| International CAM: India Hosts IM Group, Homeopathy Challenged in UK, Integrative Care in Haiti | |
Summary: Welcome to this Integrator travelogue, linking you to international policy developments in traditional medicine and complementary and alternative medicine practices ... A citizen's referendum in Switzerland forces inclusion of CAM practices in healthcare planning ... In England, a report from the King's Fund concludes that we need both new methodologies and new attitudes, thank you, to optimally research complementary medicine and health ... A report on non-conventional medicine (the preferred term) in Italy calls for an end to 20 years of procrastination, and shares what's already covered in Tuscany and parts north ... Actuary Heather McCloud, a CAM leader in the International Association of Actuaries, is setting up a similar group in a new African health economics organization ...
Navin Shah, MD - headed the delegration for the Indian government
1. Indian Health Ministry hosts delegation of 6 integrative
medicine
academics to help bring Ayurveda to US
At the request of the India Health Ministry,
a group of
six academic leaders in integrative medicine visited India in January
2010 "to explore
the
possibilities of introduction of evidence-based Ayurveda, Yoga,
meditation, and oil massage treatment in the United States medical
education, research, and patient care areas," according to this
article in the India Journal. The
US team consisted of leaders associated with
the Consortium of Academic Health
Centers for Integrative Medicine (CAHCIM): David
Eisenberg,
MD, Anastasia Rowland-Seymour, MD,
Johns Hopkins
University, Benjamin Kligler, MD, MPH, Albert Einstein College of
Medicine, Aviad Haramati, PhD, Victoria Maizes,
MD, MPH, and Anne Nedrow, MD, Oregon Health &
Science
University. India has 150 Ayurveda
colleges, 50 post-graduate Ayurveda institutions,
70,000 students, 10,000 faculty members and 3,000
Ayurveda hospitals. One focus was on the
possibilities of joint Indo-U.S. research. The group was
led by urologist Navin
Shah,
MD.
Adi Haramati, PhD: part of US team
Haramati, the founding
vice chair of CAHCIM and an organizer of the team, told the Integrator
that the delegation heard presentations on evidence, visited an
Ayurvedic medical
school and toured an Ayurvedic products factory. The team was received
by high-level policy makers in India. Included, said Haramati, was a
meeting with "the Indian equivalent of
the US Secretary of Health." Presentations focused on the treatment
benefits of Ayurveda in major conditions and specifically on the role of
diet in both health and diseases. In October of 2010, two
professors
of Ayurveda from India will follow-up by coming to the United
States and visiting the 6
institutions represented by the US delegation.
Comment: Haramati noted
that the individualized, lifestyle and health-oriented Ayurvedic
approaches are often less focused on quick disease cure than on health
creation. One wonders whether partnering with the NIH, an agency which
does not typically focus on health creation, is the Indian government's
best strategy. Ayurdevic medicine is likely to get tangled, as
"complementary and alternative medicine" has, in a web of questions that
hardly touch on the parallel functionality, satisfaction and lowered
cost claims that practitioners make. To the extent that the Ayurvedic
approaches focus on creating health, the Indian Ministry of Health and
Family Welfare might better by form alliances for research with US
employers through the Corporate Health Improvement
Program run by Ken Pelletier, PhD, MD (hc) or the Institute for Health
and Productivity Management where the focus is on functionality and
health. Such a strategy might yield more bang for their bucks.
NCH's Gahles: Raising questions about implications for the US
2. Storm over homeopathy: Controversial recommendation to
drop UK recognition raises questions about impacts here
"Homeopathy in United Kingdom (UK) has long stood as a model for the
United
States," begins Nancy Gahles, DC, CCH, RS (Hom), president of the
National Center for Homeopathy in her column in the Spring 2010
issue of
Homeopathy
Today. Gahles references work of
Parliament's Science
and
Technology Committee (STC) leading to a February
2010 report entitled Evidence
Check
2. Gahles
adds, referencing the report's recommendation against covering
homeopathy in the National Health Service: "But we're sorry to say - this
is
no longer the case." However, as
author and homeopathy advocate Dana
Ullman, MPH points out in this March
3, 2010 Huffington Post column, Parliament as a whole has
not acted against homeopathy and may not. The STC action was only
advisory, in the form of recommendations in a committee report. And for reasons not explained, the recommendations
were endorsed by just 3 of 14 STC committee members. (Just 4 members 4
are on record as voting on the issue.)
Pro-homeopathy supporters immediately organized a "mass lobby" as
shown in this video . The campaign delivered 28,112 signatures
against the report's recommendations on February 24, 2010. Ullman
reports that leading
UK policy makers appear reluctant to wrestle with an issue which
reflects, as he told the Integrator, a "homeopathic portion" of
the UK's health budget. The prevailing, hands-off homeopathy view may
have been captured in a March 13, 2010 editorial in the Lancet entitled:
"On
Reflection: Magic is acceptable." The
British Homeopathic Association has filed a series
of reports and rebuttals to the STC report.
Ullman: Downplays likely impact
The National Center's
Gahles, in her Homeopathy Today column, asks if
"the long arm of the UK anti-homeopathy coalition (will) reach
across the pond to the United States." Notably,
the STC report and its conclusions were seized upon here by Stephen
Novella, MD, the Yale
school of medicine faculty member and anti-CAM blogger
at Science-Based Medicine. Novella exults in the report as an exemplary governmental approach not just to
homeopathy but for all of complementary medicine. (Notably, the force behind the STC investigation in the UK was, according to both
Gahles and Ullman, a similarly anti-CAM blog-site called Sense About Science.)
Novella argues that it is time to put the US
recognition of homeopathic products under similar scrutiny. Gahles believes that a trans-Atlantic anti-homeopathy campaign has already
begun. She cites a November 2009 commentary
published in the American Journal of Medicine by Edzard
Ernst and Michael Baum, principle scientists behind Evidence Check 2,
who state that they are "happy to confess that our minds have closed
down on homeopathy." Gahles writes that the commentary was "the first
U.S. salvo of a highly determined, sophisticated and well-funded
alliance that aims to eliminate homeopathy whereever it is practiced."
Comment: A brief interview with Ullman leads me to believe that governmental
action to make the STC recommendations law is unlikely in the UK, as
it is any off-shoot of federal policy action here. These developments do remind
us again how infinitesimal doses, whether or not one values their
clinical effects, can be immensely
powerful in potentizing the politics of science. Ullman's last two Huffington Post columns, relating to homeopathy, have generated over 3000 comments. (Thanks to Integrator
reader Paolo Roberti de Sarsina for keeping me abreast of
developments.)
Acupuncturist Van Voast: An exceptional account of his experience
3. Integrative practice in Haiti: Report from a returning LAc, Tzu Chi Foundation, assessment efforts for long-term LAc and ND strategies
The journal of Jordan Van Voast, LAc on his February 2010 trip to Haiti is a remarkable internal and external look at the extreme experience of care-giving. Van Voast reflects on the limits of his tools, the desire for medicines in the population he served and his wrestling with the use of placebos. A community acupuncturist who runs the Communi-Chi clinic in Seattle, Van Voast was sponsored through the Buddhist Compassion Relief Tzu Chi Foundation. Tzu Chi has established a steady foothold in Haiti. Seattle healthcare practitioner and Integrator reader William Wulsin, ND, LAc, MPH, who begins a care trip through Tzu Chi on March 26, 2010, shares that a key part of his decision to work through Tzu Chi is the quality of its presence. One issue, according to Wulsin,
is basic security. Wulsin has been involved with the Haiti Disaster Relief Collaborative that represents over a dozen
stakeholder organizations "committed to the wise and effective
applications of
natural medicine in Haiti and beyond."
Both Acupuncturists Without Borders (AWB) and Natural Doctors International (NDI) a naturopathic physician-led organization, have each sent individuals or teams to Haiti to assess strategies for their organization's long-term efforts. Perhaps the key question is how to best ground them locally. AWB, which has partnered with Boston-based Pathways to Wellness, had its Haiti visit documented by Sarasota-based SNN Local News 6. The news clip is available here on the AWB site. A March 24, 2010 report sent to AWB's e-list provides a look at the variety of hospital and tent encampment sites where the organization's teams deliver care.
Sabine Thomas, ND, LMT, a Haitian-American who is heading up NDI's exploration, shared with the Integrator that he combination visit to her family (two members were killed) and fact-finding has led her to caution against anyone coming down who might be adding to the chaos. Thomas set up relationships with key Haitian officials who are helping guide NDI which is planning to clarify its strategy in an April 10, 2010 meeting in Portland, Oregon.
Wulsin, who has been in dialogue with Thomas and other naturopathic physicians looking into care giving anticipates
undertaking some exploration which may be of use to his ND
colleagues.
Comment: I particularly recommend the account from Van Voast, whose clinical services I have used, as an honest, internal reflection on the experience. Additional note: Functional medicine leader Mark Hyman, MD continues to offer perspectives based on his early journey into the disaster. Hyman's March 1, 2010 posting in here.
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