No sugar coating, just tea please
The medical profession in the Arab and Islamic worlds is looking beyond the narrow scope of pills and injections onto the wider horizons of alternative medicine. Amira El-Noshokaty considers the options
Traditional therapy has kept millions healthy, almost, for centuries and gave birth to modern medicine as we know it. More than an act of magnanimity, of child recognising parent, the belated admission of the value of conventional medicines was created out of tangible fact. For years now, patients in terminal ailments, and those with pain disorders or rare diseases, have found comfort and solace in natural herbs and therapeutic methods that modern medicine is just beginning to comprehend.
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Vendors of herbs and spices in Khan Al-Khalili are gaining popularity as people turn to their goods for alternative medicine
The first steps are being taken, and one was the medical seminar held 12-15 October in Cairo. The International Seminar on the Integration of Traditional Medicine into Modern Medicine was sponsored by the Islamic Organisation For Medical Sciences in Kuwait, IOMS; the World Health Organisation, East Mediterranean Regional Office, WHO EMRO; and the Islamic Organisation For Education, Science and Culture, ISESCO.
For decades now, the medical establishment was content with its growing array of sugar coated pills and dull brown bottles, which often, but not always, helped. Alternative medicine, meanwhile, is affordable and, in certain cases, more efficient. According to the WHO, traditional medicine is widely used in both developing and developed countries. Up to 80 per cent of the population in Africa depend on conventional therapeutic methods. And, in Germany, 77 per cent of the pain clinics provide acupuncture treatment.
According to WHO's Strategy for Traditional Medicine: Review of the Global Situation and Strategy Implementation in the Eastern Mediterranean Region, the comprehensive term "traditional medicine" (TM) refers both to traditional medicine systems, such as traditional Chinese medicine, Indian Ayurveda medicine, Unani medicine and to the various forms of indigenous medicine. In countries where the dominant health care system is based on modern "Western" medicine or where traditional medicine has not been incorporated into the national health care system, traditional medicine is often termed "complementary", "alternative" or "non-conventional" medicine (CAM).
The traditional medication involves the use of herbal medicines, animal parts and minerals. Traditional non-medication involves various techniques, primarily without the use of medication. They include for example, acupuncture and related techniques, chiropractic, osteopathy, manual therapies, Qigong, tai ji, yoga and other physical, mental, spiritual and mind-body therapies. The techniques it uses are as often as not esoteric (acupuncture, Qigong), and -- to make matters more intricate -- the therapists often allude to the need for balance between mind and body, even between soul and the universe. No wonder the medical profession, for most of its illustrious and short past, was sceptical. It was only in the past three or four decades that doctors came to admit that some of their patients, having found no solace in modern methods, have actually improved by taking off to the rice fields of Asia and trying something different.
Recognising the need to understand alternative medicine, the experts who met recently in Cairo recommended that an inventory of available medicinal plants be compiled and made available to medical practitioners. The timely concession does not mean that modern medicine is losing heart or totally changing tack. "Less than 5 per cent of patients use CAM, on its own. More than 95 per cent use it integrated with modern medicine," says Gerard Bodeker, who teaches traditional medicine at Oxford.
The experts agree that a composite approach to therapy may actually help many patients. In the Cairo conference, they called on Muslim countries to follow the example of medically advanced societies and recognise alternative medicine as a parallel, or auxiliary, therapeutic system. Some of these countries have already done so.
Kuwait's Islamic Organisation for Medical Sciences (IOMS), was created in 1984. It is active in researching and applying alternative therapy, says Ahmad El-Guindi, who heads one of its research centres. "We get 15,000 patients annually. But we are not disease-oriented. We are more interested in the healing process. We see our patient in a comprehensive light. One of the patients was suffering from asthma and it turned out he had asthma because of a psychological reason. He suffered from involuntary urination and was ashamed of it," he told Al-Ahram Weekly. The IOMS has so far registered 97 medical plants.
Iran is another country trying its hand at alternative medicines. "Now there are laws and clinics for the practicing of acupuncture and herbal medicine. There are even modern hospitals where hegamma [a traditional therapy involving controlled head bleeding] is practiced by qualified physicians," says Ali Haaeiri who works for the Pasteur Institute in Iran. He points out that Iranian doctors are also using anti-urino lythiases (AUL), made from natural herbal substances, for flushing out kidney stones.
According to Hisham Lutfi, member of the Malaysian Association for Acupuncture, it is important that the medical profession benefit from complementary medicine, for it is cheap, effective and safe. According to US statistics, of the 2 million patients who go through surgery, 250,000 die annually. This means that intrusive medicine may not always be as safe as commonly thought, says Lutfi, whose association is active in promoting alternative therapy.
Alternative and complementary methods is gaining international momentum. So far, 25 of the 191 WHO member states have developed national TM/CAM policies and more than 70 countries have established regulations for the use of herbal medicine. Egypt is not among the 25 countries mentioned. Yet, alternative medicine is becoming more acceptable than before.
The Complimentary Medicine Unit, CMU, was created at Cairo University's Faculty of Medicine in May 2000 with the aim of exchanging information on alternative medicine with Asian-based institutes (Korea's Yong Yang University and University of Complimentary and Alternative Medicine and China's Academy of Traditional Chinese Medicine). CMU chief Ali Bayyoumi, who is also professor of internal medicine at Cairo university says that the alternative medicines are more than 200 remedies. "Some of these are clinically applicable. Some are just philosophical [inspired by] the belief and customs of different people ...Our main aim at the CMU is to introduce and promote knowledge about the complimentary medicine to both public and medical professionals. This unit is for education and research, for doctors, and [its topics of research are] not yet included in the medical education programme for undergraduates. We grant 11 courses, national and international." The courses were all based on guidelines of clinical research in acupuncture, issued by WHO Western Pacific office in 1995.
Acupuncture is a key method of alternative healing, but is widely misunderstood. Most practitioners tend to use it for weight reduction purposes, but originally it is a holistic approach aiming to create balance of body, mind, and environment. "The emphasis should be on the entire person rather than on a specific malaise," says Bayyoumi. Acupuncture is based on basic knowledge about the human body. Certain pathways run through the human body, each having detectable points on the skin, with each point reflecting certain functions. Through these reaction points, experienced therapists can detect and alleviate certain medical problems.
A patient may come to you suffering from shortness of breath, and you need to ascertain the somatic and psychological process involved. If you succeed, Bayyoumi says, you will be able to help him better. This is where acupuncture comes in handy. Traditional therapy is particularly called upon in cases where conventional methods have failed, he adds.
There is no magic wand, apparently, on either side of the medical divide. Complementary medicine is just as painstaking as conventional methods are. It requires trained practitioners with exceptional skills and integrity. "The pain could be a cry for help," says pain relief consultant Samira Naguib. "One has to know when to relieve the pain and when to see through the significance of that pain, the physical illness that it may signify. Pain in the left shoulder could be an indication of a heart problem. This is where the pain specialist should pause and think." The therapists should decide whether the pain is a temporary malfunction, due to overwork or distress, or a more durable one, such as a tumour."
Naguib, who is the first Egyptian woman doctor to study alternative medicine in Japan, says that 80 per cent of health problems involve both body and mind. Commonly used comments like haraqt dammi, or "you burnt my blood," are not wide off the mark. Certain substances in the blood stream, some having the same effect as narcotics, are susceptible to mood swings. Distress could induce somatic symptoms, perhaps even blood clots, which could trigger serious medical problems. Naguib's clinic takes care of patients in constant pain, cases that modern medicine failed to alleviate. Her task is to design the course of therapy that best suits the patients' needs. Some can now be referred to a newly established acupuncture unit at the Assiut University, close to her clinic.
The latest addition to the scene of alternative medicine appeared in Lebanon last month. The Arab Organisation For Complimentary Medicine, AOCM, boasts members of Kuwait, Egypt, Saudi Arabia and Syria, as well as Lebanon -- the host country. "Our aim is to raise the awareness of complimentary medicine in a scientific form and publish its regulations and codes, so as to flush out impostors," says AOCM chief Nabil Mawsuf, who teaches pain treatment at Cairo University.
The conference had a word of advise to Islamic countries. They should protect their traditional medicine from commercial exploitation, particularly in view of the legal wrangling that may result from TRIPS, the agreement on trade-related aspects of intellectual rights property. Egyptian pharmaceutical companies are hopefully listening. If they don't patent their natural health drugs fast, someone else might.
" I believe that all chemical medications must have side effects, once you take a pill for your back problems, it would cause you a stomach ulcer," said Ghada Habashi, information specialist at the American Embassy in Cairo. Habashi believes that we are all part of one world and it is normal to seek medication from nature. "Alternative medicine is a family heritage that has been passed on to us through my Grandma who lived in Sudan for a long while as my grandpa worked for the British railways establishment in Sudan at the beginning of the 20th century. She learnt from the locals all forms of alternative medicine to treat her children in case they catch a disease. This form of medicine saved my mother for while she was an infant she caught pneumonia and could not breathe. My grandma used a mixture of herbs that did the job. Out of personal experience, in high-school, I once suffered a temporary kidney failure that resulted from taking sulpha to which I was allergic. My mother made me drink a mixture of herbs that did the trick. There was a time when I had acute bronchitis where coughing just did not stop for more than 10 days despite using all sorts of antibiotics. My aunt suggested that I spread red alcohol all over my body and cover it with newspapers, my cough disappeared over night. But the problem with alternative medicine is that except for the elders, no one could really tell the difference between the usage of leban dakar (a type of chewing-gum) and guava leaves in accordance to different types of coughing. The only thing I have to complain about is that alternative medicine does not necessarily taste good."