Sunday 24 August 2008

The practice of physic is jostled by quacks...

...on the one side, and by science on the other.

On Sunday mornings I wake up to "The State We're In: Human Rights and Human Wrongs" from Radio Netherlands and WAMU Washington, relayed on the World Radio Network. This morning, one of the topics was alternative medicines: "quackery or essential" (One man's shaman, another man's fool?).

I've talked before about the quackery in Indonesia. But it's not all promoted by quacks. I've also talked about the liver problems which are a bigger challenge than HIV for many of our friends - I've just been contacted by one who has levels of liver enzymes 15 times normal (ten times is usually considered pretty dangerous). Sadly there's not much that 'Western' medicine can do for him; there are no drugs which can repair a damaged liver.

But traditional medicine has for years offered mixtures of herbs that have proved effective for liver damage caused by poisons, such as certain other 'natural' toxins (e.g. poisonous berries). Are these effective against liver damage caused by hepatitis? There's no evidence of that. But many doctors in Indonesia are prescribing concoctions known as 'hepatoprotektor' (you can probably work out what that means) to people worried about the level of their liver enzymes. And yes, they are actually writing out prescriptions for these products!

Liver enzymes tend to 'flare'. For no apparent reason, the levels suddenly rise dramatically. Then a few days later, they drop back to around normal, again for no apparent reason. So, if someone has a test at the peak of the flare, takes the prescribed herbs then tests again a few days later, lo and behold the problem has gone.

Cause and effect? No, but tell that to the patient!

Babé

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