Traditional Health Systems and Public Policy

194 Pages·2007·7.65 MB·Spanish

Traclitional
Health Systems
and Public Policy
Proceedings of an
International Workshop,
Ottawa, Canada,
2-4 March 1994
Eclited by
Anwar Islam and
Rosina Wiltshire
Traditional
Health Systems
and Public Policy
Proceedings of an
International Workshop,
Ottawa, Canada, 2-4 March 1994
Edited by
Anwar Islam and
Rosina Wiltshire
INTERNATIONAL DEVELOPMENT RESEARCH CENTRE
Ottawa • Cairo • Dakar • Johannesburg • Montevideo • Nairobi • New Delhi • Singapore
Published by the International Development Research Centre
PO Box 8500, Ottawa, ON, Canada K1 G 3H9
November 1994
Islam, A.
Wiltshire, R.
Traditional Health Systems and Public Policy : proceedings of an international workshop, Ottawa,
Canada, 2-4 March 1994. Ottawa, ON, IDRC, 1994. 192 p.
fîraditional medicine/, /primary health care/, /indigenous knowledge/, /health programmes/, /health
policy/ , /developing countries/ - / gender/ , /cultural factors/, /policy ma king/ , / research needs/, /case
studies/, /conference reports/ , bibliographies.
UDC: 615.89 ISBN: 0-88936-751-5
A microfiche edition is available.
Material contained in this report is produced as submitted and has not been subjected to peer review or
editing by IDRC Public Information Program staff. Unless otherwise stated, copyright for material in this
report is held by the authors. Mention of a proprietary name does not constitute endorsement of the
product and is given only for information.
CONTENTS
FOREWORD ............................................... V
WORKSHOP REPORT
Preamble .............................................. 1
Goals and Objectives . . . . . . . . ·. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Session 1: Workshop Opening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Session 2: Traditional Health Systems - Issues and Concerns ............. 6
Session 3: Health Systems - Traditional/Western Dichotomy ............. 10
Session 4: Gender and Indigenous Knowledge Issues .................. 15
Session 5: Traditional Health Systems in Different Cultures . . . . . . . . . . . . . . 19
Session 6: Research and Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Session 7: Future Directions ................................. 29
Summary and Conclusions .................................. 31
TRADITIONAL HEALTH SYSTEMS - ISSUES AND CONCERNS
Law and Traditional Medicine in Kenya . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Anhur Okoth-Owiro
Traditional Knowledge and Gender: the Caribbean Experience . . . . . . . . . . . . 58
Jeanette Bell
Models of Health Care Pluralism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
David E. Young
Understanding Traditional Health Care Systems:
A Sociological Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Anwar Islam
HEALTH SYSTEMS - TRADffiONAL/WESTERN DICHOTOMY
Tradtional Health Systems and the Conventional System in Uganda ......... 86
S. Amooti-Kyomya
Developmental Therapeutics Program at the Division of
Cancer Treatment: A Short Description . . . . . . . . . . . . . . . . . . . . . . 91
Gordon M. Craig
Traditional Health Care and Public Policy: Recent Trend ............... 96
Gerard C. Bodekar
GENDER AND INDIGENOUS KNOWLEDGE ISSUES
Traditional Health Systems: Challenges in the Philippines . . . . . . . . . . . . . . 110
Ma. Chona L. Segismundo
lV
TRADffiONAL HEALTH SYSTEMS IN DIFFERENT CULTURES
Ayurveda - Fundamentally Based on the Study of Substances . . . . . . . . . . . 115
P.K. Warrier
The Unani System and Traditional Health Systems in Bangladesh . . . . . . . . . 121
Hakim Azizul Islam
The Indigenous Health System of the Peruvian Amazon . . . . . . . . . . . . . . . 129
Juan Reategui S.
RESEARCH AND POLICY
Traditional Health Systems and Primary Health Care . . . . . . . . . . . . . . . . . 131
Vanaja Ramprasad
WHO's Policy and Activities on Traditional Medicine . . . . . . . . . . . . . . . . 139
Xiaorui Zhang
Traditional Health Systems: National Policy Issues and Directions . . . . . . . . . 143
Hakim Mohammed Said
Quranic Concepts for Eliminating Negative Emotions: Another Aspect
of the Healing Effect of the Quran . . . . . . . . . . . . . . . . . . . . . . . . 148
Ahmed Elkadi
Traditional Health Services in the Middle East: Spiritual Aspects
of Healing and their Scientific Bases . . . . . . . . . . . . . . . . . . . . . . . 168
Ahmed Elkadi
LIST OF PARTICIPANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
FOREWORD
We wish to thank ail of our collaborating partners, the First Nations, World Council of
Indigenous Peoples, National Institute of Health and the National Museum of Health and
Medicine for their invaluable role in making this International Workshop on Traditional Health
Systems and Public Policy a success. The cooperation and support of IDRC President, Dr Keith
Bezanson, Director General of Health Sciences Division, Dr Maureen Law, Director General,
Corporate Affairs and Initiatives Division, Mr Pierre Beemans and Director of Special Initiatives
Programme, Mr Chris Smart, contributed in no small way to the success of this initiative. A
special thanks must also go to ail the IDRC Divisional partners who assisted conceptually,
administratively and financially in bringing the workshop to fruition.
This workshop generated wide interest, a high calibre of participants from ail parts of the world
and excellent presentations, honesty of exchange and important research and policy
recommendations. AU of these were evidence both of the growing importance of traditional
health systems globally, and the work put in by our international and local collaborators.
There were important gaps and challenges which presented themselves to the planners from the
design phase. Sorne of these were reinforced during the deliberations and emerged in
recommendations. The most fundamental of the challenges was the divergence in philosophy,
values and attitudes which underpinned premises about health and medicine and approaches to
traditional and western health systems. These differences informed basic concepts, methoclologies
and policy prescriptions. This was evident even where the articulated goals of greater recognition
of traditional health systems and collaboration seemed to be the same.
It was also clear that there is a major gap in traditional health research and policy in
identification and analysis of implications of the impact of gender on practice, knowledge and
its transmission, research priorities and policy. This workshop made a small step in informing
the analysis and integration of gender and traditional health systems and this needs to be built
upon.
We thank ail the participants and participating institutions who came from international agencies
including WHO and PAHO, health practitioners and researchers from North and South,
traditional and western for sharing their expertise in a spirit of mutual respect and common
search for solutions.
Vl
Traditional health systems are used by 80 percent of the world's population, most of them in the
South, but with increasing numbers in the North. Changes in values, the recurrence of diseases,
which until recently had been considered eliminated by modern medicine, the emergence of new
plagues, for which modern medicine has not found an answer are all influencing this shift. This
use of the traditional systems is most often combined with the use of western health systems.
Research and policy are grappling with this reality and the need for greater sharing. This
workshop, out of which emerged several regional workshops, represented an important milestone
in the process of change and the search for healthy societies and balanced and sustainable health
systems.
Anwar Islam, Ph.D Rosina Wiltshire, Ph.D
Health Sciences Division Corporate Affairs and Initiatives Division
WORSKHOP REPORT
PREAMBLE
This international Workshop on Traditional Health Systems (THS) and Public Policy was
coordinated, within IDRC, by the Health Sciences Division and the Gender and Suat.ainable
Development Unit of the Corporate Affairs and Initiatives Division. It was the outcome of a
series of activities on issues and concerns related to indigenous knowledge, health and medicine,
carried out by several international organizations and agencies. One of these activities was the
Winnipeg Workshop on Indigenous Peoples and Health held in April, 1993. On behalf of the
Pan American Health Organization (PAHO), it was organized by the Canadian Society for
International Health (CSIH) in cooperation with numerous Native organizations. The Winnipeg
Workshop emphasized the need for further exploring various issues related to traditional
medicine prevalent among indigenous communities in the Ameri.cas. Following the Winnipeg
Workshop, a two-day planning session was held at the PAHO office in Washington D.C. in
August, 1993 aimed at exploring the issues of traditional health systems and developing strategy
for future action. Along with others, this planning session was attended by representatives from
IDRC, PAHO, and the National Institutes of Health, Office of Alternative Medicine. In that
meeting, the idea was put forward of the need for a series of regional conferences on traditional
health systems which would culminate with an international conference to bring forward
resolutions and recommendations for action at the national and international levels.
Following further discussions, it was decided that IDRC would host an inaugural workshop in
Ottawa to bring together all interested parties along with a representative sample of traditional
health practitioners from around the world to identify research and policy issues, and problems
and prospects of indigenous health systems. In pursuant of that decision, an inter-divisional
organizing committee was formed at the IDRC in collaboration with other partners to plan for
the Ottawa workshop. Four Divisions of the Centre -Health Sciences Division (HSD), Corporate
Affairs and Initiatives Division (CAID), Information Sciences and Systems Division (ISSD), and
the Environment and Natural Resources Division (ENR) - were represented in the committee.
It also included representatives from the World Council of Indigenous Peoples (WCIP) and the
Native Physician's Association of Canada (NPAC).
The workshop was organized by the HSD and CAID; and was held at the Centre in Ottawa from
March 2 to 4, 1994 in collaboration with (a) the Office of Alternative Medicine, National
Institutes of Health, b) Washington based National Museum of Health and Medicine, c) the
Canadian Native Physician's Association, and d) the World Council of Indigenous Peoples.
Delegates from various Canadian and International Organizations, a number of indigenous
delegates from Canada and Latin America attended the workshop. A total of 60 participants of
varied background including traditional health practitioners, healers, medical doctors,
researchers, policy makers, and administrators from various parts of the world were present.
GOALS AND OBJECTIVES
The goal of this workshop was to bring together organizations, agencies, and individuals from
all over the world who were involved in practising, promoting and implementing programs, and
conducting research on indigenous knowledge, health and medicines; and to discuss the various
aspects of traditional health systems aimed at achieving the following objectives:
1. to promote a greater understanding and awareness about the complexity and
diversity of traditional health systems in different cultures;
2. to explore the relationship between indigenous knowledge, gender and traditional
health systems;
3. to examine the history, evolution and conceptual foundations of some of the major
traditional health systems and identify and debate the tensions between various
systems of health care;
4. to identify, discuss and debate both promising and problematic policy approaches
with respect to the role of traditional health systems in the mainstream of national
health care systems;
5. to identify and discuss priority research areas
pertaining to traditional health systems; and
6. to provide a forum for traditional health practitioners, policy makers, researchers,
and representatives of international agencies to identify and discuss public policy
issues pertaining to traditional health systems, and develop strategies to address
those issues.
Session 1
WORKSHOP OPENING
The inaugural session was chaired by Dr. Maureen Law, the Director General of the Health
Sciences Division of IDRC. Drawing from her rich experience in international health as a
member of various committees of the World Health Organization and the chairperson of the
Board of Governors of the International Centre for Diarrhoeal Disease Research, Bangladesh,
Dr. Maureen Law emphasized the need for this timely dialogue on traditional health systems.
In the true spirit of the Workshop, it started with a Native prayer that included a ceremonial
"healing circle".
The inner philosophy of the Native prayer was invigorating as it traced the history of the First
Nation's quest for a resurgence of its healing systems. It recalled a Native prophecy that
envisaged that their "way of life would change", and that Natives would enter into a period of
ill health as they get disconnected from their traditional ways. The prophecy, nevertheless, is
firm on the belief that the First Nations will again emerge from that period of ill health, and
reconnect with their traditional knowledge and share that knowledge with people of all other
races. This sharing of knowledge, we were emphatically told, is essential to bring peace and
harmony in this planet and allow us to co-exist with all other forms of life and creations.
Needless to say the prayer expressed the desire to see such sharing of wisdom at this workshop
for the betterment of health for all.
Following the prayer ceremony, Dr. Keith Bezanson, the President of IDRC, welcomed all the
delegates and expressed his "great pleasure to see IDRC, in particular the Health Sciences
Division and the Corporate Affairs and Initiatives Division, playing such an important role in
arranging this international workshop in collaborating with man y of our Canadian and American
organizations". The President remarked, "1 am enthusiastic about the wealth of knowledge and
the diversity of professional expertise and interest that are represented at this workshop. The
diversity of resource people assembled here from all over the world makes me feel proud to be
your host. 1 am confident that this richness of knowledge, wisdom and experience will make the
workshop a success".
"Although since the beginning of the century, especially since 1950s our health care has
increasingly been focused on interventions and heavily dependent of changing technology, people
in developing countries and our own indigenous population remained loyal to what we call
"traditional" health system. Quite often, health researchers and policy makers pay little attention
to the multiplicity of "other" indigenous health services that are available in various parts of the
world".