Background information

Thai traditional medicine draws from Indian and Chinese systems of traditional medicine (204). It encompasses a holistic philosophy and is based principally on plants, including the use of herbal saunas, herbal medicines, herbal steam baths, and hot compresses; traditional massage; acupressure; and reflexology. Practitioners of traditional medicine represent an important resource for the Thai health care system. Traditional Thai medicine is also practised in Cambodia, Lao, and Myanmar.

Statistics

In 1998, Thailand imported more than 35% of its allopathic medicines and about 30% of its traditional medicines (204).

Regulatory situation

Official policy towards traditional medicine in Thailand has a well-recorded history:

• 1182-1186: 102 hospitals were established, and at least 30 kinds of herbs were used in treatments.

• 1504: traditional medicine formularies received official endorsement.

• 1767: Thai traditional medicine and allopathic medicine were separated for the first time since the introduction of allopathic medicine.

• 1782-1809: herbal medicine formularies were inscribed on the wall of the temple Wat Potharam.

• 1824-1851: protocols for diagnosis and treatment were inscribed on the wall of the temple (205).

• Allopathic medicine was reintroduced by missionaries who used quinine to treat malaria.

• 1888: the Siriraj Hospital, which combined both allopathic and traditional medicine, was established.

• 1913: Thai traditional medicine and allopathic medicine were separated for the second time by the discontinuation of formal education in traditional medicine.

• 1929: a law classifying medical practitioners increased the separation between traditional and allopathic medicine: "Traditional medicine practitioners were defined as those who practice medicine based on their observations and experiences that were passed on by word and in traditional textbooks but were not based on scientific grounds" (204).

• 1941: the production and sale of 10 traditional medicine formulas by the Government dispensary were stopped.

In the last few decades, particularly following the Alma-Ata Declaration and a World Health Organization conference on traditional medicine, Thai traditional medicine has received renewed interest. The National Institute of Thai Traditional Medicine was established on 24 March 1993 as a division of the Department of Medical Services. The Institute is charged with facilitating the integration of Thai traditional medicine into the public health services.

In 1987, an amendment to a royal decree enabled the Ministry of Public Health to integrate ayurvedic doctors into the medical work force of both State-run hospitals and private clinics. Ayurvedic doctors and Thai traditional practitioners are allowed to use some basic allopathic medical tools in their practice, such as the thermometer and sphygmomanometer, but are not allowed to prescribe allopathic medicines.

The Government is currently working on developing the use of herbal medicines. The goals of the Eighth Public Health Development Plan 1997-2001 (204) are to increase the use of allopathic medicine, increase the use of traditional medicine, curb the use of extravagant medical and pharmaceutical technology, and promote traditional treatments within the national public health care system. Included in this policy is the development of research into medicinal herbs, training of traditional medicine practitioners, and use of medicinal herbs and traditional medicine practitioners in an official capacity. Specific objectives are as follows:

• support and promote Thai traditional medicine in the national health care system as a means to improve health through self-reliance at the personal, family, community, and national levels;

• upgrade the standard of Thai traditional medicine for acceptance and integration into the national health system;

• support the basis of Thai traditional medicine by developing a comprehensive system and strategy for its official use, including academic development, integration of administrative services into the national health care system, production of medicinal herbs and Thai traditional medicines, dissemination of information, and promotion of the use of Thai traditional medicine;

• support organizations and agencies that deal with Thai traditional medicine in both the Government and private sectors;

• increase the use of medicinal herbs by supporting the production of plants, developing the pharmacopoeia, and collaborating with traditional medicine practitioners.

By 1999, Thai traditional medicine was integrated into the facilities of 1120 health centres. Most of these health centres are health stations at the sub-district level, which represent more than 75% of health facilities (204).

All types of traditional medicine practitioners are registered with the Medical Registration of the Ministry of Public Health.

Education and training

The first school for Thai traditional medicine was established in 1957 at Wat Po. Since 1962, graduates from such schools have been licensed to practice general traditional medicine. In December 1997, the Ministry of Health's National Institute of Thai Traditional Medicine established the Thai Traditional Medicine Training Centre, where programmes in pharmacy, Thai traditional healing, Thai traditional massage, and reflexology are offered. For people who do not have the opportunity to attend a university, the National Institute of Thai Traditional Medicine, in collaboration with the Department of Non-Formal Education, offers courses in Thai traditional medicine at non-formal education centres at the primary and secondary school levels.

An ayurved-vidyalaya college was established in 1982 by the Foundation for the Promotion of Thai Traditional Medicine, a private organization supported by the Government. During its three-year programme, students study not only aspects of Thai traditional medicine, but also basic science and allopathic diagnostics. This later training is intended to facilitate their ability to communicate with other health care professionals.

Students of allopathic medicine receive no training in traditional medicine. Act 7 of 30 December 1966, however, enables allopathic physicians, pharmacists, nurses, and midwives who want to practice Thai traditional medicine to do so. To be eligible to practice traditional medicine, allopathic practitioners are required to follow a three-year course of training and instruction with a registered and licensed traditional medicine practitioner and to pass an examination set by the Commission for the Control of the Practice of the Art of Healing.