What are complementary and alternative medicines?
Complementary and alternative medicine (CAM) uses manual techniques, exercises, spiritual therapies, and medications derived from plants, animals, and minerals, either alone or in combination, to treat, diagnose, and prevent disease or to promote and preserve health.
CAM refers to the therapeutic and diagnostic fields that are primarily found outside of the settings where conventional medical treatment is offered.
On a global scale, there has been an unparalleled rise in interest in these medicinal delivery methods. One estimate has the proportion of people who still rely on complementary and alternative medicine in the developing world at 80%, compared to CAM usage in affluent nations at roughly 50%.
The reasons for including complementary and alternative medicine in primary healthcare
The reasons are numerous and a few of them are mentioned below:
- The healers are familiar with the sociocultural backgrounds of the people.
- They are revered and skilled in their field.
- There is a lack of modern healthcare professionals.
- Economic considerations; the distances to be traveled in some countries.
- The strength of traditional beliefs.
- Other reasons for consulting a CAM healer are the proximity, affordable fee, availability of the provider, family pressure, and the strong opinion of the community.
Evidence-based complementary and alternative medicine therapies have had amazing success in treating both acute and chronic illnesses. Different complementary and alternative medicine (CAM) treatments are firmly thought to work and heal by having an impact on the immune system of the body.
Utilizing health services depends on health-seeking behavior, which in turn is influenced by several factors, including physical, economical, cultural, and political considerations. In rural locations, cultural behaviors and beliefs frequently encourage the use of home remedies or self-care as well as consultations with traditional or CAM healers. These circumstances, which are more prevalent not only for their health but especially for illnesses affecting children, might occasionally cause a delay in seeking care.
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All cultures also commonly use CAM to treat women’s gynecological issues. These cultural customs and beliefs are widespread independent of age, family socioeconomic situation, and educational attainment. Additionally, traditional healers draw in more clients than contemporary allopathic doctors due to their cooperation, empathy, and active listening skills.
Pakistan’s situation for complementary and alternative Medicine
More than half (66%) of Pakistan’s population resides in the country’s rural areas. Health indicators have been significantly impacted by poverty, which is further exacerbated by illiteracy, low status for women, and poor water and sanitation facilities. The main obstacles have been a lack of understanding of health and disease, cultural and domestic remedies, misconceptions about a health service and its provider, social hurdles, and the cost of providing an effective health service.
The public and private sectors make up Pakistan’s healthcare system’s two primary sections. Due to flaws such as an inadequate emphasis on prevention and promotion of health, excessive management centralization, political interference, a lack of openness, inadequate human resource development, a lack of integration, and a lack of a public health policy. There are many uncontrolled hospitals, medical general practitioners, homeopaths, Hakeem, traditional/spiritual healers, Unani (Greco-Arab) healers, herbalists, bonesetters, and quacks in the private sector but relatively few accredited outlets and hospitals.
The type of disease symptoms and the length of the illness are important factors in determining health-seeking behavior and provider preference. Home remedies or traditional medicines are utilized for a mild single symptom, like a fever, but a professional health provider is more likely to be sought if there are many symptoms and prolonged sickness. People who have faith in spiritual healers, clergy, Hakeem, homeopaths, or even numerous quacks have used alternative remedies. For issues like infertility, epilepsy, psychosomatic issues, depression, etc., these are the first line of defense.
Other factors for seeking the advice of a CAM healer include proximity, an inexpensive charge, the provider’s availability, familial pressure, and the positive perception of the community. According to the literature, patients who use both allopathic and complementary medications concurrently are hesitant to tell their allopathic doctor that they also take complementary medicines. The danger of problems from combining allopathic and alternative medicine is increased by this communication barrier.
Prospects of complementary and alternative medicine
The market for herbal, “Unani,” or Greco-Arab medicine is expanding globally. Herbal products currently generate stunning annual sales of over US$40 billion worldwide. Based mostly on the Unani school of medicine, which dates back to the Indus valley civilization, Pakistan has a highly rich legacy in the use of medicinal plants for the treatment of various illnesses. Particularly in the nation’s rural and tribal regions, the traditional medicine sector has grown to be a significant provider of health care. Northern Pakistan’s moderate weather and subtropical woodlands are home to the majority of medicinal plants. Particularly in rural areas, between 70 and 80 percent of the populace consumes CAM.
The Unani system has been approved and incorporated into the public health system along with other CAM practices like homeopathy and Ayurveda.
Only Pakistan has officially recognized Unani teaching establishments in the eastern Mediterranean region. In terms of CAM regulation, there has been a lot of policy movement. In addition to non-government and private sector activities, the Pakistani government has put in place a variety of organizations and programs to bolster and coordinate various areas of the sector. The sector must, however, be better coordinated at the national level under a strategic plan to spur research and development.
There are 45000 traditional healers, and roughly 35% of them work in rural regions. For Pakistan’s majority of rural residents, the availability of these practitioners in rural regions may be seen as a source of health care delivery. About 52 600 licenced Unani doctors are working in both the public and private sectors, in both urban and rural locations. Under the supervision of the health departments of provincial governments, some 360 Tibb dispensaries and clinics offer free medication to the general people.
Types of complementary and alternative medicine
Here are some types of CAM.
1) Conventional complementary medicine
This category covers therapies that are more widely used and approved, like acupuncture, homeopathy, and Oriental therapies. These treatments have been used for millennia throughout the world. Alternative traditional medicine includes:
- Oriental or Chinese medicine
2) Body touch
Since the beginning of medical treatment, touch has been used in medicine. The concept behind healing by touch is that an injury or illness in one region of the body can impact all other sections of the body. The body can fully concentrate on mending at the site of injury or illness if the other parts can be manually adjusted back to their ideal state of health. Techniques for the body and mind are frequently combined. Body therapies include, for instance:
- Osteopathic and chiropractic medicine
- Therapy includes body movement
- Yoga Tai chi
3) External power
Some individuals think that a person’s health is directly impacted by outside energies coming from objects or other sources. External energy therapy uses include:
- Electromagnetic therapy
Even mainstream or standard medicine understands the importance of the mind-body link. According to studies, those who are in good emotional and mental health recover more quickly. Mental therapies could consist of:
Some individuals think that the sensations of touch, vision, hearing, smell, and taste might have an impact on general health. Following are some instances of therapy using the senses:
- Dance, music, and art
- Directed imagery and visualization
Limitations of complementary and alternative medicine
Similar to what occurs in any other region of the world, the relationship between the traditional allopathic physician and the CAM practitioner is one of competition and hostility. Traditional medicine has never been supported by orthodox medicine, thus these techniques are fiercely condemned by limiting access to them, decrying them as antiscientific, and punishing those who engage in them. Lack of education, training, regulation and the body of research on CAM practitioners are a few understandable reasons for this rejection.
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Additionally, a lack of accountability in the contemporary and complementary medical professions leads to unskilled quacks practicing medicine under multiple names, giving CAM practitioners a terrible reputation and eroding public confidence in them. The allopathic medical system is a British colonial legacy in terms of political economy that continues to have an impact on the nation’s whole healthcare system. With this elite-backed system, there is an established rivalry between the practitioners of the two systems as well as a mindset that the indigenous systems are inferior.
The minimal information that is now available implies that doctors may properly approve of some complementary and alternative medicine treatments while disapproving of others. Pakistan’s National Health Policy just briefly discusses a proposal to alter the current Tibb law to recognize post-graduate education, but it is unclear how the policy would be integrated or developed. Other policy documents have some gaps regarding profit sharing, intellectual property rights, herbal product registration, and other relevant laws.
The CAM therapies now in use have not been properly investigated, and the majority of the available data come from outdated papers. Additionally, indigenous people are untrained in gathering and preserving medicinal herbs, endangering their long-term viability. Indigenous knowledge of the classification and application of therapeutic herbs is rapidly disappearing.
The possibility of extinction and deforestation is also concerning because of the daily loss of forestland brought on by droughts and water shortages.
To share evidence-based information, it is necessary to integrate CAM and current systems. Giving all CAM healers the required education, access to facilities and support for referrals is necessary to integrate them into the mainstream in light of the people’s tendency to seek health, particularly in developing nations. It is necessary to take advantage of the beneficial interplay between the two systems to further our shared objective of enhancing public health.