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      The role of traditional medicine practice in primary health care within Aboriginal Australia: a review of the literature

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          Abstract

          The practice of traditional Aboriginal medicine within Australia is at risk of being lost due to the impact of colonisation. Displacement of people from traditional lands as well as changes in family structures affecting passing on of cultural knowledge are two major examples of this impact. Prior to colonisation traditional forms of healing, such as the use of traditional healers, healing songs and bush medicines were the only source of primary health care. It is unclear to what extent traditional medical practice remains in Australia in 2013 within the primary health care setting, and how this practice sits alongside the current biomedical health care model. An extensive literature search was performed from a wide range of literature sources in attempt to identify and examine both qualitatively and quantitatively traditional medicine practices within Aboriginal Australia today. Whilst there is a lack of academic literature and research on this subject the literature found suggests that traditional medicine practice in Aboriginal Australia still remains and the extent to which it is practiced varies widely amongst communities across Australia. This variation was found to depend on association with culture and beliefs about disease causation, type of illness presenting, success of biomedical treatment, and accessibility to traditional healers and bush medicines. Traditional medicine practices were found to be used sequentially, compartmentally and concurrently with biomedical healthcare. Understanding more clearly the role of traditional medicine practice, as well as looking to improve and support integrative and governance models for traditional medicine practice, could have a positive impact on primary health care outcomes for Aboriginal Australia.

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          Use of medicinal plants and pharmaceuticals by indigenous communities in the Bolivian Andes and Amazon.

          To investigate, by means of household surveys, the use of medicinal plants and pharmaceuticals in Apillapampa, a large Andean community of Quechua peasants, and in six small communities of Yuracaré-Trinitario "slash-and-burn" cultivators of the National Park Isiboro-Secure (the NPIS) in the Bolivian Amazon. A total of 12% of households in Apillapampa and nearly all households in the NPIS were interviewed about their use of medicinal plants and pharmaceuticals for treating illnesses. Informants were also asked to name any medicinal plants they knew. In spite of the presence of a primary health care service (PHC) with medical doctor in Apillapampa, an equal number of informants used medicinal plants and pharmaceuticals. In the NPIS, the prevalent use of medicinal plants or pharmaceuticals in any community depended on the distance of the community from the nearest village and from a PHC with medical doctor (r = 0.85 and r = -0.96; both P = 0.05. The NPIS communities' knowledge of plants expressed as the average number of medicinal plants mentioned correlated positively and negatively with distance from the nearest village and use of pharmaceuticals, respectively (r= 0.95, P < 0.005 and r = -0.90, P < 0.05, respectively). The cultural importance of traditional medicine and the physical isolation of communities, both in general and from PHCs, are factors that influence the use of and knowledge about medicinal plants.
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            Potential primary health care savings for chronic disease care associated with Australian Aboriginal involvement in land management.

            To identify the possible savings in the cost of primary health care of chronic disease associated with the participation by Aboriginal people in land management. In so-doing we investigate the connection of health of Aboriginal people and the extent of their involvement in land management in remote-very remote Australia. Possible savings in primary care costs for hypertension, renal disease and diabetes were estimated using multivariate regression to examine associations between Aboriginal involvement in land management and Northern Territory Government-defined chronic disease outcomes, controlling for socio-demographics and health behaviours. Participants were 298 Aboriginal adults aged 15-54 from a remote Aboriginal community, classified by their chronic disease status and a previously validated measure of self-reported participation in land management activities. Land management participants were significantly less likely to have diabetes, renal disease or hypertension. Using the sampled mean value of engagement in land management, we found the expected net annual savings for the community from involvement in land management of $268,000. This equates to a net present value of primary health care savings in chronic disease care for the sampled community over 25 years of $4.08 million. This estimate does not include further savings in other primary health conditions nor costs anticipated in referred and hospital-based health care for chronic disease. While the association between involvement in land management and better health requires further clarification, our findings indicate that significant and substantial primary health care cost savings may be associated with greater participation in land management activities. These estimated savings are in addition to the market and non-market economic benefits of a healthier population and environmental benefits. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.
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              "If you don't believe it, it won't help you": use of bush medicine in treating cancer among Aboriginal people in Western Australia

              Background Little is known about the use of bush medicine and traditional healing among Aboriginal Australians for their treatment of cancer and the meanings attached to it. A qualitative study that explored Aboriginal Australians' perspectives and experiences of cancer and cancer services in Western Australia provided an opportunity to analyse the contemporary meanings attached and use of bush medicine by Aboriginal people with cancer in Western Australia Methods Data collection occurred in Perth, both rural and remote areas and included individual in-depth interviews, observations and field notes. Of the thirty-seven interviews with Aboriginal cancer patients, family members of people who died from cancer and some Aboriginal health care providers, 11 participants whose responses included substantial mention on the issue of bush medicine and traditional healing were selected for the analysis for this paper. Results The study findings have shown that as part of their healing some Aboriginal Australians use traditional medicine for treating their cancer. Such healing processes and medicines were preferred by some because it helped reconnect them with their heritage, land, culture and the spirits of their ancestors, bringing peace of mind during their illness. Spiritual beliefs and holistic health approaches and practices play an important role in the treatment choices for some patients. Conclusions Service providers need to acknowledge and understand the existence of Aboriginal knowledge (epistemology) and accept that traditional healing can be an important addition to an Aboriginal person's healing complementing Western medical treatment regimes. Allowing and supporting traditional approaches to treatment reflects a commitment by modern medical services to adopting an Aboriginal-friendly approach that is not only culturally appropriate but assists with the cultural security of the service.
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                Author and article information

                Journal
                J Ethnobiol Ethnomed
                J Ethnobiol Ethnomed
                Journal of Ethnobiology and Ethnomedicine
                BioMed Central
                1746-4269
                2013
                2 July 2013
                : 9
                : 46
                Affiliations
                [1 ]Kimberley Aboriginal Medical Services Council Inc, Dora St, Broome 6725, Australia
                Article
                1746-4269-9-46
                10.1186/1746-4269-9-46
                3702459
                23819729
                aaa10e14-d5db-4e37-a613-03732c74883f
                Copyright ©2013 Oliver; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 December 2012
                : 17 June 2013
                Categories
                Review

                Health & Social care
                australian aboriginal health,bush medicine,traditional healers,traditional aboriginal and/or torres strait islander medicine,australian ethnomedicine

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