Shocking Medical
Statistics
16 March, 2003
The article below was written to highlight the misinterpretation of medical statistics by the Deputy Director of Health of Malaysia in his article 'Use of traditional medicine on the rise' published in The Star, March 15 2003.
I refer to the letter
by the Deputy Director General of Health of Malaysia in The Star dated
March 15, 2003 entitled "Use of traditional medicine on the rise".
In his letter, he revealed
statistics that showed an increase in spending by consumers on traditional
medicine both worldwide and in Malaysia. According to the Deputy Director
General, in the year 1997, Americans spent USD 3.24 billion on herbal
products and herbal medication whereas Malaysians spent USD 2 billion.
He went on to say "while each American spent about RM45 on herbals,
each Malaysian spent RM91, which is twice as much, taking into account
populations of 273 million and 22 million respectively".
I am glad that the esteemed
Datuk Dr. Ismail Merican revealed the statistics to us because it goes
to show how awry our Malaysian health care system has become throughout
the years. We should be shocked that in a country of only 22 million people,
the amount spent on traditional medicine is over 60% (USD 2 billion) of
what the Americans spent in 1997 (USD 3.24 billion in a population of
273 million).
Judging from the horrific
amount of money spent on traditional medicine here, and assuming that
traditional medicine has some form of proven efficacy, the health status
of the Malaysian population should be so much better than that of the
Americans, if not one of the best in the world. If the Deputy Director
General could kindly produce the statistics to show that Malaysians are
healthier, then I shall gladly rest my case.
However, in the mean
time, let us ponder on the significance of the statistical revelation
above.
The Health Ministry should be alarmed by this trend and look into the
issue of why so many people are turning to traditional medicine instead
of using our fairly advance and adequate modern health care facilities
in Malaysia. Is there a repulsive factor in our health care system that
is deflecting our people away to seek traditional treatment elsewhere?
This is what I meant by "turning a blind eye towards the health care
problems in Malaysia" in my previous letter to The Star. The health
authorities are so eager to venture into the unknown territories of traditional
medicine, that they chose not to view it as a problem. As the authority
in charge of the health of Malaysians, they should carry out studies to
look for the reasons why people are shunning modern medicine.
One of the reasons that
I can conclude from the tremendous amount of money spent on traditional
medicine here is that the price of traditional medicine itself is over
priced. People have a tendency to believe that if something is expensive,
it is definitely good, and the manufacturers and retailers of these products
seize this opportunity to over value their goods. In my opinion, the people
are being tricked into buying these products and therefore chalking up
a bill of USD 2 billion just for traditional medicine alone.
We can enact thousands
of Laws and Acts to control the sale of these medications. However, without
adequate enforcement, which sadly is the case here in Malaysia, self-proclaimed
doctors like these will continue to peddle their unproven medicine to
the unsuspecting public. I thank Datuk Dr. Ismail for enlightening me
about the Government's effort to enact a Traditional and Complementary
Medicine Act and the formation of a National Committee for Research and
Development on Herbal Medicines. I eagerly await the outcome of their
collaboration and hope that they will take into account the problem of
enforcement of whatever laws or by-laws, which they will draw up in the
future.
However, as we await
the results, let us ponder now on the business side of traditional and
complementary medicine or TCM.
There is no doubt that
traditional medicine is big business all over the world, especially in
Malaysia, where the people are so easily misled and influenced by miracle
cures and instant relief. It will be a good source of income for Malaysia
if our traditional medicine is being developed, manufactured and sold
all over the world.
However we must understand
that herbs and other traditional potions and lotions, are a composition
of thousands of chemical compounds, which have not been analysed thoroughly.
For example, when we ingest a concoction of herbs, we are actually taking
in thousands of pieces of desiccated plant material, which have not been
analysed for its active ingredient. Furthermore, no surveys or medical
testing have been done to identify their side effects and toxicity levels.
On the other hand, modern
medicine is produced after an active ingredient or compound is tested
to be effective in alleviating a certain illness or symptom. When we swallow
a pill, we are actually taking in a pure substance of which we have studied
thoroughly: the chemical structure, the way it enters the body system,
the pathway in which it works and how it is excreted from the body.
Of course one can argue
that modern medicine has side effects and all that. But one must realize
that the reason why we know so much about the side effects of modern medicine
is because countless studies and surveys have been done on them before
they are sold to the public. On the contrary we do not know anything about
the compounds that make up traditional medicine, let alone its side effects
and toxic levels.
I have a Diabetic and
Hypertensive patient who once told me that he has stopped all his medication,
which was prescribed by the hospital, and converted to traditional medicine
for his diseases. The reason stated was because he was afraid of its side
effects after hearing it from his relatives and friends. Wouldn't it be
safer, to take something which has a known possible side effect, than
risking our life to take herbal medicine which we do not know anything
about?
It would seem that nowadays,
everyone wants to play doctor. From bureaucrats to butchers, from traditional
herbalists to traditional masseurs, from direct selling salesperson to
your relatives and friends. Everyone has their own product to sell and
everyone claims that their treatment is the best.
The business of traditional
medicine is a lucrative one, as it does not require extensive and intensive
research and other complicated purification process. That is why, every
Tom, Dick and Harry is jumping onto the bandwagon to sell traditional
medicine and alternative therapy. Furthermore the price of these unproven
medicine is hiked up to conjure a false sense of efficacy and reliability.
Lastly I would like
to stress that I do not have any intention of being known as a Crusader
of Western Medicine, nor do I intend to become the Slayer of Traditional
Medical Practitioners. I support the formation of the National Committee
for Research and Development on Herbal Medicines (NRDHM) to systematically
coordinate and integrate the various research and development activities
on herbal medicine conducted by the country's various research institutions.
However the process
of research, testing and incorporating traditional medicine into mainstream
health care takes many years. Even after that, we will still have to deal
with the issue of adequate enforcement of the laws and acts, which are
to be enacted to control these traditional medical practitioners. During
this long period of waiting, the Health Ministry should continue its efforts
to upgrade its current health facilities nationwide. It should also conduct
public awareness programs to educate the public on how to choose wisely
between these two forms of treatment options.
The statistics given
by the esteemed Deputy Director General of Health seems to be laden with
dollar signs. Medicine should never be looked at as a business entity
like trade and commerce. Throughout the years, medicine has evolved to
become an art of healing based on scientific findings. The Ministry of
Health should not be seen to advocate traditional medicine over modern
medicine, unless and until all avenues of modern medicine have been exhausted.
Statistics are merely
digits, which can be interpreted to suit one's argument. Datuk Dr. Ismail
Merican chose to glorify the popularity of traditional medicine by revealing
the tremendous amount of money spent on these items. On the other hand,
I chose to analyse the statistics further and ask myself the question
why there is an increase in the number of people seeking traditional medicine,
and whether our present health care system has become so unreliable as
to discourage people from using it.
We should never turn
a blind eye to reality and look the other way. Neither should we shut
out the inquisitive moaning of the people with a deaf ear.
With that, I wish the Deputy Director General of Health, good luck in his Ministry's quest to try and bring traditional and complementary medicine to the forefront of health care. As for me, I will continue to practice modern medicine on my patients, until the day when researchers can scientifically proof to me that a piece of sun dried leave or a boiled bundle of twigs can cure a disease.
Thank you
Health Care Monitor
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