Healing Practices & Traditional Asian Health Beliefs

This newsletter introduces our community of readers to some of the basic concepts behind the traditional medicines and healing practices of Asian cultures. People belonging to these Asian cultures are accustomed to relying on distinct health practices and beliefs that are significantly different from those of native born Americans and other immigrants. As patients’ health beliefs can have a profound impact on clinical care, it is important for American medical professionals to be familiar with the concepts introduced here.

This topic is expansive, so links for further study are embedded throughout the article. We will be focusing on the health beliefs and practices of people from Southeastern Asia (i.e. Vietnam, Thailand, Cambodia, Laos, Burma as well as East Asian countries (i.e. China, Japan, and Korea. A brief explanation of the interrelatedness of the primary traditional medicine practices if followed by a brief description of each.

 

East Meets West

In the 17th century, traditional Vietnamese and Chinese practitioners began identifying their medicine as Dong Y to distinguish their medicine from the Western colonial medicine. Similarly, people in the West began to use the term “Oriental medicine” to differentiate Eastern medical practices from Western ones. Today, the terms Eastern medicine and Asian medicine are more commonly used in this country, and perhaps they are the better terms. The use of oriental has shifted to refer to home furnishings, carpets especially, and certainly in the field of cross-cultural communications, the word oriental is never used as a category of culture.

Many Americans quickly associate Chinese herbal remedies and acupuncture with Eastern “alternative” medicine, but are largely unfamiliar with other common practices from across Asia. The philosophies of health and illness causation at the root of Eastern medicines are even less understood and just as important. Traditional Chinese medicine, or TCM, is the best known Asian medicine practiced in the U. S., but it is not the only traditional medicine worthy of our attention. Traditional Vietnamese medicine (TVM) actually evolved together with traditional Chinese medicine and arguably the development of the two are so-intertwined that it is impossible to separate them. However, there are differences. Closely related to both are Japanese and Korean traditional medicines. Historically speaking, many societies in Eastern and Southeastern Asia have been part of the Chinese cultural sphere due to trade, migration, and occupation. Thus it is safe to say that the healing traditions of most Asian cultures are intertwined to some extent, much as their religious philosophies are.

Beliefs and Practices Briefly Described

Traditional Chinese Medicine

TCM is inextricably linked to Chinese Cosmology, as system of beliefs that can be summed up as follows: all of creation is born from the marriage of two polar principles, Yin and Yang. Examples are earth and heaven, winter and summer, night and day, cold and hot, wet and dry, inner and outer, body and mind. These pairs of opposites are connected via a circular harmony. The yin and yang symbol is helpful in representing this concept. Harmony means health, good weather, and good fortune, while disharmony leads to disease, disaster, and bad luck. The strategy of Chinese medicine is to restore harmony. Each human is seen as a world in miniature, and every person has a unique terrain to be mapped, a resilient yet sensitive ecology to be maintained. Like a gardener uses irrigation and compost to grow robust plants, the doctor uses acupuncture, herbs and food to recover and sustain health. 

Health Beliefs and Clinical Care

The greatest challenge for Western healthcare professionals once they’ve grasped the basics of different cultural remedies and treatments is to understand the beliefs and attitudes about sickness that drive these ancient practices. Health beliefs can have a profound impact on the clinical care of Asian patients in the United States, affecting the accuracy of health histories and compliance with treatment recommendations from Western providers. Because the principles behind the Western medical model are so different from those of Eastern medicine, it is difficult for American providers to shift gears when talking to Asian patients and consider a mind-set where health is seen as a state of balance between the physical, social, and super-natural environment. Western medicine tends to approach disease by assuming that it is due to an external force, such as a virus or bacteria, or a slow degeneration of the functional ability of the body. Disease is either physical or mental. The Eastern approach assumes that the body is whole, and each part of it is intimately connected. Each organ has a mental as well as a physical function. Perhaps a melding of the two belief systems would be ideal, but it isn’t easy in hectic settings or crisis situations to bring such divergent belief systems together during medical consultation and care.

 

Tibetan Medicine

It is known as gSo-ba Rigpa in Tibetan, meaning ‘the science of healing’. The basic principle is to balance the three principal energies of the body. The practitioner employs the ancient tools of pulse diagnosis and urine analysis, to find the root causes of disease. Treatment is carried out through diet, lifestyle adjustments and herbal medicines grown naturally in Tibet and the Himalayas. Tibetan Medicine is based on Buddhist principles and the close relationship between mind and body.

Traditional Vietnamese Medicine

The distinguishing feature of TVM is the emphasis on nourishing the blood and vital energy, rather than concentrating on specific symptoms. TVM views building up the blood and energy as the key to good health. The main treatments employed by TVM are herbal medicine, acupuncture, and moxibustion.The cornerstone of its theories is based on the observed effects of Qi (energy) in the body. Qi can be inherited from one’s parents or it can be extracted from food. It is also blood and “fuel” gathered and stored by the body.

Chinese Herbal Medicine

Herbal medicine is an important part of Traditional Chinese Medicine (TCM). Herbs are prescribed holistically according to the patient’s individual condition (not only on the basis of current symptoms). Herbal medicines are used to regulate the natural balance of the body and restore health. They come in the form of pills, powders, tinctures and raw herbs taken internally or as balms for external use. Chinese herbal medicine has been used for centuries to treat most health conditions and as a preventative dietary supplement. They can also be used safely in conjunction with many western therapies. Diagnosis is made by talking to the patient, looking at physical characteristics and employing the ancient arts of tongue and pulse diagnosis.

Japanese Herbal Medicine

Kampo is Japanese herbal medicine, which has a long history of clinical application. Kampo uses precisely measured herbs to treat illness, based on the skillful use of well-known formulas, valued for their impact on clear as well as vague conditions. (Kampo does not use rare or endangered plant or animal products). The distinguishing feature of Kampo is it’s method of diagnosis through abdominal palpation. Kampo medicine is based on the theory that diseases arise because of a disharmony in the flow of Qi (Chi). By stressing prevention, Kampo helps the patient to maintain good health according to natural principles.

Acupuncture

Acupuncturists insert tiny needles into specific points on the energy channels of the body, to promote healing and stimulate the free flow of energy in the body and mind. It is used to treat many conditions including muscular pain, headaches, asthma, gynecological problems, digestive complaints, as well as anxiety and depression. Acupuncture is also useful for preventative health care.

Moxibustion, Coin Rubbing & Cupping

Moxibustion is a therapy utilizing moxa, or mugwort herb. It plays an important role in the traditional medical systems of China, Japan, Korea, Vietnam, Tibet, and Mongolia. Suppliers usually age the mugwort and grind it up to a fluff; practitioners burn the fluff or process it further into a stick that resembles a (non-smokable) cigar. They can use it indirectly, with acupuncture needles, or sometimes burn it on a patient’s skin.

Coin Rubbing in Chinese is called Gua Sha, or literally “to scrape away fever.” It is an ancient technique used to scrape away disease by allowing the disease to escape as sandy-looking objects through the skin.” The Vietnamese term for this practice is cạo gió (pronounced “cow zaw”), meaning roughly to “scrape wind.” It is also used in Indonesia.

Cupping Fire, or simply cupping, is a form of traditional medicine found in several cultures. It involves placing glass, plastic, or bamboo cups on the skin. This technique, in varying forms, has been found in the folk medicine of China, Vietnam, the Balkans, Iran, Mexico, Russia and Poland. In traditional Chinese medicine (TCM), cupping is a method of applying acupressure by creating a vacuum next to the patient’s skin. The therapy is used to relieve what is called “stagnation” in TCM terms, and is used in the treatment of respiratory diseases such as the common cold, pneumonia, and bronchitis. Cupping is also used to treat back, neck, shoulder, and other musculoskeletal pain.

 

Conclusion

This brief introduction to traditional medicines of Asian cultures no doubt leaves many questions unanswered and so it seems appropriate to invoke Ben Franklin’s caution, “a little learning is a dangerous thing.”  This article is meant to assist clinicians by providing a general framework, a baseline for learning.  No hard and fast rules about interacting with Asian patients and families are being offered. Becoming fully familiar with the normative cultural values affecting interactions with patients from different cultures is a process that takes time and experience. Using the links provided for further study, consulting colleagues from other ethnic groups, and speaking to interpreters and community members are all ways to learn more about the practices and health beliefs one encounters that are different from one’s own. It is also important to learn to ask patients questions in a culturally sensitive way, understanding that fear of making mistakes in communicating with them blocks the exchange of vital information.  There have been instances where practices such as coining and cupping have been misinterpreted by conscientious healthcare workers and reports of child abuse made in error. Thorough efforts at communication might have prevented these erroneous reports which traumatized families.

A cross-cultural mindset requires understanding one’s own health beliefs and behaviors first and then applying that baseline of understanding as a means of making effective comparisons across cultures. Clinicians should keep in mind that individuals subscribe to group norms to varying degrees. Factors such as socio-economics, education, degree of acculturation and English proficiency have an enormous impact on an individual’s health beliefs and practices. Searching out and really trying to understanding the individual patient is crucial.

Complementary and Traditional Health Practices

The integrative, complementary and traditional health practices field is a fascinating world where science, ancient healing traditions, modern medical systems, psychology, philosophy and even technology meet to create a thrilling universe of possibilities for promoting and restoring health and creating wellness.

Our Section, founded over 20 years ago as a Special Primary Interest Group, is an ever-growing community of practice that recently gained Section status within APHA. Our membership is a vibrant, diverse association of professionals and students dedicated to promoting public health aspects of integrative, complementary and traditional health practices, including health care professionals, researchers, academics, policy advocates, and trainees A thriving international membership gives our Section a global reach, which enhances the potential for multidisciplinary interaction, facilitates the development of a wider perspective of the field and bolsters collaboration.

The Section cherishes student members and offers mentorship opportunities for professional enrichment and career development. We value student participation in all activities and committees and are cognizant of the fundamental role that new generations play in creating a shared vision, promoting creativity and invigorating the field

We publish a vibrant quarterly newsletter that fosters professional development and participation, featuring articles on academic exchange and policy, training and continuing education announcements, networking and collaborating opportunities, as well as contributions for and by students. The Section also develops a stimulating scientific program for each APHA Annual Meeting and Exposition, often in collaboration and fellowship with other Sections..

We warmly invite you to be in touch with us and collaborate in policy undertakings and scientific program development. Together, we can work toward the goal of creating a health care system that includes wellness as a right, not a privilege.

Taking Care of Your Baby And You While You're Pregnant

Is prenatal care important?

Prenatal care is very important. To help make sure that you and your baby will be as healthy as possible, follow some simple guidelines and check in regularly with your doctor.

How much weight should I gain during pregnancy?

Talk to your doctor about how much weight you should gain. It's different for everyone, but most women gain about 25 to 30 pounds. If you don't weigh enough when you get pregnant, you may need to gain more. If you're overweight when you get pregnant, you may need to gain less.

What will happen during prenatal visits?

After you find out you are pregnant, you should make an appointment with your doctor. Your first prenatal visit will likely be when you are 6 to 8 weeks pregnant. Your doctor will probably start by talking to you about your medical history and how you've been feeling. You'll be weighed and have your blood pressure taken. These measurements will most likely be taken during each doctor's visit.

On your first visit, you'll also have a pelvic exam to check the size and shape of your uterus (womb) and a Pap smear to check for abnormalities of the cervix (the opening of the uterus).

Urine and blood tests samples will be taken on the first visit and again at later visits. Other tests are performed, such as urine tests to check for bacteria in your urine, high sugar levels (which can be a sign of diabetes) and high protein levels (which can put you at risk for preeclampsia, a type of high blood pressure during pregnancy). Blood tests to check for low iron levels (anemia), blood cell count, infectious diseases (such as syphilis and hepatitis) and blood type are also performed.

Sometimes, an ultrasound may be done to help figure out when your baby is due or to check on your baby's growth and position in your uterus. An ultrasound uses sound waves to create an image of your baby on a video screen.

Other tests may be needed if you or your baby are at risk for any problems.

What should I eat?

Eating a balanced diet is one of the most important things you can do for yourself and your baby. There are a few foods that you should be more careful about eating while you are pregnant. Meat, eggs and fish that are not fully cooked could put you at risk for an infection. Do not eat more than 2 or 3 servings of fish per week (including canned fish). Do not eat shark, swordfish, king mackerel or tilefish. These fish sometimes have high levels of mercury, which could hurt your baby. If you eat tuna, make sure it is light tuna and eat no more than 6 ounces per week of albacore tuna and tuna steaks. It is safe to have 12 ounces per week of canned light tuna.

Wash all fruit and vegetables. Keep cutting boards and dishes clean. Eat 4 or more servings of dairy foods each day. This will give you enough calcium for you and your baby. Do not drink unpasteurized milk or eat unpasteurized milk products. Soft cheeses such as Brie, feta, Camembert, blue cheese and Mexican-style cheeses such as queso fresco may have bacteria that can cause infections.

If you drink coffee or other drinks with caffeine, do not have more than 1 or 2 cups each day.

It is okay to use artificial sweeteners such as aspartame (some brand names: Equal, NutraSweet) and sucralose (brand name: Splenda) while you are pregnant, but you should use them in moderation. If you have a genetic disease called phenylketonuria, or PKU, you shouldn't use aspartame at all.

Should I take vitamins?

You should take 1,000 mcg (1 mg) of folic acid every day during your pregnancy. Folic acid can help prevent problems with your baby's brain and spinal cord. It is best to start taking folic acid before you get pregnant.

Your doctor might want you to take a prenatal vitamin. If you do take a prenatal supplement, make sure you're not taking any other vitamin or mineral supplement along with it unless your doctor recommends it.

Is it okay to take medicine?

Check with your doctor before taking any medicine, including pain relievers or other over-the-counter medicines. Even medicine you can buy without a prescription may cause birth defects, especially if it's taken during the first 3 months of pregnancy.

How long can I keep working?

This depends on whether you have any problems with your pregnancy, what kind of work you do and if you're exposed to anything at work that could harm your baby. For instance, lifting heavy objects or standing for long periods can be hard on your body. Radiation, lead and other heavy metals, such as copper and mercury, could be damaging to the baby. However, working in front of a computer screen is not thought to cause harm to an unborn baby. Talk with your doctor about your work environment.

What about exercise?

Unless you have problems in your pregnancy, you can probably do whatever exercise you did before you got pregnant. Exercise can help ease discomfort during pregnancy. Try to get at least 30 minutes of exercise each day. Talk to your doctor about any special conditions that you may have.

Some women say exercising during pregnancy makes labor and delivery easier. Walking and swimming are great choices. If you didn't exercise before pregnancy, start slowly. Don't overdo exercise. Listen to your body. Call your doctor if you have symptoms such as blurred vision, dizziness, chest pain or abdominal pain while you are exercising. Don't get overheated. Be sure to drink plenty of water so that you don't get dehydrated. It's best to avoid anything that could cause you to fall, such as water skiing or rock climbing. It's also best to avoid contact sports such as basketball or soccer.

Is it okay to have sex?

Yes, unless your doctor believes you're at risk for problems. Don't be surprised if you're less or more interested in sex while you are pregnant. As you get larger, you may find you need to try different positions, such as lying on your side or being on top. If you have oral sex, tell your partner not to blow air into your vagina. This could force air inside you, which could cause an air embolism. Air embolisms can cause permanent brain damage and even death to a pregnant woman and her baby.

What can I do to feel better?

Here are the most common discomforts of pregnancy and some tips for handling them:

Morning sickness. Nausea or vomiting may strike anytime during the day (or night). Try eating frequent, small meals and avoid greasy foods. Keep crackers by your bed to eat before getting up.

Talk to your doctor if morning sickness lasts past the first 3 months of pregnancy or causes you to lose weight.

Tiredness. Sometimes tiredness in pregnancy is caused by anemia, so tell your doctor. Get enough rest. Take a daytime nap if possible.

Bleeding gums. Brush and floss regularly, and see your dentist for cleanings. Don't put off dental visits because you're pregnant, but be sure to tell your dentist you're pregnant.

Stuffy nose. This is related to changes in the levels of the female hormone estrogen. You may also have nosebleeds.

Edema (retaining fluid). Rest with your legs up. Lie on your left side while sleeping so blood flows from your legs back to your heart better. Don't use diuretics (water pills). If you're thinking about cutting down on salt to reduce swelling, talk with your doctor first. Your body needs enough salt to maintain the balance of fluid and cutting back on salt may not be the best way to manage your swelling.

Leg cramps. Gently stretch the calf of your leg by curling your toes upward, toward your knee.

Constipation. Drink plenty of fluids. Eat foods with lots of fiber, such as fruits, vegetables and bran cereal. Don't take laxatives without talking to your doctor first. Stool softeners may be safer than laxatives.

Hemorrhoids. Don't strain during bowel movements. Try to avoid becoming constipated. Clean yourself well after a bowel movement (wet wipes may be less irritating than toilet paper). Take several warm soaks (sitz baths) a day if necessary.

Urinating more often. You may need to urinate more often as your baby grows because he or she will put pressure on your bladder. This can't be helped.

Varicose veins. Avoid clothing that fits tightly around your legs or waist. Rest and put your feet up as much as you can. Move around if you must stand for long periods. Ask your doctor about support or compression hose, which may help ease or prevent varicose veins.

Moodiness. Your hormones are on a roller coaster ride during pregnancy. Plus, your life is undergoing a big change. Don't be too hard on yourself. If you feel very sad or think about suicide, talk to your doctor.

Heartburn. Eat frequent, small meals. Avoid spicy or greasy foods. Don't lie down right after eating. Ask your doctor about taking antacids.

Yeast infections. The amount of discharge from the vagina increases during pregnancy. Yeast infections, which can also cause discharge, are more common during pregnancy. It's a good idea to talk with your doctor about any unusual discharge.

Skin changes. Stretch marks appear as red marks on your skin. Lotion with shea butter can help keep your skin moist and may help reduce the itchiness of dry skin. Stretch marks often can't be prevented, but they often fade after pregnancy.

Other skin changes may include darkening of the skin on your face and around your nipples, and a dark line below your belly button. Staying out of the sun or using a sunscreen may help lessen these marks. Most marks will probably fade after pregnancy.

Call your doctor if you have:

• Blood or fluid coming from your vagina
• Sudden or extreme swelling of your face or fingers
• Headaches that are severe or won't go away
• Nausea and vomiting that won't go away
• Dizziness
• Dim or blurry vision
• Pain or cramps in your lower abdomen
• Chills or fever
• A change in your baby's movements
• Less urine or burning when you urinate
• Any illness or infection
• Anything that bothers you

Warnings

"Don't do this, don't do that." You've probably heard every old wives' tale. Here are some warnings worth heeding:

• Don't smoke. Smoking raises your risk for miscarriage, premature birth, low birth weight and many other problems.
• Don't use drugs. Cocaine, heroin, marijuana and other drugs increase your risk of miscarriage, premature birth and birth defects. Your baby could also be born addicted to the drug you've been abusing, which can cause serious health problems.
• Don't drink alcohol. Drinking alcohol during pregnancy is the major cause of preventable birth defects, including fetal alcohol syndrome.
• Don't clean your cat's litter box or eat raw or undercooked red meat. You could get toxoplasmosis, a disease that can cause birth defects.
• Don't sit in a sauna or hot tub. The high heat raises your risk of miscarriage and birth defects.
• Don't douche. Douching could force air into the vagina, which can cause an air embolism. The vagina doesn't require cleansing in addition to normal bathing. Douching disrupts the helpful bacteria that keep the vagina clean.

five eating own weight in sugar for Children

The average five-year-old consumes the equivalent of their body weight in sugar in the course of a year, health officials have warned.

Parents are being urged to take control of their children’s habits, as the Government prepares to publish its strategy on child obesity, amid calls to introduce a tax on sugary drinks and foods.

The new campaign by Public Health England (PHE) warns that five-year-olds should only be consuming the equivalent of five sugar cubes a day.

On average, child are having three times their recommended maximum daily intake, which rises to six cubes for six to ten-year-olds, and seven cubes for anyone of the age of 11.

Over the course of a year, a child aged between four and 10 will consume around 5,500 sugar cubes – or three and half stone - the average weight of five year old, PHE said.

Officials have launched a new free app, which reveals how much sugar is in everyday food and drink in a bid to encourage parents to take control of their families’ sugar consumption.

It works by scanning the barcode of products and showing the total sugar in each product in cubes and grams.

Tooth decay has become the most common reason that five-to-nine year olds are admitted to hospital, with a 14 per cent increase in admissions in three years.

In total, 25,812 children aged between five to nine-years old were admitted to hospital with a primary diagnosis of dental caries in 2013/14, official figures show, with almost half of eight-year-olds suffering decay.

One in five children is overweight or obese by the age of five – rising to one in three by the age of 11.too much sugar, three times the maximum recommended amount. This can lead to painful tooth decay, weight gain and obesity, which can also affect children’s wellbeing as they are more likely to be bullied, have low self-esteem and miss school.”

Obesity costs the NHS £5.1 billion per year which is projected to rise to £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year.

There are now 2.5 million people suffering from Type 2 diabetes, 90 per cent of whom are overweight or obese.

This month the Government is due to publish its strategy on childhood obesity.

Ministers are expected to unveil plans to clamp down on marketing and advertising of unhealthy foods, with restrictions on TV ads during “family viewing” times, and a crackdown on “two for one” deals on junk fare.

David Cameron has so far resisted calls for a “sugar tax” on drinks and foods, despite calls from PHE, celebrity campaigner Jamie Oliver and the Commons health select committee.

Health officials have previously urged families to cut back on fruit juice and smoothies, which are pushing up sugar intake in some families.

PHE have said that a single 150ml glass of fruit juice a day is the most anyone should drink.

Fruit juices and fizzy drinks are the largest source of sugar for children aged between four and 18, the National Diet and Nutrition Survey by Public Health England found.

Last year, Government scientific advisors halved the recommended daily sugar limits, amid warnings about spiralling obesity rates.

The new advice says sugar should make up no more than 5 per cent of daily calories – which means about 30g of sugar a day for adults – less than the contents of one can of Coca Cola.

The targets for children mean those aged four to six should have no more than 19g sugar daily.

Super foods that will help spice up your sex life!

Erectile dysfunction (ED) has become a common problem among men nowadays. However, research has shown that eating right and a diet rich in fruit, vegetables and whole grains can help decrease the likelihood of ED.

Here are a few foods that can help improve your sexual stamina and overcome erectile dysfunction:

Leafy green vegetables: Leafy green vegetables such as spinach, fenugreek, celery may increase circulation due to their high content of nitrates, which have beneficial effects on erectile dysfunction.

Beetroot: Beetroot has been found to be really high in nitrates and is one of the best foods for erectile dysfunction. Sometimes, beetroot is refered to as nature’s Viagra as it works in a similar way as the popular ED drug.

Dark Chocolate: Favonoids in dark chocolate are found to improve circulation. Poor circulation can cause erection problems. Flavonoids are naturally-occurring antioxidants that protect plants from toxins and help repair cell damage.

Watermelon: Studies suggest that watermelon may have effects on erectile dysfunction similar to Viagra and may also increase sexual desire. This wonder summer fruit is also high in L-citrulline and lycopene, two components vital for boosting male sexual health. Both citrulline lycopene help blood vessels to relax and promote blood circulation helping to keep an erection for longer.

Pistachios: Studies suggest that eating a handful of pistachios everyday can improve sexual desires, including erectile dysfunction. This may be due to the presence of a protein called arginine in pistachios may help relax blood vessels. Arginine also improves good cholesterol level and lowers blood pressure, both of which are important for a good erection while delaying the onset of erectile dysfunction.