Medicine - used together withAlternative Medicine - used in place of

-National Center for Complementary and Alternative Medicine, NIH, US

Traditional Medicine (TM)Traditional Medicine (TM)“is the sum total of knowledge, skills and practices on holistic health care which is recognized and accepted by the community for its role in the maintenance of health and treatment of diseases. It is based on the theory, belief and experiences that are indigenous to the different cultures, and that is developed and handed down from generation to generation.”

-World Health Organization

Definition of Terms

Traditional and Alternative Health Care Traditional and Alternative Health Care (TAHC)(TAHC)

“is the sum total of knowledge, skills and practices on health care other than those embodied in biomedicine, used in the prevention, diagnosis and elimination of physical or mental disorders.”

-Traditional and Alternative Medicine Act, Philippines

Definition of Terms

Traditional and Alternative Health Care Traditional and Alternative Health Care (TAHC)(TAHC)

Traditional Medicine- the sum total of knowledge, skills and practices on health care not necessarily explicable in the context of modern, scientific framework, but recognized by the people to help maintain and improve health towards the wholeness of their being, the community and society, and other interrelations based on culture, history, heritage and consciousness.

-Traditional and Alternative Medicine Act

Definition of Terms

Traditional and Alternative Health Care Traditional and Alternative Health Care (TAHC)(TAHC)

Alternative Medicine- other forms of non-allopathic, occasionally non-indigenous or imported healing methods, though not necessarily practiced for centuries, nor handed down from one generation to another.

-Traditional and Alternative Medicine Act

Definition of Terms

Definition of Terms

Integrative MedicineIntegrative Medicine

“combines mainstream medical therapies and CAM therapies for which there is some high- quality evidence of safety and effectiveness.”

-National Center for Complementary

and Alternative Medicine, NIH, US

Forms of CAM

1.1. Alternative Medical SystemsAlternative Medical Systems

2.2. Mind-Body InterventionsMind-Body Interventions

3.3. Biologically-based TherapiesBiologically-based Therapies

4.4. Manipulative and Body-based MethodsManipulative and Body-based Methods

5.5. Energy TherapiesEnergy Therapies

Forms of CAM

1.1. Alternative Medical SystemsAlternative Medical Systems• Have complete systems of theory and practice• Evolved apart from and earlier than

conventional medicine

Alternative Medical Systems:Alternative Medical Systems:Traditional Chinese Medicine

Alternative Medical Systems:Alternative Medical Systems:Ayurveda

Alternative Medical Alternative Medical Systems:Systems:

HomeopathyNaturopathy

Forms of CAM

2. Mind- Body Interventions2. Mind- Body Interventions• Enhance the mind’s capacity to affect bodily

functions and symptoms

Mind- Body Interventions:Mind- Body Interventions:MeditationHypnosisPrayer healingDance/Music/Art Therapies

Forms of CAM

3. Biologically-based Therapies3. Biologically-based Therapies• Use of substances found in nature

Biologically-based Therapies:Biologically-based Therapies:Herbal therapiesSpecial dietsMegavitaminsIndividual biological therapies

Forms of CAM

4. Manipulative and Body-based Methods4. Manipulative and Body-based Methods• Manipulation and/or movement of one or more

parts of the body

Manipulative and Body-based Manipulative and Body-based Therapies:Therapies:

MassageChiropractic

Forms of CAM

5. Energy Therapies5. Energy Therapies• Bioelectromagnetic-based therapies• Biofield therapies

Energy Therapies:Energy Therapies:QigongReikiTherapeutic TouchMagnetic Therapy

Reasons for the use of TM/CAM

48.5%

90.0%

60.0%

49.0%

60.0%

69.0%

57.3%

45.0%

50.0%

Australia

China

Hong Kong

Japan

Nauru

Republic of Korea

Philippines

Singapore

Vietnam

Percentage of population using Traditional Medicine, selected countries in the Western Pacific Region, 2001 (source:WHO-WPRO)

Reasons for the use of TM/CAM

1. Effectiveness

2. Affordability

3. Accessibility: geographical, cultural

4. Safety

5. Use of natural materials and the holistic approach

Issues in the use of TM/CAM

1. Issues raised by practitioners of conventional medicine

1.1 Efficacy

1.2 Safety

1.3 Delay in seeking conventional treatment

1.4 Danger can be increased when used as complement to conventional

medicine

Issues in the use of TM/CAM

2. World Health Organization (2001, WPRO Regional Meeting)

2.1 Need for evidence- based approach

2.2 Need to establish appropriate standards

2.3 Need to protect and conserve indigenous health resources

2.4 Need for political support

Issues in the use of T/CAM

2. World Health Organization (2001, WPRO Regional Meeting)

2.4 Need for political support

Integrated Part of mainstream health services

SupportedNot a part of mainstream health services Government recognition of TM roleGovernment efforts to bring into mainstream

Recognized Government announces TM potential role

Neglected Only conventional medicine is recognized

1992 Administrative Order No. 12 Administrative Order No. 12

Traditional Medicine Program

Traditional Medicine Program“Promote and advocate TM nationwide”

1997 Republic Act No. 8423 Republic Act No. 8423 Traditional and Alternative Medicine ActPhilippine Institute of Traditional and Alternative Health Care (PITAHC)

Traditional Medicine Program

Objectives:Objectives:1. Encourage scientific research

2. Promote and advocate use

3. Coordinate skills training courses

4. Formulate standards, guidelines and codes of ethical practice

5. Formulate policies for protection

6. Formulate policies to strengthen the role of TAHC

7. Promote TAHC

Traditional Medicine Program

PRACTICE:PRACTICE:1. TAHC accepted in the Philippines:

1.1 Indigenous/folk medicine

1.2 Massage therapy

1.3 Acupuncture

1.4 Use of herbal medicine

Common name Scientific name Indication

1. Akapulko Cassia alata Fungal infections

2. Ampalaya Momordica charantia Diabetes mellitus

3. Bawang Allium sativum Hypercholesterolemia

4. Bayabas Psidium guajava Antiseptic

5. Lagundi Vitex negundo Anti-asthma

6. Niyug-niyugan Quisqualis indica Anti-helminthic

7. Sambong Blumea balsamica Anti-urolithiasis

8. Tsaang-gubat Ehretia microphylla Intestinal motility

9. Ulasimang bato Peperomia pellucida Hyperuricemia

10.Yerba buena Mentha cordifolia Body pains

Traditional Medicine Program

PRACTICE:PRACTICE:2. Other modalities being studied:

2.1 Chelation

2.2 Homeopathy

2.3 Chiropractic

2.4 Nutritional healing

2.5 Colonics

2.6 Hydrotherapy

Traditional Medicine Program

RESEARCH:RESEARCH:1. Clinical trials for ampalaya

2. Bibliography of indigenous healing practices

3. Screening for medicinal plants3.1 Tinospora crispa

3.2 Lagerstroemia speciosa

3.3 Centella asiatica

3.4 Euphorbia hirta

3.5 Cyperus rotundus

Traditional Medicine Program

EDUCATION:EDUCATION:1. Training/seminar series on the various

TAHC modalities

2. Library

3. Website

4. Bibliography of indigenous healing practices

5. Integration of TAHC in the Health Sciences Curricula, 2002