Traditional Medicine: Why Include Traditional Knowledge in a Health System?

Colombia has become the center of controversy and debate in Latin America in recent months, especially due to the controversial reforms that the government of President Gustavo Petro has put into public conversation. The leftist leader has wanted to establish major changes on issues such as pensions, work, and politics. However, health has become an Achilles heel that has put the national government between a rock and a hard place.

The reform that seeks to transform the health system of the South American country has sparked several controversies among the Colombian political class and has even cost Carolina Corcho the job, who until recently served as Minister of Health. Among the discussions that have taken place around this situation, one of the most important revolves around the inclusion of ancestral medicine (sabedoras, healers, midwives, herbalists, taitas, sobanderos, pulsadores, guaraleros, among others) in the Plan National Health of that country.

Although these practices have been part of Colombian ancestral cultures for centuries, they have only recently begun to be discussed in broader terms, as ancestral medicine has become increasingly popular. While some argue that they should be considered legitimate medical practices and allowed to operate legally, others warn that their lack of regulation can put people's health at risk. There is also debate about whether the people who perform these practices should be considered "healers" or "shamans", or if they should have some kind of official accreditation.

How to approach the subject of ancestral medicine?

Now, the fact that this discussion is being generated in Colombia up to now, does not mean that it is not a topic that has already been debated at a global and regional level in the past. In fact, most of the controversial points have already had a response from international organizations, such as the Pan American Health Organization (PAHO) and the World Health Organization (WHO).

In the first case, there is a report developed in August 1997 entitled "Strengthening and Development of Traditional Health Systems", which, in a few words, establishes the need to establish, regulate and practice a strategy of "organization and provision of health services in multicultural populations”.

For PAHO, it is clear that “the historical processes of colonization and the tendency to homogenize the peoples of the region have prevented a serious consideration of the multicultural characteristics of the continent. In this sense, both the real value of the cultures that have survived and are in force have been left aside, as well as the presence of new cultural expressions that were born as a result of miscegenation and interaction between cultures.

For this reason, it is important, according to this organization, to cover and spread the knowledge of traditional cultures that have seen in their customs and forms the way to cover what the WHO defines as health: "biological, psychological and social well-being of an individual ”.

“ The specific concept of health, which follows a predominantly "Western" paradigm, must evolve into a conception that encompasses and respects other health concepts that are equally valid and proven in practice. The complementation between the traditional and western medical systems, within the framework of integrality and interculturality, would occur both on the intellectual level – theory, concepts – and in the verification that the solutions identified in this joint work are valid and permanent. – practice”, adds PAHO.

In this sense, it can be said that there is already a framework of context and knowledge with which Latin American governments can be guided to establish concepts and regulations regarding ancestral medicine in their respective territories.

The idea is to see traditional medicine not as a set of mystical knowledge from the past, but as a perfectly current series of knowledge that explains the way in which ethnic groups (indigenous, Afro, gypsy, among others) view health, and even more importantly, successfully treat the problems related to this fundamental area of the human being.

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Examples of its implementation

Although the health reform in Colombia has been decisive in returning to talking about ancestral medicine as a system that fits perfectly into a national health plan, the truth is that this conversation has already taken place in several countries in the region, such as Ecuador and Mexico. In these territories, strategies have already been established to make this type of medicine a valid and real option for the treatment of its inhabitants.

For example, in the case of Ecuador, the Government of that country has been working hand in hand with the indigenous population to bring their traditional medical knowledge closer to the population accustomed to Western medicine. According to the Ministry of Health, in 2022 progress had already been made towards this goal, through projects that seek to adapt the knowledge of communities in the Amazon, Sierra, and Coast to the Ecuadorian health model.

“Traditional and Western medicine are complementary. We are giving value to these cultural and ancestral practices that the communities have”, explained the Minister of Public Health, José Ruales.

For its part, Mexico already has an "Implementation Guide" developed by the Ministry of Health of that country, which has served as a route to strengthen health services with traditional medicine. Mexicans already have a network of health services with this ancestral knowledge, in which hospitals and health units based on this knowledge stand out.

Likewise, they have established traditional midwifery modules (which according to the UN can provide 90% of all sexual, reproductive, maternal and neonatal health services), as well as a "Green Pharmacy" model in which some indigenous birth control remedies from traditional medicine in national health units are offered.