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Bangkok Post February 1 1999 Herbal medicines can be far cheaper than their packaged Western variety, and they often also do not have the same nasty side-effects. But still most doctors don't like herbs.
APHALUCK BHATIASEVI Herbal and other traditional medical arts have been used in Thailand for centuries, but they have yet to receive the international recognition accorded other practices such as acupuncture from China or ayurvedic medicine from India. One reason for this is the pervasiveness of more modern medical technology, whose convenience makes it the treatment of choice with most medical practitioners. But traditional Thai medicine is beginning to re-establish itself as a valid form, and a major reason for this is the work of Dr Pennapha Subcharoen, the director of the Institute of Traditional Thai Medicine. Dr Pennapha has helped rebuild the credibility and dignity of traditional healers who, up until very recently, could only practise illegally. But that was before Dr Pennapha pushed for the recognition of traditional healing as a medical profession under the new Medical Premises Law. She also managed to regain some respect for the art of traditional massage and its practitioners, people who have been grouped together in the public consciousness with sex workers employed at "massage parlours". Dr Pennapha graduated in medicine from Songkhla University, but always has been interested in traditional ways of healing and has attended training sessions with traditional healers. She said her interest in traditional medicine stemmed from her father, who used to take her into the forests to pick herbs for use with his patients. "I enjoy reading books on traditional healing and have been able to identify plants since childhood," she said. The respect showed her father by his patients was the main reason she chose to study medicine. "I remember patients coming to our home for medicine and always bringing food with them in exchange. Money was not a common means of exchange for products and services in our hometown in Nadi (a district in Prachin Buri)." As the fifth of eight children in a poor family, Dr Pennapha's childhood was not completely seamless. She lost her father when she was 10 and took turns attending school with her sister because her mother could not afford an education for both of them at the same time. She also helped take care of her younger brothers and sister. "I would go to school for one year, then take a break for a year to sell food and let my sister study. Then I would resume studies again the next year." Consequently, Dr Pennapha was the oldest in her year by the time she graduated. Her professional use of herbs as an alternative to modern medicine began when she was the director of Wang Nam Yen Community Hospital in Prachin Buri on the Cambodian border. She said she had always kept traditional medical practices in mind and incorporated them with her modern medical training at the rural hospital. Dr Pennapha said at first it was the heavy cost of modern medicines on impoverished villagers that encouraged her to reduce their use. "Many of my patients had to spend the only money they had to hire vehicles to get to the hospital only to find that the medicines they needed were out of stock." This shortage of medicines was a common occurrence in rural hospitals at the time. Dr Pennapha said she now looks on traditional medicine as not just as an alternative for use with the poor but as something which has genuine benefits towards good health. "It's been proven that the use of natural products is better any day than synthetic chemicals," she said. Dr Pennapha in the past paid visits of 7-10 days to different provinces, including Maha Sarakham where she learnt to read the Dham-Isan language from Poh Yai Chan Khen Lavong, who was then 80 years old. This traditional healer taught her to read the ancient scripts and books on traditional medicine. "I began to realise that it was we doctors who had made patients dependent on modern medical technology. We make them less independent in solving their own health problems. In time, Dr Pennapha closed her private practice and focused exclusively on managing the hospital. She said she then faced the enormous task of convincing her supervisors of the benefits of her work with herbal medicines. She began with a herb garden on eight rai near the hospital and encouraged villagers to help plant herbs in the area. Later, in 1985, she established a small clinic for traditional healing within the hospital and integrated it into the public health ministry's primary health care policy. But despite the advances, there were always obstacles thrown up by the public health community. And so rather than bother about promotions and recognition, Dr Pennapha found her satisfaction in improving the hospital's services. Although, she admits, there have been times when she has become despondent. She has frequently been made a laughing-stock for her use of herbs at the hospital level. "I'm still often criticised by people in the same profession. Many call me a quack because I prefer to use traditional medicines instead of modern equivalents." Dr Pennapha said she did not mind the criticism. "If they understood the benefits of traditional therapy, they wouldn't have been so much against me," she said. "I realised we had to be self-reliant. There is continuous fighting in the area bordering Cambodia and we had to do something to keep ourselves stocked with drugs and medical supplies." Instead of waiting for medicine from Bangkok, patients suffering diarrhoea were often treated with guava leaves boiled in water with a pinch of salt. Banana leaves were used for patients with burns and other wounds. Dr Pennapha's life has been threatened in the past by drug distributors who sell their medicines direct to villagers. This was partly because she discouraged the use of painkillers. "I had to work out and then show the people that the whole village was wasting about 30,000 baht a month on their daily purchases of painkillers. Only then did they listen to me," she recalled. She may have won the cooperation and appreciation of the villagers, but she has not avoided criticism, most of it from her own colleagues in the ministry. The development of traditional Thai medicine still is under a heavy cloud, according to Dr Pennapha. "We have to strengthen ourselves. We need to be autonomous - with sufficient authority, funding and networking to strengthen the institution." Medicine, she said, should be considered a social welfare service and not a business which focuses on maximising profits. To revive the use of traditional herbs, Dr Pennapha said time needed to be taken to avoid the rush to take advantage of the practice and make it too commercial. Comments to: Webmaster |
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