Survey on Traditional Medicine, Mawlam KAP Survey on Traditional Medicine in Mawlam Village, Meghalaya Department of Allied Health Martin Luther Christian University Introduction Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being. Countries in Africa, Asia and Latin America use traditional medicine (TM) to help meet some of their primary health care needs. In Africa, up to 80% of the population uses traditional medicine for primary health care. In industralized countries, adaptations of traditional medicine are termed “Complementary“ or “Alternative” (CAM). TM has maintained its popularity in all regions of the developing world and its use is rapidly spreading in industrialized countries. Over one-third of the population in developing countries lack access to essential medicines. The provision of safe and effective TM/CAM therapies could become a critical tool to increase access to health care. While China, the Democratic People’s Republic of Korea, the Republic of Korea and Vietnam have fully integrated traditional medicine into their health care systems, many countries are yet to collect and integrate standardized evidence on this type of health care. All systems of medicine in India can be classified into two streams: a.

b.

Classical stream: This comprises of the codified and organized medicinal wisdom with sophisticated theoretical foundations and philosophical explanations. Systems like Ayurveda, Siddha, Unani, Amchi and Tibetan, etc. are examples. Folk stream: Comprising mostly the oral traditions practiced by the rural villages. The carriers of these traditions are millions of housewives, thousands of traditional birth attendants, bone setters, village practitioners skilled in accupressure, eye treatments, treatment of snake bites and the traditional village physicians/herbal healers and the tribal physicians. This stream of inherited traditions are together known as Local Health Traditions (LHT). LHT represent an autonomous community supported health system which efficiently and effectively manage the primary health care of the Indian rural mass. LHT is still alive and runs parallel to the state supported modern health care system; but its full potential is still not fully utilized and also that the great service it is rendering to the rural people go largely unnoticed because of the dominant western medicine.

Khasi traditional medicine is an example of the folk stream. Its use goes back to the origins of the people and it is widely practiced in the rural and urban areas. While the methods have not been codified, the oral tradition is strong and widespread. Recently a few texts written by traditional healers have appeared in Khasi. Surveys of medicinal

plants and some laboratory investigations have been conducted in various academic institutions in the state. Aim of the study The aim of this study was to evaluate the knowledge, attitudes and practices (KAP) of the people of Mawlam village which is located in Pynursla Block of the East Khasi Hills District of Meghalaya. The village has a population of approximately 900, with approximately 200 households.

Methods A KAP questionnaire was designed, translated into Khasi and pre-tested as a biostatistics class project of the department of allied health of Martin Luther Christian University. 80 households were randomly selected and teams of two students each administered the questionnaire to an adult in the household. The survey was conducted on March 8, 2007.

Results In 23 of the 80 questionnaires filled out, many questions were unanswered so 57 were analysed. The following results were obtained: A.

Demographic profile of respondents: Sex of respondents: F 49 M 8 Age of respondents: Range 13-80 years Mean 36 years SD 16 years Education: No education 35 Class 1-3 13 Class 4-7 9 Occupation: Farmer 24 Labourer 14 Broom making 10 Other 13

B.

Responses to questions

1.

Do you use traditional remedies at home? Yes No Total

17 36 53

2.

Can you give 2-3 examples? Yes 5 No 23

3.

Is there a traditional healer(s) in the area? Yes No Don’t know Total

40 7 6 53

4.

Can you give the names of one or two? 24 gave names

5.

Are they full-time or part-time? Fulltime Parttime Don’t know Total

6.

25 10 41

Are traditional healers popular? Yes No Don’t know Total

7.

6

21 10 10 41

Is the use of traditional healers decreasing? Yes No Don’t know Total

18 9 13 40

8.

Can you name some medicinal plants?

9.

Yes 8 No 10 Don’t 20 know Total 38 Do the healers use medicinal plants? Yes No Don’t know Total

10.

23 2 12 37

Do the healers use non-herbal treatments? Yes No Don’t know Total

11 11 15 37

Can you give 1-2 examples of non-herbal treatments? Yes 1 Animal fat

11.

Traditional medicine treatments are affordable?

12.

Yes 33 No 5 Don’t 6 know Total 44 Traditional medicine is good? Yes No Don’t know Total

13.

32 3 15 50

Traditional medicines are better than allopathic medicines? Yes No Don’t know Total

10 19 24 53

14.

Traditional medicines are cheaper than allopathic medicines? Yes No Don’t know Total

15.

43 3 7 53

Traditional healers should be recognized by the government? Yes No Don’t know Total

8 8 29 45

16. How many times in the last year has a family member consulted a traditional healer? 1-4 times 13

17.

5+ 2

26

What formulations of traditional medicine were taken? Powder Liquid Ointment

19.

DK 7

Members of the family for which traditional medicine was taken. Children Adults/elders 13 Pregnant 4

18.

Many 8

5 27 14

How much money was spent on traditional healers last year? Up to Rs 100 Rs 100-500 Above Rs 500 Not much DK

11 9 0 2 3

20. How many times in the last year has a family member consulted an allopathic doctor? Up to 10 visits More than 10 Many times Sometimes

21.

For which family members were allopathic treatments taken? Children Adults/elders Pregnant

22.

18 1 13 1

28 20 12

For what type of illnesses do family members go to an allopathic doctor? Minor illnesses Major illnesses Check-up All/other Failure of TM

9 18 2 7 2

23.

How much money was spent on allopathic treatments in the last one year? Up to Rs 100 1 Rs 100-999 11 Rs 1000+ 6 Rs 3000+ 8 DK 4 More than TM 1 Lots 1

24.

Types of illnesses for which TM was sought Fever Eye problems 3 Flu 3 Constipation Chest pain 1 Kidney Dysentery 1 Mild stroke Child diarrhea Skin 1

25.

1 1 1

Gastric 1 Whoop cough 1

1 1

Average expenditure on traditional and allopathic medicine in the last one year. Traditional medicine Allopathic medicine

Rs 160 Rs 2100

Discussion The majority of the respondents were women, indicating perhaps that the menfolk were at work, as the survey was conducted during the day. The education level of the respondents could provide an indication of the educational status of the women in the village. Most of the households appear to have occupations that are unskilled or semiskilled. A majority of the respondents are familiar with traditional medicine, could name a local traditional healer and had some knowledge of their type of practice and their use of medicinal plants. Many households had consulted and used the services of traditional healers, occasionally or frequently during the previous one year, mainly for minor illnesses, especially for children. Most of the respondents felt that traditional medicine is good and economical. Most of the respondents also used allopathic medicine services, especially for major illnesses for all members of the family. The expenditure on allopathic medicine was considerable higher than for traditional medicine.

Conclusions and recommendations Traditional medicine is respected and widely used in the rural areas of Meghalaya. Allopathic services are also used but may not be convenient to access and is also expensive. Traditional medicine should be encouraged, especially in rural areas as it contributes substantially to primary health care. The government should consider integrating traditional medicine into the formal health system of the state. Two cautionary provisions are recommended. Firstly, the conservation of animals and plants should be kept in mind in the preparation of folk medicinal preparations. Secondly, there should be a method of evaluating the knowledge and expertise of the folk healers. References www.who.org www.indianmedicine.nic.in Acknowledgements The survey and analysis was conducted by the following allied health students: Eddie O. Lyngdoh Archieson Lyngdoh Alleysha Syiemlieh Balajied Iawphniaw Grace Cia Bell Sna Banshanhi I. Nongkhlaw Nengneilhing Hangshing Dakaruhipaya War Deepa Lamin Khonglah Tifully Sohkhlet

Bahunlang Dhar Lalonging M. Lyngdoh Persara Kharjana Baiadapdor Diengdoh Frieda M. Umlong Khonzani A. Nguillie Melbourne Marbaniang James Maitphang Suchen Fearless Ryngksai Lurstep Phyrnai Mawlong

Pynhunlin Lyngdoh Pynshailang Mukhim Rymphanglin Jyrwa Biak Lura Kaipeng Hopingstar Shylla Madelson Slong Evawanda N. C. Syiem George Glarius Marbaniang Dolly Marak Baleisha Kurbah Wanbianghimo T. Nongrum Mayreen Ryngksai Ritika C. Kharkongor Balasara H. Jyrwa Iaisankyrhai Nongkynrih Mar Leki Pohlong Lapyntngenlin L. Nonglait Rilangmiki Dkhar Glorisha Lyngdoh Nivan Yoo War Ibalabynta Syiem Silver Bell Shylla Banshembha Kharumnuid Samborlang Wankhar Neil Robert Wahlang Dashisha Paliar Rudalangki Shylla Moffida Patweth Richmond Suna Carefulness Tiewsoh Isabel Kurkalang Imondaris Nongrem

The teacher facilitators: R Jennifer War, Bonnie M Nicol, Wadamika Lyngdoh The instructor for the course: Glenn C Kharkongor