NATURAL AND TRADITIONAL MEDICINE IN CUBA: OUTMODED QUACKERY OR A LEGITIMATE TRIBUTARY TO SUSTAINABLE HEALTHCARE?

Abstract

Abstract'Quackery', 'charlatanism', 'hocus pocus' or more simply, 'fraud'; natural and traditional medicine has long been subject to disparaging judgements from the annals of Western medicine (Manewtiz 2001). Despite this however, one country securely anchored within the paradigm of Western, empirically-based medicine and in possession of superior health indicators, continues to employ these controversial methodologies; this country is Cuba (MEDICC 2011; WHO 2008). Cuba is a world leader in the integration of natural and traditional medicine (NTM) into its conventional practices and this essay sets out to examine this anomaly (Bancroft-Hinchey 2010). This article begins with a clarification of the term NTM, and examples of its multiple modalities. It then attends to the factors that precipitated the rise of NTM in Cuba initially, underscoring the economic necessity of its adoption. It then examines its proliferation and the manner in which it has been integrated into mainstream medical practice. Before concluding, the article examines the rationale behind NTM's continued use, considers its scientific basis and whether there are factors other than economic savings that necessitate its inclusion within the Cuban healthcare system. To conclude, the article confronts the question: should Cuba's healthcare system abandon the integration of natural and traditional medicine or does it truly have something to offer?Keywords: natural medicine, complementary medicine, healthcare, Cuban health systemWhat is NTM?This section seeks to highlight the various incarnations of NTM within Cuban healthcare practices. It begins however, with a working definition of natural and traditional medicine and its standing in 'integrative medicine'.'Natural and traditional medicine' would be the Cuban synonym for the Western term 'complementary and alternative medicine' (CAM) but for one significant difference. On the one hand, both terms refer to practices that fall outside the allopathic interventions of pharmaceuticals and surgery. In the West, therapies used instead of conventional medicine are termed 'alternative', whilst those used alongside conventional practices are said to be 'complementary' (Barrett et al. 2003). CAM is widely regarded as being seated in foreign paradigms of medicine that are incongruent with allopathic medicine (Dresang et al. 2005). NTM on the other hand seeks to both inform, and be informed by, conventional medicine. It is therefore further enveloped under the umbrella of 'integrative medicine' which seeks to have a single overarching paradigm rather than two irreconcilable systems working in parallel or even in opposition (Barrett et al. 2003). Integrative medicine is the 'thoughtful incorporation of concepts, values and practices from alternative, complementary and conventional medicines' and it is within this environment that NTM sits comfortably (Dresang et al. 2005).Whilst the traditional disciplines and folklore from which NTMs were devised can still be offered as explanation for the mechanism of action, in many cases they have been superseded by allopathic theories and empirical data. For example, the symptomatic relief generated by acupuncture can still be expressed in terms of energies and blockages, but increasingly the explanation is couched in terms of neurological or neuroendocrinological responses to the insertion of needles (Venzke, Calvert and Gilbertson 2010).Until this point NTM has been used as a singular, all-encompassing phrase, but it is now essential to clarify exactly what it encapsulates. The large array of NTMs offered in Cuba can loosely be grouped into three categories: oral/ topical preparations, physical stimulation, and psychological/'energy' stimulation (although many therapies belong in multiple categories). Table 1 shows examples of the more common practices (though it is by no means an exhaustive list) (Rossi et al. 2010; Dresang et al. 2005). …