Is there a role for trado-medicine in the Nigerian health sector? (19)

6 January, 2019

Dear all,

For umbilical cord management in Zambia from Neil, would you please specify which streams of traditional practice is harmful? Would love to see more quantitative researches showing the epidemiology and magnitude of the problem. Interestingly, here is a brief article on the role and evidence of use of acupuncture during delivery. (https://www.hindawi.com/journals/ecam/2014/672508/) . Sterilised processing of umbilical cord was documented more than 1000 years ago in Chinese medicine.

For review of effectiveness of Chinese medicine / other forms of traditional medicine, I agree it would be good to consolidate the evidence. But before repeating the effort done by others on other platforms, it would be good to take a look on the review database of British Acupuncture Council. (https://www.acupuncture.org.uk/category/a-to-z-of-conditions/public-revi...) They have done so much in the past and can serve as the starting material. In addition, for evidence of Chinese medicine in the conditions mentioned:

Labour

https://www.hindawi.com/journals/ecam/2014/672508/

Acute appendicitis

https://academic.oup.com/bja/article/115/2/183/324122

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159140/

Snakebite

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388772/

Myocardial infarction

https://www.ncbi.nlm.nih.gov/pubmed/29079906

https://www.hindawi.com/journals/ecam/2013/675906/

Joseph, I do agree that there is a reluctance among some clinicians being reassessed on what they have been doing, so does for allopathic medicine. Take the case of the reluctance in replacing trauma treatment with tranexamic acid. Even tranexamic acid is proven to be a better management, clinicians are still focusing on the old way. (https://www.ncbi.nlm.nih.gov/pubmed/23477634)

We have completed a series of focus group interviews on clinicians from Chinese medicine and western medicine recently and we found that that the differential epistemology between CM/WM, the failure of existing biomarkers to predict important health outcome and the insufficiency of using biomarkers in assessing CM were the biggest hurdles for evaluation of CM. Even some WM clinicians reconciled that we cannot directly use the methods in WM to assess CM because the outcome measurements (UACR, GFR, HbA1c etc) aare simply not good enough to demonstrate the effects (in diabetic kidney disease). CM offers a totally different dimension that WM may have yet to explore.

Neil, I am happy to summarise the past discussions on this topic if most of us are too busy to do so. Please let me know the arrangement / procedures.

Best,

Chris

HIFA profile: Chris received training in basic science, biomedical science, clinical Chinese medicine and public health from the University of Hong Kong, Hong Kong Baptist University and London School of Hygiene & Tropical Medicine. He is currently a research clinician based in Hong Kong and has been actively engaged in clinical medicine, clinical trials, basic science research and qualitative research. He had served for Hospital Authority, World Health Organisation, KPMG Advisory and hospitals on research consultancy, medical administration and clinical medicine in Hong Kong and mainland China before his academic engagement.