African Renaissance in health education: developing an integrative programme of Unani-Tibb training for health care professionals in Southern Africa
Bhikha, Rashid Ahmed Hassen
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The present healthcare system in South Africa suffers from a number of serious deficiencies. Whilst orthodox bio-medicine is well established in most first world countries, its total introduction and implementation into all communities within South Africa faces many obstacles. The cost of diagnostic techniques, investigative procedures and pharmaceutical products, the availability of competent medical staff in the non-urban areas, and the lack of acceptance of the philosophy and practice of orthodox bio-medicine in rural regions are but some of the factors which conspire against the general application of this orthodox medical paradigm. Another problem confronting healthcare and medical practice in South Africa, particularly at this stage of our historical development, is the absolute focus on orthodox bio-medicine, often to the detriment of other medical paradigms that also have advantages to offer. Can the integration of another medical paradigm, such as Unani-Tibb, enhance the practice of orthodox bio-medicine in this country?The aim of the thesis was to investigate the possibility of integrating Unani-Tibb with orthodox biomedicine (also termed conventional, Western or allopathic medicine) and assess its potential for improving delivery of an effective, affordable and appropriate healthcare system in South Africa.The research questions which the thesis seeks to answer is whether this integration is possible and whether the delivery of healthcare to the South African population can be enhanced. Changes in the provision of medical education are necessary, and occupy a pivotal role in allowing for this integration. Unani-Tibb is a traditional medical system practiced extensively on the Indian sub-continent and in other parts of the world. At present, however, it is minimally practiced in South Africa. Its primary principle is the energetic promotion of health maintenance behaviour and the prevention of disease, through effective application of dietotherapy, pharmacotherapy and other interventions, as well as the empowerment of the patient towards adopting behavioural changes and lifestyle adaptations. One positive aspect of Unani-Tibb is that it has many features in common with both orthodox biomedicine and African Traditional medicine. These commonalities should allow for greater acceptance by orthodox healthcare professionals, as well as the general population. The first part of the study involved the research and conceptualisation required for the production of a series of customized training modules which introduced the theory and practice of Unani-Tibb. A twelve month part-time training programme based on these modules was subsequently conducted with a number of healthcare professionals presently in active practice and with a background of orthodox medical or nursing healthcare. This outcomes-based training programme included a number of specifically designed training activities, such as case studies, practical exercises and assignments. Appropriate evaluations and assessments were pursued in order to measure performance outcomes and attitudes. Questionnaires for assessing the motivation and satisfaction of the participants were also completed. The second part of the study was in the form of a pilot participant research project, in which the participants applied the information from the integrative programme to a number of chronically ill patients who had previously been treated with standard orthodox bio-medical procedures. The parameters derived for clinical efficacy, cost-benefit and improvement in Quality of Life from Unani-Tibb treatment were then compared to equivalent results obtained by orthodox bio-medicine. In all parameters inspected, the integrative training programme compared favourably to orthodox bio-medical practice. Not only was there an improved clinical efficacy, but the cost-benefit was shown to be superior in most indices measured. The Quality of Life comparison, which assessed the patient and total health status, subjective behaviour and attitude, generally favoured the integrative training programme. The thesis serves to suggest that the integration of Unani-Tibb into orthodox bio-medical training in South Africa is a distinct possibility, and could ultimately allow for treatment which is clinically acceptable, cost-effective and which provides an improved Quality of Life for the population as a whole. I suggest that this pilot study be repeated more extensively, thereby allowing for a more confident and objective assessment.