Integrating Health

When dealing with the term “medicine,” there is no single definition, static through space and time.  Many of the world’s medImageical systems illustrate diverging, sometimes opposing, stories of health and healing, and each culture invariably believes in its own medicine.

Unfortunately, our globalized world has been slow to recognize the medicine of the “other.”  Last month the Prince of Wales was dismayed by delay tactics of the government in creating a register of healthcare practitioners that would include alternative, complementary, and holistic professionals alongside their biomedical counterparts. On the heels of widening usage of complementary healthcare, Prince Charles has advocated regulation and evaluation of alternative routes to health beyond those readily sanctioned by the state. However, the plan set out two years ago to create a more inclusive register of healthcare services has yet to be implemented. Such a register would ensure regulation of herbal, Chinese, and other alternative medical practitioners that would elevate both safety and access.

Reluctance to include alternative medicine in standard healthcare evaluation compromises the safety of patients. Similar problems with regulation have been found in the herbal supplement industry, where a lack of oversight has resulted in false advertising of ingredients, and occasionally the addition of harmful substances.

Recently, researchers published a study about the benefits of Chinese medical treatments in preventing diabetes. The findings in The Journal of Clinical Endocrinology & Metabolism showed that the herbal mixture Tianqi lowers the risk of developing Type 2 diabetes among individuals with damaged glucose tolerance. Medicine like Tianqi may represent logical alternatives or additions to pharmaceutical treatments, and it is research and regulation that will allow patients to benefit.

There are models of integrated medical treatment already in place, and we can learn much from the long road that converging medical systems took to reach this meeting point. In Bolivia, many patients initially avoided the primary healthcare clinics that arrived asserting biomedicine’s authority on all matters of well-being (see Joseph Bastien’s book Drum and Stethoscope: Integrating Ethnomedicine and Biomedicine in Bolivia). Those who did visit the alien doctors described the treatments as ineffective, and for all intents and purposes the patients did not improve. Thus biomedicine was dethroned in rural Bolivia.

There is a cultural component to this phenomenon. At first, a pre-natal tetanus vaccination campaign failed completely when the foreign doctors and nurses brandished their vaccines and claimed panacea. The local and indigenous communities had ideas as concrete as the biomedical gospel of the doctors—they believed the primary cause of tetanus to be malignant spirits and not microscopic pathogens. Furthermore, mistrust abounded as healers and shamans questioned the purpose of such “vaccines.” It appeared as though the doctors were stealing precious “fat” with these contraptions, “fat”embodying a source of life and health for people in this region. Nobody imagined that the primary health clinics would fail, but as the doctors distanced themselves further and further from the people, insisting on the infallibility of their views and the archaic beliefs of the villagers, the doctors and their sterile, white lab coats were alienated entirely.

It was not until later, when the doctors engaged a dialogue with local healers and shamans, hiring them as equals in the health clinics, that more and more infants lived past the first few weeks of life. Today many Bolivian health clinics host biomedical doctors and nurses, community healers, herbalists, and even shamans in a network of healthcare support that caters to the individual, instead of the preferences of the few who create the healthcare guidelines. The results have been impressive, boasting overall improvement in community health. Health is complex set of physical, psychological, and cultural processes, and therefore, the efficacy of treatment is not based solely on cut and dry pathology but also personal background, beliefs, and attitudes toward the healthcare itself.

How does this relate outside Bolivia? The integration of complementary and biomedical approaches to healthcare can produce optimal results in patient health. The individual comes from a wide variety of experiences and world views, all of which influence response to treatment and consultation. Moreover, there are methods from diverse medical systems that are gaining widespread acceptance.

Through regulation of all of these different options for safety and efficacy, healthcare can be more than a mass product—a finely tailored treatment, fitting like a glove around every inflammation and concern. Perhaps it is time to clear away the delay tactics and move toward the formation of a healthcare system that heals the individual, not the system.

By Natalia Magnani

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