Putu Oka Sukanta
In Indonesia today there are some 300,000 registered practitioners of traditional medicine, although many more operate without a licence. A number of NGOs and universities now offer training in traditional medicine, and the Department of Health has conducted training in acupressure and herbal medicine in a number of provinces. However, the vast majority of traditional medical practitioners have no formal training. With the community increasingly seeking natural treatments, this lack of formal training means that practitioners are unable to satisfy the public’s desire for information about traditional medicine.
Since the 1980s, the World Health Organisation has encouraged the governments of developing countries to acknowledge and regulate the use of traditional medicine. The Indonesian Department of Heath has acted on that advice, moving to include traditional medicine in its national health guidelines. In 2002, a Ministerial Decision on Traditional Medicine was drafted. The Decision, which has yet to be formalised, addresses the classification, licensing and practice of traditional medicine. It divides traditional treatments into four categories: those based on skill (such as massage), herbs, the supernatural and religion. It also makes provisions for the systematic study of traditional treatments considered complementary to modern medicine, such as acupuncture, and their integration into the formal health system.
Although the government’s formal definition locates traditional treatments outside the boundaries of modern medicine, traditional treatments are increasingly forced to accommodate Western medical norms and standards. In the process, traditional treatments have become commodities. As they are regulated, licensed and registered, ordinary people lose the skills and knowledge associated with these treatments. As a result, communities are at once culturally impoverished and forced to depend on the companies that manufacture traditional medicines commercially.
Perhaps the biggest threat to the practice of traditional medicine in Indonesia is the formation of the ASEAN Free Trade Agreement. Foreign investors have already put forward proposals to establish traditional treatment centres and factories to produce traditional medicines in Indonesia. The staffing of these treatment centres by foreigners means that Indonesian practitioners will be relegated to the periphery. The draft Ministerial Decision attempted to address this by proposing limits on foreign labour and capital in the industry, but these measures have yet to be implemented.
Community-based traditional medicine is not just a health issue. It is a solution to poverty. Access to traditional health care mediates communities’ dependence on the pharmaceutical industry, and the financial and cultural costs associated with that dependence. Information about traditional medicine is now more widely available. However, the Indonesian government must produce health policy that facilitates programs to empower communities culturally, not just medically. NGOs concerned with human rights need to view access to traditional healthcare as a right that should be defended and promoted in order to protect the community from foreign control of their health.
Putu Oka Sukanta is an acupuncturist and an activist in traditional health movement and HIV-AIDS programs. He can be contacted at firstname.lastname@example.org