THE ROLE OF TRADITIONAL MEDICINE IN PRIMARY HEALTH CARE

Abstract. The global interest in natural therapies and traditional healing modalities has surged, leading to a widespread adoption of herbal medicines for treating various diseases. The incorporation of traditional medicine into healthcare systems presents a promising opportunity to address health conditions that modern medicine may struggle to treat, even amidst possible economic constraints and limited resources.

Keywords: Traditional medicine, modern medicine, herbal remedies.

Introduction

The World Health Organization (WHO) defines traditional medicine as the knowledge and practices based on cultural beliefs and experiences, used for maintaining health and treating illnesses. Complementary medicine is a broad set of healthcare practices not part of a country's tradition or conventional medicine. Herbal medicinal products are a primary source of healthcare in developing countries. [researchgate, 2019] India has a rich traditional system of medicine, such as Ayurveda and Unani, which mainly use herbs. [Chaughule & Barve, 2023] There is a growing interest in natural products for developing modern drugs and dietary supplements worldwide. Kazakhstan has many economically valuable plants used for medicinal purposes, animal forage, and the food industry, making phytotherapy popular and complementing traditional therapy. [Gemejiyeva & Ludmila Grudzinskaya, 2018] I chose this topic because I observed how elderly people used folk remedies, such as fats of animals, to children with high fever when medications prescribed in the hospital did not help. I believe that both traditional and modern remedies are necessary, with folk methods being useful for mild diseases or when expensive drugs are not affordable, and modern medicine being essential for severe illnesses like cancer or diabetes.

Context

There is a growing interest in natural therapies and self-care, leading to an increase in the popularity of traditional healing modalities. Studies have shown that herbal medicines are commonly used for treating various diseases in different regions, such as hypertension, type II diabetes, infertility, and osteoporosis. In the Kingdom of Saudi Arabia, traditional herbal medicine is widely utilized, with more than 25 plants being used for treatment. Furthermore, the usage rate of traditional herbal medicine in KSA is reported to be as high as 69.9%. [Abdelmola et al., 2021] The acceptance and interest in herbal remedies are not limited to specific regions but are expanding rapidly worldwide, with natural products being used for the development of modern drugs and dietary supplements. This trend indicates a high level of confidence in the safety and efficacy of traditional herbal medicines.  [Chaughule & Barve, 2023)] So, the growing global dependence on traditional herbal remedies signifies a notable move towards holistic healthcare practices, indicating a strong belief in the efficacy and safety of natural treatments.

Traditional and complementary medicine has been a longstanding and essential health resource in households and communities throughout history. 170 countries have reported on the utilization of traditional medicine, with acupuncture emerging as the predominant form of practice in 113 countries. Developed nations are increasingly acknowledging and incorporating traditional medicine into their healthcare systems. [World Health Organization, 2023] Research has indicated that individuals from diverse cultural backgrounds may possess varying levels of understanding regarding various disease treatments. Disparities in access to healthcare information and services across cultures can result in differences in awareness and utilization of treatment options. [World Health Organization, 2021]  For instance, traditional Chinese medicine is prevalent in China and other East Asian regions, while Ayurveda is commonly embraced in India, but these practices may not be as widely recognized or accepted in Western societies. [Patwardhan et al., 2005]  In essence, these findings suggest that individuals' awareness of different disease treatments can be shaped by their cultural heritage, beliefs, and access to healthcare resources.

Traditional medicine has the potential to treat diseases that modern medicine may struggle to cure. Recent research has indicated that traditional medicine's holistic approach and emphasis on natural remedies can provide unique treatment options for specific conditions that modern medicine finds challenging to address. [Muralidas et al., 2023] A 2020 meta-analysis in the Journal of Ethnopharmacology explored the effectiveness of traditional Chinese medicine in managing various diseases, revealing promising outcomes in chronic pain, gastrointestinal disorders, and mental health issues where modern medicine may have limitations. [Yang et al., 2021] Governments may face the economic consequences of introducing traditional medicine into health systems. One of the challenges is the cost of integrating traditional medicine methods, such as training practitioners, conducting research on traditional remedies, and ensuring quality control and safety standards. [Park et al., 2022] This can have a negative impact on already limited health budgets and resources. Despite this, the potential of traditional medicine to offer alternative solutions to treat diseases that modern medicine may not be able to completely eliminate underscores its value in healthcare. Therefore incorporating traditional medicine into healthcare systems offers a hopeful opportunity to tackle difficult health conditions that modern medicine may find challenging to treat, even in the face of possible economic constraints and limited resources.

The incorporation of traditional medicine into contemporary healthcare systems presents difficulties stemming from environmental and technological issues. The environmental consequences of gathering traditional medicinal plants and animal products can give rise to ethical and sustainability dilemmas. [Chen et al., 2016] Additionally, the absence of technological progress in traditional medicine methods may restrict their efficiency and safety in today's society. [Ministry of Science and Technology of the People’s Republic of China, n.d.] WHO has conducted research emphasizing the environmental impact of collecting medicinal plants for traditional medicine, expressing concerns about overexploitation, habitat destruction, and biodiversity loss. [Asigbaase et al., 2023] Furthermore, a report by the United Nations Development Programme (UNDP) highlights the deficiency of modern technology and scientific validation in traditional medicine practices, impeding their acceptance and integration into modern healthcare systems. [FUTURE of KNOWLEDGE a FORESIGHT REPORT, n.d.] The obstacles associated with integrating traditional medicine into contemporary settings are complex, involving environmental and technological elements. Overcoming these challenges will necessitate a balanced strategy that supports environmental sustainability and enhances the safety and effectiveness of traditional medicine practices through technological advancements. So, successfully integrating traditional medicine into modern healthcare systems necessitates a well-rounded strategy that considers environmental sustainability, technological progress, and ethical factors to improve the safety and efficacy of these practices.

Aims

The purpose of the research project was to find out whether traditional medicine can be trusted to treat certain diseases. The aim was to find out how well NIS students know about the using of traditional medicine in treatment and what they think about its necessity. This includes their attitude towards changing opinions about the use of folk remedies.

Therefore in this research the main research questions were:

• What factors contribute to the rising popularity of herbal medicines?
• What kind of medicine people prefer more?
• Is the safety of traditional medicine unquestionably guaranteed?
• What is the probability that implementation of traditional medicine into primary healthcare will be effective?

The results of the study were designed to identify the reasons why popularity of traditional medicine is growing.

Methodology

I will gather quantitative data by conducting a survey. Survey is the collection of information from a sample of individuals through their responses to the questions. The survey, which will include questions about familiarity and frequency of herbal medicine use, will target both NIS students and residents of Taldykorgan. I will conduct the survey online. I aim to identify for what reasons people use traditional medicine more frequently, assess awareness levels, and understand the role of herbal medicine across individuals.

I plan to gather qualitative data through an interview with the dietary supplements seller and the acupuncturist. Anonymous supplements seller has year experience in selling vitamins and other products that improve the health from Republic of Korea. Anonymous acupuncturist graduated from medical university, took special courses several times and worked as an acupuncturist for  several years. Currently, the person does not practice acupuncture. An interview is a conversation for gathering information. The interview will cover topics such as safety, experiences with traditional medicine, and the individual's attitudes towards it within their medical specialty. Conducting an interview enables me to ask follow-up questions for more detailed insights, request additional information for clarification, and benefit from the expertise of someone with direct experience in the subject area of my study.

Results

RQ1. What factors contribute to the rising popularity of herbal medicines?

Based on the results of a survey involving 50 participants, three main reasons for the increasing demand for traditional medicine have been identified. The highest number of votes, at 26%, went to the response “Herbal remedies and treatments are readily available and easy to use”. A majority of 25% of respondents agreed that medical services are expensive. 22% chose the option “There is no desire to take chemicals”. The least supported statement, with only 4% agreement, was “Medicine is not developing”. [Image  8] Regarding the question of which illnesses prompt participants to use traditional medicine, the predominant response was “Cold and flu”. Other options such as gastritis, allergies, depression and anxiety disorders garnered similar average percentages. [Image 9] Some people answered “Other” and explained their answers in the following open question, out of 5 people, 80% identified  “Stress”, which can be included in the option “Depression and anxiety disorders”. [Image 10]

RQ2. What kind of medicine people prefer more?

The importance of modern medicine was rated highly by 84% of participants, giving an average importance score of 4.74 on a scale of 1 to 5. [Image 3] Regarding the significance of traditional medicine, the majority - 42% rated traditional medicine with the highest score of 5 points. The average importance score for traditional medicine was calculated at 3.88. [Image 4] Participants' average attitudes towards the integration of traditional medicine methods into primary healthcare was calculated at 3.82. [Image 5] More than half - 52% of the survey participants reported using some traditional medicine methods, while 24% did not use them. [Image 6] Those who affirmed their use of traditional medicine methods highlighted common practices such as herbal remedies, using sheep fat, massages, and acupuncture. [Image 7] Based on responses to a question about preference between modern and traditional medicine,  68% of participants favored modern medicine due to advanced technologies, greater opportunities, and reliability. Meanwhile, 18% opted for traditional medicine because of its accessibility, long-standing existence, and perceived effectiveness compared to antibiotics. A small percentage - 8% believed in the effectiveness of both methods. [Image 11]

RQ3. Is the safety of traditional medicine unquestionably guaranteed?

Both the dietary supplements seller and the acupuncturist agree that traditional medicine can be safe for patients when used appropriately and under proper supervision. The dietary supplements seller emphasizes the importance of consulting with healthcare professionals before incorporating traditional medicine into one's healthcare routine to ensure safety and efficacy. Factors such as the quality and purity of herbs, individual patient characteristics, proper dosing, and potential interactions with other medications play a crucial role in determining the safety of traditional medicine. [Image 15] The accupuncturist also highlights the safety of traditional medicine when practiced by trained professionals. [Image 22] Acupuncture, in particular, has been used for thousands of years with minimal side effects when administered by qualified practitioners. Open communication with healthcare providers is essential to ensure the safe and effective use of traditional remedies. The practitioner stresses the importance of conducting a thorough assessment of each patient's health status and needs before recommending any traditional treatments to guarantee safety. [Image 21]

RQ4. What is the probability that implementation of traditional medicine into primary healthcare will be effective?

While challenges exist in integrating traditional medicine into primary healthcare, collaboration among traditional healers, healthcare providers, and researchers can help bridge the gap between traditional and modern medicine. By working together to address issues such as standardized training and regulation there is a potential for effective implementation of traditional medicine into primary healthcare. [Image 18] The dietary supplements seller supposes the challenges related to the lack of scientific evidence, standardized protocols, and dosing guidelines for traditional remedies. [Image 17] Despite these obstacles, the seller believes in the value of incorporating natural remedies to provide patients with a personalized approach to health. [Image 18] Similarly, the acupuncturist acknowledges the challenges posed by the absence of standardized protocols and scientific evidences. [Image 24] However, the acupuncturist thinks that for the integration of traditional medicine into modern treatment approaches to offer patients a comprehensive approach to health and well-being. [Image 25]

Discussion

One of the main problems is the lack of confidence in the honesty of the answers in the survey, since some people could answer the questions fast without paying attention to the details. Also, as the majority of the survey participants were teenagers, this did not give an accurate understanding of which options older people would choose. To continue my work, I would take a live survey on sheets of paper, since in this way people would pay attention to each question. Also, it is important to take answers 50% of teenagers and 50% of adults.

The research about the integration of traditional medicine into modern healthcare systems has significantly influenced my personal perspective on healthcare and holistic healing practices. The research findings have highlighted the potential of traditional medicine to address challenging health conditions that modern medicine may struggle to treat effectively. I have also come to understand that successfully integrating traditional medicine into modern healthcare systems requires a comprehensive approach that considers environmental sustainability, technological advancements, and ethical considerations.

The next step for research would be to conduct a comprehensive study on the use of traditional medicine methods in the treatment of diseases by specialists from different countries. The goal of this future research would be to determine the effectiveness and potential benefits of combining traditional medicine with modern medicine in the treatment of various diseases.

The next step for me to continue this project in Kazakhstan would be to establish collaborations with universities that have a faculty of medicine. By partnering with these institutions, I can explore the benefits of herbal medicine and its compatibility with modern medical practices. This collaboration will help me to gather valuable insights and data to further research and potentially develop new treatment approaches that combine traditional and modern medicine.

Conclusion

The rise in demand for herbal medicines is attributed to several factors based on a survey of 50 participants. The reasons identified include the easy availability and user-friendliness of herbal remedies (26%), high costs of medical services (25%), and a preference for natural ingredients over chemicals (22%). These conclusions were drawn by analyzing responses from Image 8, which highlighted participants' reasons for choosing traditional medicine. Additionally, common illnesses prompting the use of traditional medicine were identified, with "Cold and flu" being the most prevalent choice among respondents, followed by gastritis, allergies, and mental health issues like depression and anxiety disorders. The data from Images 9 and 10 further support the trend towards utilizing traditional medicine for various health concerns.
According to the survey data, 68% of participants prefer modern medicine for its advanced technologies and reliability, while 18% opt for traditional medicine due to accessibility and perceived effectiveness. Only 8% believe in the effectiveness of both methods. These conclusions were drawn by analyzing responses from Image 11, showing preferences for different types of medicine based on reasons provided by participants.

According to both the dietary supplements seller and the acupuncturist, traditional medicine can be safe when used correctly and supervised. Consulting healthcare professionals before incorporating traditional medicine is crucial for safety and effectiveness. Factors like herb quality, individual characteristics, dosing, and interactions with medications determine safety. Trained professionals ensure safety in practices like acupuncture, known for minimal side effects over centuries. Open communication with healthcare providers and thorough patient assessments are vital for safe traditional medicine use.

The probability of effectively integrating traditional medicine into primary healthcare is promising with collaboration among healers, healthcare providers, and researchers. Challenges like standardized training and regulation must be addressed. The dietary supplements seller highlights the need for scientific evidence and dosing guidelines, while the acupuncturist emphasizes the value of a comprehensive health approach despite challenges.

The worldwide increase in natural therapies and traditional healing practices, as seen through the growing popularity of herbal medicines, indicates a move towards comprehensive healthcare. Growing trust in the safety and effectiveness of traditional remedies is pushing for their inclusion in healthcare systems globally. The significant role of traditional and complementary medicine in promoting health and well-being highlights the importance of building cultural connections and improving access to treatments. While traditional medicine holds promise for treating complex conditions, its incorporation presents challenges related to economics, the environment, and technology. Overcoming these obstacles through sustainable methods, technological progress, and ethical considerations can blend traditional medicine with modern healthcare, enhancing patient care and treatment choices.