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Impact of Education on Ethno-Medicine and Health Care

Practices between the tribal peoples of India

                                                                                   

 

We must protect the forests for our children, grandchildren and children yet to be born. We must protect the forests for those who can’t speak for themselves such as the birds, animals, fish and trees.

 

INTRODUCTION

 

Anthropology as an integrated science of man is biological and cultural aspects of man. Currently, more anthropologists in applying their knowledge and techniques for the welfare of the people involved.

Ethno-medicine is the branch of medical anthropology and deals with the study of traditional medicine: not only those relevant written sources (eg Traditional Chinese Medicine, Ayurveda), but especially those who have knowledge and practices passed on orally through the ages .

Scientific issues are ethno-medical studies, usually by a strong anthropological approach, marked more than a bio-medical. The focus of this research is the perception and context of the use of traditional medicines, and not on their bio-evaluation.

TRIBES IN INDIA

            The Indian sub-continent is inhabited by 88. 2 million tribal populations belonging to over 577 tribal communities that come under 227 linguistic groups. They inhibit varied geographic and climatic Zones of the country. Their vocation ranges from hunting, gathering, cave dwelling nomadic to societies with settled culture living incomplete harmony with nature.

            Forests have been their dear home and totally submitted themselves to forest settings. Their relationship with the forest was symbolic in nature. They have been utilizing the resources without disturbing the delicate balance of the eco-system. Tribal thus mostly remained as stable societies and were unaffected by the social, cultural, material and economic evolutions that were taking place with the so called civilized societies. But this peaceful co-existence of the tribal has been disturbed in recent years by the interference in their habitats. Traditional communities living close to nature have, over the years acquired unique knowledge about the use of living biological resources. Modernisation, especially industrialization and urbanization has endangered the rich heritage of knowledge and expertise of age old wisdom of the traditional communities.

            A study on the utilization of local tribal revealed that they hold precious knowledge on the specific use of a large number of agents of wild plant and animal origins, the use of many are hitherto unknown to the outside world.

HERBAL history and tradition in the Indian context

          The Rigveda, the oldest document of human knowledge mentions the use of medicinal plants in the treatment of man and animals. Ayurveda gives the account of actual beginning of the ancient medical science of India, which according to western scholars was written between 2500 to 600 B. C. Charaka and Susruta wrote around 1000 B. C. Charaka concentrates more on medicine while Susruta deals with surgery in details along with therapeutics.

TRIBES AND ETHNO-MEDICINE

            Ethno-medicine refers to “those beliefs and practices relating to disease which are the products of indigenous cultural development and are not explicitly derived from the conceptual frame work of modern medicine” (Hughes, 1968, cited from Misra et al, 2003). Various institutions are now concerned with the traditional health care system and means of traditional treatment.

The tribes are the true guardians of medicinal plants. Out of 45,000 wild plants 7500 species for medicinal purposes. The World Health Organization (WHO) is promoting a movement for “Saving equipment for saving lives.” This is due to the growing understanding of the important role medicinal plants play in the herbal health diseases.

            India is the home of several important traditional system of health care like Ayurveda. This system depends heavily on herbal products. Several millions of Indian households have been using through the ages nearly 8000 species of medicinal plants for their health care needs. Over one and half million traditional healers use a wide range of medicinal plants for treating ailments of both humans and livestock across the length and breadth of the country. Over 800 medicinal plant species are currently in use by the Indian herbal industry.

            In recent times with the increased knowledge of life and culture of the tribal communities, the social scientists are taking interest in ethno-medicinal studies. Many works have been reported especially from among the rural and tribal communities of India (Choudhury, 1986; Bhadra and Tirkey, 1997; Sharma Thakur, 1997). Ray and Sharma (2005) have given a description of ethno-medicinal beliefs and practices prevalent among the Savaras, a tribal community of Andhra Pradesh.

Kumari (2006) gave a report on the concept of diseases and disorders and the use of folk medicine Saureas of Jharkhand. However, ethno-medical studies, relatively few in Northeast India. Guha (1986) has reported from the Boro-Kachari tribe of Assam. A look at the health of indigenous practices among the tribes of the plains of Assam Thakur Sharma (published 1999). The socio-economic status of some of the tribes of Arunachal Pradesh and their problems of health and indigenous methods of treatment was reported by Choudhury (2000), Duarah andPathak (1997), Kohli (1999), Bhasin (1997, 1999, 2002, 2003, 2005).

ETHNO-MEDICINE AND HEALTH CARE PRACTICES AMONG SONOWAL KACHARIS IN ASSAM (INDIA)

 

            The Sonowal Kacharis is an endogamous group of Kachari tribe and a popular plain scheduled tribe population of Assam. Various types of locally available herbs and leaves of wild plants are used by them as medicine. Like many other communities of the region, there are few herbal specialists among the Sonowal Kachari. These specialists or medicine-men have considerable knowledge about the herbs and its medicinal use. Normally they learn about these medicinal plants and its uses from their ancestor. These medicine-men are referred by different term according to the cultural norms. Among the Sonowal Kachari’s they are called as Bez (Barua and Phukan, 1958: 334). Of course in rural Assam, they are mainly known by this term.

 

It has been observed in the villages that use of herbal medicine for curing certain diseases are quite known to the people and besides medicine-men, many elderly persons known about the use of herbal medicines. Some of the diseases and their indigenous methods of treatment are given below:

(1) Fever: Lime (Citrus auran tifolia) juice mixed with sugar is applied on the forehead of the patient to get relief from fever.

(2) Diarrhoea: Dry goose berry (Emblica officinalis) powder and black salt mixed with cold water is taken. Bark of Long Pepper (Pipoli tree) mixed with Misiri water is also used to cure the disease.

(3) Dysentery: Lime (Citrus auran tifolia) juicewith hot water and little salt is used in dysentery. The juice of black Tulsi leaves (Ocimum sanctum) and Sirata (Swertiachirata) is also used for the purpose. The juice of tender leaves (three numbers) of mango (Mangifera indica), black berry (S. cuminii) and goose berry (Emblica officinalis) (equal proportions) together with honey are mixed with goat milk and is taken to cure blood dysentery. Honey together with the juice of Dubari grass (Family-Gramineae) can cure blood dysentery and need to be taken for three/ four days. They also use a kind of wild herb, locally called Manimuni (Centila asiatica). The juice of this herb mixed with sugar or honey should be taken continuously for a month to cure the disease. They also use limewater (chun pani) mixed with juice of turmeric (Purcuma domestica) leave to get relief from blood dysentery and mucous.

(4) Blood Vomiting: A table spoon of carrot (Dancus carota) juice mixed with honey can cure blood vomiting.

(5) Liver Disease: Two to three raw or ripe Papayas (Carica papaya) daily can cure liver disease. A curry prepared from the bud of banana (Musa paradisiaca) and the meat of pigeon is also used as a medicine for the purpose.

(6) Jaundice: The medicine is prepared by pounding five or six number of Silikha (Myroballum) mixing with jaggery and it can cure jaundice. A glass of sugarcane (Saccharum officinarum) juice twice daily prescribed for the purpose. Boiled raw papaya (Carica papaya) is said to be good for curing the disease. Kardoi (Averrhoa carambola), Goose Berry (Emblica officinalis), Sugar cane (Saccharun officinarum), Neem leave (Azadirachta indica), a wild herb known as Duran ban (Lecas aspera), Brahmi sak (Herpestis monnieria), Purakol (Musa sapientum) are prescribed edibles for the patient.

(7) blood nose: Flower of the grenade apple (Punica granatum Linn) has break and 3-4 drops of juice has been poured in the nose give the emergency aid.

(8) Tonsilities: Juice is prepared by mixing one Amara seed (Sponolias mangifera), one Silikha seed (Mysoballum) and a piece of Turmeric (Purcuma domestica) and advice the patient gargles for a week regularly.

(9) Worms: Paste of five lemon seeds (Citrus aurantifolia) mixed with water and is prescribed to eat in empty stomach for a few days. The twigs of Chirata (Swertia chirata) are soaked in the water overnight and the water is prescribed to drink in empty stomach in the morning for one week regularly.

(10) Scabies: Lemon juice (Citrus aurantifolia) mixed with coconut oil is massaged for curing scabies. To remove scabies they take bath with hot water in which leaves of Neem (Azadirachta officinarum) were boiled. Twigs of Chirata (Swertia chirata) arecrushed into paste with water to be used as an ointment and applied on the skin. Chirata water is prescribed to drink in the morning in empty stomach.

Cooked (11) pain in the ear, the juice of Tulsi (Ocimum sanctum) is and that make it in the ears to ear pain heals.

The pati? nt are treated with the available kruiden, plants and minerals. Some of these are huismiddeltjes and some have been devised by kruidenvrouwtje or traditional medicine prescribed for people in the community. The practice of etnisch-geneeskunde are a complex multidisciplinary system are the use of plants, spirituality and the natural surroundings and are the source of cicatrisation for people for millennia. The mental aspects of health and sickness are an integral part of the etno-medical practice for centuries.

Sicknesses cause by anger of supernatural

 

Disease

Supernatural agencies

Pujas (Rituals)

Dysentery, mental diseases, cancer

 

Deo

 

Satisfied by sacrificing two red cocks, a red chicken and egg, with other products of the festival. Regulation is done in the bunch.

Asthama, Mental

Disease, cancer

 

Lord of water

 

Jalkhai puja, worshipped by sacrificing one white duck and other items of feast, rice, salt vegetables, etc.

Accident, sudden illness

 

Burah-dangoria

No sacrifice. Only raw items, e. g. gram, rice, powdered rice, etc. are offered to propitiate Burah-dangoria.

Gastritis

 

Ancestral spirits

Ai puja, no sacrifice is made except offering of raw articles, powdered rice, gram with betel nut and leaves.

 

Epidemic and natural calamities

Mother goddess

Community worship by the elaboration bhur utuwa Puja. A couple of the betelnoot and booklet is available at each family. A red duck has been offered on behalf of the villagers. All offered Article have been placed in a boat.

Epidemic and large scale death of men and animals

 

Mother goddesses of forest.

A white goat is a must for the Puja besides other offering.

PRESENT POSITION OF TRIBES

The tribal practices and the health care for the treatment of sicknesses on the basis of their deep belief and observation in nature. But with the development of the education and their conscience of the health and health care, but also with the arrival of modern medical supplies, activities, health administration these people always prepare geïnteresseerd are important in modern medicine place of the traditional kruiden medicine.

SAVING THE PLANT IS SAVING THE LIFE

            According to the text of Vishnu Samhita, causing any harm to the plants/animals is a sin. Even purloining of parts/ products of any of these living beings is a crime. The sinner/ criminals are liable to chastisement in this life and also after death. The punishments are of diverse nature:-pecuniary, corporal, expiatory and donation of specific articles to Brahmins.

CONCLUSION

            The growing disinterest in the use of the ethno-medicinal plants and its significance among the younger generation of the tribes will lead to the disappearance of this practice. Educated younger generation of the tribes should be encouraged by the Government to protect and cultivate these valuable herbal plants before they get lost due to the impact of modernization and urbanization and also due to deforestation.

            The role of Anthropology is also very important in the field of saving herbal plants. By educating tribal people we can preserve all these things for future generation. It is the Government duty to take necessary steps to preserve all these things.

 

 

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Week of March 15, 2010The White House last week continued to rail against rising health insurance premiums to help build popular support for his health care reform package. But the effort to focus the blame for rising costs on insurers was questioned, in particular, by state insurance experts and economists quoted in a New York Times story last week. Insurance commissioners said that trying to hold down premiums before costs were under control would be very risky. This approach could mean solvency issues in some cases, they told the Times. To help educate Americans about the true drivers of rising health care costs, America’s Health Insurance Plans, the industry trade association, last week launched a new national ad campaign. The ad demonstrates that health insurance company costs represent a small slice of the overall health care cost pie. FederalWith a cadre of staff operatives searching for the right health insurance reform provisions among those previously discarded from the House, Senate and the President’s proposals, Democratic leadership has been relentlessly pursuing every possible pathway to pass a final bill. The expected process would have: 1) the House pass the Senate-adopted reform bill (which most House members hate), 2) the House passing a bill to “fix” all the things it hates using a reconciliation legislative vehicle, followed by 3) the Senate passing the very same reconciliation bill — requiring only 51 votes in the Senate. The House Budget and Rules Committees are expected to start the review, hearing and mark-up process of the reconciliation bill this week. The Senate commitment to using reconciliation was made official in a scathing letter from Leader Harry Reid to the Minority Leader. Along the way the two Chambers will need to see the latest CBO “scores” on the bill before voting, and 216 House Democrats will have to resolve policy disagreements over abortion, federal health insurance rate review and authority, and other substantive issues. Additionally, the House will have to trust that the Senate can pass the reconciliation measure without changing one comma. Partisanship has blossomed into open hostility over health reform. Whether Congress can overcome these policy, process and political mine fields remains as murky as ever, but Democrats have chosen to try and will push for resolution by the Easter recess. The Senate has passed Jobs Bill II and shipped it off to the House, where passage is not certain. Within the bill are two health-related items of note. First, the COBRA eligibility and subsidy program will be extended to the end of 2010. (These provisions are set to expire at the end of March. ) Second, the bill contains a suspension until September 30, 2010 of the cut to physician Medicare reimbursements for the current calendar year. (This provision is also set to expire at the end of March. ) Aetna urged Congress to apply the “doc fix” to next year’s reimbursement as well, since insurers’ Medicare rates are based on what doctors are paid, but in the end Congress failed to make this change. Aetna and the industry will continue to find ways both to establish a more lasting, if not permanent, doc fix and to devise a legislative solution to the disconnect between doctor reimbursement and Medicare Advantage rates for 2011 and beyond. StatesARIZONA: Budget issues remain front and center as the governor and Republican leadership proposed a plan they hope will close the $700 million deficit this year and reduce the anticipated $2. 6 billion deficit in 2011. Righting the state’s fiscal ship has become a very partisan exercise, with the Republicans supporting reductions in Medicaid and KidsCare, and the elimination of full-day kindergarten. As the special session on the budget is running concurrently with the regular session, no other bill hearings were held. The oral chemotherapy parity bill may be dead for this year as proponents did not meet the deadline for submitting amendatory language. CALIFORNIA: The Assembly Accountability and Administrative Review Committee chaired by Assemblyman Hector De La Torre held a hearing last week to examine how the Department of Managed Health Care (DMHC) and the Department of Insurance (CDI) has handled issues surrounding the rescission of policies in the individual market. According to a report prepared for the committee by Bryan Liang, director of the Institute of Health Law Studies at the California Western School of Law, fewer than 300 of 6,000 former policyholders are participating in health insurers’ agreements to settle such cases. Republican committee members were highly critical of this witness, while De La Torre was critical of the Departments. The DMHC reported that since their settlements were completed there have only been nine rescissions over the past two years, proof that the DMHC and the health plans have revamped their processes for rescission and have worked to address the problem. COLORADO: A bill mandating maternity and contraceptive coverage in individual policies continues to receive significant attention in the Senate. The most recent amendment proposes requiring maternity coverage in at least three of the plans marketed by an insurer. It would also allow a current member of a plan without maternity coverage to switch to a plan with maternity coverage from the same carrier during the first trimester. The other major bill would require that second level appeals be performed by physicians who are actively involved in clinical practice. This measure is counterintuitive in the current economy, since it would result in outsourcing appeals and drive up costs for plan sponsors and their employees. CONNECTICUT: A proposal that would require health insurance plans to cover oral chemotherapy in the same way that intravenous chemotherapy is covered made it through the legislature’s Insurance and Real Estate Committee last week. Currently, many health plans treat the two kinds of cancer treatments differently. Chemotherapy treatments that come in pill form are often categorized as prescription drug benefits that can require patients to pay a larger share of the cost. Cancer patients, doctors and patient advocates spoke in favor of the bill, while insurers and the Connecticut Business and Industry Association opposed it, arguing that it would put a mandate on health plans that could raise costs and make it more difficult for employers to afford insurance. GEORGIA: A bill restricting the use of rescissions in individual health insurance policies passed a Senate committee last week. Aetna continues to work with its trade organizations to educate legislators about the adverse effect of this type of legislation. Discussions also continue regarding legislation affecting the use of rental networks. KANSAS: Roughly half way through the legislative session, several health care bills are still moving through the process. On the regulatory front, the Insurance Department has proposed a regulation that would mandate coverage of routine patient care costs while the insured is enrolled in a cancer clinical trial – a mandate that was rejected by the legislature in 2008. A hearing will be held on April 20, and Aetna will have an opportunity to present testimony on this issue. Bills still alive include mandates for autism and orally administered chemotherapy, legislation prohibiting dental contracts that require the dentist to follow a fee schedule for non-covered services, and a ban on “most favored nation” clauses by some insurers. Another bill would allow small employers to create individual HRAs to fund premium payments on individual policies, require administering insurers to offer employees the option of receiving health insurance coverage through a high-deductible health plan with an HSA, and requiring insurers who offer small group health plans to offer high-deductible health plans with HSAs, while authorizing tax deductions for health insurance premiums for individual insurance policies. Separate legislation would amend the definition of “eligible employee” to include part-time workers (currently less than 30 hours per week). Pending legislation concerning hospital charges would prohibit charging private-pay patients more than 25 percent of what the hospital’s highest volume private payer would pay for the same goods or services. Legislation that died includes a telemedicine mandate and creation of a health care insurance database for employers. KENTUCKY: Health issues that are being hotly debated by the legislature right now include an autism mandate, a dental bill that would not allow insurers to hold dentists, optometrists or ophthalmologists to a fee schedule for non-covered services, and a bill setting a reimbursement floor for chiropractic services. The chiropractic services proposal would allow chiropractors to bill, and would require insurers to reimburse, an evaluation and management (E&M) CPT code on each and every visit. In addition to billing for follow-up services for manipulations and other therapies, the chiropractor would be allowed to submit, and the insurer required to pay, for another E&M code on each and every visit. The legislation would also add a new mandated benefit to the Kentucky statutes. Currently, reimbursement for chiropractor visits is required only if the chiropractor performs a service already covered by the health benefit plan. Under the proposal, any service within the scope of practice of a chiropractor that is billed would become a mandated benefit. Finally, the bill would require health benefit plans to provide reimbursement without the chiropractor having to provide any documentation that the services were medically necessary. Each of these bills has, or is expected to, pass at least one chamber. SOUTH DAKOTA: Several important legislative deadlines are approaching, resulting in a flurry of activity. Bills or resolutions not passed by the second chamber by March 9 died. But the Governor has already signed a bill that amends the premium rate-setting procedure for the high-risk pool so that rates for a given classification are 150 percent of the average actively marketed premium. The pool will have to offer three or more plan designs, remove coverage requirements for the plans (such as disease management) and remove set cost-sharing values. The bill was signed by the Governor on March 1 and will become effective on July 1, 2010. The Governor has also signed a bill prohibiting rating based on injuries caused by domestic violence and legislation requiring refunds of premiums for partial months, in the case of mid-month cancellations. Both chambers have passed legislation prohibiting contract language requiring dentists to accept a fee schedule for non-covered services, and the bill awaits the Governor’s signature. Finally, the legislature passed a resolution opposing the federal health care reform proposals passed in the U. S. Senate and House.

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