JEDDAH, 20 May — Does integrated medicine have a place in Saudi Arabia’s health care system? Dr. Ahmed Al-Jarallah, consultant, pediatric neurologist at King Saud University, Riyadh, dealt with the question here last week. “Several methods practiced in oriental medicine have been attempted and even used in treatment of common conditions,” Al-Jarallah said at the three-day international integrated medicine symposium and exhibition organized by King Faisal Specialist Hospital and Research Center (KFSH&RC).
In the beginning of the 20th century, he said, the people in the Kingdom depended entirely on oriental medicine. However, with rapid progress in health services, the dependence became more on Western medicine, which resulted in eradication of bacterial diseases and improved survival for patients with chronic conditions. “But since then it did not eradicate these conditions; patients used oriental medicine in addition to Western medicine to treat chronic diseases. Should we not attempt to answer the question whether integrated medicine has a place in the Kingdom?” he asked.
In fact, Dr. Essam Al-Sabban, executive director of the research center and chief of the international collaboration program at KFSH&RC, observed that integrated medicine was a comprehensive form of medical practice, which provided complementary and alternative therapies alongside conventional medicine. “It’s practiced by physicians who are able to prevent, diagnose and treat different illnesses. People who prefer integrated medicine to conventional medicine claim that it’s safe and addresses the mental, emotional and spiritual needs of the patient. In a growing market of such therapeutic modalities it’s not enough to address the associated risks of this practice but it’s time to work together to set research priorities to endorse certain complementary and alternative approaches as safe and effective therapeutic modalities,” he said.
“Two questions that need to be addressed are what is the appropriate research methodology applicable to integrated medicine practice and how its application can be regulated in the health care sector,” said Dr. Al-Sabban who is also consultant pediatric nephrology at the hospital.
Saudi folk medicine covers a very broad spectrum of non-conventional therapies, ranging from herbal medicine, cupping, cautery setting broken or dislocated bones to various forms of self-care. Many people in the Kingdom believe strongly in such medications research into the safety and efficacy of such forms of therapy continues.
King Abdul Aziz City for Science and Technology has sponsored a project “Merits and demerits of Saudi folk medicine’ which was mostly carried out by College of pharmacy, King Saud University, said Dr. Manosur Al-Said, professor and dean, College of Pharmacy, King Saud University, Riyadh.
About traditional herbal medicine in Saudi Arabia, Dr. Mohammed Al-Tufail, director of toxicology, bioanalysis and GMO Laboratories, KFSH&RC, Riyadh, said beneficial effects of many Saudi plants were well established and many time-honored herbal remedies used effectively to treat minor self-limiting conditions. “It’s known that some herbs have both beneficial and harmful effects on humans and their long-term effects need investigation. This is very difficult due to variations in the composition of herbal remedies. Also, these remedies are taken in a variable dosage and frequency,” said Al-Tufail who has an extensive experience in the analysis and toxicology of herbal medicine and other products used by traditional healers.
Dr. Faiz M. El Gali, director, alternative medicine center, at King Fahd General Hospital, Jeddah, discussed the role of acupuncture, a form of traditional Chinese medicine that has developed over thousands of years, in pain management based on King Fahd Hospital’s experience in Jeddah. In addition to medication, physiotherapy and therapeutic exercise, acupuncture as an alternative method offers other unique and effective safe method for relief of pain. Musculoskeletal pains are a common problem in many hospitals all over the world, although there is a great variability in its treatment responses.
Acupuncture is well known worldwide and its contribution to analgesia and anesthesia is well documented and recognized by World Health Organization, according to him. In a presentation on management of musculoskeletal pains, he said: “We’ve dealt with 131 definite chronic pain syndrome in the last five months, with different ailments including acute and chronic head and neck pain, back pain, and acute strains, spasms or stiffness. We’ve successfully dealt with them both in the acute and chronic phase and also followed this through the rehabilitation phase,” he added.
Dr. Dahong Zhuo, professor and director, WHO Collaborating Center for Rehabilitation, Sun Yat-sen University of Medical Science, China, said oriental medicine such as traditional Chinese medicine (TCM) played an important part in daily medical rehabilitation in his country. “Usually TCM methods are used in combination with Western technology. The value of TCM in medical rehabilitation lies in its holistic approach, effectiveness for many conditions, and popularity and accessibility as an appropriate technology. Among others, Chi Kung (Chinese style meditation), Tai Chi exercise, acupuncture/moxibustion, Chinese style manipulation and massage and Chinese herbal drugs are the most commonly used methods in medical rehabilitation bringing positive physical and psychological effects on the body and the mind. New herbal drugs for a faster and better recovery of functions after stroke are being tried with good results,” he said.
According to Dr. Michael O. Smith, director, Lincoln Hospital Substance Abuse Division, Lincoln Recovery Center, Bronx, New York, more than 1,000 drug and alcohol treatment programs in the United States and 40 other countries have added an acupuncture component to their protocol over the years. This development is based on the 20-year experience of Lincoln Hospital that provides 100 acupuncture treatments per day as part of its comprehensive program. Acupuncture provides a physiological, and psychosocial message to a wide range of patients.
Dr. Detlef Schikora, assistant professor, University of Paderborn, Germany, referred to a study that compares the effects of traditional metal-needle acupuncture with the new, noninvasive laser needle acupuncture. He presented several case examples of noninvasive laser needle acupuncture.
According to Dr. Sulthan Bahabri, chief executive officer, KFSH&RC, Jeddah, many people seek alternative therapy when options for conventional therapy are exhausted. It is generally recognized that effectiveness of conventional therapy is limited for some illnesses. There is also a general fear about the side effects and complications of modern medicine. “However, there has been a two-decade-long movement toward more natural methods to treat a host of diseases. Furthermore, patients may feel a loss of control that leads them to use alternative therapy as a way to exercise some control over their care,” he said.
Dr. Akbar Kimawi, medical homeopathy, oriental medicine and acupuncture consultant, King Fahd Hospital, Jeddah, described homeopathy, a medical discipline discovered by S. Hahnemann in 1790, was a non-evasive form of therapy, non-toxic remedy and using high-diluted single remedy. “Homeopathy entails a holistic approach with the concept that a whole cannot be divided into sum of its parts, taking into consideration the mind, emotions, reaction to weather changes in addition to patient symptoms. Dr. Sayed Rafatullah of King Saud University, emphasized that homeopathic treatment was non-invasive and gently, thus utilized by infants, children, men and women and elderly people alike.
“It’s believed that sickness is related to the whole person and not to one particular part or organ of the body, thus homeopathy treats the patients not the disease,” he said. According to Abdul Hayy Hodijk, associate director, the writing program, department of English and comparative literature, American University in Cairo, the use of homeopathy has increased by leaps and bounds as the trend is more for integrated health care the world over.
Also highlighted were transformational breath by Dr. Nora A. Al-Suhail of Transformational Breath Foundation, Eastern Province, and alternative therapies for refractory angina by Dr. Rohit R. Arora, professor and director division of cardiovascular diseases, University of Medicine & Dentistry of New Jersey.
Dr. Arora said one of the options available was enhanced external counter pulsation (EECP) — a noninvasive treatment. “It provides initial benefit and long-term results for patients suffering with the symptoms of angina pectoris who may not be candidates for the more traditional invasive procedures. It utilizes the same hemodynamic principle of counter pulsation utilized in the intra-aortic balloon pump. Increased diastolic augmentation increases coronary blood flow and perfuses the myocardial muscle. It has been demonstrated in clinical studies, published in peer review journals that EECP therapy reduces angina, decreases the need for nitroglycerine and increases cardiac output,” he said.
Another effective and more natural method of medication is the herbal supplements introduced by Dr. Luke Cua, president and researcher of American Herbal Laboratories in California. Dr. Cua is the inventor of the new Vita, a full line of 33 natural herbs.
“The products are easy to use and very effective for my patients. They have great results in three to 14 days,” he said, adding that the utilizing of these products had helped him maintain a heavy patient load. Vita products, according to him, include many treatments for most of the body organs like stomach, kidney, thyroid, liver, immune system, lung, heart, respiratory system and blood vessels. Moreover, a very effective treatment of hair loss and alopecia is also on its list.