An approach to public engagement which respects grass-roots and community knowledge has an important role to play in improving our understanding of the relationship between traditional healing and Western-style medicine in low- and middle-income countries, and could generate new approaches to tackling antimicrobial resistance, according to a new paperpublished in Medical Humanities.
As part of the Warwick-led project Antibiotics and Activity Spaces, a research team journeyed to 72 villages across northern Thailand to study medicine use and health behaviour, including traditional medicine. Unlike typical approaches to engagement that “raise awareness” or “mobilise communities,” this project built on medical humanities approaches of knowledge co-production, storytelling, and public dialogue.
Many fascinating tales of treatment were gathered through participatory workshops with villagers, and meetings with traditional healers, and were re-told through the Tales of Treatment photo exhibitions held in Thailand (Chiang Rai and Bangkok) and the UK (Warwick Arts Centre and Oxford).
In the paper, published in the journal Medical Humanities, the researchers reflect on the benefits of this non-hierarchical public engagement process in academic research.
Ahealing stone brought from Burma a generation ago lies on Abor’s wooden table. Scraping this “Black Stone” against a rock creates a fine grey powder, which Abor dissolves in water and applies to wounds that he had previously perforated lightly with a hammer holding small nails. Legends tell of people with broken bones who, unable to stay off work during the hospital’s recommended three-month recovery period, would convalesce within a week after receiving Abor’s treatment.
Research officer Nutcha (Ern) Charoenboon recalls: “It’s not only interesting to learn how villagers make sense out of modern medicine during our time in the field, but when we brought the stories from Chiang Rai to Bangkok, it was also fascinating to see how urban audience members interpret these ‘traditional treatments,’ ‘old-days solutions,’ and ‘rural beliefs.'”
Reflecting on the relationship between traditional medicine and modern global health problems, project leader Dr Marco J Haenssgen argues, “The Tales of Treatment are not only a vibrant account of Northern Thai culture and customs, but they also reveal an ironic situation in global health.
“Modern medicine has often discredited traditional medicine as unscientific and created a widespread dependence on Western pharmaceuticals. This dependence has quite plausibly accelerated the development of antimicrobial resistance, yet the threat of antimicrobial resistance may also entail a recognition of traditional forms of healing as a substitute for needless use of pharmaceuticals.
“While we do see a co-existence of different systems of medicine in some health systems like in India and China, there is perhaps more that Western biomedicine can and should learn from local knowledge.”
While the researchers argue that this form of medical-humanities-driven public engagement opened new perspectives on health systems, healing practices, and even global drug resistance, the risks and costs of engaging the public in health research also require extensive evaluation.
This research project “Antibiotics and Activity Spaces” was funded by the Antimicrobial Resistance Cross Council Initiative supported by the seven research councils in partnership with the Department of Health and Department for Environment Food & Rural Affairs (grant ref. ES/P00511X/1, administered by the UK Economic and Social Research Council).The ‘Tales of Treatment’ exhibition at the Warwick Arts Centre was further supported by the University of Warwick’s Humanities Research Fund and the Global Research Priority on Connecting Cultures.
Haenssgen, MJ, Charoenboon, N, Thavethanutthanawin, P & Wibunjak, K. (2020). Tales of treatment and new perspectives for global health research on antimicrobial resistance. Medical Humanities. doi: 10.1136/medhum-2020-011894