Within this presentation, CAM will interchangeably also be referred to as Traditional medicine.

Medicalization is not a new concept and neither are its issues. Western countries frequently come across issues involving medicalization and the issues are even more severe in developing countries. Continuously creating new medical diagnoses can be beneficial to the communities that can afford the solutions. However, that is not the case in many developing countries. For example, childbirth in many cultures is seen as a natural process that doesn’t require medical intervention. However, increased pressure has resulted in more women involuntarily giving birth in a medical facility. “Obstetrician involvement and medical interventions have become routine in normal childbirth, without evidence of effectiveness” (8). Overmedicalization is an issue that results in more burden than benefit, especially towards communities that can't afford the financial luxury.

Health issues treated in Western countries are not viewed and treated the same way in countries that rely on Traditional medicine. For example, individuals in the US who are battling with medical depression are prescribed antidepressant drugs such as Sertraline or Citalopram (5). Depression within Western medicine is viewed as a chemical imbalance (6). However, in Traditional Chinese Medicine, herbal concoctions are used to treat depression. Depression in the eyes of TCM is the result of a deficiency in ‘vital energy’ of multiple physiological systems in the body (7). For Chinese people, there is a conflict with what system of medicine they should rely on in the treatment of depression. Switching from one system of medicinal belief is hard for many individuals, especially when they have relied on one treatment their entire life.

Even among non-Western countries that have completely implemented the orthodox medical system, it has been recognized that completely disposing of the former medicinal system can decrease the effectiveness of healthcare. Recent studies have shown that traditional healers present aspects of diagnosis and healing that Western medicine can not. “Traditional healers have contributed to promoting positive health behavior and serve as a good referral point to modern health care system” (9). It’s important to integrate the two medical systems together to provide realistic treatment. Western medicine needs to change when used in Africa so that it’s more applicable to the healthcare system there. However, Traditional medicine in Africa also needs to become more standardized and integrated into legal frameworks (9). It’s only when Western and Traditional medicine are effectively integrated together, can we see patients receiving personalizable.

The Ebola outbreak highlights the importance of learning the local culture and establishing good relations with the community before incorporating public health help. Along with various other structural factors, medical aid workers failed to keep the communities safe. They unintentionally fuelled hopelessness and despair, disregarded the help of traditional healers, and ignored the cultural practices with funeral and burial rituals (10). Along with a shortage of healthcare workers, the aid was carried out in an environment that the workers were not familiar with. The medical aid workers, although with good intentions, overlooked these important aspects and in result caused more infective and fatality cases that could have been avoided.

One incident can cause mistrust forever. Because Western medicine is such a broad field, there are bound to be practitioners that are neglectful and abusive. In May of 2004, a group of medical workers were found to have intentionally affected Libyan children with HIV (11). Although it was a small group of medical workers, it caused a huge wave of fear throughout the entire continent. Communities throughout Africa became fearful and suspicious of all Western medical practitioners. This one case has immensely greated a negative impact on the well being of many people in Africa. “For example, polio has been on the rise in Nigeria, Chad and Burkina Faso because many people avoid vaccinations, believing that the vaccines are contaminated with H.I.V. or are actually sterilization agents in disguise” (11). Furthermore, disregarding these suspicions and distress only causes further distrust among the patients. It’s important to recognize the validity of people’s fears and concerns, especially when they have experienced the negative sides of Western medicine.

Western medicine is seen as objective and definitive. The technology, terminology, even ethics. However, it is ignorant to assume the same ethics can be applied to non-Western countries when practicing medicine. Conventional medicine sees organ donation as a form of selflessness, an altruistic deed that everyone should uphold if able. But organ donation is not viewed the same way within Islamic countries. Organ donation creates controversy because the donors suffer harm and there is “utilitarian secular moral reasoning” (12), which violates the Islamic moral code. Western practitioners should not assume the willingness of organ donations and continue to educate themselves in religious reasoning to minimize the ignorance caused by social barriers.

Beneficence is relative. Autonomy should be upheld. These points are quickly forgotten when Western medicine tries to make decisions out of the best interests for their patients. Disregarding these points causes detrimental effects, some even as long as generations. For the indigenious population in Peru, they suffered unwanted and unconsented sterilization. In the 90’s, President Alberto Fujimori ordered the sterilization of “more than 200,000 women and 20,000”(14), in efforts to decrease poverty. There was little consideration of the indigenous’ cultural value to have large families and “over 96% of the female victims did not consent to their being sterilized”(13). Western medicine had violated the basic human rights and insincerely assumed the cultural values of what was best. We continue to praise the humanitarian acts that Western medicine brings to underdeveloped countries while we continue to ignore the consequences that these discriminated populations faced.

A majority of the time, the visit to the doctor is not the financial burden, but rather the treatment or the prescription. Families within low income countries struggle to meet the financial needs of their prescription. Supply of standard quality medication is short and expensive. Therefore, to save money, many are taking unsafe doses and brands not knowing whether it could kill them. Moreover, “counterfeit drugs are often packaged just like brand medicines, so it is very difficult for pharmacists to tell the difference”(15). Lastly, little progress has been made in opposition to decreasing the prices essential drugs are needed that are set by pharmaceutical monopolies. Faulty implementation of conventional medicine has caused a widespread population left untreated and struggling.

Even with the implementation of modern medicine, how can it continue with the lack of funds, experience, and workers? Many countries are open to adapting and standardizing Western medicine but lack the numbers of qualified healthcare within these healthcare settings. Furthermore, low income countries do not have the financial resources to support expensive medical technology that constantly needs to be updated and maintained. As a result, “an estimated 40 percent of donated medical equipment in developing countries is out of service”(16). There is a mismatch between the intent and the reality of Western medicine in low income countries. Before a MRI can be purchased, a qualified doctor must be present to use it, to have a qualified doctor, there must be available education. These issues can not be solved through simple donations. Addressing systematic and economic affairs come first.

In this pandemic, the ideals of Western medicine can not be assumed for all the countries around the world. Conventional medicine calls for everyone to quarantine, practice hygienic routines, and get vaccinated. However, it’s not as simple. Western countries “enjoy the fruits of modernization while letting others disproportionately bear the cost”(17). Especially in these times of need, it’s important to remember that Western medicine can not be the answer for everyone around the world.

There are many points to pull from this presentation. However, I would like to focus on what we can do better to close the gap of disparity in Western medicine between developed and developing countries. First, investigating a population’s culture before practicing medicine is crucial. But don’t just study from afar, engulf yourself in the community. Understand the culture and create personal relationships with the local community. Second, find ways to accommodate other cultures when practicing medicine. “Biomedicine must use approaches that recognize and account for the views and values of the individual and of cultures, not only in determining the nature of a patient's problems but also in describing solutions”(18). Third, continuously practice empathy and awareness of the cultural barriers within medicine (cultural competence). Last, be aware of cultural imperialism that comes along with Western medicine. Western medicine, although the most mainstream, is not the superior form of medicine and it is definitely not the only solution.