Oral tradition in medicine is the original form of medical treatment based on specificities and the context in which a patient is located. This tradition is fundamental to many formal and informal systems of medicine but it is highly visible in tribal medicine. The essential features of traditional healing systems have not been documented except in relation to African tribal medicines and some contexts in India.[i] However, oral traditions with respect to tribal customs, art forms, songs, myths, stories, hunting practices etc. have been well-documented.[ii] The reason for non-documentation with respect to medicine is partly due to the extreme secrecy associated with the modes of treatment. In many cases, the knowledge is considered as very sacred which prevents its dissemination or documentation. The practice is widely prevalent not just for treatment of diseases but it is also commonly practiced in birthing and child care.[iii]
Mass perceptions regarding the utility of medicinal plants have undergone a change despite the exclusionary nature of such knowledge. It is important to understand the changing health culture of Kerala when people are faced with a host of health problems especially fevers of different types in epidemic proportions.
Available data from the Kerala legislative proceedings show that between January to July 2017, there were 1,956,198 cases in the state which could be termed as an extra-ordinary epidemic situation. The actual situation could be much more alarming as there could be under-reporting.. But even this data reflects the seriousness of the epidemic. The mortality from fevers was also significant. Kerala also witnessed the outbreak of cholera where the strain is similar to the Haitian type, which is antibiotic resistant, although this was presently limited to the migrant workers.[iv]
When such a medical emergency strikes the families, and when the modern medical systems fail to address such epidemics in terms of both cure and prevention, people lose faith in medical systems and tend to experiment with other ways of cure. Social bonding and channels of inter-personal and inter-household communication for exchanging disease experiences, information, and different ways of cure were enhanced during this period. Definitely, one can surmise that there are indications of ‘syncretic holism’ – a new health orientation among the people with a conscious and informed choice regarding the ways of treating the symptoms due to common ailments, especially fevers of different kinds. Such a health orientation for the moment shows a secular trend with acceptance of contextual, regional, caste or religious specificities in the utilization of ‘drug’ formulations. And this is what could be termed as a positive landmark in the development of a popular culture with respect to medical systems. The new orientation of syncretic holism reflects the oral tradition characteristic of tribal cultures but which has undergone a transformation to one which does not depend on any specific practitioner.
From a public health point of view, the epidemic demolished the bygone glory of the health service system in Kerala. The much-acclaimed strength of the system was tested with both public and private hospitals flooded with fever patients. The foremost lesson from the epidemic is the need for an integrated, holistic vision which the suffering people adopted as an innovation for alleviating their suffering.
Kesavan Rajasekharan Nayar MA, MCH, PhD
Santhigiri Social Research Institute and Global Institute of Public Health, Thiruvananthapuram, Kerala.
Lekha D. Bhat MSW, M.Phil, PhD
Assistant Professor, Department of Epidemiology and Public Health, Tamil Nadu Central University, Thiruvarur, Tamil Nadu.
Lucy George MSc., M.Phil
Assistant Professor, Department of Bio-Sciences, Mar Athanasios College of Advanced Studies, Thiruvalla, Kerala.
Competing Interests: none declared
[i] Sindiga I, Nyagotti-Chacha C, Kanuah MP. Traditional Medicine in Africa. (eds.). Kenya: East African Traditional Publishers. 1995; Abdullahi AA. ‘Trends and Challenges of Traditional Medicine in Africa’. Afr J Traditional Complement Altern Med. 2011 July 3; 8 (5): 115-123; Sen S, Chakraborty R. Revival, ‘Modernization and integration of Indian traditional herbal medicine in clinical practice: Importance, challenges and future’. J of Trad and Complementary Med. 2017; 7 (2):234-244; Shankar R, Lavekar S, Sharma BK. ‘Traditional healing practice and folk medicines used by Mishing community of North East India’. J Ayurveda Integr Med. 2012 Jul-Sep; 3(3): 124–129.
[iii] Gonzales, P. Red Medicine: Traditional Indigenous Rites of Birthing and Healing. Tucson: University of Arizona Press, 2012.
[iv] Narendrakumar L, Suryaletha K, Reghunathan D, Prasannakumar M, Thomas S. Insights into the draft genome sequence of a Haitian variant Vibrio cholerae strain isolated from a clinical setting in Kerala, South India. Genome Announc .2017 Sep; 5(36).