Traditional, Complementary and Alternative Medicine
اسلاید 1: www.tabaye.ir
اسلاید 2: Traditional, Complementary and Alternative Medicine Barry Kistnasamy
اسلاید 3: Emerging TechnologiesTodayTomorrow
اسلاید 4: belongs to the trash bin has no role or place in health care given its lack of a “scientific base’’ has some therapeutic possibilitiesI think that TCAM …
اسلاید 5: 2,56 trillion $ is spent on health globally 0.4% of this is spent in AfricaClose on 80% of the world’s HIV+ people live in Africa 0.4% Africa
اسلاید 6: TCAM spendingChina – 30% to 50% of medicinal consumptionJapanese per capita consumption of herbal medicine highest in world1400 herbal drugs in EUZAR250m on traditional healers$27b in USA
اسلاید 7: FinancingMainly out of pocket In kindFew Medical Aids
اسلاید 8: South Africa’s Quadruple BurdenNatural & Non-natural disastersResidual of Infectious DiseasesEmerging New EpidemicsEpidemiological Transition
اسلاید 9: Trends …International migrationUrbanisationIndustrialisation‘bacteria move just as fast as capital’
اسلاید 10: The Human Balance35000 doctors150 000 nurses 200 000 traditional healers“co-existence versus integration”
اسلاید 11: The Supply ChainplanningHealthproductionEducationmanagementHealth
اسلاید 12: The Regulatory FrameworkAllied HPCHealthSAQA /CHEEducation? SAMMDRAHealthTraditional HC
اسلاید 13: TCAM ResearchInstitute for Traditional Medicines (CSIR, MRC & WHO)Indigenous Knowledge SystemsNational Research FoundationUniversitiesUseful Plants Garden - Kirstenbosch Ethno veterinary practiceRef: Moorman & Pick, 1998
اسلاید 14: DistributionEzinyangeni - the place of healers - Mai Mai: muti capital of Joburg
اسلاید 15: DistributionSangomas normally detect two kinds of bad luckOne is inflicted through witchcraft, usually by a jealous rival, the other is caused by unhappy ancestors. It is here that patients are counseled to slaughter a beast to appease and rekindle relations with the ancestors. Sangomas diagnose and prescribeInyangas generally heal, although they can also prescribe, depending on the nature of the problem or whether their ancestors give them the power to help a patient
اسلاید 16: PrescriptionBMJ 2001;322:164-167 ( 20 January ) Once the muti is obtained, it can be taken in various ways, depending on its form and nature. While some muti is just good for washing with, smearing on ones body, or for burning and inhaling, other muti is designed for elaborate uses like ukuphalaza (regurgitating), ukuchatha (applying by means of an enema), or nokugquma (steaming).
اسلاید 17: PrescriptionIsende lehashi (horse penis) Zamafufunyane (for nightmares and hysteria), Owobusoka (guaranteed to improve the romantic fortunes of a bachelor), Zikatokoloshe (to ward off an imaginary evil goblin said to spread terror at night)
اسلاید 18: Zimbabwe healer moots magic chastity potion
اسلاید 19: Ayurvedic PreparationsBronchial asthma, ischaemic heart disease and hyperlipidaemia Curcumin - rheumatoid arthritisAcute viral hepatitisPterocarpus marsupium effective in reducing levels of blood glucose and glycosylated haemoglobin in patients with non-insulin-dependent diabetes mellitusFistula-in-ano patients were randomised to surgery or application of medicated thread (Ksharsootra). Surgical treatment led to a faster cure but recurrence rates were lower with medicated thread.
اسلاید 20: Traditional Chinese Systems of MedicineHerbal remedies, acupuncture, acupressure, massage and moxibustion40% of all health care delivered in China The first documented source of Chinese medical theory, the Huangdi Nei Jing (Inner Classic of the Yellow Emperor) was written between 300 BC and 100 BC
اسلاید 21: Traditional Chinese Systems of MedicineBMJ 1997;315:115-117 (12 July)
اسلاید 22: Is it a Communist plot?Norwegian Law Brings Alternative Medicine to the Mainstream Journal of the National Cancer Institute, Vol. 96, No. 4, 254-255, February 18, 2004
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اسلاید 24: complementary medicine in medical & nursing education philosophical / spiritual paradigm scientific foundation practice & evidence of efficacy & safety develop national centres of excellence 30 medical schools involvedBlue Ribbon Panel USA - 1996
اسلاید 25: adopted a number of resolutions has a Traditional Medicine programme 19 collaborating centres in 10 countries 1996 – 28 monographs of 28 plantsWorld Health Organisation…South Africa… political support NRF / MRC support various educational initiatives (UKZN, Limpopo, UCT, UWC, Zululand)Traditional Healers legislation
اسلاید 26: Minnesota MedicinePublished monthly by the Minnesota Medical Association July 2000/Volume 83Error in Medicine: What Have We Learned?Is the grass greener?
اسلاید 27: integration complementarities rivalry co-existenceIntegrated Medicine Initiative
اسلاید 28: traditional & alternative systems mind – body interventions biological – based therapies manipulative & body movement methods energy therapiesReview of TCAM – major domains
اسلاید 29: enhance curriculum development of service sites resource mobilisation (local & international) documentation academic exchange & research supportWhat are we doing?
اسلاید 30: Alternative & Complementary African systems Indian systems Chinese systemsLearning Opportunities
اسلاید 31: basic principles & assumptions (rigor & relevance) strategies for peer review, evaluation & validation research priority areas may be paediatrics, cancer, mental health & cardiovascular disease, HIV/AIDS horizontal integration with ethno-botanists, chemists, anthropologistsResearch agenda…
اسلاید 32: develop adverse effects registry credentialing & practice numbers coding billing system record keeping valuesOperational Research agenda…
اسلاید 33: Diagnostic classification Adequacy of treatment Placebo vs non-placebo Outcome measures Assumptions about randomisationConceptual & Contextual Issues
اسلاید 34: certificate diploma degreeProgram mixAcademic development
اسلاید 35: Together…
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اسلاید 37: barryk@ebucksmail.comThank You!
اسلاید 38: to form a BHF TCAM task group to sponsor research have nothing to do with TCAM initiativesI suggest that BHF’s interventions in TCAM should be: …
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