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Medical frontiers in an ancient desert
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Gavin Kingcome/Science Photo Library
Features Medical frontiers in an ancient desert
Published Online October 1, 2015 http://dx.doi.org/10.1016/ S2213-2600(15)00405-1 For the Utopia Bush Medicine Project see http://www. healthinfonet.ecu.edu.au/keyresources/programsprojects?pid=2819
846
Travelling through the desert and savannah to the northeast of Alice Springs in central Australia, all that can be seen is termite mounds, scrubby trees, and red soil. The Alyawarr-speaking Indigenous Australians live in this region, with an abundance of medicinal plants that have been used by local people for tens of millennia. “We have possibly the world’s best treatments here in Australia’s bushland….the Indigenous people are the true experts of their traditional plants, and we are merely trying to communicate it in such a way that the general population can appreciate”, says Nicholas Sadgrove, from the University of New England (Armidale, NSW, Australia). The desert fuschia (Eremophila dalyana) has traditionally been used for curing colds and infections by the Indigenous Australians who inhale the steam from heating the leaves. “Although the eudesmol isomers of this plant are known and have a proven track record in the health literature for amazing effects in many illnesses, we have now discovered myodesert1-ene [which treats lung infection]”, says Sadgrove. Other more well known plants used by Indigenous people throughout Australia include tea tree (Melaleuca alternifolia) oil, which is drunk to soothe throats and sore lungs from coughing, and Eucalyptus oil, which is infused to treat fevers and respiratory illnesses. Traditionally, the boiled bark of the umbrella bush (Acacia bivenosa ssp wayi) has also been used as a cough suppressant and the leaves of the liniment tree (Asteromyrtus symphyocarpa) are rubbed on the chest to ease pain from coughing. Many species of wattles have also been used to treat respiratory infections. However, the general acceptance of traditional Indigenous medicine into mainstream health care seems unlikely. “We don’t know if any useful compounds from Indigenous materia medica will find their way into conventional pharmaceuticals. Even if they may be useful, somebody has to first prove safety and efficacy and then there has to be an agreement with Indigenous people and perhaps a synthesis of the respective compound”, Sadgrove says. New compounds require rigorous clinical testing or a proven record of safe use for longer than 75 years before government approval in Australia. According to the Lowitja Institute (Melbourne, VIC, Australia), which undertakes research into Indigenous health care, indigenous people will often delay resorting to western medicine until they are seriously ill, because of cultural reasons, such as a lack of Indigenous doctors and transport. This delay can lead to chronic morbidity of lung disorders. For example, Indigenous children in remote Australia have very high rates of pneumonia with some developing bronchiectasis. Some individuals will seek traditional medicine before visiting a public hospital, but because of scarce written records and few Indigenous people living a
traditional way of life, some traditional knowledge has been lost. However, recently, the Alyawarr have been involved in a project to record their medical knowledge and culture in words and on film through the Utopia Bush Medicine Project, began in 2007 by a local group of Indigenous women on Alyawarr and neighbouring Anmatyerr lands. According to Margaret Carew, from the Batchelor Institute (Alice Springs, NT, Australia), which participated in the project, “We wanted to ensure that the young people learn from the older people, where to find traditional plants and also how to use them”. This record has been truly multidisciplinary with linguists and artists helping to describe the medicinal uses of the many local plants including the fuschia bush that Sadgrove’s team are investigating. In a separate project, CSIRO (Canberra, ACT, Australia) is working with indigenous people in Arnhem land to produce an atlas of medicinal plants, and WHO has produced reports about traditional plant medicines from the Pacific and Asia for lung health—eg, the use of extracts from the Casuarina tree as an antiviral, which is also found in Australia. However, traditional medicine is also holistic, concerned with a person spiritually and physically. Francesca Panzironi understands this aspect of Indigenous health care well because she has spent the past 5 years working in indigenous communities. She is convinced that this holistic approach is needed to close the gap between the high rate of morbidity and mortality among Indigenous compared with other Australians. Panzironi proposes a state-wide policy framework that involves a two-way health-care model, providing spiritual healers with western medicine. “Traditionally in indigenous communities and still now, respiratory problems are tackled through the use of a medicinal plant called irmangkairmangka (Eremophila alternifolia), which the Ngangkari call ‘medicine number one’ as it has been used from time immemorial in the central desert area as a warm tea to be drunk a few times a day and as a rub”, explains Panzironi. Also, the Ngangkari give a type of massage for respiratory problems. “We had a couple of clients with respiratory issues. The Ngangkari have intervened by working on the respiratory system through a special hands-on healing technique called pampuni in Pitjantjatjara language. They say they work with their hands on the patient to open the air channels to allow the air to pass through more easily”, says Panzironi. However, for now, Panzironi and Sadgrove are working at the frontiers of mainstream medicine and learning from an ancient culture, one that in time might be important to a wider public. “There is a body of traditional knowledge that is still alive that just needs to be rediscovered”, concludes Panzironi.
Georgina Kenyon www.thelancet.com/respiratory Vol 3 November 2015
Gavin Kingcome/Science Photo Library
Features Medical frontiers in an ancient desert
Published Online October 1, 2015 http://dx.doi.org/10.1016/ S2213-2600(15)00405-1 For the Utopia Bush Medicine Project see http://www. healthinfonet.ecu.edu.au/keyresources/programsprojects?pid=2819
846
Travelling through the desert and savannah to the northeast of Alice Springs in central Australia, all that can be seen is termite mounds, scrubby trees, and red soil. The Alyawarr-speaking Indigenous Australians live in this region, with an abundance of medicinal plants that have been used by local people for tens of millennia. “We have possibly the world’s best treatments here in Australia’s bushland….the Indigenous people are the true experts of their traditional plants, and we are merely trying to communicate it in such a way that the general population can appreciate”, says Nicholas Sadgrove, from the University of New England (Armidale, NSW, Australia). The desert fuschia (Eremophila dalyana) has traditionally been used for curing colds and infections by the Indigenous Australians who inhale the steam from heating the leaves. “Although the eudesmol isomers of this plant are known and have a proven track record in the health literature for amazing effects in many illnesses, we have now discovered myodesert1-ene [which treats lung infection]”, says Sadgrove. Other more well known plants used by Indigenous people throughout Australia include tea tree (Melaleuca alternifolia) oil, which is drunk to soothe throats and sore lungs from coughing, and Eucalyptus oil, which is infused to treat fevers and respiratory illnesses. Traditionally, the boiled bark of the umbrella bush (Acacia bivenosa ssp wayi) has also been used as a cough suppressant and the leaves of the liniment tree (Asteromyrtus symphyocarpa) are rubbed on the chest to ease pain from coughing. Many species of wattles have also been used to treat respiratory infections. However, the general acceptance of traditional Indigenous medicine into mainstream health care seems unlikely. “We don’t know if any useful compounds from Indigenous materia medica will find their way into conventional pharmaceuticals. Even if they may be useful, somebody has to first prove safety and efficacy and then there has to be an agreement with Indigenous people and perhaps a synthesis of the respective compound”, Sadgrove says. New compounds require rigorous clinical testing or a proven record of safe use for longer than 75 years before government approval in Australia. According to the Lowitja Institute (Melbourne, VIC, Australia), which undertakes research into Indigenous health care, indigenous people will often delay resorting to western medicine until they are seriously ill, because of cultural reasons, such as a lack of Indigenous doctors and transport. This delay can lead to chronic morbidity of lung disorders. For example, Indigenous children in remote Australia have very high rates of pneumonia with some developing bronchiectasis. Some individuals will seek traditional medicine before visiting a public hospital, but because of scarce written records and few Indigenous people living a
traditional way of life, some traditional knowledge has been lost. However, recently, the Alyawarr have been involved in a project to record their medical knowledge and culture in words and on film through the Utopia Bush Medicine Project, began in 2007 by a local group of Indigenous women on Alyawarr and neighbouring Anmatyerr lands. According to Margaret Carew, from the Batchelor Institute (Alice Springs, NT, Australia), which participated in the project, “We wanted to ensure that the young people learn from the older people, where to find traditional plants and also how to use them”. This record has been truly multidisciplinary with linguists and artists helping to describe the medicinal uses of the many local plants including the fuschia bush that Sadgrove’s team are investigating. In a separate project, CSIRO (Canberra, ACT, Australia) is working with indigenous people in Arnhem land to produce an atlas of medicinal plants, and WHO has produced reports about traditional plant medicines from the Pacific and Asia for lung health—eg, the use of extracts from the Casuarina tree as an antiviral, which is also found in Australia. However, traditional medicine is also holistic, concerned with a person spiritually and physically. Francesca Panzironi understands this aspect of Indigenous health care well because she has spent the past 5 years working in indigenous communities. She is convinced that this holistic approach is needed to close the gap between the high rate of morbidity and mortality among Indigenous compared with other Australians. Panzironi proposes a state-wide policy framework that involves a two-way health-care model, providing spiritual healers with western medicine. “Traditionally in indigenous communities and still now, respiratory problems are tackled through the use of a medicinal plant called irmangkairmangka (Eremophila alternifolia), which the Ngangkari call ‘medicine number one’ as it has been used from time immemorial in the central desert area as a warm tea to be drunk a few times a day and as a rub”, explains Panzironi. Also, the Ngangkari give a type of massage for respiratory problems. “We had a couple of clients with respiratory issues. The Ngangkari have intervened by working on the respiratory system through a special hands-on healing technique called pampuni in Pitjantjatjara language. They say they work with their hands on the patient to open the air channels to allow the air to pass through more easily”, says Panzironi. However, for now, Panzironi and Sadgrove are working at the frontiers of mainstream medicine and learning from an ancient culture, one that in time might be important to a wider public. “There is a body of traditional knowledge that is still alive that just needs to be rediscovered”, concludes Panzironi.
Georgina Kenyon www.thelancet.com/respiratory Vol 3 November 2015