Another article from Professor Debra
Conditions That Compel People to
Explore Traditional Chinese Medicine Treatment at the Huai Hua Red Cross
Hospital for Difficult and Chronic Conditions in Southwestern China
Purpose:
To discover the physical and
psychological motivations that compel patients and loved ones to explore and
use Traditional Chinese Medicine at the Red Cross Hospital for Chronic and
Difficult Conditions, the sacrifices each patient and family makes to do so
and whether it is effective in a transnational, culturally and
linguistically diverse social setting.
According to the World Health Organization 2002 Policy Perspectives
Publication:
Populations throughout Africa, Asia, and Latin America use
traditional medicine (TM) to help meet their primary health care needs. As
well as being accessible and affordable, TM is also often part of a wider
belief system, and considered integral to everyday life and well-being.
Meanwhile, in Australia, Europe and North America, ＾complementary and
alternative medicine￣ (CAM) is increasingly used in parallel to allopathic
medicine, particularly for treating and managing chronic disease. Concern
about the adverse effects of chemical medicines, a desire for more
personalized health care and greater public access to health information,
fuel this increased use [Appendix A]
For the past six years, persons
from over two hundred countries with difficult
and chronic conditions,
i.e., diverticulitis, cancer, and incurable autoimmune diseases such as
Systemic Lupus Erythematosis (SLE), Multiple Sclerosis (MS), Lou Gherig¨s
Disease (ALS), have been motivated to explore the options Traditional
Chinese Medicine (TCM) offers them at Huai Hua Red Cross Hospital (Ming,
2006). Since these conditions are chronic and often times incurable, they
have led many patients and/or their family members to seek and decipher
complex, baffling, and, obscure medical information and to explore options
encountered beyond the diagnostic and treatment scope generally available to
them. Despite their diverse cultural backgrounds, many persons reach this
intersecting destination at the time-honored tradition of TCM and the Huai
Hua Red Cross Hospital for Difficult and Chronic conditions.
Due to a rare invitation from Dr. Ming, the
International outpatient director and Vice President of this hospital, I
have been granted an eight to ten-week opportunity to research and
experience its methods.
According to Dr. Ming (2005), patient testimony, and case studies posted on
the hospital site, many of these patients have never experienced these
methods. They complete the online consultation questionnaire and,
admittedly, anxiously await the herbal prescription and treatments suggested
by Dr Ming and his staff. Since many of these patients have complex, and/or
advanced conditions, intensive, comprehensive Traditional Chinese Medicine
treatment (WHO, (Jia), 2005:23) at the hospital offers what it argues is the
'last and/or best hope for recovery or symptomatic relief (Dr. Ming, 2006).
Although the journey to this hospital in
Southwestern China poses many obstacles and necessitates many sacrifices,
patients and their family members cast aside geographic, linguistic, and
cultural displacement and endure a rather arduous journey.
Methods:
I plan to discover the patents' motivations and
sacrifices through three avenues: experiencing treatments, which I have used
for 8 years, patient interviews, and quantitative data. I believe my onsite
experience will provide both a unique vantage point and the best opportunity
to discover the motivations for patients and family members to endure the
arduous and intensely personal journey to this Traditional Chinese Medicine
(TCM) in China and the sacrifices they made. This location and
intermediary placement will yield access to patients, families, and
professionals. Therefore, I can also discover whether the
5,000-year-old methods employed by the TCM professionals are effective from
the doctors¨ and patients¨ perspectives and how these methods are viewed by
the patients. This will also allow me to learn how patients view health and
illness from a cultural perspective. According to Penn et. al.:
An individual's belief about
the cause of illness could determine who is to conduct the diagnostic
interview, what expected treatment modalities might entail, efficacy of
treatment for diagnosis and treatment and whether the victim is stigmatized
by the illness.
To gather this information, I will employ a variety of traditional
anthropological methods. I both experience treatment methods and observe
them. To supplement participant observation, I will conduct formal and
informal interviews and evaluate case studies. Those interviewed will
include the International Outpatient Director, Dr. Ming, his assistants and
staff, TCM students, approximately 20 patients, and their family members.
Since I also have access to many case studies conducted at the Huai Hua Red
Cross Hospital and Dr. Ming¨s assistance with records and TCM explanation, I
will also use this information to substantiate and enrich my research. This
will illuminate how TCM and the patients view illnesses, life, death, and
recovery.
Participant observation,
entering the community, is extremely effective in this arena, since many of
these patients are foreigners, have stepped beyond their comfort zones and
face both the uncertainty of this environment and the obstacles chronic and
difficult diseases pose within everyday life. At a time of such uncertainty
and vulnerability, a＾shared history,￣ in this case, experience with chronic
illness, the journey to this hospital, and a shared community within the
hospital affords a strong rapport-building factor. Since mealtime is shared
in a family setting in Traditional Chinese style at the hospital, these
gatherings yield invaluable time and opportunities time to share experiences
in an informal setting. Furthermore, participant observation is the method
cultural anthropologists use to understand peoples and their culture. It
affords the time, place and methodology to learn from people, to discover
what Spradley (2003) terms the hidden principles of another way of life.
This shared two and a half month experience and place yield the
opportunities to discover how these peoples view illness and the journey
(Nolan, 2000), how they arrived at this place and why. This method allows
the discovery of these terms and experiences and, ultimately, how the
application of these principles addresses cultural perceptions and
disease-identification (Farquhar, 1996), and is particularly useful in
globalized transnational settings. Additionally, teaching English to
hospital workers will also yield insight to classification of disease, cause
and treatment.
Participant observation yields invaluable nuances and discovery of
perceptions of disease but must be weighed by the case studies, medical
understanding and evaluation of such, and the tangible knowledge available
through archives. Case studies provide valuable insight within both the
Eastern and Western medical realms and provide additional comparative data.
(Reading them often illuminates the culture of the medicine.) Expert
explanations provided by Dr. Ming and his assistants will also highlight and
detail obscure concepts. Combining medical and cultural methodology will
provide a balanced view of the motivations and treatments, the outcomes
through the TCM doctors' and patients' eyes, and reveal "hidden" cultural
concepts.
Results: Besides the medical
conditions that motivated these patients and their family members to come to
the Red Cross Hospital in China, I also expect to discover the other factors
that led to these avenues of exploration. Among these factors, I believe I
will encounter the effect of Traditional Chinese Medicine (TCM) doctors and
practitioners emigrating from China and the effects of China, consequently,
opening its doors to foreigners exploring TCM methods. I also expect to find
the World Health Organization (WHO) endorsement of Traditional Chinese
Medicine and acupuncture, in particular, as a motivation for more persons to
explore, investigate, and use the treatment options it offers (WHO,
1978-2006).
To share this
information, I plan to present my findings at the Rall Symposium, the ACAA
and the National Conference for Undergraduate Research (NCUR). If the
opportunity allows, these presentations may also include Dr. Ming or one of
his assistants. I also intend to share my written work with the National
College of Acupuncture and Oriental Medicine (NCAM). With Dr. Krystal¨s
assistance and guidance, I also plan to submit these findings for the 2007
yearly meeting of the Society of Medical Anthropology and to the American
Anthropological Association for the publication
Anthropology News.
Personal Goals (Short term):
To explore the culturally diverse views of illness, treatment, outcomes, and
the particular relevance of Traditional Chinese Medicine in an ethnically
plural setting with respect to chronic and difficult conditions currently
managed and treated by Western Medicine with significant side effects and
toxicity concerns (WHO, (PPO), 2002).
Many conditions motivate
these patients from two hundred countries to experience these methods.
Therefore, it is important to see how these views of illness and treatment
intersect, as well as how they differ. Since the 2005 World Health
Organization conference in Thailand deemed chronic illness the focus of
2005-2006, this study may illuminate hidden aspects of culture and medicine
midst Globalization.
Concurrently, Western
Medicine is exploring how ethnicity, culture, and medicine relate,
particularly concerning conditions and unequal distribution of disparity
among minorities (Penn, 126-7,2000). It is also the focus of many studies
within forensic and medical anthropology. Because Chinese medicine formulas
and treatments are highly individualized, prescribed according to a pattern
of symptoms rather than according to disease identification (Hadady, 1996),
these applications within a culturally diverse community, addressed in a
holistic fashion (WHO, 1978:14), comprise the facets of a current two year
National Institute of Health (NIH) cancer treatment study in China (NIH,
2005). Therefore, I hope to serve as a cultural bridge, lending
understanding of illness and healing, and how it is viewed within a
culturally and linguistically diverse community, through the international
lens midst globalization.
Long term: In the Age of Globalization, when
West meets East in the field of medicine, my unique background will assist
in achieving open dialogue and the exchange of cultural, medical, and
technical information. Ethnicity, culture, and medicine have led me to
explore Traditional Chinese Medicine in this context long term. I plan to
use this study as a base for further study through another grant based
study, future fieldwork, a part of a Graduate education, the Fulbright
Scholar Program, or a more in depth indigenous peoples Lupus study. I may
also later explore the recently discovered Qing Dynasty documents that
reveal the tracks of Systemic Lupus Erythematosis through their society and
their methods of treatment.
Concerning chronic diseases, specifically autoimmune diseases, (which rise,
according to the American Autoimmune and Related Diseases Association (AARDA,
2005) at an estimated 200% annually within the United States since 2002, I
hope to shed new insight and understanding onto the triggers of such
diseases, alternative treatments, and the sacrifices such illnesses require
of both the patients and the family members. Since autoimmune diseases are
so difficult to diagnose and treat, this investigation and study may promote
more open dialogue and explore such facets as culture and medicine,
environmental health and, ultimately, yield less suffering.
Personal Application: The
need to promote global understanding and medicine has always motivated me.
Upon returning to school, I engaged in Chinese history, language, and
culture classes to help me understand the roots of the Traditional Chinese
Medicine that I was and am concurrently studying and using in my daily life.
Although this coursework was not required, I felt it would yield invaluable
insight with regard to cultural concepts. Through this coursework, I also
studied ethnicity, culture, and medicine, biomedical ethics, physical and
cultural anthropology, and conducted several field studies including:
Lupus in the Sioux Indians (which stimulated interest at the Indian
Health Service in the US and in Canada), Why Chinese Americans Study
Chinese Language and the Diglossic and Triglossic Situations it Creates in
their Homes, and The Shinnyo-en Temple.
As a non-traditional
student, I have walked many paths. Throughout most of my adult life,
serendipity and many life situations revealed many unforeseen paths and
avenues of discovery and learning than I could have ever anticipated. As a
freelance writer and researcher, I contracted for: medical organizations,
including JAMA and the AMA, doctors, and governmental agencies (Government
Services Agency), BP Amoco, where I reviewed, edited, and wrote Material
Safety Data Sheet reports in several languages (French, Italian, German,
Spanish, Portuguese, Chinese) in the toxicology lab, translated a novel for
a Cuban man, penned petitions for human rights organizations addressing the
UN council, researched for the World Health Organization, and studied people
and culture informally. I also served as a bilingual aide for 120 students
daily at an elementary school and currently help ESL students edit their
papers.
Perhaps, the most life
altering experience occurred as a direct result of an unexpected journey to
a Chinese medicine/tea shop where they spoke only Chinese and I spoke only
formulaic Chinese. This quickly led me to a circle of Traditional Chinese
Medicine (TCM) healers from China and merely propelled my exploration and
formal study of TCM, Chinese language, history, and culture. Although I have
written case studies for both medical doctors and Chinese Medicine doctors,
including Dr. Zhengang Guo who is both an M.D. and a seventh generation TCM
healer, shared my experiences with patients and professionals, served as a
liaison for many new TCM patients, worked on Alternative Medicine
legislation issues with Henry Hyde¨s legislative assistant, educated
legislators and patients, and studied Western Medicine formally and
informally since I was nine, these experiences were mere stepping stones to
this research. They have provided me with the necessary tools do
conduct this intensive field research, but I am still the ＾understudy￣ in
this arena. This study will mark the first time that I will study TCM in
China.
From these varied
yet intertwining and sometimes encompassing experiences, I have acquired the
capacity and skills to communicate in linguistically and culturally diverse
situations, collect, and analyze interviews and data. As a student and a
patient of Traditional Chinese Medicine (TCM), I can illuminate different
aspects of treatment and diagnosis in this hospital where its practice is
unbridled. I also understand the path of these patients and these
families since I stepped onto a similar path many years ago, when I made
such a choice, not knowing what to expect. Upon this experience, I can build
bonds that most persons could not. Combined with my Anthropological field
study experience and training, my enhanced multi-cultural, linguistic, and
Chinese cultural knowledge, TCM studies, Chinese-American community
involvement, and Chinese language study, I feel I can offer a unique insight
into the concepts that elude the Western world and illuminate aspects that
all people share with regard to illness, suffering and the motivations to
improve their conditions amidst adversity.
Bibliography
American Autoimmune and Related
Diseases Association
2006
Accessed on 12/2006-2/19/2006 at:
http://www.aarda.org
Provides research
information, statistics, NIH and legislative updates.
Angrosino, Michael
1986 Health
and Illness in Sociocultural Perspective in A
Health
Practitioner's Guide to
the Social and Behavioral Sciences.
Pp.53-64.
Auburn Press.
Angrosino, from his own participant observation in a mental health care
facility, details the cultural view of illness and its role in a health care
setting.
1986 Life Histories
in
A Health Practitioner's Guide to the Social and
Behavioral Sciences.
Pp.79-81. Auburn Press.
This
details how life histories provide ethnographic data and highlight cultural
concepts.
Chrisler, Joan C. and O'hea, Erin L.
2000
Gender, Culture, and Autoimmune Disorders in Handbook of
Gender, Culture and
Health. Richard M. Eisler and Michael Hersen. Pp.
321-342. First Edition.
Mahwah: Lawrence Erlbaum Associates, Inc.
This highlights the current
discourse surrounding autoimmune disease, factors, incidence, and belief
systems of different cultures.
1996
Knowing Practice:
The Clinical Encounter of Chinese Medicine
(Studies in and belief
graphic Imagination). First Edition. Boulder, CO:
Westview
Press
This Researcher/ University of Chicago
Anthropology professor highlights the differences in knowledge required to
practice and understand Traditional Chinese Medicine (TCM). Through her
journey of discovery at Guangzhou College of TCM in post Cultural Revolution
China, she details how the college translated these concepts to its
students, and how their understanding of patterns of symptoms was and is
crucial to diagnosis and treatment.
Hadady, Letha
1996
Asian Health Secrets:
The Complete Guide to Asian Herbal
Medicine. First Edition.
New York: Three Rivers Press
This
acupuncturist/herbalist culturally "translates" Chinese, Indian, and Tibetan
herbal
medicine concepts. She shares her journey across post Cultural
Revolution China in search of medicinal secrets and the cultural insights
she
gained.
Her experience provides the proper lens to view these medicinal
aspects
and contrast Eastern and Western methodologies of diagnosis and
treatment. She also details the alignment and harmonization of mind, body,
and
spirit.
Han,
Henry, Miller, Glenn E, Deville, Nancy
2003
Ancient Herbs, Modern Medicine.
First Edition. New York: Bantam
BooksThis provides insight about the combination of Traditional Chinese
Medicine and Western medicine. He details Yin and Yang principles,
acupuncture techniques, chronic and debilitating illness, common ailments
and
diagnostic differences.
Ming, Dr.
2006
The
Huai Hua Red Cross Hospital
Accessed on 12/2006-2/19/2006
at: <http://www.tcmtreatment.com/hospital.htm>
Patient
form accessed at:
http://www.tcmtreatment.com/form.htm
Patient
case studies: <
http://tcmtreatment.com/hospital01.htm >
This
details case studies, provides patient contact information, patient letters,
treatment details, and Chinese Medicine information.
Mc Curdy, David W.
1995
Using Anthropology in Conformity and Conflict:
Readings in
Cultural
Anthropology.
James Spradley and David W. McCurdy, eds. Pp.
415 -427. Eleventh edition.
Boston: Allyn and Bacon.
The applications of Anthropology within
everyday life situations are highlighted and explored. Mc Curdy explains its
applicability in marketing, the uses of observation for research and design
and how culture filters into every aspect of routine, including utensils we
use and design.
Penn, Nolan E., Kramer, Joyce, Skinner, John F., Velasquez, Roberto J.,
Yee, Barbara, W.K., Arellano, Letticia M., Williams, Joyce P.
2000 Health Practices and Health Care Systems Among Cultural
Groups in Handbook
of Gender,
Culture and Health.
Richard M. Eisler and Michael Hersen. Pp. 105-138. First Edition. Mahwah:
Lawrence Erlbaum Associates, Inc.
This Chapter
highlights the incidence of disease and cultural views of health concepts
among different ethnic and religiously connected ethnic groups.
World Health Organization
1978 The Promotion and Development of Traditional Medicine
2001
Traditional Medicine: Growing Needs and Potential.
2006 Accessed on: 12/2005-2/19/2006
at: <http://www.who.int>
2006
Traditional Medicine: Definitions.
2006 Traditional Chinese Medicine Could Make
"Health for One" True (Jia)
Traditional
medicine
is the sum total of the knowledge, skills, and practices based on the
theories, beliefs, and experiences indigenous to different cultures, whether
explicable or not, used in the maintenance of health as well as in the
prevention, diagnosis, improvement or treatment of physical and mental
illness.
Complementary/alternative
medicine (CAM) The terms "complementary
medicine" or "alternative medicine" are used inter-changeably with
traditional medicine in some countries. They refer to a broad set of health
care practices that are not part of that country's own tradition and are not
integrated into the dominant health care system.
Acupuncture is the insertion of one or more
needles into specific locations called acupuncture points. Acupuncture is
one of the oldest forms of healing known to mankind. It originated in China
nearly five thousand years ago.
Cupping
is an ancient Chinese method of causing local congestion.
A partial vacuum is created in cups placed on the skin either by means of
heat or suction. This draws up the underlying tissues. When the cup is left
in place on the skin for a few minutes, blood stasis is formed and localized
healing takes place. Cupping affects the body up, penetrating the surface up
to four inches into the tissues.
Gua Sha: Gua Sha is a method
of treating repletion heat distention patterns. The skin on the back, limbs
or other area of the body is lubricated and the scraped with a ceramic spoon
or similar objective. The area is scraped until the red papules become fully
visible to releasing heat.
Moxa:
The prepared leaves of mugwort used in a technique called moxibustion.
Moxibustion is heat therapy preformed by a method of burning moxa (prepared
mugort) to heat the skin or a needle that is inserted. Moxibustion is
commonly used in Chinese medicine to treat cold and dampness disease.
Tuina:
Tuina is a form of Chinese bodywork, which its origin dates back to 100B.C..
Bodywork has always been an integral and respected tool of a TCM
practitioner. The hand techniques within this system can manage qi flow
within the human body thus having a wide array of healing possibilities.
Herbal medicines
Herbal medicines include herbs, herbal
materials, herbal preparations and finished herbal products, that contain as
active ingredients parts of plants, or other plant materials, or
combinations.
，
Herbs:
crude plant material such as leaves, flowers, fruit, seed, stems, wood,
bark, roots, rhizomes or other plant parts, which may be entire, fragmented
or powdered.
，
Herbal materials:
in addition to herbs, fresh juices, gums, fixed oils, essential oils, resins
and dry powders of herbs. In some countries, these materials may be
processed by various local procedures, such as steaming, roasting, or
stir-baking with honey, alcoholic beverages or other materials.
，
Herbal preparations:
the basis for finished herbal products and may include comminuted or
powdered herbal materials, or extracts, tinctures and fatty oils of herbal
materials. They are produced by extraction, fractionation, purification,
concentration, or other physical or biological processes. They also include
preparations made by steeping or heating herbal materials in alcoholic
beverages and/or honey, or in other materials.
，
Finished
herbal products:
herbal preparations made from one or more herbs. If more than one herb is
used, the term mixture herbal product can also be used. Finished herbal
products and mixture herbal products may contain excipients in addition to
the active ingredients. However, finished products or mixture products to
which chemically defined active substances have been added, including
synthetic compounds and/or isolated constituents from herbal materials, are
not considered to be herbal.
Traditional use of herbal medicines
Traditional use of herbal medicines refers to
the long historical use of these medicines. Their use is well established
and widely acknowledged to be safe and effective, and may be accepted by
national authorities.
(WHO Traditional Terms 2006,
et. al)
Appendix B
Interview questions (based
on patient liaison experience and the focus of study)
will include:
What is the nature of your
illness or condition? What caused it?
How long have you
had it? How were you diagnosed?
What led you here?
How did you discover the Huai Hua Red Cross Hospital?
What other methods
have you tried? What was your prognosis?
What did you have
to do or sacrifice to come to this hospital?
What are the challenges of being here?
(Answers may range from weather, familiar food scarcity, etc. - may
illuminate cultural displacement.)
Is it frightening
for you to try acupuncture, cupping, moxibustion, etc? (Appendix A)
How are you treated
differently at the Huai Hua Red Cross Hospital?
Has the treatment
been effective? Does it meet your expectations?
Although the
hospital has some translators, what are the difficulties in communication?
(This will include both the linguistic difficulties of verbal and the
hidden, non-verbal communication. The latter, gestures, in particular, most
often discovered through observation of instances or through the
storytellers themselves.)
