Methodology on Literature Search
I have used a few search engine and technique to complete this literature review. Search
engine and data base from International Medical University (IMU) library were my first
approach while looking for articles and journals related to my research topic. Besides that, I
have also used google search engine to look for related research material which linked me to
collect my researches from trustable resources such as journal articles from NCBI and
Science Direct. I have also implemented Boolean’s operator and technique like truncation
and wildcard to search for information more easily. For examples, tradition?l, tradit* and
many more. I have also set a few criterial while doing the research. For instance, the year of
publication should not be earlier than year 2009, the articles must be in English language and
the research must be done with population in Malaysia.
Introduction
The tittle of this literature review is about the impact of traditional medication and
complementary medicine in Malaysia. Both of these treatments are usually being written as
TCT as short form which can be elaborated as traditional and complementary medical
treatment for easier referencing (1,2,3). Different kind of TCTs has been invented by our
ancestors since few thousand years ago, and it’s existent is well known around the world.
TCT is usually related to the use of meditation and herbs that vary according to ethnicity.
Every ethnic group has their own beliefs system in curing disease since old back time until
now. At the same time, TCT is a form of health practices which targets to prevent or cure
diseases (1). Most importantly, there are research found out that it actually helps to preserve
the mental health and overall human well-being. Malaysia is a multicultural and
multiethnicity country, which simultaneously makes Malaysia as a potential country to be
used on doing research on their variety types of TCT. Among them are the famous TCT
which came from the race such as Indian, Chinese and Malay and also Islamic homeopathy
and medical treatment (3,4).
Content
According to statistic, the highest population which uses TCT (traditional and complementary
medical treatment) are the Sabah Native and followed by Malay users. This can be due to the
high population of Malay ethic and bumiputera, the native citizen in Malaysia (4). Most of
these people lives in rural area which makes them less likely to explore to modern
medication. Since each ethnicity has their own way of treating patient, we known it generally
as TCT, there must be someone in their living area who act as the “doctor” to treat the
residents of the area. These “doctor” are usually being known as bomoh in Malay language.
However, as Malaysia gets more modernized, the treatment knowledge from these people are
being discovered and researched which evolve to become the recognized way of medical
treatment plan that some hospital in Malaysia are implementing nowadays (5).
TCT has gotten a rapid growth in Malaysia nowadays. In view of the demand and potential
growth of TCT in Malaysia, the government of Malaysia has decided to set up the TCT
division in the Ministry of Health in year 2004 which then proceed with the decision to
establish integrated hospitals in year 2006 (2,3). Among that, there are 6 programmes
available in TCT instilled among the 5 higher education institutions. For examples,
International Medical University Bukit Jalil Campus, Collage Nilai, INTI International
University College, College of Complementary Medicine Melaka, Management and Science
University (MSU), Cyberjaya University College of Medical Science (CUCMS) Cyberjaya
and Management and Science University Shah Alam. At the same time, there are also 9
integrated public hospital which are practicing TCT in Malaysia. For examples, Hospital
Kepala Batas, Putrajaya Hospital, Sultan Ismail Hospital, Sultanah Nur Zahirah hospital,
Hospital Port Dickson, Hospital Sultanah Bahiyah, Hospital Cameron Highland, Sarawak
General hospital and Duchess of Kent hospital in Sabah (2,6,8).
According to the government platform, these hospitals are currently providing TCT services
such as acupuncture, herbal oncology, traditional Malay massage and postnatal massage to
the patients. In which, patients with chronic illness, stroke, cancers are the most popular
being recommended to accept TCT treatment plan (1,5,6,7,8,9). To be more precise,
traditional massaging and acupuncture are usually being introduced to patient with chronic
pain and stroke while herbal medication are recommended to oncology ward patients which
used with complement treatment with allopathy therapy. Meanwhile, TCT has brought great
beneficial and improves quality of life of woman after child delivery (7.8). The hospitals
provide postnatal massage to relieve muscle cramps and fatigue of the mothers after labour.
At the same time, herbal medication also involved in postnatal care treatment plan.
Furthermore, TCT field has open up a new market and job opportunity in healthcare system.
Precisely, in year 2006, more than seven thousand practitioners who major in traditional and
complementary medicine were registered with their respective bodies (4,10). Now, the
number of TCT practitioners has increased to more than 10,000 which includes applicants for
professional visa by foreign practitioners and voluntary registries by local practitioners.
Currently, the population ration of traditional and complementary medicine practitioner with
patient is at 1:24213. According to the year end report from government sector, Traditional
and Complementary Medicine division has received government fund around 2 million
ringgit budget which is a lot higher as compare with year 2007 for development and
operational expenditure (4,10). In the blueprint of Malaysia future mission view, the
government has written and wish to establish at least 2 traditional and complementary
medication branch office each year.
The rose of traditional and complementary treatment has slowly influence Malaysian to lay
towards the TCT treatment. This can be proof with a survey in year 2004 whereby more than
70% of Malaysian population use TCT in their whole life and about half of them used
traditional and complementary treatment in each year. There is also another survey which is
done in primary care clinics in Kuching, Sarawak Malaysia in year 2004, around 51.4% of
patients used traditional and commentary treatment and 47.8% of those patients used more
than one type of TCT treatment (2,9).
According to the treatment services that are written in multiple hospital official website, TCT
has being infused in treating communicable and non-communicable diseases. It is especially
being used extensively towards ongoing and chronic disease patients such as RA(rheumatoid
arthritis), depression, diabetes, stroke, osteoarthritis, gastrointestinal, cancer asthma, eczema,
premenstrual syndrome, migraine, chronic fatigue, menopausal symptoms, irritable bowel
syndrome, dengue fever and many more (5,7). And most of the cases in Malaysia have been
found successfully relieve the symptoms with the use of TCT therapy. TCT also involved in
treatment of dengue fever patients. The practitioners used crab soup, papaya leaf extract and
isotonic drinks which gotten from fruits are found to be useful in treating dengue fever (3).
On the other hand, there are also survey saying that with comparison with most of the
modern treatment plan, traditional and complementary medical treatment have lesser side
effect while successfully treat and control certain diseases (3,6,7). Not to mention, the lifetime bearing diseases like HIV/AIDS has took part in the research with using TCT as a part
of treatment plan (2,6,8). In the research, after experiencing 4 to 8 months of herbal therapy
among HIV patient, scientist found the achievement of significant health improvement. To be
more precises, the researched patients have great increase in CD4+ T cell counts which is
usually affected in HIV patient (2,6,8).
There are also two very extreme parties from the research arguing that whether liver disease
patient can receive traditional and complementary medication especially the herbal
medication treatment. As for the reason from the disagreed parties, liver is in-charge of drug
metabolism and detoxification which is crucial to remove the left-over impurities of the herbs
in the body after it has taken the effect on the disease (8). This will simultaneously increase
the workload of the liver and especially create more harm to the patient suffering from
chronic liver disease (9,10). On the other hand, the agreed parties have given their reasons
with research results. According to Malaysian Journal of Public Health Medicine 2011, use of
TCT has significantly improved the liver function during chemotherapy towards cancer
patients. It’s involvement has proven to decrease the liver damage that is brought by
chemotherapy, and it also actives antioxidant (7,8). TCT has also being used to treat hepatitis,
and are found to have the ability to decrease ALT and AST (liver damage laboratory finding)
and alleviating metabolic load (7,8).
There are a few surveys with the objective of finding out patient’s will of choosing TCT as
their choice of treatment. In the perspective of the cost of TCT treatment, there are also
voices from 2 different parties, one saying that TCT treatment is more expensive than modern
treatment which create more burden to the patient while the other one saying that TCT
treatment is very affordable and greatly reduce the burden while increase the quality of the
patient (3). According to the compiled information from most of the insurance company,
traditional and complementary medication services are usually not covered by health
insurance (4). Therefore, consumers who opt for TCT treatment needs to bear with the cost
by themselves. However, in government TCT sector, most of the medical fees are being bear
by the government so contradictory, the price is obviously much cheaper than the private
TCT services (4). There are also respondents and cases reported that, some Indian traditional
medicine practitioner tends to provide pricier services with the reason of limited practice of
the treatment field. At the same time, there are also certain treatments from Chinese TCT
style cost highly compare to other treatment due to the rare and valuable species of herb they
used along the treatment like ginseng and donkey-hide gelatine (3). At the same time, there
are variety types of herbs are suitable to be planted in Malaysia which became one of the
reasons of TCT treatment being cheaper than modern medical treatment. There is a study
showed that there is a high prevalence of TCT treatment used by Malaysian especially in the
use of herb-based therapies (6). Herb-based therapy are being wisely use for both health
issues and health maintenance. Most importantly, most of the herb are easily accessible from
the store nowadays.
Conclusion
In conclusion, Traditional and complementary treatment are currently gaining more support
from the society. However, in order to avoid people from misusing the popularity of TCT,
strict should be implement from the government to reduce the risk of criminal cases. At the
same time, public education is also important to allow the society to get to know more about
the knowledge of TCT and able to choose their medical therapy wisely. Last but not least,
there are still tons of unknowns in this field as we can still find many arguments of the
medication used in TCT toward human health, more further discover and research should be
done and supported in order maximize the benefits of TCT in healthcare field.