Traditional health systems in danger of extinction: Why should we care?

doi:10.15406/ijcam.2024.17.00699

International Journal of

eISSN: 2381-1803

Complementary & Alternative Medicine

Editorial Volume 17 Issue 4

Traditional health systems in danger of extinction: Why should we care?

Salim M Adib

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Professor of Public Health, American University of Beirut, Lebanon

Correspondence: Salim M Adib, MD, DrPH, Professor of Public Health, American University of Beirut, Lebanon

Received: July 11, 2024 | Published: July 12, 2024

Citation: Adib SM. Traditional health systems in danger of extinction: Why should we care? Int J Complement Alt Med. 2024;17(4):166-167. DOI: 10.15406/ijcam.2024.17.00699

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Editorial

Globalization is closing down on all nations with a mixed bag of blessings and curses. One of those curses is the negative impact of modern “evidence-based” medical practices on traditional health practices worldwide. Traditional health “is the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness”.¹ With very few exceptions, traditional systems across cultures and regions are increasingly at risk of extinction.² Undoubtedly, some traditional practices deserve to disappear since it is clearly demonstrated that they result in more harm than good. In traditional Arabic and Indian medicine for example, the “remedy of last resort” was cauterization or iron-hot branding (“al-kayi) of patients mostly on limbs, but also sometimes on the neck and skull, to create an abscess supposed to “suck” out the disease. In addition to useless pain inflicted oftentimes on young infants and children and to a permanent scar, this practice put patients at risk of an infected cutaneous lesion that compounded the weakness already caused by the initial ailment. This practice now clearly identified as harmful is prohibited and slowly disappearing with no visible side effects on the health of the community.^3,4 On the other hand, cupping (“al-hijamah”) practiced on the upper back of adults, also supposed to “suck” out disease, is surviving mostly because no evidence of harm has been found. Some patients feel better if only through a possible, but yet to be evidenced placebo effect.³ Occasionally, patients who prefer traditional forms of treatment over conventional medical practices may be endangering their recovery and/or survival. This pre-supposes of course that conventional medicine is an option, when the reality in several remote locations of the world is that traditional practices are actually the only form of care available, accessible, affordable or perceived as relevant. In all nations, it is imperative that modern medicine is made available at adequate levels of quality and cost, while protecting the choice of patients to also use non-harmful traditional practices in which they believe. Similar to cupping, hundreds of neutral, or potentially beneficial practices may disappear under the pressure of modern medicine before they are ever described and/or assessed for possible benefits. Traditional practices are even more at risk when the population originally nurturing them is itself at risk of assimilation and elimination. This demographic factor is a major determinant of survival for various Chinese practices, as well as those associated with the Ayurvedic tradition of India.^2,5 Many traditional systems have already vanished with the extinction of their human substratum. A good example would be the scarcity of factual knowledge regarding healing practices in pre-Columbian civilizations, beyond remnants still found in indigenous communities in Latin America.⁶ Practices of smaller nations still surviving in our times, whose experience of healing is often a holistic process based on the interconnectedness of mind, body, spirit, and the natural world, are at risk of rapid and silent extinction. The potential benefits of traditional practices in those cultures including the use of medicinal plants, rituals, ceremonies, and spiritual healing connected to the local environment and cultural beliefs may be lost forever. With the emergence of more complex antibiotic microbial resistance (AMR) and the increasing incidence of chronic irreversible diseases, humanity cannot afford to allow possible important therapeutic discoveries to be wiped out with their cultural/human substratum.⁷ The preservation of diversity in human cultures and practices is arguably as important as the preservation of animal and floral diversity and deserves at least the same level of international commitment. Safe repositories have to be created at national and/or international levels to archive and protect documents, tools, seeds and other paraphernalia associated with traditional practices everywhere, until researchers are able to unravel their modus operandi and to extract any positive element they may possess. The integration of traditional practices in community-based primary health care centers is also a method to preserve those practices as a living entity, not just as historical documents.⁸ It is important that the World Health Organization (WHO) has responded to the demands of Member States in reaching global proactive policies and implementing action plans that will strengthen the role traditional medicine plays in keeping populations healthy. WHO published a first “Traditional Medicine Strategy: 2002–2005”, subsequently updated for the period 2014–2023. The implementation of these strategies is supervised by the Traditional, Complementary and Integrative (TCI) medicine unit mandated to promote the potential TCI contribution to integrated health services, Universal Health Coverage and health-related Sustainable Development Goals.¹ A review of progress realized by WHO strategies at country-level has to be conducted, especially in view of the delay caused everywhere by the covid-19 pandemic (2019-2023). In summary, while modern healthcare systems bring numerous benefits, discarding traditional systems entirely could overlook valuable cultural, holistic, accessible aspects of care delivery and potential sources of future therapeutic advances. Integrating traditional and modern approaches where appropriate may offer a more balanced and inclusive healthcare system.