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In a refreshingly rare show of pluck uncharacteristic of key government office bearers, especially as far as multilateral lending agencies are concerned, the current finance minister, Abul Maal Abdul Muhith, lashed out at the reservations expressed by a visiting delegation of the International Monetary Fund. The delegation, while reviewing the state of the economy, had expressed strong disapproval about the substantial government subsidies for fuel and fertilisers. According to a report in New Age on Friday, the finance minister had told the delegation that in order to keep the economy stable and provide it with a firm footing, the government would continue to support key sectors that needed its assistance.
   The current government plans to distribute a large amount of government funds in subsidising agricultural inputs including fuel and fertilisers, not to mention its planned expenditure on the large social safety nets that also include provisions for government services to the poorer sections of the people. Also, there have been indications that the government would provide protection for local industries by raising tariffs. These measures have been followed by numerous other developed countries and are also currently in place in a number developing countries. But as with any such protectionist measure that necessarily increases trade distortion and is contrary to the spirit of unfettered liberalisation of the economy and free trade, institutions like the International Monetary Fund and other such lending agencies oppose them.
   But it appears to escape the multilateral lending agencies that other countries that have grown and emerged as developed economies had all passed a certain phase of such protectionism that allowed their domestic producers and industries to gain a firm footing before they had to compete at the international level. It was only after those economies had reached a certain level of maturity that the countries initiated open market policies more in line with those that these agencies champion. However, even today the developed countries as well as the advanced developing countries continue to subsidise and protect some of their crucial and strategic sectors due to political and economic considerations.
   We have stressed these points numerous times before in these columns and a similar reasoning from the finance minister is therefore rather delightful. But to add a word or two of caution, the lending agency also predicted high inflation and low growth with which the finance minister disagreed. He insisted that Bangladesh would have a far higher growth than that which was projected. While it must be acknowledged that the Awami League’s last tenure between 1996 and 2001, was marked by low inflation and decreasing disparity, that must have been among its great successes, the finance minister would do well to turn his attention to better distribution rather than just growth in this tenure also. Furthermore, while the government had been spectacularly successful in bringing down the prices of essentials almost overnight, after it took office earlier this year, that success appears to be waning. Perhaps it is time that essentials’ prices should be given renewed attention since it affects the poorer sections harder and the government’s achievements could well come to a nought if inflation rises.

Lynching undermines
civilised values

Few things, perhaps, can underscore the absence of the rule of law more than mob justice taking the form of lynching. Lynching has been going on in the country as is reported from time to time from different parts of the country. This is a challenge to the established justice delivery system and has a dangerous potential of escalating in which case it can target anyone and everyone, generate social tension and undermine stability.
   The popular anger which engenders such lawless acts is understandable but not supportable. Crimes of all variety are rampant and these must be dealt with in accordance with democratic principles and human rights. Justice delivery system in this country is an extremely tardy process, no doubt. Everything should be done to accelerate this process but no shortcut can be chosen that denies an individual the right to justice. Both ‘crossfire’ killing and lynching are equally abhorrent and must be stopped. Mob fury and resort to injustice reflects the people’s loss of faith in the police. The common feeling is that if a suspect is handed over to the police, which is the normal course for a citizen to follow, the police will turn it to their own financial advantage and eventually release the suspect without initiating any convincing legal action and the accused will return to society and repeat his crimes. Yet laxity and corruption cannot be met by another kind of illegal operation, especially when it means beating a citizen to death on the spot.
   In the latest instance an unidentified woman was beaten to death by a mob on suspicion of having stolen an 18-month-old baby from Nandipara in Narayanganj, according to a report filed by our Narayanganj correspondent and published in this newspaper yesterday. The alleged child lifter was caught by the local people and the baby was recovered. The people then beat up the woman mercilessly till she fell unconscious. At the hospital she succumbed to her injuries. Such ugly scenes of violence also brutalises the perpetrators and tends to banish tenderness and compassion from society itself.
   As perpetrators are the nameless faceless mob, the government does nothing to investigate and prosecute. There is not even any verbal condemnation by the high-ups. Of course such condemnation by a government that itself talks self-righteously in defence of extra-judicial killings will sound hypocritical. But not to condemn and hold enquiry will amount to indirect encouragement. Lynching undermines civilised values. These violent incidents also carry a potent message for the country’s police force. The police must try to improve their image and create confidence in the public mind.

USUALLY when we talk about health care we mean ‘western’ or allopathic medical care. We forget that in almost all cultures and countries there are other forms of health care based primarily on using plants and herbs as therapeutic agents. These healthcare systems variously termed as ‘traditional’ or ‘alternative’ medicine existed since time immemorial. This use of natural resources as therapeutic agents was predicated on a unique belief system encompassing the concepts of health, physical or mental illness, diagnosis, treatment and prevention. The accumulated knowledge of such health practices and products is a rich cultural heritage common to all human societies, sometimes ignored or unrecognised in a formal or institutional sense. What separates this body of knowledge referred to as ‘traditional medicine’ from ‘modern medicine’ is the fact that the latter is anchored in ‘science’, while the former in practical experience. As long as science continued to be narrowly defined, traditional medicine remained largely unnoticed. It took sort of a scientific revolution, a paradigm shift, to draw renewed interest in traditional medicine. Increasingly, the very validity of this ‘traditional-modern’ dichotomy is being questioned. Traditional medicine differs from the ‘modern’ or ‘western’ medicine not in terms of goals or effects, but in terms of their underlying cultural and historical contexts. Although there is strong resistance from some quarters, this traditional-modern dichotomy is increasingly becoming irrelevant and anachronistic. Nowadays traditional medicine, in different names and different associated axioms and practices, are found in all cultures and all regions – Bangladesh being no exception.
   The diversity as well as the maturity of traditional medicine across cultures is truly fascinating. From China, India, Indonesia to the African states and the indigenous peoples throughout the Americas, there is a variety of systems that may be termed ‘traditional medicine’. Although, as noted earlier, for lack of a better term, these diverse systems are lumped together under the rubric ‘traditional medicine’, the term does not really reflect the fundamental nature of these systems. The term ‘medicine’, for example, tend to emphasise the treatment or curative aspect of these systems, ignoring their preventive aspects. Moreover, the term ‘medicine’ neglects the diverse practices that encompass any system of traditional medicine. In Bangladesh, India or Pakistan, there are the Unani and Ayurvedic systems of medicine. Chiefly based on remedial agents from plants, the Unani system derived its name from Greece – Unan in Persian. It proudly proclaims Aristotle (Aflatun in Arabic) as its founder, being responsible for registering the therapeutic value of thousands of plants. It has its own theories and principles. Long before the WHO declaration, the Unani system considered health not merely in terms of absence of disease but as a relative ‘physical, mental, spiritual and social well-being’. This system adopts a holistic approach and considers humans to be an integral part of the totality of the environment. Health implies a state of equilibrium among all the constituent elements of the environment. In such an approach, the individual’s social, cultural and physical environment, temperaments, constitution, predispositions, as well as diet regimen, food, compatibilities, living habits and mental composure or spiritual beliefs are considered significant in causation and cure of ill health. Such a holistic perspective on human health is perhaps a common link between all traditional medicines prevalent in diverse settings – from the herbalists and shamans in rainforest areas of South America through to the spiritual healers among the indigenous peoples in Canada, Australia, the United States and the Latin American countries.
   Philosophy, religion and spirit are central to traditional medicine found among the indigenous peoples of the Americas. Traditional medicine, in this case, is intricately tied to the belief system. According to a recent study, their belief system ‘is built upon the concept of a balanced universe made up of energy fields. The world, the environment, the community, the family, and the self are interwoven and move in harmony to each other. The medicine wheel reflects this philosophy. It depicts the circularity of life, of energy never being lost, and of continual learning and quest for knowledge.’ It encompasses the teachings, the values, the beliefs, and the social mores of traditional Aboriginal Indian culture, according to a 1993 report of the Aboriginal Nurses Association of Canada. Aboriginal Indian culture believes in four components of the self: body (one’s physical self), mind (cognitive abilities), emotion (psychological self), and spirit (spiritual/religious beliefs). These components are intertwined, and for one to be healthy, all these components of the self must be in a stat of equilibrium. Good health is God’s precious gift; by maintaining good health we are showing our appreciation to the Creator. And to maintain good health, one must establish a balance between these four elements of the self. If one element is neglected, an imbalance pervades all other elements and, ultimately, affects the self. For good health, one must establish a balanced relationship with oneself, with family, community, the land, the environment and the world at large. In other words, sickness is being perceived as an imbalance which may begin in the physical or the mental realm; or in the emotional or the spiritual realm. It is important to note that in the indigenous culture, the term medicine is also defined in a much broader sense than in the western tradition. Medicines include all things that heal. These can be internal to oneself such as laughter, tears, communication; or it can be external such as, words that one hears, behaves or actions or medical remedies and tonics. Placed within this perspective, traditional medicine includes what western scientific medicine calls health practices and behaviour, as well as medical treatments and remedies. The Chinese or Vietnamese traditional medical practitioners may differ in vocabulary and formulary from their Bangladeshi, Indian or Aboriginal Indian counterparts. However, they all share a remarkably similar philosophy of human health, illness and nature. Yet, it is the underlying culture that makes them different and distinct.
   The traditional medicine of different countries and cultures vary from one another in another important respect – the level of formal recognition. While in China or in the Indian subcontinent or in other parts of Asia, traditional medicine is fully recognised formally, in most African or South American countries such recognition is largely missing. In the Americas, particularly involving health practices and products of indigenous people, there is little acceptance of even their very existence. Consequently, indigenous knowledge in health is in danger of being lost, unless rigorous efforts are made to preserve them for future generations. The differential evolution of traditional medicine can be traced back to the differential nature of colonialism that countries around the world had to endure. Apart from brutal incursions from imperial Japan, the Chinese belt of Asia remained largely unscathed by colonialism. India, Bangladesh and Pakistan, on the other hand, endured almost 200 years of British rule. Before the British, the Moghuls from Central Asia came to conquer India and settled in and ruled it, by and large, as rather benevolent rulers. The Moghuls not only brought a rich cultural heritage of their own but also contributed immensely to further cultural, social and economic development of India. Under the Moghul rule, the Indian traditional medicine (Kabiraji, Ayurvedic, Siddha, etc) received royal encouragement to flourish. The Unani system came through the Muslims who settled in India during the Moghul rule. Surprisingly, these traditional medicinal systems acquired and retained to this day, a religious orientation – Unani by Muslims, while Kabiraji/Ayurvedi by Hindus. In Bangladesh or Pakistan, it would be difficult to find a Hakim who is a Hindu; similarly there is hardly any Ayurved or Kabiraj who is a Muslim. By the time the British came, these systems were quite developed, with their own schools and formularies. The religious-ethnic groups identified so strongly with one or the other of those systems that the British found it difficult to ignore them, even when they were looked upon with disdain. Between 1757 and 1835, the new colonial power largely tolerated the indigenous medical systems, while laying the foundation for the western medical system. Since 1835, officially at least, the British adopted a policy of regarding western medicine ‘as the hallmark of a higher civilization’, as a sign of the moral purpose and legitimacy of colonial rule in India. Quite naturally, the British casually equated the indigenous medical ideas and practices with ‘ignorance and barbarism’. Nevertheless, the social, political and geographical reality of India made the British adopt an attitude of benign neglect towards the indigenous medical systems. Quite often, in the interest of political expediency and in following the policy of divide-and- rule, the British was almost forced to patronise one or the other of the traditional medical system from time to time. Consequently, these systems continued to develop along with the newly introduced ‘western’ system of medicine.
   Encouragement and support given by post-colonial or, in case of China, post-revolutionary governments also contributed to the continued development of these traditional medical systems in the Indian sub-continent and China. As early as in 1955, a few years after the revolution, the Chinese government emphasized the need to promote traditiona1 medicine. Driven by pragmatic reasons, the Chinese government concluded: ‘We must also fully realise that our ancient cultural heritage is the fruit of the genius and creative labour of the Chinese people and that many of our contributions to culture are worth preserving and developing... If only we could enlarge the scope of our studies in Chinese medicine, rediscover the hidden treasures in our ancient science and art of healing, and make them available to the people, great achievements could result.’ Needless to say, such a refreshingly revolutionary attitude made the traditional Chinese medicine grow and slowly recognised by the world at large. Some of the elements of the traditional Chinese medicine – acupuncture, for example – are widely available in many countries in Europe and the Americas.
   In India, Bangladesh and Pakistan, traditional health systems received recognition and state support only after independence. It was in 1962 that Pakistan first enacted the Unani and Ayurvedic Medical Practitioners Act to recognise and regulate these traditional health systems. In India, the Ayurvedic system gained recognition during the 1950s and gradually become a ‘separate profession’. In the Indian subcontinent and China, traditional medical services are available as a routine part of national health services. Practitioners are trained in four or five year degree programs in separate institutions recognised and regulated by the government. Often traditional medical practitioners’ associations oversee the licensing process and establish and monitor professional standards. In most parts of Asia including Bangladesh, traditional medical practitioners provide most to their services in rural areas, where the overwhelming majority of its population live.
   The African countries went through a different kind of colonialism. Labelled as the ‘dark continent’, it suffered the indignity of slavery, apartheid, most extreme form of repression and oppression. When slaves were not treated as humans, there was no question of providing any respect for their culture. Thus there was least or no respect for their health practices and products. On the contrary, they were repressed, often brutally. In Africa, ‘colonial governments and early Christian missionaries despised and therefore attempted for many years to discourage the use of traditional medicine,’ remarked one of the foremost authorities on African traditional health systems, Professor GL Chavunduk. Unlike their Asian counterparts, the African traditional medicine, therefore, did not enjoy a natural process of evolution and development. It remained undeveloped, neglected and largely unrecognised. Consequently, African traditional medicine stagnated and often further degenerated during the long period of colonial rule.
   A different type of colonialism prevailed in the America, Australia and New Zealand. In those places, colonialism was physical and permanent. The Aborigines were physically uprooted and annihilated. A new society was created on the ashes of the old. When the first European arrived in the fifteenth century, Native Americans had already inhabited the continent for some thirty thousand years and numbered several million. The European settlement and parallel policy of ‘replacement of the Natives’ were so efficient that ‘by the early 1800’s few Native Americans remained east of the Mississippi river’ and ‘by the beginning of this century, the vanishing Americans numbered only about 250,000 in the United States.’ The indigenous population of Mexico decreased from 2.3 million in 1650 to about one million by 1890s.
   Quite obviously, this brand of colonialism had scant respect for the culture of the vanquished. Health practices and products of the indigenous peoples of the Americas, therefore, remained unrecognised and unexplored. It not only suffered from lack of a natural growth, but also faced the spectre of total extinction along with the annihilation of its adherents. Unlike the African or the Asians, the Natives did not regain independence, but struggled with continued discrimination, segregation and socio — political isolation. Not surprisingly, Native traditional medicine is perhaps one of the most endangered cultural heritages of modern times. Some of the indigenous knowledge is fast disappearing, and is likely to extinct, if not preserved immediately. Preserving and further developing indigenous health practices and products must be regarded as great challenges of our time.
   In the past few decades there has been a resurgence of interest in traditional medicine both in developing and developed countries. What factors led to this resurgence of interest? How do we react to this resurgence of interest in traditional medicine? Let us discuss these issues in a future encounter.
   Dr Anwar Islam is associate dean and director, James P Grant School of Public Health, BRAC University