Nursing Process to Deliver Application of the Nursing Process to Deliver Culturally Competent Care: Malay culture

Each society has devised its own methodology of dealing with diseases. As per the old Manuscript MSS1292 KitabTib (Book of Healing) (a 19th century Malay manuscript), people of Malay have successful and strong healing practices which work wonderfully well in case of integrative and complementary medicines (Baharuddin & Sidik, 2010). An analytical approach is required to study the contents of the Malay manuscript for understanding it deeply. As per the research, there are three kinds of methods in case of healing diseases (Baharuddin & Sidik, 2010). These are as follows:

Natural resources

Wafak (written symbols)

Quranic verses for healing purposes and offering respect to prophet (P.B.U.H)

It is quite evident that these traditional practices were ecological and holistic in origin, which is stressed upon even today (Baharuddin & Sidik, 2010).

Background

The roots of Malay conventional medicine lie in traditional Unani medicine as well as Galenic philosophy (Jamal, 2006). Apart from that, it also takes inspiration from Chinese, Indonesian, Indian and Orang Asli (conventional) medicines. The ailments are treated with the help of a holistic approach which incorporates mental, spiritual, physical, emotional and behavioral elements.

Diseases are diagnosed on the basis of physical assessment and taking spiritual elements in consideration such as ghosts and bad spirits. In case of Malay conventional medicine, every person is built of four elements:

Suprawi (Fire)

Suddawi (Earth)

Dammawi (Wind)

Balpawi (Water)(Jamal, 2006)

These characteristics match those of Greek model of humors and elements. Apart from, prayers (doa), chants (jampi), abstinence (pantang), massage and other methods, Malay conventional medicine takes animals, plants, microorganisms and minerals for treating the ailments, illnesses and revitalizing health. The medications are available in many shapes or forms for instance, pills, capsules, powders, medicated oils, makjun, infusions, decoctions, simple distillates, poultices and paste (Jamal, 2006).

This alternative / complementary and conventional medicine is used widely for preventing, treating and diagnosing tons of illnesses (Baharuddin & Sidik, 2010).

Multiple factors have worked for the widespread popularity of conventional / complementary medicine all over the world, especially in the last two decades. In certain areas, conventional and complementary/alternative medicine is easily available (Baharuddin & Sidik, 2010).

As a matter of fact, one third of the global community and third world countries of Asia and Africa are devoid of basic medicines (Baharuddin & Sidik, 2010). The reason most commonly heard is that conventional and complementary / alternative medicine is cost effective, responds to patients mentality and less authoritarian unlike the modern medicines (Baharuddin & Sidik, 2010).

Definition of Health and Illness and Traditional Methods of Healing

Conventional healing means including many methods, knowledge, approaches and ideas, which incorporates exercises, techniques, spiritual therapies, applied separately or used in combination to cure, prevent and treat an ailment (Baharuddin & Sidik, 2010). As per World Health Organization (WHO), traditional medicine (TM) is defined as health practices, methods, ideas, knowledge which unifies minerals, plants, animals, spiritual therapies, exercises, manual methods used separately or in combination to cure, treat and diagnose ailments and maintain a healthy living (Jamal, 2006). In case of Malaysia, conventional medicine and complementary medicine is categorized in six groups. They are as follows:

Traditional Malay Medicine

Traditional Chinese Medicine

Islamic Medical Practice

Traditional Indian Medicine

Homeopathy

Complementary Medicine (Ghani & Hamid, 2011).

Prior to 15th century, conventional medicine was used by the Orang Asli dwelling in Malay Peninsula and Pribumi dwelling in Sarawak and Sabah area (Ghani & Hamid, 2011).

In that time period, the Malay medicine was inspired from elements of Hinduism-Buddhism, which has its roots in India. After the arrival of Islam and Chinese advances, medicine began to take a new form and meaning incorporating modern elements. During that time, conventional Chinese medicine was becoming popular as Indian medicine also reached shores of Malay.

Malay community uses natural ingredients for healing purposes. Natural ingredients here mean flora. The prime reason for using flora for remedial purposes is that Allah (Supreme Being in the Islamic Faith) is the only god and all of this vegetation and animals are for the humans alone. Hence, the reason of using the herbs and vegetation is in conjunction with their existence in the first place (Sidik & Baharuddin, 2010). In thorough analysis of MSS1292 KitabTib indicates the usage of 258 different kinds of flora for healing multiple forms of ailments. Apart from that, floras are local. The author gives 13 instances of flora which are basis of remedies as shown in MSS1292 KitabTib (Sidik & Baharuddin, 2010).

At the conclusion of 19th century, British with itself brought modern...

In this time period, complementary medicine began appearing in Malaysia as well. In case of 20th century, modern medicine was here to stay in Malaysia and T&CM medicines were available as an added bonus (Ghani & Hamid, 2011).
Practice of Traditional healer

As is the case in many third world countries, traditional healers are an integral component of Malaysian healthcare. It was found that 69% patients of mental health had sought the assistance of traditional healers who are known as bomoh prior to visiting a psychiatric care.

As per World Health Organization (WHO), 80% of the global population still uses traditional methods of healthcare although modern medicine is knocking at the doors (Muhamad & Merriam, 2009). As per WHO, an amount of U.S. $500 million is expended each year on this form of healthcare in comparison to U.S. $300 million in case of allopathic medicine.

Traditional healers are a significant part of their culture and sometimes, they are the only source of treatment for local population. In other cases, users of western medicine seldom seek assistance of bomohs (Muhamad & Merriam, 2009). One problem in case of cancer is that by visiting a bomoh first, identification and cure are postponed, which is the reason why Malaysia has an overwhelming rate of diagnosis of advanced cancer and elevated rate of mortality in comparison to western nations. The Malay traditional healers can diagnose and cure cancer (Muhamad & Merriam, 2009).

The Malay traditional healers are categorized into the following kinds as follows:

Islamic healers using Islamic verses and ideas to cure the disease

Traditional healers who use the folklore of disease, causation and cure. They are called bomoh (Muhamad & Merriam, 2009). Bomoh involves a lot of conventional methods of treating and diagnosing patients with the help of incantation, ceremonial rites, ceremonial rites, exorcism and sorcery

Bomohpatah, which means bone doctors / bone setters.

Some overlap exists between these types.

The Quranic healer can use other methods for treatment such as herbs and plants. The traditional bomoh may use Islamic prayers for treating bone fractures (Muhamad & Merriam, 2009).

In one study, eleven interviews were held in Bahasa, Malaysia. Three were in pure English while in others occasional English was used. The interviews were transcribed verbatim and used for data analysis (Muhamad & Merriam, 2009). The Bahasa transcriptions were sent for English translation. Comparative method of data analysis was employed for analyzing the interview data. The 14 healers claimed treating cancer patients. Homeopathic and herbalist doctors claimed that they could alleviate early stage cancer. A broad array of methods was employed for diagnosing cancer for that matter (Muhamad & Merriam, 2009).

Current Health Care Problem

Malaysian traditional medicines are indicators of a valuable, rich and cultural heritage of Malaysia and its citizens showing a diverse culture and customs (Farooqui, 2013).

The modern healthcare system is embraced with open arms, which the Malaysian federal cabinet approved. Whilst supporting and encouraging the western system of health care in every possible way, the plan to initiate certain medicine programs which would cater to T&CM methods for instance traditional Malay massage, acupuncture for curing post stroke management and chronic pain, herbal treatment for treating cancer. Malay post natal care aspires to guarantee security and quality maintenance of T&CM to keep the clients satisfied (Farooqui, 2013).

At present, there are around ten hospitals housing integrated medicine units catering holistic approach for stepping up and improving quality of life. Foreigner and local practitioners who aspire to work in this Malaysian sector need to register with T&CM which is under the umbrella of Ministry of Health, Malaysia (Farooqui, 2013). The practitioners need to comply fully with the given regulations for substantiating proof of their practices. Standard Operating Procedure (SOP) for carrying out T&CM services in a hospital setting requires a session with allopathic practitioners prior to consenting to traditional therapies. Currently, T&CM treatments are given as an outpatient only (Farooqui, 2013).

Numerous endeavors are underway for ensuring the growth and professional development of these traditional practitioners via training and education programs (Farooqui, 2013).

The domestic universities are offering bachelor degree programs in Malay medicine, Traditional Chinese Medicines (TCM), Ayurveda and chiropractic and homeopathic studies (Farooqui, 2013). Apart from that, diploma certificate programs are underway in:

Islamic medicine

Reflexology

Aromatherapy

Acupuncture

Islamic medicine

Malay massage

The future benefits of amalgamating T&CM in modern healthcare system's fold are to reduce the net cost of healthcare treatment whilst enhancing the level of healthcare. Apart from that, bringing patients onboard of conventional healthcare is a considerable undertaking which can influence health outcomes (Farooqui, 2013).

Traditional medicines have a role to play in national healthcare system.…