1. TRADITIONAL AND COMPLEMENTARY MEDICINE IN PATIENT CENTERED HEALTH CARE AND INTEGRATIVE MEDICINE Julius W. Mwangi, School of Pharmacy, University of Nairobi, Patient Centered Care: Training and Delivery of Universal Healthcare Conference, Kenyatta University Nairobi, Kenya, 29th September – 2nd October, 2015 © UoN, 2015 ISO 9001:2008 Certified http://www.uonbi.ac.ke

2. 4000 Years of Medicine joke by Linda Curran (USA) 2000 BC: Here, eat this root 1000 AD: That root is heathen! Here, say this prayer 1865 AD: That prayer is superstition! Here, drink this potion. 1935 AD: That potion is snake oil! Here, swallow this pill. 1975 AD: That pill is ineffective! Here take this antibiotic! 2000 AD: That antibiotic is poison! Here, eat this root!

3. Traditional medicine (WHO) Traditional medicine is the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. Complementary/alternative medicine (CAM) They refer to a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system.

4.  integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle.  It emphasizes the therapeutic relationship between patient and physician and makes use of all appropriate therapies, both conventional and traditional and complementary medicine  Picks the best therapies from both system Get patient better by using safe, effective and less invasive and cost effective intervention

5. Traditional & Complementary medicine Healing therapies include Traditional medical systems (TCM, herbal medicine, Homeopathic,Aromatherapy, acupuncture, Reflexology, Ayurveda) manual medicine (Chiropractic, osteopathy, massage), lifestyle changes (nutrition, exercise) mind-body therapies (yoga, Tai Chi,Pet, Laughter,).

6. justification  cost effective and easily accessible,  advantage of history on its side  lacks the sophistication of modern medicine in tackling modern ailments.  Integration of combinations of traditional with modern medicine has been shown to be better than either of them  current health care waits until symptoms of disease arise, as opposed to spending more time and effort on disease prevention so that those problems do not occur in the first place.  Becoming more and more popular in integrative medicine

7. Justification..  recent globalization of unhealthy lifestyles, rapid unplanned urbanization, and demographic aging universal rise of cardiovascular diseases cancer, diabetes and mental disorders.  rate of new better drug development has plateaued in recent times Adverse side effects Toxicity in human trials Post approval withdraws for new drugs

8. POPULARITY??? CONGESTION: LOLIODO ion at 8

9. POPULARITY  Developed countries-looking to herbal medicines beyond their nutritional value; WHY?  Usefulness in prevention and treatment of disease.  Increased concern about the adverse effects of conventional drugs. 9

10. POPULARITY….  Greater public access to health information internet, face book, twitter, You Tube  Gentler means of managing chronic, debilitating diseases heart disease rheumatoid arthritis cancer diabetes 10

11. POPULARITY…  Criticism of high-technology, specialized medicine, despite all its well-documented merits. WHY? Too much invasive examinations. Treatment of ‘lab results’ NOT patients. Medical care has become depersonalized; “hardhearted” ? 11

12. POPULARITY… Absence of compassionate doctor-patient relationship. Patient not a person, assembly line of body parts. Thus Managed by different specialists in a non-integrated manner. 12

13. FOOD AND HEALTH Let food be your medicine and let medicine be your food - Hippocrates  Healthy foods prevent rise of chronic non-communicable diseases;  Heart disease  Cancer  Diabetes  Mental disorders

14. FOOD AND HEALTH..  Rectal and colon cancer-Cabbage family.  Diabetes-Beans, peas, dolichols, soya  Cancer of stomach & prostate- Unskinned tomatoes.  “A clove of garlic a day keeps the doctor away”. CVS, many cancers  Citrus, blueberries, pomegranate, grapes  Turmeric  Anti-Angiogenesis therapy? 14

15. EATING HEALTHY?  Take Sour milk, yogurt or “Mursik”.  Avoid SOLID FAT -“Bad cholesterol”.  Avoid Mouldy foods, beverages or medicines.

16. broccoli To prevent cancer

17. pomegranate Ripe fruits

18. TURMERIC

19. DIAGNOSES IN TRADITIONAL AND COMPLEMENTARY MEDICINE  Diagnosis takes account of the whole (total) person  Dress, walk, talk, overweight, complexion, height  State of past health and life circumstances  health of ones family, employment or occupation, difficult with relations  What foods one dislikes or like  Effect of change of weather, allergies  What upsets one and whether even or quick tempered  Hope, fears (tangible and intangible)  Aspirations  musical or artistic are recorded.

20. DIAGNOSES  A doctor in Kenya practices patient centered health care in his clinic  Patients report as early as 6.00am to book appointments  He attends to 8-14 patients daily and spends 0.5-1.0hr per patient  HE MUST BE USING TRADITIONAL MEDICINE!!

21. Hippocrates It’s more important to know what sort of person has a disease than to know what sort of disease a person has.