Traditional Medicine and Quest for Covid-19 Cure

NEW HAVEN: Southeast Asian governments offer varied responses to the Covid-19 pandemic – from Rodrigo Duterte’s televised call for police to execute recalcitrant Filipinos as the country went into lockdown to the Malaysian government’s social media campaign against domestic violence, advising women to avoid being “sarcastic” towards husbands while under quarantine, or Indonesia’s reluctance for lockdown.

This mixed response is hardly surprising for observers of Southeast Asian affairs. Although banded under the ASEAN economic alliance, modern Southeast Asian states have long acted largely on their own for sociopolitical issues. Citizens’ perceptions on government responses also vary. While the majority of Singaporeans and Vietnamese suggest that their governments take proper measures against Covid-19, fewer Indonesians and Malaysians, and very few Thais, share the sentiment, suggests a poll conducted by Dalia.

Online information increasingly shapes the experiences of all. While much of the policy and academic discourse surrounding online health information centers around misinformation – defined as false, misleading and inaccurate – less is said about traditional, non-biomedical knowledge from locations such as Southeast Asia finding new expression online to a larger audience.

Against rapidly evolving governmental responses and public awareness, as well as shifting opinion on what qualifies as adequate measures, an unlikely grassroots response may bind Southeast Asian citizens together: a resurgence of indigenous non-biomedical practices fueled by peer-to-peer information circulate on social media platforms. To be clear, traditional medicines and therapies never ceased to exist in the region. Although colonial powers invariably marginalized and stigmatized indigenous forms of therapy throughout the region during the 20th century, these treatments remain widely practiced – a result of insufficient reach and investment of resources from colonial governments as much as the allure of traditional cures. Post-colonial governments across Southeast Asia also coopt, scientize and revitalize medical traditions as part of their nation-building projects.

The internet gives historically contingent developments greater visibility, an imagined sense of coordination, highlighting the dynamic longevity of knowledge existing at margins of scientific enterprise.

In areas with weak health systems and institutions, familiar wisdom kicks in as people nervously hunt for ways to protect themselves. For example, cure-alls and self-concocted remedies circulating on the Vietnamese internet for Covid-19 include drinking boiled lemongrass and orange zest upon entering or exiting home; rubbing medicated oil on one’s feet before bed; adding spices such as chili, ginger and garlic to everyday meals; or blowing a hairdryer along one’s spine and toes.

Cambodian YouTube recommends drinking boiled garlic juice, sunbathing in scorching heat, or swabbing one’s nose with garlic juice.

Indonesia has seen a surge in demand for turmeric and ginger – ingredients for a drink known as jamu, endorsed by the president for boosting the immune system, thus warding off Covid-19 – sent prices soaring for these plants.

In Malaysia, dried ginseng, scallops and sea cucumber are in demand as ingredients for tong sui, a traditional Chinese sweet warm soup believed to boost immunity.

In Thailand, bitter-tasting kariyat is advocated as an effective treatment of coronavirus symptoms, while the Department of Thai Traditional Medicine and Government Pharmaceutical Organization eyes developing Covid-19 cures using the medicinal herb Andrographis paniculate, so far with inconclusive results.

In a similar vein, the Philippine Council on Health Research and Development of the Department of Science and Technology is reported to research coconut oil as a potential agent against the virus.

Southeast Asian states are not alone in aspirations to develop treatments for Covid-19 by drawing on knowledge paradigms closely bound in nationalistic sentiments about culture and tradition. To the north, China advocates for “Chinese solutions” to the pandemic and sharing “Chinese experience” in the form of a "lung-cleansing and detoxifying soup" distributed in Wuhan hospitals. China’s National Health Commission also endorsed injections that contain bear bile powder as treatment, to the dismay of critics. The ultimate goal in ending Covid-19 rests in development of a vaccine, cautions Clifford Steer of University of Minnesota Medical School, adding no evidence points to bear bile as an effective treatment. Animals Asia, a non-profit devoted to ending bear bile farming, criticizes the neglect and disease commonly associated with bear farms as well as health risks associated with ingesting bile from sick bears, including contamination with feces, pus, urine and bacteria.

Many unorthodox practices have yet to be researched or proven. Still, dismissing them as knee-jerked reactions or misguided nationalism may miss the point. In the wide gap between evidence-based public health measures and local sociopolitical circumstances lies everyday management of a global health crisis and a virus new to all.

Nested hierarchies of ‘traditions’ exist across non-biomedical practices throughout Asia. In Vietnam, for example, the Chinese-inspired thuốc Bắc, literally “Northern medicine” is considered a more learned and theoretical tradition, whereas the indigenous thuốc Nam“Southern medicine,” is considered mainly empiricist. There is also thuốc gia truyền, or “family transmission medicine,” as a body of practice, drawing on medical recipes kept within Vietnamese “medical families” or sold to patients through local networks.

Impulsive creators of new inventions frequently try to attach their products to traditional treatments, usually responding to a specific crisis, catering to anxieties within society. Others are simply desperate. Even the US president pondered if doctors should try injecting or applying disinfectant, under the supervision of doctors, a suggestion rejected by public health experts and media. The internet is both battlefield for health communications and an emerging ecology.

Within the context of Covid-19, public health experts praise social media platforms such as Facebook, Twitter and YouTube for combatting misinformation. Unlike political misinformation, more subjective and contentious, public health experts along with credible institutions quickly refute misinformation. The risks of Covid-19, highly contagious with a fatality rate of about 3 percent, present strong grounds to justify institutional intervention. Framing of online misinformation within public health communications casts the internet as a battle with a need to extinguish fires as soon as they spark.

Indeed, such framing has been effective in helping experts focus attention and resources on responding to targeted problem communications. After a Facebook post falsely claimed that UNICEF Cambodia recommended drinking hot water to combat Covid-19, warning against consumption of ice cream and cold foods, the organization swiftly refuted the misinformation. In India, when some speculated on WhatsApp about whether clapping together at certain times could kill the virus, the Indian Press Information Bureau debunked the claim.

Traditional medicines do not refute or challenge scientific knowledge. In many cases, traditional practitioners actively coopt modern scientific methods as they renew living practices. New digital expressions reflect historically contingent narratives about health as much as they actively shape contemporary everyday experiences of modern disease. The modern Southeast Asian patient often draws on multiple therapies to manage illness, relying on the internet to find information about both proven and unproven therapies. The internet is not only a battlefield for quarrels over misinformation, but also a living health ecology that augments and alters social health processes beyond the digital realm. Analyzing traditional treatments requires a proactive approach: monitoring and modeling mobilization of ancient wisdom and beliefs with technology’s help.

The internet, while not displacing the institutional power of state and scientific enterprises, has leveled the health communications landscape, amplifying marginalized voices. While strategies such as checking sources and consulting expert opinions might work for the reactive fight against internet misinformation, other strategies are required to tackle difficult questions around contested knowledge and revived claims to legitimacy in a much less regulated online environment. Public experts must start with thoughtful, rigorous engagement rather than stigmatizing and dismissing non-biomedical knowledge claims – charting the dynamic evolution, assembling their stories, and then devising informed and knowledge-based policies to deal with the intricate realities of everyday health and illness.

There are no quick fixes to ideas that persist and mutate over time. Recognizing their full complexity is a first step in devising best practices for public health.