Integrated Care Using Aboriginal Bush Medicine
Bush medicine, as practiced by the Aboriginal people of Western Australia, is a traditional medicine heavily reliant on the use of plants for maintaining health and in preventing, diagnosing and treating physical and mental illnesses. (WHO) Bush medicine is connected to the holistic worldview in such a way that the interplay between the physical, emotional, social and spiritual aspects is crucial in attaining well-being. (Clarke, 2008)
I located a paper that examined the use of bush medicine integrated with western medicine in treating cancer among Aboriginal and Torres Strait Islander people, who are traditional inhabitants and Indigenous people of Australia. The study findings showed that as part of their healing, some Aboriginal Australians use traditional bush medicine for treating their cancer. These traditions were preferred by some because it helped to reconnect them with their heritage, land, culture and the spirits of their ancestors bringing peace of mind during their illness. (Shahid et al. 2010)
There are several cultural barriers to treating cancer using western medicine in the Aboriginal population. It was noted in the article that cancer is perceived as a “white man’s disease” by Aborigines, and thus when diagnosed, it brings great shame to the individual. (pg. 2) Sicknesses like cancer are blamed on such things as sorcery, breaches of religious sanctions and social rules of behavior, intrusions of spirits and disease-objects, or loss of soul. (Clarke, 2008) Private physical examinations routinely done in western medicine, especially when conducted by someone of the opposite sex, as well as hospital settings in general, are a source of social unease for Aboriginal patients. (Shahid et al. 2010) Also, many of the respondents reported a fear of bio-medicine, noting they would rather take their chances with bush medicine than suffer the effects of chemo and radiation for only a 2% chance of healing using these harsh interventions. (pg. 4)
Interestingly, many of the respondents that were interviewed for this study commented on viewing stress as a primary cause of the disease and saw bush medicine “as a preventive means to cope with the stress of cancer believing that the healing powers could help to cure and relieve the anxiety and conditions of cancer.” (p. 3) Another significant belief that was found to be held by most respondents was that “engaging with bush medicines and the associated healing rituals that accompany its use is spiritually significant to Aboriginal people whose identity and connection is embedded in their relationship to the land.” (pg. 3)
Bush medicine is a belief-based medicine, making it of critical importance for western based medicine to understand and address in using an integrated medical model. According to Clarke, “in Aboriginal Australia, it is the healer’s job to diagnose problems, advise on remedies, suggest and perform ritualized healing procedures, explore the impact of community social and cultural issues upon the illness, and to reassure their patients that they can be cured.” (Clarke, 2008)
In order to best serve the Aboriginal patients, non-conventional care was prioritized in such a way as to incorporate all aspects of bush medicine in their treatment protocol. The following insights were defined:
Appreciate and understand Indigenous beliefs and work to incorporate these understandings into their service delivery systems in relation to health care.
Adopt a family-centered, integrative approach that works with the individual in concert with their familial and cultural support.
Honor the request to incorporate bush medicine into their treatment plan where western based interventions were used to respect Aboriginal people's choice to utilize bush medicine as a part or whole of cancer treatment in their overall search for health and wellbeing.
Gain an understanding of aboriginal spiritual and cultural practices in order to begin the journey of working with Indigenous epistemology and ways of doing.
Understand the value for western practitioners to know that their patients are taking bush medicine because there can be potential risks involved in using both. Plants, leaves and trees used in making bush medicines may be bioactive and can have physiological, emotional and psychological effects. (pg. 8)
Recognize and understand of the use of traditional medicine and healing systems in boosting the confidence of Aboriginal people to access mainstream services.
The model that emerged aligned very well with the philosophy and model of consciousness-based medicine (CBM). The CBM model utilizes seven levels of healing and are presented in their order of usage, in decreasing order of generalizability and safety and increasing order of invasiveness and risk. Those levels being spirit, mind, body, touch, supplements, pharmacological agents and surgery. (Fauver, 2018) The model that emerged in Australia could be applied to the CBM model in the following way:
Spirit - Understanding the spiritual community of the Aborigines in order to meet their needs of engagement on their level in dealing with their illness.
Mind – Skillful communication with Aboriginals based on a clear understanding of their culture.
Body – Respecting the Aborigines beliefs around physical examinations and gender, and providing services to them in their own community by same sex practitioners rather than in traditional treatment rooms.
Touch – Aborigines using bush medicine, have touch related treatments that meet their cultural needs and work with their belief systems.
Supplements – Utilizing the natural plant-based bush medicines of the Aborigines.
Pharmacological agents – Intervening with western medicines only when accepted by the Aborigines as an effective form of treatment, and respecting when these treatments were refused based on belief of further harm.
Surgery – although the study by Shahid et al. did not specifically address surgery, it is my belief that it would be used as a last result for this particular population.
Spiritual beliefs and holistic health approaches and practices play an important role in the treatment choices for Aborigines. The paper by Shahid et al. provides a beautiful view on how the medical system in Australia integrated the spiritual and cultural beliefs, and the bush medicine of the Aboriginal People into their treatment protocol for cancer.
References:
WHO Traditional Medicine: Definitions. Retrieved from http://www.who.int/traditional-complementary-integrative-medicine/about/en/
Shahid, S., Bleam, R., Bessarab, D. & Thompson, S. C. (2010). "If you don't believe it, it won't help you": use of bush medicine in treating cancer among Aboriginal people in Western Australia. Journal of Ethnobiology and Ethnomedicine, 20106(18), 1-9. doi:org/10.1186/1746-4269-6-18
Clarke, P. (2008). Aboriginal healing practices and Australian bush medicine. South Australian Museum Journal of the Anthropological Society of South Australia, 33, 1-36. Retrieved from http://www.friendsofglenthorne.org.au/wp-content/uploads/Clarke-Vol-33-2008.pdf
Fauver, R. (2018). The Seven Layers of Health, Retrieved from chrome-extension://gbkeegbaiigmenfmjfclcdgdpimamgkj/views/app.html