Folk medicine and traditional medical practices in Bangladesh

Heritage, folk medicine and traditional medical practices are closely related to each other. Preservation of heritage is about making sense of our past and developing a sense of identity. Traditional medicine (TM), a form of intangible cultural heritage (ICH), constitutes a part of cultural identity of the communities, while traditional medical knowledge (TMK) is the complex manifestation of their culture and religion, the ecology they live in, the beliefs they hold and the rituals (physical activities/exercise/yoga, music, dance, and prayers) they practice.  
Studies in Medical Anthropology have confirmed the significant contribution of natural and plant-based medicine in curing diseases and prolonging lives parallel to those of conventional medicines. But due to a variety of factors including mistrust about conventional medicine, many people prefer to use folk/ traditional/ non-conventional medicine as a relaxing alternative or as complementary to conventional method of treatment. Though there is a contrast between 'biomedicine' and 'contemporary and alternative medicine' (CAM), the emergence of 'new age' movements (a range of spiritual or religious beliefs and practices) for health and well-being has led to the rising popularity of CAM in many western countries.
According to many scholars, heritage is primarily defined by the cultural work, knowledge, beliefs, rituals and practices of ordinary people. It is the result of repeated and ongoing interactions among people, forming 'chains of connectivity', and it keeps the past alive in the present for the future. Indigenous or traditional medical practices of different communities are very much pertinent to the heritage. From time immemorial, plants and allied products have been used in the treatment of various ailments all over the world, especially among the rural poor and ethnic/ indigenous communities.
The ancient Chinese started using medicinal plants about 6000 years ago. A large percentage of people living in India, China, Africa and even Europe and America still use traditional medicine for their primary healthcare. The desire to capture the wisdom of traditional healing systems has led to a resurgence of interest in herbal medicines, particularly in Europe and North America, where herbal products have been incorporated into 'alternative', 'complementary', 'holistic' or 'integrative' medical systems. The WHO has listed over 21,000 plant species used around the world for medicinal purposes. Over 7500 species of plants are estimated to be used by 4365 ethnic communities for human and veterinary health care in India and about 2,500 plant species are being used in indigenous methods of treatment. 
Bangladesh and a significant part of South Asia possess a vibrant and thriving medical pluralism. This 'medical pluralism' has been turned into an intrinsic feature of medical system in historical and contemporary contexts. A number of studies have examined the 'traditional medicines' and their relation to other systems of medicine, each with a distinct perspective. Multiple medical systems such as Biomedicine (the term used for allopathic medicine), Ayurvedic, Yoga, Unani, Siddha and Homoeopathy (AYUSH), Naturopathy, Kabiraji and other folk traditions are widely practised in meeting the needs of healthcare. 
The emergence and arrival of different medical systems, their acculturation into various communities, and the ways of their integration with the traditions are quite unique to the medical and cultural history of Bangladesh. As a country of rural societies, a large portion of its population still relies on traditional practitioners and local medicinal plants for their primary healthcare needs. In most cases, the attitude of the people towards different diseases is shaped by  factors such as economy, culture, religion, education and environment. Research shows that whether educated or not, rich or poor, some people still use folk medicine for specific diseases. Visits to shrines or going to the 'shamans' (person who acts as intermediary between the natural and supernatural worlds, using magic to cure illness) for folk methods of healings can still be found. Despite the existence and significant use of traditional/herbal medicine among the major rural communities in Bangladesh, the TM is still not officially well recognised and is facing the questions of validation and standardisation. 
Medical anthropology helps to understand the direct effects of culture on physiology and biological processes, to know how local practitioners use their cultural practices to address health problems and to analyse how different cultural, social and ecological factors affect health. Further studies from medical anthropology perspective are needed to know about the socio-economic background of the traditional medical practitioners and the people using traditional medicines, the efficacy and safety aspects of the preparation, the use of medicine and the process of treatment in Bangladesh. More in-depth studies are also required to: 
a. Know about the relationships between the patients and practitioners living in the hilly, coastal or remote rural areas, where modern medical facilities are not available and relatively advanced villages where certain modern health facilities are available;
b. Know how the medical knowledge, experience, skill, habits and practices of the past are handed down by the elders to the new generation without reference to books or print materials;
c. Know, if higher education, higher earning or the availability of modern doctors and health services have any impact in reducing the use of TM;
d. Gather specific information about the efficacy of the TMs and to understand the reason of preference for TMs by the users, and
e. Protect, promote and safeguard the various cultural properties associated with traditional medical practices for ensuring the low cost, easily available and less-harmful use of traditional medicines by the people of Bangladesh.
The writer is Professor of Anthropology, University of Dhaka. 
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