East Meets West
A few months ago, a young intern named Ana was riding her scooter through the streets of Sant Antoni when a car came out of nowhere and blindsided her. She was sent flying off her bike but miraculously, while the ambulance was en route with its sirens growing louder, Ana surprised her civilian caregivers by standing up, dusting off her torn business suit, and lamenting her broken helmet. Unfortunately, though, her streak of good health ran out a few weeks later when she developed excruciating back pain. “There were periods when I couldn’t walk,” Ana said. “I was forced to sleep in the fetal position with a pillow stuffed between my knees just to get some relief.”
Ana may have had access to the most up-to-date technology and top-notch medical facilities, but when deciding on treatment for her back pain, she did something many Barcelonese have been doing more and more of in recent years: she deserted mainstream medicine and opted for the traditional kind, a means of recovery, health and wellbeing which has been claiming an increasing share of the public’s awareness.
According to a 2011 report by the World Health Organization, between 70 and 95 percent of the world’s developing population relies on traditional medicines for primary care. In industrialised nations such as Canada, Germany, France and Italy, between 70 and 90 percent of people have tried traditional medicines as either an alternative to, or as well as, western medicine. In Catalunya, according to Professor Manuel Rodríguez Cuadras, a practitioner of traditional Chinese medicine, the figures are anywhere between 50 and 70 percent.
Cuadras’s estimate tells us two things. It shows not only that Spain has a lot of catching up to do with the rest of Europe and the world, but that there is also a lack of accurate statistical data. The latter is the most important for natural therapists since it is clearly the direct consequence of the government’s opposing stance towards alternative medicine.
“Not considered, not regulated,” says Cuadras in his office on Rambla de Catalunya. His statement, which rings like a picket chant at a complementary and alternative medicine rally, speaks volumes. Natural therapists, who are medical specialists in their own right, are hardly tolerated by the ministry of health, and are in many cases seen as intruders. Thus, validation has proven to be a contentious point since the practice of medicine is the exclusive right of allopathic doctors. Allopathic and non-allopathic practitioners, however, share many commonalities such as caregiving, illness prevention, diagnosis and the overall health management of their patients permitted by many years of rigorous study. Yet the problem in recognition is based on the gross imbalance in scientific research favouring “Greek” medicine over the holistic kind. Paradoxically, the only way the government would consider regulation of alternative medicine is if it invested in research in order to produce evidence-based data on the efficacy of alternative medicine, yet it doesn’t want to invest in research to produce evidence-based data because it sees alternative medicine as little more than pseudoscience or folk medicine. Over the years, this position has given little hope of integration into the public health apparatus, meaning that natural therapists must set up practice privately. During such difficult times there are more and more sick people lacking the ability to finance alternative treatments. Their only choice is between seeing their local GP for prescription pills or buying a packet of Paracetamol for €1.50. Ten sessions of acupuncture for €200 are not an option.
Lack of validation also prevents the use of proper terminology. A place to get treated by alternative means is not a hospital nor is it a clinic but a school of traditional medicine or a private office. Professional designations are also affected. Miguel López Alarcón, a shiatsu therapist at ISMET, is obliged by law to correct me when I mistakenly call him doctor. “A Chinese acupuncturist [in China] is a doctor, legally,” says Alarcón. “In Spain, the legislation simply forbids us to say we are. We’re not doctors nor are we healthcare workers.”
Professor Cuadras addresses this state of legal limbo more poignantly. “We don’t know where we situate ourselves. Within the law? Outside the law? We are not illegal, we are alegal.”
Over the years this legal vacuum has conditioned natural therapists to the ever-present danger of possible reprimand by the government. That is because, according to Article 44 in the Code of Medical Professional Ethics, methods which have not been scientifically validated to make a diagnosis or to treat a patient, are prohibited. Despite the many efforts in recent years to harmonise alternative with standard healthcare, the relationship continues to be neither congenial nor collegial.
The tense nature between both schools also finds its equivalent in those who prefer standard medicine to natural means of treatment. “My mother never believed in anything but regular medicine,” said Ana, “and so when I told her about acupuncture, she scoffed at the idea of pins being inserted into my body.”
Though Ana’s mother may be representative of the supporters of the status quo, Barcelona’s high population of tourists and expats, as well as a growing number of well-informed patients and healthcare professionals is slowly contributing to the inertia of the acceptance of traditional medicine. The demand has been increasing so much that some medical doctors have started gaining additional accreditation to practice herbal medicine, acupuncture or tuina (Chinese massage). Yet by law, they are still obliged to promote such treatments as coadjutant to orthodox medicine, informing their patients about the priority of primary care medicine.
“[Natural therapists] are very well accepted in society,” says Alarcón when asked about perceptions. “And there are many people who practise yoga and tai chi. We are here, the people demand our services, yet the problem is more with our exclusion from the current healthcare system.”
Arantxa Delgado, Director of Communications at the Escuela Superior de Medicina Tradicional China, concurred. “I’ve been in this centre for three years and even within this time people’s perceptions have changed greatly. Catalans are opening up to Chinese medicine. More and more people are seeking alternatives and we are doing well only by word of mouth advertising.”
Ana’s treatment for her back injury was acupuncture with herbal therapy. When asked about her primary motivation to try traditional medicine, I was not surprised to hear her answer. “I looked through the information booklet of my father’s pain medicine and was not happy with what I read.” What Ana read would have been disconcerting to anyone as well as being the deciding factor for going ‘natural’—a list of possible side-effects rolling down like a medieval scroll.
The most popular alternative treatment in Barcelona is acupuncture, the king of traditional and complementary medicine techniques. Despite those like Ana’s mother who believe it is merely the sticking of pins into the body, the procedure does successfully treat many pathologies that occidental medicine has found no cure for, such as migraines, severe back pain, strains and cramps, and the rigidity of muscles. At the Escuela Superior de Medicina Tradicional China in Barcelona, Arantxa even claims a 99 percent success rate in fertility with the use of acupuncture. Moxibustion, a form of acupuncture which burns Artemisia, is also popular for the treatment of pain, especially in patients with chronic arthritis. Phytotherapy, especially the use of Bach Flower Remedies, is used to restore the delicate mind/body balance by ridding emotions such as fear, worry, hatred and indecision. It is also popular in reducing aggression in children.
With such a high consumer demand for traditional and complementary medicines, how long will it take the government to start taking notice and action? The WHO’s recent publication, Traditional Medicine Strategy 2014-2023 recognises the importance of traditional and complementary medicines around the world and seeks to support policies that address the integration of such therapies into existing health care systems. It seems that traditional medicine has momentum on its side and it is probably just a matter of time before we are able to claim Chinese medicine on insurance or be referred to an acupunturist by the CAP. How much time? Well that’s anybody’s guess.
Escuela CENAC specialises in acupuncture and naturopathy. Jota 13 (near Fabra I Puig metro station).
Instituto Superior de Medicinas Tradicionales offers courses as well as affordable prices for treatments as part of their students’ practicum. Floridablanca 18-20.
Escuela Superior de Medicina Tradicional China offers practitioner training in traditional Chinese medicine. Gran Vía de Carlos III 64-66.
Professor Manuel Rodríguez Cuadras specialises in acupuncture, Chinese medicine for children, as well as phytotherapy. Rambla Catalunya 62, 1º, 2º A.
Tania Spearman is a Uk-trained acupuncturist. www.taniaspearman.com Tel. 644 322 161. See here for more information.