Nursing Process and Culturally Competent Care: Malay Culture

Introduction to Malay Traditional Healing

Each society has devised its own methodology for dealing with disease. According to the old manuscript MSS1292 KitabTib (Book of Healing), a 19th-century Malay text, the Malay people possess successful and well-established healing practices that work effectively as integrative and complementary medicine (Baharuddin & Sidik, 2010). An analytical approach is required to study the contents of this manuscript in depth. According to the research, there are three principal methods of healing disease (Baharuddin & Sidik, 2010):

It is evident that these traditional practices were ecological and holistic in origin, an emphasis that persists even today (Baharuddin & Sidik, 2010). The World Health Organization's framework on traditional medicine acknowledges the continued global relevance of such indigenous healing systems.

Background and Philosophical Foundations

The roots of Malay conventional medicine lie in traditional Unani medicine and Galenic philosophy (Jamal, 2006). In addition, it draws inspiration from Chinese, Indonesian, Indian, and Orang Asli (indigenous) medicines. Ailments are treated through a holistic approach that incorporates mental, spiritual, physical, emotional, and behavioral elements.

Diseases are diagnosed on the basis of physical assessment while also taking spiritual elements into consideration, such as ghosts and malevolent spirits. In Malay conventional medicine, every person is understood to be composed of four elements (Jamal, 2006):

These characteristics closely resemble those of the Greek model of humors and elements. In addition to prayers (doa), chants (jampi), abstinence (pantang), and massage, Malay conventional medicine employs animals, plants, microorganisms, and minerals to treat ailments and restore health. Medications are available in many forms, including pills, capsules, powders, medicated oils, makjun, infusions, decoctions, simple distillates, poultices, and paste (Jamal, 2006).

This alternative, complementary, and conventional medicine is widely used for preventing, treating, and diagnosing a broad range of illnesses (Baharuddin & Sidik, 2010). Multiple factors have contributed to the widespread popularity of conventional and complementary medicine worldwide, particularly over the last two decades. In certain regions, conventional and complementary or alternative medicine is more readily accessible than modern pharmaceutical options (Baharuddin & Sidik, 2010).

Definition of Health, Illness, and Traditional Methods

In fact, one-third of the global community — including many third-world countries in Asia and Africa — lacks access to basic medicines (Baharuddin & Sidik, 2010). The most commonly cited reasons for the continued use of traditional medicine are that it is cost-effective, more responsive to patients' cultural worldviews, and less authoritarian than modern medicine (Baharuddin & Sidik, 2010).

Conventional healing encompasses many methods, bodies of knowledge, approaches, and ideas — including exercises, techniques, and spiritual therapies — applied separately or in combination to cure, prevent, and treat ailments (Baharuddin & Sidik, 2010). According to the World Health Organization (WHO), traditional medicine (TM) is defined as health practices, methods, ideas, and knowledge that unify minerals, plants, animals, spiritual therapies, exercises, and manual methods, used separately or in combination to cure, treat, and diagnose ailments and maintain healthy living (Jamal, 2006). In Malaysia, conventional and complementary medicine is categorized into six groups (Ghani & Hamid, 2011):

Prior to the 15th century, conventional medicine was practiced by the Orang Asli dwelling in the Malay Peninsula and the Pribumi dwelling in the Sarawak and Sabah regions (Ghani & Hamid, 2011). During this period, Malay medicine was influenced by elements of Hinduism and Buddhism, rooted in Indian traditions. After the arrival of Islam and Chinese advances, medicine began to take on new forms, incorporating more diverse elements. Traditional Chinese medicine was growing in popularity even as Indian medicine also reached the shores of Malaya.

The Malay community uses natural ingredients — primarily flora — for healing purposes. The underlying rationale for using plants in remedial treatments is connected to the Islamic belief that Allah (the Supreme Being in the Islamic faith) is the sole creator, and that all vegetation and animals exist for the benefit of human beings. The use of herbs and vegetation is therefore seen as consistent with their very purpose of existence (Sidik & Baharuddin, 2010). A thorough analysis of MSS1292 KitabTib indicates the use of 258 distinct types of flora for treating multiple ailments. Furthermore, these flora are locally sourced. The author identifies 13 examples of flora that form the basis of remedies documented in MSS1292 KitabTib (Sidik & Baharuddin, 2010).

At the close of the 19th century, the British introduced modern medicine to Malaysia, which rapidly gained popularity due to its demonstrable results (Ghani & Hamid, 2011). During this same period, complementary medicine also began to appear in Malaysia. By the 20th century, modern medicine had become firmly established, while traditional and complementary medicine (T&CM) continued to be available as an additional resource (Ghani & Hamid, 2011).