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PARADIGMS IN COMPLEMENTARY AND ALTERNATIVE MEDICINE


INTRODUCTION

Complementary and alternative medicine (CAM) as defined by the National Centre for Complementary and Integrative Health (NCCIH) is a diverse group of medical and healthcare systems, practices and products that are not generally considered part of mainstream medicine. These forms of treatments/health interventions are used exclusively or in addition to mainstream standard medical practice either as therapeutic measures or to improve health and wellbeing. They include spiritual and faith-based healing, cupping, acupuncture, chiropractic care, herbal or dietary medicine, Reiki and healing touch, Ayurvedic medicine, etc.

Despite general acceptance and belief by users to be effective, CAM, for the greater part, lacks scientific proof for efficacy, standardised measures (including dosage) and techniques. For these reasons, it was difficult to integrate CAM into mainstream clinical care. However, this trend is gradually changing as more healthcare practitioners are open to the concept albeit with initial resistance.
Research has shown that CAM will be a part of healthcare for the foreseeable future (Dietlind, et al, 2006). An evidence to this is seen in one of Ghana’s Ministry of Health’s objectives, stated on their website as to “ensure effective development and integration of traditional and alternative medicine as a distinctive medical practice system within the national healthcare system”.


History and evolution of CAM

It is important to note that allopathic medicine started as a primitive nature-derived therapy through the use of animal and plant products as well as culture-specific practices in the treatment of ailments. With the advent of science, these were developed and enhanced into the evidence based clinical practice as we know it today.
Every society has peculiar health-seeking behaviours and age old practices which are deeply ingrained in its culture. Overtime, different cultures learnt and borrowed these practices from each other through cross-cultural interaction and globalisation. Even with the advancement of allopathic medicine, it is difficult, if not impossible, to completely uproot these cultural practices. This is partly due to religious beliefs and cultural inclinations which are the major driving forces that shape our thought processes, largely govern our choices and determine our decisions. However, in order for allopathic medicine to be effective and to avoid drastic outcomes due to drug-drug interactions or other detriments, it may be necessary to curb some of these cultural habits. Harmful practices are to be completely avoided. Moreover, since allopathic care is largely dependent on strict adherence and compliance of the patient, any other practice alongside it may thwart a successful medical intervention.
The World Health Organisation (WHO) estimates about 70% of Ghana’s population to depend solely on traditional medicine while the rest of the population combined both allopathic and traditional medicine. In the United States, approximately 38% adults and 12% children use CAM (NCCIH, 2007). The percentage of worldwide population using CAM is about 50% annually with the vast majority using it in combination with allopathic medicine (Hoenders, 2014).

Paradigms in CAM

CAM tends to be holistic in nature. It takes into consideration the individual’s mind, body and soul, often requiring the active participation of the patient with lifestyle changes including diet and exercise, spiritual and psychological exercises among others. These regimes are tailored to suit the patient’s needs and may differ in both content and method from one individual to another and even in the same individual overtime.
Naturally, CAM includes therapies from diverse historical and cultural backgrounds. It features therapies that are diverse in nature and origin and also thought to work in an equally diverse manner of ways. Methods include reviving the body’s natural ability to heal itself (homeopathy); improving the person’s “sense of coherence” to better cope with, and appreciate life’s experiences as meaningful (salutogenesis); healing through spiritual or other non-physical means, etc.
Alternative medicine is also particularly based on subjective experience, intuition and belief. It makes use of natural sources and the concept of “inner science” which is often criticised by mainstream allopathic medical practitioners as irrational or irreconcilable with rational science (Hoenders, 2014). It is also relatively cheap and readily accessible to users.




In contrast, allopathic medicine tends to be reductionist and pathogenic in perspective, uses manufactured drugs and technological devices and “outer science” or evidence based techniques. The physician is usually considered the expert who is responsible for the treatment, giving the therapeutic involvement and contribution of  the patient a minor role. It is also relatively costly and not always readily accessible to those who need it.

Conclusion

As previously stated, mainstream allopathic medicine evolved from the so-called “alternative medicine”. People are increasingly reverting to CAM for their health needs for reasons related to their concerns on side-effects of conventional drugs, accessibility and affordability of medical care, dissatisfaction with conventional medicine and to better accommodate their cultural and religious beliefs. There is therefore a need to, on one hand, address the main issues of concern regarding CAM (e.g dosing, hygiene and drug-drug interactions) and to devise and implement regulatory measures with the aim of integrating CAM into mainstream medical practice. On the other hand, there is a need to take a critical look at the elements lacking in allopathic medicine which make alternative care more appealing. These include warmth, empathy, cultural integration, religious consideration and the use of safe natural products where the ‘therapeutic poisons’ (pharmaceutical drugs) could be avoided. Many will agree to the fact that the mere inclusion of these factors into the equation makes allopathic care more holistic and therefore more satisfactory. Doing this will provide patients with the best of both worlds as well as ensure a more promising future for both practices.

Author: Hafsah Hassan


REFERENCES

Dietlind L., Wahner R., Vincent, A.,Bauer B., (2006). Evidence Based Complementary and alternative Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1697740/
Ghana Ministry of Health (2005). Policy Guidelines on Traditional Medicine Development. Retrieved from http://www.moh.gov.gh/policy-documents/
Hoender, R. H. J.  (2014).Western and Alternative Medicine: A comparison of paradigms and methods.Retrieved from https://www.researchgate.net/publication/23457244_Western_and_Alternative_Medicine_A_Comparison_of_Paradigms_and_Methods
National Centre for Complementary and Integrative Health (NCCIH), (2007). The use of Complementary and Alternative Medicine in the United States. Retrieved from  https://nccih.nih.gov/research/statistics/2007/camsurvey_fs1.htm
Work the World. (n.d). Ghana’s Fight to preserve traditional medicine. Retrieved from https://www.worktheworld.com/blog/ghanas-fight-preserve-traditional-medicine
World Health Organisation (WHO), (2001). Legal status of Traditional Medicine and Complementary/ Alternative Medicine: A worldwide Review. Retrieved from https://www.who.int

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