Traditional and Complementary Medicine Programme in Malaysia

Transcription

A
H
d
n
a
b
oo
f
o
k
Traditional and
Complementary
Medicine Programme in
Malaysia
Acknowledgement
This handbook was crafted through generous mentoring and
encouragement. Special acknowledgement is due to Dato’ Dr.
Maimunah bt A. Hamid, Deputy Director General of Health
(Research and Technical Support), Ministry of Health Malaysia, for
sparking the idea. Similarly, special acknowledgement is given to
Dr. Ramli bin Abd. Ghani, Director of the Traditional and
Complementary Medicine Division, Ministry of Health Malaysia, for
his continuous support and endless encouragement.
Also, the Traditional and Complementary Medicine Division greatly
appreciates the valuable work of every individual who contributed
to the success in the preparation of this handbook.
Last but not least, special appreciation to the reviewers for their
valuable comments and input.
Editorial Committee
Traditional & Complementary Medicine Division
October 2011
Foreword
Medicine is in the new era. In the past century, the health care
system has seen major changes not only within the modern
medicine but also, the integration of traditional and
complementary medicine into the modern medical system.
This is due to the fact that the world population is
increasingly seeking natural or drugless remedies or
solutions to their health problems. Realising this, Malaysia
strives to achieve a balanced and safe use of both modern
and traditional and complementary medicine.
Dato’ Dr. Maimunah bt A. Hamid
Deputy Director General of Health
(Research and Technical Support)
Ministry of Health Malaysia
October 2011
This handbook is a reflection of what transpired, what was
planned and achieved by the Government of Malaysia in
realising the dream of integrating both types of medical
systems. The contents of this handbook have been carefully
selected and organised in such a way that it delivers much of the
needed information to the public as well as the professionals
involved.
I would like to convey my deepest appreciation to the editorial
committee who have worked hard to put together this
remarkable book for the benefit of the people of Malaysia.
Preface
Dr. Ramli bin Abd. Ghani
Director
Traditional and Complementary Medicine Division
October 2011
Today, Traditional and Complementary Medicine (T&CM) is an
important component of the healthcare system. It co-exists with
modern medicine to improve health and the quality of life.
T&CM plays a crucial role in the aspect of prevention, health
promotion and healing. In the local community, traditional
remedies are commonly sought after to accelerate the process
of healing and in maintaining health after treatment or
diagnosis from an allopathic medical practitioner.
This handbook marks our first attempt to provide a general
overview of the practice of T&CM in a localised setting whilst
promoting public awareness towards its safety and quality.
The idea of this handbook came from Dato’ Dr. Maimunah bt A.
Hamid, Deputy Director General of Health (Research and
Technical Support), Ministry of Health Malaysia. The information
and facts in this handbook are intended for the people of
Malaysia from all walks of life who care about the society they
live in and the people whom they share their lives with.
I would like to thank the editorial committee for devoting their
time with genuine interest and enthusiasm to ensure the
realisation of this book.
Contents
CHAPTER 1
Introducing... Traditional & Complementary Medicine
Overview
Definitions
Classifications of T&CM in Malaysia
Roles and Functions of T&CMD
1–6
CHAPTER 2
Development of T&CM – Globally and Locally
7 – 19
Global Development
International Collaboration in Traditional &
Complementary Medicine
Development of T&CM Programme in Malaysia
T&CM Practices Available at the Integrative Hospitals
T&CM Units at the Integrative Hospitals
CHAPTER 3
Modalities in T&CM
Therapeutic Versus Wellness Concept
Home-grown Modalities
The Scope of Practice of T&CM Modalities
20 – 23
CHAPTER 4
EBP in Supporting Development of T&CM Practices
EBP – Evidence-based Practice
Steps involved in the EBP Process
Use of EBP in Developing T&CM Guidelines
24 – 28
CHAPTER 5
Education & Training
29 – 32
CHAPTER 6
Research in T&CM
33 – 35
CHAPTER 7
Promotional, Enforcement & Public Education Activities 36 – 44
Promotional Activities
Inspection Activities
Public Education
GLOSSARY
EDITORIAL COMMITTEE
45 – 49
50
1
Chapter 1
Introducing... Traditional & Complementary Medicine
Overview
Traditional Medicine (TM) is an ancient medical practice which
existed in human societies before the application of modern
science to health. It has evolved to reflect different
philosophical backgrounds and cultural origins. The practice of
modern medicine may be widespread but the use of traditional
medicine is still practiced in many countries although it is not
always included as a part of the healthcare system recognised
by the government. It is one of many types of non-standardised
health care services which involve varying levels of training and
efficiency.
TM/CAM (Complementary & Alternative Medicine) has been
widely utilised by the world population for decades. In some
Asian and African countries, 80% of the population depend on
traditional medicine for primary health care purposes. In many
developed countries, 70% to 80% of the population have used
some form of complementary or alternative medicine, with
herbal treatments being the most popular form of TM.
In the West, the umbrella term CAM is widely accepted as
including both TM and other recent forms of non-standardised
medicine. In Malaysia, the term Traditional and Complementary
1 World
Health Organisation (2002) WHO Traditional Medicine Strategy. Geneva: WHO
(2011) Beijing Declaration 2008 [Online]. Switzerland: WHO. Retrieved from: http://www.
who.int/medicines/areas/traditional/congress/beijing_declaration/en/index.html
[Accessed 14th February 2011
2 Anon.
Medicine (T&CM) is used to denote a practice of medicine that is
other than the practice of medicine or dental practices utilised
by registered medical or dental practitioners.
In accordance with the World Health Organization ( WHO)
Traditional Medicine Strategy 2002 – 2005 1 , member countries
are:1. To develop a policy that promotes the integration of TM/CAM
into the national health care system.
2. To promote safety, efficacy, and quality of TM/CAM services
and products.
3. To increase the availability and affordability of TM/CAM and
4. To promote rationale use of TM/CAM.
These sentiments were repeated in the Beijing Declaration
2008 2 , in which WHO states that participating countries should,
in accordance with national capacities, priorities, relevant
legislation and circumstances:
a) Respect, preserve, protect and communicate widely and
appropriately the knowledge of traditional medicine,
treatments and practices;
1
2
b) Governments should formulate national policies, regulations
and standards to ensure appropriate, safe and effective use
of traditional medicine,
c) To integrate traditional medicine into national health systems,
d) To further develop traditional medicine based on research
and innovation,
e) To establish systems for qualification, accreditation or
licensing of traditional medicine practitioners,
f ) To strengthen the communication between conventional
and traditional medicine providers.
Traditional medicine has made a significant contribution to the
health care of the Malaysian community. It continues to be
patronised by our people in their bid to seek treatment for
diseases and in maintaining health. In a recent study by Z.M Siti
et al. published in the Journal of Complementary Therapy in
Medicine in November 2009, it is found that the prevalence of
use of T&CM amongst Malaysians in their lifetime was 69.4%
(67.6—71.2%) and 55.6% (53.8—57.4%) within the last period of
12 months of the study 3 . Realising this, the Ministry of Health
took a positive and proactive approach in nurturing traditional
and complementary medicine to ensure the quality and safety
of practices and products of T&CM. The National Policy of
Traditional and Complementary Medicine 2007 states that:
3 Z.M.
Traditional/complementary medicine (T&CM) system shall be an
important component of the healthcare system. It will co-exist
with modern medicine and contributes towards enhancing the
health and quality of life of all Malaysians.
The government will facilitate the development of T&CM in the
country and ensure the quality and safety of practices and
products of T&CM. It will support the identification of its health,
economic and social benefits.
Thus, the Traditional and Complementary Medicine Unit was born
in 1996 and later upgraded to the Traditional and Complementary
Medicine Division (T&CMD) in the Ministry of Health in 2004.
Definitions
Malaysian perspective
Currently, there is no universally
agreed definition for “Traditional
Medicine” and/or “Complementary
Medicine”. However, the definition
below shall be the basis of the
Malaysian Government’s approach
Figure 1.1: National Policy of Traditional and
Complementary Medicine (Second Revision, 2007)
to the development of T&CM.
Siti, A. Tahir, A. Ida Farah, S.M. Ami Fazlin, S. Sondi, A.H. Azman, A.H. Maimunah, M.A. Haniza, M.D. Siti Haslinda, A.K. Zulkarnain, I. Zakiah, W.C. Wan Zaleha (2009) Use of traditional and
complementary medicine in Malaysia: a baseline study', Complementary Therapies in Medicine, Vol. 17, No. 5, pp. 292-299.
(2007) The National Policy of Traditional and Complementary Medicine . 2nd ed. Kuala Lumpur: Traditional and Complementary Medicine Division.
4 Anon.
3
Traditional and Complementary Medicine is a form of
health-related practice designed to prevent, treat, and/or manage
illnesses and/or preserve the mental and physical well-being of
individuals and includes practices such as traditional Malay
medicine, Islamic medical practice, traditional Chinese medicine,
traditional Indian medicine, homeopathy, and complementary
therapies, and excludes medical or dental practices utilised by
registered medical or dental practitioners.
National Policy of Traditional & Complementary Medicine
Ministry of Health Malaysia (2007)
Globally
a. WHO
“Traditional medicine is defined as diverse health practices,
approaches, knowledge and beliefs incorporating plant,
animal, and/or mineral based medicines, spiritual therapies,
manual techniques and exercises applied singularly or in
combination to maintain well-being, as well as to treat,
diagnose or prevent illness.”
WHO Traditional Medicine Strategy 2002-2005
“Complementary medicine, in practice refers to a wide range
of health interventions originating from different cultures
across thousands of years of history.”
Scottish Office Department of Health, Complementary Medicine
and the National Health Services (London, November 1996)
b. USA
Complementary and Alternative Medicine (CAM) as defined
by the National Center for Complementary and Alternative
Medicine (NCCAM) is a group of diverse medical and health
care systems, practices, and products that are not generally
considered part of conventional medicine.
NCCAM, USA (2007)
c. UK
Complementary and Alternative Medicine (CAM) is a title
used to refer to a diverse group of health-related therapies
and disciplines which are not considered to be a part of
mainstream medical care. Other terms sometimes used to
describe them include 'natural medicine', 'non-conventional
medicine' and 'holistic medicine'.
House of Lords, Parliament, U.K (November 2000)
4
Classifications of T&CM in Malaysia
In Malaysia, Traditional and Complementary Medicine
are classified into six major groups. They are:
1. Traditional Malay Medicine
2. Traditional Chinese Medicine
3. Traditional Indian Medicine
Roles and functions of Traditional and
Complementary Medicine Division (T&CMD),
1. To regulate the practice of T&CM practitioners through
T&CM Bodies using a phased approach, from
self-regulation to statutory regulations.
4. Homeopathy
2. To facilitate the development of T&CM practices and its
integration into the national healthcare system.
5. Complementary Medicine
3. To establish a registry of all T&CM practitioners.
6. Islamic Medical Practice
4. To ensure all T&CM practitioners undergo a formalised
system of education and training.
5. To facilitate the development of standards and criteria
in T&CM, regulation and monitoring of accredited
learning centres, setting the quality and standards of
T&CM programmes, and to evaluate their effectiveness.
6. To f a c i l i t a t e a n d a s a c o l l a b o r a t o r i n r e s e a r c h a n d
scientific evaluation of T&CM modalities; towards
promoting evidence -based medicine.
The T&CM Division is situated at Jalan Cenderasari,
Kuala Lumpur, with five T&CM branch offices to
date located in Pulau Pinang, Terengganu, Johor,
Sarawak dan Sabah (Figures 1.2 and 1.3).
5
T&CMD Headquarter and Branch Offices
TRADITIONAL AND
COMPLEMENTARY MEDICINE DIVISION
MINISTRY OF HEALTH MALAYSIA
BLOK E, JALAN CENDERASARI,
50590 KUALA LUMPUR
Tel No.: 03-26985077
Fax No.: 03-26911259
http://tcm.moh.gov.my/
Figure 1.2: Contact details of the Traditional & Complementary Medicine Division Headquarter,
6
Contact details of T&CM Branch Offices
Figure1. 3: Contact details of T&CM Branch Offices.
7
Chapter 2
Development of T&CM - Globally and Locally
Global Development
The use of traditional and complementary medicine is increasing worldwide. In low- and middle-income countries, up to 80% of the
population may rely on T&CM for their primary health care needs. In many high-income countries, CAM utilisation is becoming
increasingly popular, with up to 65% of the population reporting that they have used this form of medicine (Figure 2.1).
Use of Traditional Medicine to Help Meet Primary Health Care Needs in Developing Countries
100%
90%
90%
80%
70%
60%
60%
60%
Uganda
Tanzania
70%
70%
70%
Benin
Rwanda
India
50%
40%
30%
20%
10%
0%
Figure 2.1: Percentage of use of T&CM amongst the populations of developing countries.
Source: WHO Traditional Medicine Strategy: 2002 – 2005
Ethiopia
8
Populations in developed countries who have used CAM
at least once
100%
75%
80%
60%
40%
50%
48%
40%
42%
20%
0%
ce
an
Fr
A
a
ia
l
ra
d
na
US
Ca
st
m
iu
lg
Au
Be
Figure 2.2: Percentage of Populations in Developed Countries who have used
CAM at least once.
Source: WHO Traditional Medicine Strategy: 2002-2005
Figure 2.3: Percentage of CAM use in USA.
Credit: National Center for Complementary and Alternative
Medicine, NIH, DHHS
9
Table 2.1: Use of CAM from a practitioner (all therapies) in the
past 12 months by geographical region in Britain (2004)
Region
Received CAM
Frequency
%
95% CI
n = 100%
England
152
10.0
8.6–11.7
1513
Wales
10
10.0
5.5–17.4
100
Scotland
17
9.8
2.3–15.1
174
North
20
4.3
2.8–6.5
469
Midlands and East Anglia
67
14.4
11.5–17.9
464
London
12
7.4
4.3–12.5
162
South East
32
12.5
9.0–17.1
256
South West
21
13.0
8.6–19.0
162
Source: Thomas K, Coleman P. Use of CAMs in a General Population in
Great Britain. Journal of Public Health 2004 Vol. 26, No. 2, pp. 152–157.
Figure 2.4: Percentage of CAM use by Race/Ethnicity among adults in US – 2007.
Credit: National Center for Complementary and Alternative Medicine, NIH, DHHS
10
CAM Out-of-Pocket Spending: Self-care* vs. Practitoner Costs
Nonvitamin, Nonmineral, Natural
Products $14.8 billion (43.7%)
Yoga, Tai Chi, Qi Gong
classes $4.1 billion
(12.0%)
Homeopathic Medicine
$2.9 billion (8.6%)
Practitioner Costs $11.9 billion
(35.2%)
Relaxation Techniques†
$0.2 billion (0.6%)
Total Practitioner Costs
$11.9 billion (35.2%)
Total Self-care Costs
$22.0 billion (64.8%)
* Self care costs includes CAM products, classes and material.
† Relaxation techniques include relaxation, guided imagery, progressive
relaxation and deep breathing exercises.
Figure 2.5
Source: Nahin, RL, Barnes PM, Stussman BJ, and Bloom B. Costs of
Complementary and Alternative Medicine (CAM) and Frequency of
Visits to CAM Practitioners: United States, 2007.
National Health Statistics Reports; No. 18. Hyattsville,
MD: National Centre for Health Statistics. 2009.
International Collaboration in Traditional &
Together with the World Health Organisation ( WHO), Malaysia
has made a significant number of collaborations with many
ASEAN countries, India and China in an effort to strengthen the
base for traditional and complementary medicine in the
country. An example is the Memorandum of Understanding
(MOU) signed between Malaysia and the People’s Republic of
China in 2005 regarding cooperation on policy-making,
regulation and promotion of traditional medicine. Five years
later, Malaysia signed its second memorandum with India on the
traditional system of Indian Medicine.
In 2008, Dr. Ramli Abd. Ghani, Director of T&CM Division was
appointed as WHO temporary consultant for Interventional
Regulatory Conference for Harmonisation (IRCH) on TM,
marking a milestone for Malaysia in being recognised as a
significant contributor in T&CM. He subsequently attended IRCH
meetings held in Montreal (2009) and Dubai (2010). Thereafter,
several other bilateral meetings in T&CM were conducted
between Malaysia and Thailand, Brunei and Indonesia.
In 2009, Malaysia and WHO successfully organised a workshop
on the Development of Harmonized Policy and Standards of
Integrative Medicine amongst ASEAN countries. In 2010, at
the 2nd ASEAN Traditional Medicine Conference in Vietnam,
the separation of pharmaceutical products from traditional
11
medicine was decided upon. In addition to that, two Malaysian
representatives namely Dr. Shamsaini Binti Shamsuddin from the
Traditional & Complementary Medicine Division and Dr. Zakiah
Ismail from the Institute for Medical Research were appointed as
focal points of the TM Section in ASEAN countries.
From time to time, Malaysia has aggressively pursued
opportunities for cooperation whilst strengthening ties with
both ASEAN and non-ASEAN countries through official visits,
international
conferences,
seminars
and
attachment
programmes to nur ture the grounds of T&CM in Malaysia.
Development of Traditional and Complementary
Medicine Programme in Malaysia
Before the 15th century, indigenous or traditional native medicine
is the type of medicine practised by the Orang Asli of the Malay
Peninsular and the Pribumi of Sabah and Sarawak. During this
period, traditional Malay medicine was strongly influenced by the
animistic culture of Hindu-Buddhism, which originated from India.
Subsequently, with the introduction of Islam and with the
arrival of the Chinese, the practice of medicine began to change,
incorporating these new set of values. At about the same time,
Traditional Chinese Medicine practices were introduced and
Traditional Indian Medicine too began to take root in the soils of
Malaya.
At the end of the 19th centur y, modern medicine was brought
in by the British and was taken up quickly due to its ease of
practice and effectiveness. During this period, complementary
medicine also started to appear in the country.
By the 20 th century, modern medicine was the mainstream
medicine practised in Malaysia, with T&CM treatments available
as a complement.
Figure 2.6 (next page), demonstrates the chronology of events
of development of T&CM in Malaysia. Subsequent pages show
the T&CM Units at various hospitals and the services they
provide.
12
2002
1998
• Establishment of the
T&CM Standing
Committee
1987
• Preparation of
proposal for
research in
alternative medicine
2007
2000
first Integrated
Hospital in Kepala
Batas, Pulau Pinang
• Launch of Herbal
Medicine Research
Centre
1996
2009
• Establishment of
Global Information
Hub and National
Committee in R&D
on Herbal Medicine
2001
• Formation of the
Traditional &
Complementary
Medicine (T&CM)
Unit under the
Family Health
Develoment
Division
2008
• Launch of National
Policy on T&CM
1999
T&CM services in
Putrajaya Hospital,
Putrajaya and
Sultan Ismail
Hospital, Johor
2004
• Formation of five
Umbrella Bodies for
T&CM
T&CM Division in
Ministry of Health
(MOH)
regional T&CM
offices in MOH:
o Northern region
– Pulau Pinang
o Southern region
– Johor Bahru
o Eastern region –
Kuala Terengganu
o Sabah – Kota
Kinabalu
o Sarawak Kuching
2009
T&CM Units at
Sultanah Nur
Zahirah Hospital in
Kuala Terengganu,
Duchess of Kent
Hospital in
Sandakan, Sabah
and Sarawak
General Hospital
Figure 2.6 : Timeline depicting the development of T&CM in Malaysia.
2010
T&CM Units in Port
Dickson Hospital,
Negeri Sembilan
and Sultanah
Bahiyah Hospital in
Alor Setar, Kedah
2011
T&CM Unit in
Sultanah Hajah
Kalsom Hospital,
Cameron Highlands,
Pahang
T&CM Units at Integrated Hospitals in the Ministry of Health (2011)
Figure2.7: T&CM Units at Integrated Hospitals in the Ministry of Health (2011)
13
14
T&CM Practices Available at the Integrated Hospitals
Herbal Therapy as
an Adjunct
Treatment for
Cancer Patients
Acupuncture
Malay
Massage
Putrajaya Hospital
Putrajaya Hospital
Sultan Ismail Hospital
Kepala Batas Hospital
Sultanah Nur Zahirah
Hospital
Sultanah Nur Zahirah
Hospital
Duchess of Kent Hospital
Duchess of Kent Hospital
Sarawak Public Hospital
Sarawak Public Hospital
Hospital Umum Sarawak
Port Dickson Hospital
Sultanah Bahiyah Hospital
Sultanah Hajah Kalsom
Hospital
Sultanah Hajah Kalsom
Hospital
Malay
Postnatal
Treatment
Putrajaya Hospital
Putrajaya Hospital
Hospital Umum Sarawak
Table 2.2: T&CM Practices available at the Integrated Hospitals
15
T&CM Units at the Integrated Hospit
Hospitals
T&CM Unit
Jalan Bertam 2
13200 Kepala Batas
Pulau Pinang
Tel: 604-5793333, ext 113
Fax: 604-5791088
Email: [email protected]
T&CM Unit
Putrajaya Hospital
Ground Floor
Putrajaya Hospital
Precinct 7, 62250 Putrajaya
Tel: 603-83124200
Fax: 603-88880137
16
T&CM Units at the Integrated
Inte
Hospitals
T&CM Unit
Sultanah Nur Zahirah Hospital
Jalan Sultan Mahmud
20400 Kuala Terengganu
Terengganu
Tel: 609-6212121, ext: 2394
Fax: 609-6221820/ 609-6227139
T&CM Unit
Jalan Persiaran Mutiara Emas Utama
Taman Mount Austin
81100 Johor Bahru Johor
Tel: 607-3565000
Fax: 607-3565034
17
T&CM Units at the Integrated Hosp
Hospitals
T&CM Unit
Sarawak General Hospital
Jalan Tun Ahmad
Zaidi Adruce,
93586, Kuching,
Sarawak
Tel: 6082-276666, ext 5150
Fax: 6082-276703
T&CM Unit
Duchess Of Kent Hospital
KM 3.2 Jalan Utara
90000 Sandakan
Sabah
Tel: 6089-212111
Fax: 6089-219359
18
T&CM Units at the In
Integrated
nte
tegr
grat
ated
e Hospitals
T&CM Unit
Hospital Sultanah Hajah Kalsom
Jln Persiaran
Dayang Endah
39000 Tanah Rata
Pahang
Tel: 05 4911966
Fax: 05 4913355
T&CM Unit
T&CM
KM 11, Jalan Pantai 71050 Si Rusa
Port Dickson
Neg
Negeri Sembilan
Tel: 606-6626333
Fax: 606-6625003
19
T&CM Units at the Integrated Hospitals
T&C Unit
T&CM
Sult
Blok T
Sulta
Lebu
Lebuhraya Darulaman
Alor Setar
Keda
Kedah
Tel: 04-740
0
6233
Fax: 04-735
0
0232
20
Chapter 3
Modalities in T&CM
Therapeutic Versus Wellness Concept
The modern medical system introduces four
main concepts that are curative, therapeutic,
and palliative or wellness. However, T&CM a
adopts the concept of therapeutic and wellness
only only (Table 3.1).
Therapeutic concept refers to healing, such as a
form of medicine or therapy that has the
capability to help in treating a disease or
disability. It is used for either physical and
mental health, which may be a drug, substance
or an activity that supports the healing of one's
mental or emotional health.
On the other hand, wellness concept refers to
modalities that assist in balancing positive
health in an individual as exemplified by quality
of life and a sense of well-being.
Table 3.1: Modalities in T&CM Practices.
Type of practice
Treatment concept
Therapeutic
Wellness
Islamic Medical
Islamic Medical Practice
Practice
(Ruqyah)
Traditional Malay
Herbal Medicine
Urut Melayu
Medicine
Urut Melayu (Malay Massage)
(Malay Massage)
Indigenous Massage
Indigenous Massage
–
Bekam (Cupping)
Traditional
Chinese Medicine
Herbal Medicine
Acupuncture and
Moxibustion
Tuinalogy
Cupping
Qi Gong
21
Type of practice
Home-grown Modalities
Treatment concept
Therapeutic
Traditional Indian
Medicine
Ayurveda
Siddha
Unani
Homeopathy
Homeopathy
Complementary
Medicine
Chiropractor
Naturopathy
Osteopathy
Nutritional therapy
Hypnotherapy
Psychotherapy
Therapeutic Massage
Wellness
Yoga
–
Spa Therapy
Reflexology
Aromatherapy
Thai massage
Swedish massage
Balinese/Javanese massage
Shiatsu massage
Colour Vibration Therapy
Crystal Healing
Reiki
Aura metaphysic
Raoha
Ozone Therapy
Chelation Therapy
Note: Please refer the Glossary, for description of each modality.
There are a number of modalities established by
Malaysians which creatively infuses different
knowledge and techniques into a new,
combined form of therapy. Colour Vibration
Therapy and Aura Metaphysic are examples of
home-grown modalities.
22
The Scope of Practice of T&CM Modalities
The practitioner must exert professionalism at
all times especially during consultation sessions
with the client and should follow the rules and
regulations as stipulated in the Code of Ethics
and Conduct of T&CM Practitioners. Listed below
is a guide to what a practitioner is allowed and
not allowed to practice for a particular modality.
Table 3.2: What is allowed or not allowed to be practiced for each T&CM modality. List
of permitted practices for each T&CM modality.
Type of practice
Permitted Practices
Prohibited Practices
Islamic Medical
Practice
(Ruqyah)
- Based on Al-Quran
• Misuse of the Holy Quran (physically and
Quranic verses)
• Bedah batin (virtual surgery)
• Use of azimat (amulet), tangkal (talisman),
susuk (charm needles)
• Use of black magic
Traditional Malay
Medicine
Herbal Medicine
• Misuse of the Holy Quran (physically and
Quranic verses)
• Bedah batin (virtual surgery)
• Use of azimat (amulet), tangkal (talisman),
susuk (charm needles)
• Use of black magic
Urut Melayu
(Malay Massage),
Indigenous Massage
Bekam (Cupping)
–
Bekam lintah (Leech Therapy)
Acupuncture and
Traditional
Chinese Medicine Moxibustion
Herbal Medicine
Tuinalogy
Cupping
Acupuncture using gadgets
Traditional
Indian Medicine
Ayurveda
Siddha
Unani
Yoga
Yoga – cannot be practised by Muslim as it is
prohibited by the religion (refer to Fatwa
Majlis Kebangsaan Bagi Hal Ehwal Ugama
Islam Malaysia Kali Ke-83)
Homeopathy
Homeopathy
–
23
Type of practice
Complementary
Medicine
Subgroup
Permitted Practices
Manipulative therapy
Chiropractic
Reflexology
Osteopathy
Massage:
• Therapeutic
• Swedish
• Thai
• Balinese/Javanese
• Shiatsu
Energy medicine
Reiki
Aura metaphysics
Colour vibration therapy
Crystal healing
Bach flower
Raoha
Biological based
Aromatherapy
Nutritional therapy
Mind-body therapy
Hypnotherapy
Meditation
Psychotherapy
Others
Chelation & Ozone Therapy – is only for
practitioners with a medical degree
(allopathic medicine)
Note: Claims of treating acute conditions are prohibited
All T&CM Practitoners are required to adhere to
guideline for ethical conduct, as outlined in the
Code of Ethics and Code of Practice for
Traditional and Complementary Medicine
Practitioners (Figure 3.1) at all times during the
provision of services to the public.
Figure 3.1: Code of Ethics & Code Of Practice for T&CM Practitioners.
24
Chapter 4
EBP in Supporting Development of T&CM Practices
EBP – Evidence-Based Practice
EBP is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual
patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research 5 ”.
Evolution of the definition:
Evidence-based Medicine
Evidence-based Healthcare
Evidence-based Practice
• Evidence-based medicine (EBM)
is the conscientious, explicit and
judicious use of current best
evidence in making decisions
about the care of individual
patients
• Evidence-based health care
(EBH) is the conscientious use of
current best evidence in making
decisions about the care of
groups of individuals or the
delivery of health services
• Evidence-based practice (EBP) is
the application of such principles
across the broad field of health
care, including policy making,
education, practice management
and health economics
EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient
care. Clinical expertise refers to the clinician's cumulated experience, education and clinical skills. The patient brings to the encounter
his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant
research that has been conducted using sound methodology 6 .
5 Sackett
DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS (1996) Evidence based medicine: what it is and what it isn't [Online]. US: BMJ Publishing Group Ltd. Retrieved from: http://www.bmj.
com/content/312/7023/71.full [Accessed 1st February 2011].
(2010) Introduction to Evidence-Based Practice [Online]. US: Duke University Medical Center Library and Jill Mayer University of North Carolina at Chapel Hill Health Sciences Library. Retrieved
from: http://www.hsl.unc.edu/services/tutorials/ebm/index.htm [Accessed 1st February 2011].
6 Anon.
25
Steps involved in the EBP Process
ASSESS
the patient
The evidence does not make a decision but it can help
to support the patient care process. Integration of these
three components into clinical decisions enhances the
opportunity for optimal clinical outcomes and patient’s
quality of life. The practice of EBP are usually attemps at
answering questions about the effects of therapy, utility
of diagnostic tests, prognosis of diseases, or the
etiology of disorders triggered by patient encounter.
Evidence-Based Practice requires a clinician to obtain
new skills such as efficient literature searching and
evaluation of the clinical literature by applying formal
rules of evidence.
Even though EBP has evolved over the years based on
allopathic medicine, there should be no barriers in
applying the process to T&CM practices.
1. Start with the patient – a clinical problem
or question that arises form care of the
patient
ASK
the question
1. Construct a well built clinical question
derived from the case
ACQUIRE
the evidence
3. Select the appropriate resource(s) and
conduct a search APPRAISE
APPRAISE
the evidence
4. Appraise that evidence for its validity
(closeness to the truth) and applicability
(usefulness in clinical practice)
APPLY:
talk with the
patient
5. Return to the patient – integrate that
evidence with clinical expertise, patient
preferences and apply it to practice
Selfevaluation
6. Evaluate your performance with this
patient
26
Use of EBP in Developing T&CM Guidelines
An immediate attraction of EBP is that it integrates medical
education and clinical practice. It has the potential of improving
continuity and uniformity of care through the common
approaches and guidelines developed by its practitioners. It
provides common framework for problem solving and helps
providers make use of limited resources by enabling them to
evaluate clinical effectiveness of treatments and services, whilst
eliminating unsound and unsafe practices.
Upon approval of the proposal to set up an Integrative Medical
Programme by the Malaysian Cabinet in January 2006, several
guidelines that are supported by EBP were developed to
support the T&CM services provided at selected government
hospitals. The Integrative Medical Programme aims to
incorporate selected T&CM practices into the mainstream
healthcare system, and the hospitals involved are termed as
Integrated Hospitals. Incorporating T&CM practices into the
mainstream healthcare system does not only achieve a holistic
approach towards enhancing health and improving quality of
life, but also enables the protection and preservation of
valuable traditional knowledge.
To support the implementation of T&CM in the country, T&CM
Division produces two types of guidelines, aiming at two
different categories of practitioners;
Practice
Guideline
For the use of practitioners in the
Integrated Hospitals
Good Practice
Guidelines
Consensus guidelines for
practitioners practicing in Malaysia
At the time of publication of this book, T&CM Division has
published the following guidelines (Table 4.1a and 4.1b) which
have been used in integrating T&CM practices into the mainstream
healthcare system.
27
Table 4.1a: Guidelines developed by T&CM Division.
Developed Guidelines
(2007)
Reviewed Guidelines
Old Publication (2007)
Revised Publication (2009)
Guideline on Herbal Therapy as an
Adjunct Treatment for Cancer
Standard Operating Procedures
for T&CM Unit
Standard Operating Procedures
for T&CM Unit
Guideline on Malay Postnatal Care
Guideline on Malay Massage
Guideline on Malay Massage
28
Table 4.1b: Guidelines developed by T&CM Division.
Reviewed Guidelines
Old Publication (2007)
Revised Publication (2009)
Guideline on Acupuncture
Guideline on Acupuncture
Good Practice Guidelines (2011)
Good Practice Guideline
on Reflexology
Garis Panduan Perkhidmatan Spa
(Spa Services Guideline)
Good Practice Guidelines (2010)
Work in progress is directed towards
the following guidelines;
1. Practice Guideline on Shirodhara
2. Practice Guideline on Homeopathy
3. Practice Guideline on Chiropractic
4. Garis Panduan Pengubatan Islam (Practice
Guideline on Islamic Medical Practice)
on Malay Massage
on Acupuncture
29
Chapter 5
Education & Training
Through collaborations between the T&CM Division with
various governmental agencies, several education and training
programmes were developed for the various T&CM modalities.
The aim of these programmes were to ensure that all T&CM
practitioners acquire standardised and internationally accepted
knowledge and skills through means of formal education to
ensure the delivery of T&CM services of the highest quality.
In Malaysia, the education pathway is comprised of three higher
educational sectors, as outlined by the Malaysian Qualifications
Framework (MQF) in Figure 5.1. They are the skills, vocational
and technical and academic (university) sector. Each sector is
supported by lifelong education pathways and is differentiated
by learning outcomes, credit hours and student learning time.
In total, there are eight levels of qualifications. Levels 1 to 3 are
Skills Certificates awarded by the Skills Sector. Academic and
Vocational and Technical Certificates are at Level 3. Meanwhile,
Diploma and Advanced Diploma are at Levels 4 and 5. Bachelor
Degree is at Level 6, Masters Degree at Level 7 and for the
Doctorates, Level 8 7 .
T&CM Division classifies the level of education and training
programmes for each T&CM modality based on the therapeutic
or wellness concept (as discussed in Chapter 3). Modalities that
fall under the therapeutic concept are to follow the academic
pathway whilst those in the wellness concept are to be obtained
through the certificate training programme (or the skills sector).
For the academic sector, thirteen standards and criterias for
diploma and bachelor degree have been developed to support
the provision of education programmes by both the public and
private centres of higher education. To date, seven bachelor
degree programmes and six programmes for diploma, as
outlined in Table 5.1, have been established and the courses are
presently being offered by the local institutions listed in Table
5.2.
In addition, the Malaysian Public Service Department has
recognised three universities from the People’s Republic of
China to award the degree programmes listed in Table 5.3.
30
MQF BASED QUALIFICATION LEVEL AND EDUCATIONAL PATHWAY
Figure 5.1: Malaysian Qualifications Framework.
Bachelor Educational Programme
Diploma Training Programme
• Bachelor of Traditional Chinese Medicine (Acupuncture)
• Diploma in Malay Massage
• Bachelor of Traditional Chinese Medicine
• Diploma in Traditional Chinese Medicine (Acupuncture)
• Bachelor of Complementary Medicine (Natural Medicine)
• Diploma in Natural Medicine
• Bachelor of Homeopathy
• Diploma in Aromatherapy
• Bachelor of Malay Medicine
• Diploma in Islamic Medicine
• Bachelor of Ayurveda Medicine
• Diploma in Reflexology
• Bachelor of Chiropractic
Table 5.1: Bachelors and diploma educational programmes developed by MQA.
* Further information can be obtained from the Malaysian Qualifications Agency (MQA) at www.mqa.gov.my.
31
The educational programmes below are presently being provided by the following public and private institutions:
No.
1.
Institutions
Courses Offered
Southern College, Skudai
• University Foundation For Degree Programme (Traditional
Chinese Medicine)
• Bachelor Degree of Traditional Chinese Medicine 4+1 in
collaboration with Xiamen University, China
2.
Tunku Abdul Rahman University (Sungai Long Campus)
• Bachelor of Traditional Chinese Medicine (Hons)
3.
INTI International University College
• Bachelor of Traditional Chinese Medicine (Hons)
4.
Cyberjaya University College of Medical Sciences (CUCMS)
• Bachelor of Homeopathy (Hons)
5.
Management and Science University (MSU)
• Bachelor in Traditional Chinese Medicine (Hons)
• Diploma in Traditional Chinese Medicine
6.
International Medical University (IMU)
7.
Malacca College of Complementary Medicine
• Bachelor of Science (Hons) Chinese Medicine
• Bachelor of Science (Hons) Chiropractic
• Diploma in Natural Medicine
Table 5.2: Institutions providing T&CM courses in Malaysia.
To date, three universities from the People’s Republic of China have been recognised by the Public Sector Department of Malaysia
to provide the following education programmes:
No.
Institutions
Courses Offered
1.
Beijing University of Chinese Medicine (BUCM)
• Bachelor of Chinese Medicine
2.
Nanjing University of Chinese Medicine (NUCM)
• Bachelor of Chinese Medicine (Clinical Medicine)
3.
Shanghai University of Traditional Chinese Medicine (SHUTCM)
• Bachelor of Medicine (Traditional Chinese Medicine)
Table 5.3: T&CM degree courses and universities from People’s Republic of China which are recognised by the Malaysian Public Sector Department.
Source: Public Sector Department of Malaysia (http://pengiktirafan.jpa.gov.my)
32
Currently, T&CM Division together with the Ministry of Higher
Education and the Malaysian Accreditation Agency (MQA) have
introduced an Advanced Diploma for Urut Melayu as a Training
of Trainers programme. It is a one-off, one year programme at
the Sultan Salahuddin Abdul Aziz Shah Polytechnic, Shah Alam.
The first batch of students will be graduating in August 2011.
In the skills sector, the standards and criteria for the issuance of
a skills certificate are defined in the National Occupational Skills
Standard (NOSS). NOSS is a specification of the competencies
expected of a skilled worker, who wishes to gain employment in
Malaysia for an occupational area and level.
Development of NOSS involves the participation of industrial
experts from the Department of Skills Development (DSD),
under the auspices of the Ministry of Human Resources. NOSS is
used by DSD accredited training centres to offer skills training
for the specified modalities. Individuals who have completed
their training under the skills programme will be awarded the
Skills Certificate by DSD, which is a formal recognition to
individuals who has shown capabilities and competencies to
carry out the specified modality. These skills training
programme are being offered by the government in Malaysia,
and not by a Non-Governmental Organisation as practiced in
other countries.
As of 2010, six T&CM modalities have been developed under the
Malaysian Skills Qualifications. This includes reflexology,
aromatherapy, massage, manual lymph drainage, crystal
healing and spa. These NOSSs are part of the effort to promote
lifelong training and development, upgrading the competencies and enhancing the competitiveness of Malaysians involved
in the industry. More Malaysian Skills Qualifications will be
developed for T&CM modalities in the near future. More
information on NOSS can be obtained from the Department of
Skills Development at www.dsd.gov.my.
33
Chapter 6
Research in T&CM
T&CM is currently considered an important component of the
healthcare system. Its co-existence with modern medicine
contributes towards enhancing the health and quality of life of
Malaysians. In support of the Malaysian National Policy on
T&CM, especially in ensuring the quality and safe use of T&CM
products and practices, Research and Development (R&D)
Section was formalised in T&CM Division in August 2008.
The objectives of this section are:
1. To prioritise, encourage, facilitate and conduct research
on T&CM practices and products
2. To establish methods and technologies for quality
control, safety and efficacy of herbal medicines and
traditional remedies
3. To set up T&CM information database to support
information needs for healthcare providers, consumers,
manufacturers and other related agencies
The introduction of T&CM modalities in integrated hospitals in
Malaysia opens the opportunity for more T&CM research in
clinical practice.
Current research efforts carried out by the R&D section focuses
on integrative medicine such as urut Melayu, acupuncture and
use of herbal medicine as an adjunct therapy in oncology.
Presently, the studies conducted uses case reports, surveys and
qualitative techniques. Future studies will look into areas of
effectiveness of these modalities.
The T&CM R&D section collaborates closely with the National
Institutes of Health (NIH), Ministry of Health in the conduct of its
research. This section participates actively in presentations at
scientific meetings and conferences.
The first article on urut Melayu was published in the Journal of
Alternative and Complementary Medicine (JACM), November
2010 edition and more publications shall be pursued.
One of the activities to promote research on herbal medicines
was the annual workshops conducted in collaboration with the
National Conference for Clinical Research (NCCR). Currently,
efforts are being made for product development under the
National Key Economic Areas (NKEA) based on five selected
herbs such as Tongkat Ali, Kacip Fatimah, Misai Kucing,
Hempedu Bumi and Dukung Anak. It is a crucial step to ensure
the availability of raw products as Malaysia strives to become
the leader in the production of nutraceuticals and botanical
drugs 8 .
34
Another initiative by the Malaysian government in promoting
integrative medicine is through the development of a portal for
information sharing: Global Information Hub on Integrated
Medicine (GLOBINMED) at www.globinmed.com.
For those interested to conduct research on T&CM in the
Ministry of Health institutions and facilities, the NIH Guidelines
for Conducting Research in the MOH Institutions and Facilities,
provides the guide and it can be downloaded from the NIH
website at www.nih.gov.my.
The guideline requires:
1. Registration of all research that involves MOH personnel or
that is to be conducted in MOH facilities or to be funded by
MOH research grants
2. Review and approval of the research by a designated entity
to whom authority has been delegated for the purpose
3. Research involving human subjects requires prior review and
approval by the MOH Research and Ethics Committee (MREC)
4. Approval from the Director General of Health for all research
publications, whether in the form of research report, journal
article or conference proceeding, by the NIH initially and
thereafter by the Director General of MOH
Figure 6.1: GLOBINMED’s homepage
Apart from conducting researches, T&CM R&D section provides
consultation for interested parties to conduct researches on
T&CM modalities, in a bid to increase the availability of
evidences, thus promoting evidence based practice.
35
A Qualitative Study On Urut Melayu – The Traditional Malay Massage
8th Ministry of Health Malaysia – Academy of Medicine of Malaysia Scientific Meeting 2009
Urut Melayu for Post-Stroke Patients: A Qualitative Study
Asia-Pacific Primary Care Research Conference 2009
36
Chapter 7
Promotional, Enforcement & Public Education Activities
Promotional Activities
In order to increase consumer knowledge and awareness about
T&CM services in Malaysia, T&CM Division has conducted
numerous promotional activities through road shows,
exhibitions and public talks, including television and radio talks
since the year 2007. These activities involve the participation of
various parties such as government agencies, practitioner
bodies and non-governmental organisations (NGOs).
Apart from that, the T&CM Division regularly organise Continuing
Medical Education (CME) and Continuing Professional Development
(CPD) activities for staff members of the Ministry of Health as well
as conferences, workshops and public forums for the general public.
37
During the course of these promotional activities, we have distributed various pamphlets, posters, books and bulletins to stimulate
public awareness towards the various types and benefits of T&CM modalities.
Table 7.1: T&CM Division Bulletins.
T&CMD Bulletin – Volume 1
(Sept – Dec 2006)
(Jan – Jun 2007)
(Jun – Dec 2007)
(2008)
(Jan – Jun 2009)
(Jun – Dec 2009)
(Jan – Jun 2010)
(July – Dec 2010)
38
Table 7.2: Posters by T&CM Division.
Traditional Malay Massage:
A Qualitative Study
Traditional Malay Massage for Post
Stroke Patients: A Qualitative Study
Haram Practices in
Traditional Medicine
Services in T&CM Units in
Integrated Hospitals
T&CMD Annual Report 2008
Table 7.3: Annual Reports.
39
Table 7.4: Pamphlets.
Promotion of T&CM Modalities
Acupuncture
Traditional Malay Practices in Post Natal Care
Traditional Malay Massage
Public Education
Philosophy and Function of T&CMD
Common Mistakes Found in the Practice of T&CM
40
Public Education
Guidelines Before Seeking
Traditional & Complementary Services in Malaysia
e-Pengamal Registration for
Traditional & Complementary Medicine Practitioners
8 Registered Practitioner Bodies
In Malaysia
Inspection Activities
The Inspectorate and Enforcement Section (I&E) of T&CM
Division have successfully carried out enforcement activities
such as mapping and inspection of premises as well as
consumer/ public education throughout Malaysia. The I&E
section have collaborated with other governmental agencies
such as the Pharmacy Enforcement Division, Immigration
Department, Private Practice & Medical Control Section (CKAPS)
and City & Local Government Councils in carrying out integrated
enforcement activities. In addition, I&E section also contributed
to the development of the Traditional and Complementary
Medicine Bill which is planned to be tabled in the Parliament
late 2011. Once gazetted, surveillance of T&CM services in
strengthened will be strengthened whereby only qualified
T&CM practitioners are eligible to register with the Ministry of
Health and be allowed to practice.
41
Public Education
Consumer education is the best way to ensure public safety.
T&CM Division actively organises consumer education activities
and publications that primarily educates the public on various
T&CM modalities, the implementation, safety and efficacy of
T&CM services in Malaysia as well the requirement for
registration for all T&CM practitioners of traditional and
complementary medicine.
Some examples on the messages for the public are highlighted
below:
You might ask #1
There are advertisements that provide statements such as
“scientifically proven”, “proven effective”, “based on Western
technological advancement”, “acknowledged by the Ministry
of Health” and many more. Are these statements for real?
Our answer to You: Questionable statements
and testimonials
Advertisements that provide statements such as “scientifically
proven”, “proven effective”, “based on Western technological
advancement”, “acknowledged by the Ministry of Health” etc
should be confirmed before one places confidence or believes in
a particular treatment. When in doubt, do not hesitate in seeking
advice from a doctor or a Ministry of Health representative.
You might ask #2
I chanced upon an advertisement which featured a new
concept in alternative medicine (previously unheard of )
and was deemed capable of treating various diseases. Can
I believe this statement?
Our answer to you: Understand the new
treatment concept
Dear consumer, do not be deceived by new treatment
concepts with miraculous claims. All treatment types, be it
modern, traditional or complementary should be
supported with existing profiles of quality, safety and
efficacy. Each treatment has to be subjected to a battery
of clinical trials over a period of time before it can be
safely introduced to the public. Do not try any of these
treatments if you are not confident of its safety and
effectiveness and check with the Ministry of Health if you
have any doubts.
42
What should you do first?
Wh
1. A
Ask the practitioner for his valid certificate. Why?
Pra
Practicing
certificates are issued by Practitioner Bodies appointed by the Ministry of Health
Mal
Malaysia. This certificate will indicate that the practitioner is qualified. Can’t identify which
cert
certificate is the genuine one? These are the logos of the currently appointed Practitioner
Bodies.
Bod
Federation of Chinese Physicians
Fede
and Medicine-Dealers
Associations
A
of Malaysia
(FCPMDAM)
Federation of Chinese Physicians
& Acupuncturists
Association of Malaysia
(FCPAAM)
Malaysian
Chinese Medical Association
(MCMA)
Majlis Perubatan
Homeopathy Malaysia
(MPHM)
The FFederation of Complementary
& Natural Medicine
Association Malaysia
(FCNMAM)
Pertubuhan
Perubatan Tradisional
India Malaysia
(PEPTIM)
Persatuan Kebajikan
dan Pengubatan
Islam Darussyifa’
Gabungan Pertubuhan Pengamal
Perubatan Tradisional
Melayu Malaysia
(GAPERA)
43
2. Don’t be easily influenced by the front title “Dr”. Why?
Besides the Doctor of Philosophy (PhD), only those registered with
the Malaysian Medical Council, under the Medical Act 1971, can
use the title “Dr”. Otherwise, it is against the Act. Do be alert on this
when you enter any traditional or complementary medicine centre.
the Practitioner Body. MOH has begun its registration on all
practitioners since November 2008. To check, please email us at
[email protected] or call us at 03-26985077.
4. Ensure that the health products or herbal medicines
supplied are registered with MOH. Why?
In our market sur vey, 12% of T&CM practitioners were found
supplying unregistered products to their customers. How do
you check? Simple, just look for the produc t registration nu
mber (e.g.: MAL05051150TC ) and the Ministr y of Health
(MOH) hologram sticker. Still in doubt? Check online at
http://por tal.bpfk.gov.my/produ ct_search.cfm
3. Ask the practitioner whether he has been registered
with a Practitioner Body or the MOH. Why?
Registration with a Practitioner Body will confirm his qualification
to practice. Normally they will be given a practicing certificate by
44
5. If you are a woman, please do not be alone with any
T&CM male practitioners during treatment. Why?
There have been incidences of molestation, pederasty and rape
reported when women were found alone with T&CM male
practitioners.
45
Glossary
Description of Traditional & Complementary Medicine Modalities
TYPE OF PRACTICE
TYPE OF MODALITY
DESCRIPTION
Islamic Medical
The effort at seeking treatment for physical and spiritual ailments; done by a Muslim who is
Practice
knowledgeable and skilled in treatment methods using Quranic verses, Hadith, the practices
of the pious and righteous scholars, and of the venerated religious teacher; and also skilled
with the use of methods or materials permitted by the Islamic law.
Traditional Malay
Malay Herbs
Medicine
The herbs are used as a complement to various physical diseases/conditions or for wellness
based on Malay community beliefs
Urut Melayu
Massage is the use of hands, or mechanical means, to manipulate the soft tissues of the body,
(Malay Massage)
particularly muscle. It can be used for relaxation, stimulation or rehabilitation of the whole
body or part of it. It promotes suppleness of the muscle, improves circulation and reduces stress.
Bekam (Cupping)
Bekam (cupping) is a form of traditional medicine practice found in many cultures worldwide.
It involves placing cups containing reduced air or pressure (creating suction or a relative
vacuum) on the skin. It is known in other languages as badkesh, bahnkes, nuhang, bantusa,
kuyukaku, gak hoi, hijamah and many other names.
Traditional Chinese
Acupuncture &
Technique of inserting and manipulating fine filiform needles into specific points on the body
Medicine
Moxibustion
to relieve pain or for therapeutic purposes associated with or without moxibustion that
involves the burning of mugwort, a small, spongy herb, to facilitate healing.
Chinese Herbs
The herbs are used as a complement to various physical diseases/conditions or for wellness
based on Chinese community beliefs and based on the Chinese Materia Medica.
46
Spa Therapy
The term spa is associated with water treatment which is also known as balneotherapy.
Therapy for the promotion of water-based treatments which include body wraps, body
scrubs, baths, etc. Whose main services consist of water based applications.
Reflexology
Is the practice of massaging, squeezing, or pushing on parts of the feet, or sometimes the
hands and ears, with the goal of encouraging a beneficial effect on other parts of the body, or
to improve general health and well being.
Thai Massage
Incorporates elements of mindfulness, gentle rocking, deep stretching, and rhythmic
compression to create a singular healing experience
Swedish Massage
Refers to a variety of techniques specifically designed to relax muscles by applying pressure
to them, and rubbing in the same direction as the flow of blood returning to the heart.
Balinese/Javanese Positioned above the client, the Balinese/Javanese massage therapist performs a
Massage
combination of kneading strokes, skin rolling, and foot massage. Treatment is followed by an
application of coconut oil infused with spices.
Shiatsu Massage
Also known as acupressure massage. The therapist applies pressure with his thumbs, finger,
and palms to specific areas of the client's body that have been determined during an
assessment period prior to the massage session.
Aromatherapy
Massage
Uses volatile liquid plant materials, known as essential oils (EOs), and other aromatic
compounds from plants for the purpose of affecting a person's mood or health.
Aromatherapy massage combines the therapeutic benefits of using essential oils with
Swedish massage techniques.
Complementary Medicine Colour Vibration
(Energy Medicine)
Therapy
Deals with energy fields
of two types:
• Veritable, which can be
Crystal Healing
measured
• Putative, which have
yet to be measured
Colour vibration therapy utilizes the aromatherapy concept as a nutrient for the brain/mind.
The aromatherapy - called 'Essential Nutrition' will calm those who inhale it. The white rose is
the most essential element in the aroma vibration oil.
Crystal healing is the use of crystals to bring about healing and positive changes in the mind
and body
47
Homeopathy
Homeopathy
A system for treating disease based on the administration of minute doses of a drug that in
massive amounts produces symptoms in healthy individuals similar to those of the disease
itself.
Complementary
Medicine (Biological
based Practice)
The domain includes,
but is not limited to,
botanicals, animalderived extracts,
vitamins, minerals, fatty
acids, amino acids,
proteins, prebiotics and
probiotics, whole diets,
and functional foods.
Nutritional
A system of healing based on the belief that food provides the medicine we need to obtain
Therapy
and maintain a state of health: our food is our medicine and our medicine is our food.
Naturopathy
Emphasizes the body's intrinsic ability to heal and maintain itself. Natural remedies such as
herbs and foods are used.
Chelation Therapy Chelation therapy is an intravenous treatment designed to bind heavy metals in the body in
order to treat heavy metal toxicity. Proponents claim it also treats coronary artery disease and
other illnesses that may be linked to damage from free radicals (reactive molecules).
Ozone Therapy
Ozone is known to eliminate microorganisms such as fungus, viruses, bacteria, etc. and also
helps oxidize toxins such as heavy metals, pesticides, hydrocarbons and other environmental
pollutants.
Complementary
Medicine (Manipulative
based Practices)
Focus on the structures
and systems of the
body, including the
bones and joints, soft
tissues, circulatory and
lymphatic systems.
Chiropractic
A health care approach that emphasises diagnosis, treatment and prevention of mechanical
disorders of the musculoskeletal system, especially the spine, under the hypothesis that
these disorders affect general health via the nervous system.
Osteopathy
Treatment of the musculoskeletal system (bones, muscles and joints) facilitates the
recuperative powers of the body.
Therapeutic
Massage
Therapeutic massage involves the manipulation of the soft tissue structures of the body to
prevent and alleviate pain, discomfort, muscle spasm, and stress; and, to promote health and
wellness.
48
Reiki
The belief is that the energy will flow through the practitioner's hands whenever the hands
are placed on, or held near a potential recipient, who can be clothed
Aura Metaphysic
The combination of three parts of knowledge which is Aura, Meta, and Physic. Aura is a wave
energy or bioelectromagnetic frequency while meta is something that crosses the
expectations and physics means natural or nature. Thus, combination of these can be
defined as a philosophy or knowledge of unusual or unexpected natural law that exist in our
life
Roaha
Therapy for optimize the oxygenation of cell via alkaline water through detoxification and
increase body immunity
Bach Flower
They gently restore the balance between mind and body by casting out negative emotions,
such as, fear, worry, hatred and indecision which interfere with the equilibrium of the being
as a whole.
The Remedies allow peace and happiness to return to the sufferer so that the body is free to
heal itself
(Mind Body Soul Therapy)
Focuses on the
interactions among the
brain, mind, body, and
behaviour, and on the
powerful ways in which
emotional, mental,
social, spiritual, and
behavioural factors can
directly affect health.
Phytobiophysics
Utilization of the infinite energy of flowers and plants to harmonize and balance the
disturbances of humanity on all levels of consciousness: Spiritual, Mental, Emotional and
Physical
Hypnotherapy
Often applied in order to modify a subject's behaviour, emotional content, and attitudes, as
well as a wide range of conditions including dysfunctional habits, anxiety, stress-related
illness, pain management, and personal development.
Psychotherapy
Intentional interpersonal relationship used by trained psychotherapists to aid a client in
problems of living.
Aims to increase the individual's sense of well-being and reduce their subjective sense of
discomfort.
49
Editorial Committee
ADVISOR
DATO’ DR. MAIMUNAH BT A. HAMID
CHIEF EDITOR
DR. SHAMSAINI SHAMSUDDIN
EDITORS
DR. AIDATUL AZURA ABD RANI
DR. MARIA SAFURA MOHAMAD
DR. NUR HIDAYATI ABDUL HALIM
MR. MOHD HADI MOHD ZIN
MDM. WONG WEI CHYI
MDM. ASMIRAH MD REDZUAN
INTERNAL REVIEWER
DR. RAMLI ABD GHANI
MR. JAAFAR LASSA
MDM. NUR HAZIRAH KAMARUDIN
MS. NG ANGELINE
EXTERNAL REVIEWER
PROF. DR. SYED MOHSIN SAHIL JAMALULLAIL
PROF. DR. ABD RASHID ABD RAHMAN
DR. ZAKIAH ISMAIL
Copyright 2011, Ministry of Health Malaysia.
All rights reserved. No part of this book may be reproduced,
stored, or transmitted in any form or by any means, electronic
or otherwise, including photocopying, recording, internet
or any storage and retrieval system without prior written
permission from the publisher.
Published by:
ISBN 978-967-10715-0-2
Designed by GNG Signature Sdn Bhd
Printed by Pencetakan Alfa Gemilang Sdn Bhd
Notes
Notes
Ministry of Health, Malaysia
Block E, Cenderasari Road,
50590 Kuala Lumpur
Tel: 603 2698 5077
Fax: 603 2691 1259
Website: http://tcm.moh.gov.my

Traditional and Complementary Medicine Programme in Malaysia

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