While a lot of people all over the world are turning to modern medicine to treat diseases, why do some Cambodians still use Khmer traditional medicine? Is it because it is cheap and effective, or merely old habits dying hard? Cambodians usually deal with illnesses through both modern and traditional medicine, often self-medicating and inevitably using more than one treatment for the same illness. However, those who use traditional medicine can in fact save themselves money. In Cambodia, there is access to over-the-counter drugs at low costs, since most are often produced in the region. Western produced medication is available in urban areas but the costs are relatively higher. This has lead to it often being a last resort when all else has failed. Khmer traditional medicine is a form of naturopathy and combines differing roots, barks, leaves of various trees, some minerals and other natural ingredients. In total this branch of medicine can treat more than 100 different diseases. Practitioners of this therapy are known as Kru Khmer.
According to Mr. Yean Ysreng, Deputy Director of National Center of Traditional Medicine, "About 40 to 50 percent of the population in remote areas are using traditional medicine because they are poor and it is cheaper than Western medicine. It also cures them of their ailments all the same." The ancient Khmers first formulated this medical lore, during and around the Angkor period. From the turn of the first millennia until the present day, this system of treatment has served the people of Cambodia. "At that time, they only had traditional medicine to treat illness--they did not have hospitals yet," said Yean Ysreng. "They also didn't have microscopes and they dealt with illness by guessing the disease. For example, when they saw someone coughing they would guess that it was tuberculosis."
Today, we don't totally depend on traditional medicine, we should look to science," he said. Using traditional remedies has no side effects: an advantage natural remedies have over their more chemical orientated counterparts. However there are also several poisonous plants that could be mistakenly administered. When correctly administered the toxicity of traditional remedies is hugely lower than the western alternatives. Yean Ysreng highlights: "Usually, Western medicine is a double edged sword, as is traditional medicine. They can sometimes help but sometimes make people worse."
Khmer traditional doctors are receiving recognition and training from the government at The National Center of Traditional Medicine. At the Center they are also looking for other traditional healers from across the kingdom. In this way, they hope to be able to train them to a uniform level and to assimilate their localized knowledge. The Center is interpreting books from Pali into Khmer, these texts describe traditional medicine and have been gathered from pagodas and even as far a field as the Middle east. "We have already interpreted 50 percent of the books, the young generations don't understand the Pali language," he said. "We will produce booklets about traditional medicine when we finish translating them."
Whilst a cure for AIDS has eluded the Western medical world, there are some Kru Khmer who allege they can treat this modern plague. Mr. Yean Ysreng is skeptical--with the wealth and technology of the western world not able to find a cure, he finds it difficult to imagine a rural Kru Khmer finding one. What these doctors offer is unclear, but Ysreng adds, "I cannot say it is effective in AIDS treatment." According to a reference book on natural medicine by Puth Yeang, a member of the Association of Cambodian Traditional Doctors, Khmer traditional medicine is a very effective treatment of illnesses, if we carefully learn about both the disease and the cure.
Nowadays, Khmer traditional medicine is available in market places as well as in traditional doctors’ surgeries in Phnom Penh. However even this practice has its share of unscrupulous practitioners and caution should be practiced. If in doubt, check with the Association first to see if the Kru Khmer is registered. A typical morning, in the front of the Phnom Penh shop of traditional practitioner Ly Bunarith, there must be about 20 people from across Cambodia waiting to discuss their sickness and to buy traditional medicine. As one patient emerges another would enter, this pattern would be repeated throughout the morning.
Ly Bunarith, is well known throughout the country as a skilled practitioner of traditional medicine. He said, "Khmer traditional medicine has little side effects to people's health and people quickly recover from their illness. "If we properly compound it, traditional medicine treats sickness effectively and the patient will recover. When we know how to use it, we will save a lot of money because Cambodia has many medicinal plants, such as the Kinin medicine (used to treat malaria) made from hopeaodorata tree (in Khmer called Duem Koki)," he said. Another example of Cambodia medicinal flora is the root of the "Tau Tim" tree which is used to treat intestinal worms. "When properly administered, patients recover and do not suffer side effects. But it could sometimes lead to people dying when they don't know how to compound it properly and take an overdose. Here is also a kind of tree called "Duem Pleung" which is traditionally used by women after childbirth. People do not know that it burns the skin and should not be carried on the shoulder. When they go to jungle to harvest for it, they often suffer a swollen shoulder on the way back--that is a problem," Ly Bunarith said.
Furthermore, some traditional medicines react with Western medication, and are not necessarily beneficial. "Bra Teal" is one such example. According to Ly Bunarith and other traditional doctors "Bra Teal" is harmful when taken with Western medicine. "If the traditional medicine is compounded totally from plants, then it is alright to take a Western pill with a small cup of traditional concoction." Ly adds. In this way the western and eastern knowledge are used as complimentary therapies. Sin Saron, a 45 year-old farmer from Kampong Chhnang who brought her son suffering a gastric ailment to a traditional doctor's house in Phnom Penh said that she had “spent much money on Western medicine for my son but my son is still sick.” "This is the first time I come here because I heard that our traditional medicine has been very effective in dealing with illnesses," said Sin Saron. "I hope that with this medicine, my son will recover and it cost me little." In Cambodia, most traditional doctors take tree bark, roots and herbs from trees to compound as Khmer medicine. These can be found on many mountains across the nation.
To make the traditional medicine very effective, before cutting each tree they have to light incense sticks and ask permission from the Neak Ta (Mountain spirit), who is believed to be the owner of the trees. Moreover, it is also believed that in order for the herbs to be truly effective, they have specific times of cutting them. Some trees should be cut at the trunk only in the morning, the leaves in the afternoon and the roots at night. A more controversial ingredient is animal parts. These have for centuries provided alleged cures. However, it is only now, in this era of conservationism, that tradition has met its match. With huge emphasis on stopping illegal wildlife trade, this practice is being increasingly pressured out of existence. It is still widespread and has always played a part in traditional medical practice. Whilst researching the story, many of the recipes collected for the cures contained animal parts. A traditional cure for Measles (an illness almost eradicated in the west, through massive inoculation practices, but rampant in the developing world.) contains the gall bladder of python as an active ingredient. With there being very little scientific data to support the healing properties of such animal parts, it is necessary perhaps to move towards a more herbological aspect of traditional medicine? It seems that people are more willing to try local medicine, both out of economic causes and due to its traditional role in society. So it is both cheaper and an old habit that is hardly dying.