Cambodia Country Report

Introduction

From the 2nd ASEAN Conference of Traditional Medicine in Hanoi, Vietnam 31st Oct -2nd Nov 2011, Cambodia has shown the significant progress on development of TM throughout the areas like legislation, education and training, raw materials and products, produce medicinal plants book and international cooperation. All these efforts are aiming to integrate traditional medicine into Cambodia national health care system through strengthen evidence base on quality, efficacy and safety of TM practice and products.

Strengthen and develop legislation

2.1. Traditional Medicine Policy was established and approved by Minister of Health on Oct 2010. It's the first Policy of Traditional Medicine in the history of Cambodia. The TM Policy was disseminated and promulgated on 7 July 2011 to all relevant stakeholders. The objective of Cambodia Traditional Medicine Policy is as the following:

  • Promote traditional medicine profession for the benefits of the health sector, society and economy as a whole by putting emphasis on:
  1. Development of additional legislations, provisions and code of ethics
  2. Rational use of traditional medicine
  3. Integration of traditional medicine into the national health care system
  • Implement formal and non-formal trainings to respond to the progress made in the country as well as in the region.
  • Pay attention to raw materials and products:
  1. Conserve and develop natural resources and biodiversities in the country to ensure potential and sustainability of the needs for raw materials and traditional medicine products;
  2. Regulate the production and distribution of traditional medicine products to ensure quality, effectiveness and safety according to the standards and based on scientific basis.
  • Support and motivate research, information dissemination and national and international cooperation
  • Undertake periodical monitoring and evaluation of the implementation of this policy.

2.2. Traditional Medicine Task Force (Cambodia) was established in May 2011, it has 11 members from nine departments under Ministry of Health that related with the development of traditional Medicine. The purpose of establish TM Task Force is facilitated and control the implementation on the Traditional Medicine Policy.

2.3. With the technical and financial support from WHO-WPRO, the draft of Traditional Medicine Strategy 2011-2020 was conducted the consultation workshop on 8 July 2011. Base on the agenda it will be approved at the end of 2011.

The purpose of The Traditional Medicine Strategy 2011-2020 provides guidance on the implementation of the Traditional Medicine Policy of the kingdom of Cambodia to maximise the health potential of traditional medicine, advance the cause of primary health care and facilitate access to a more comprehensive range of health services for the people of Cambodia.

The Traditional Medicine Strategy 2011-2020 is focused on 5 key Strategic objectives:

  1. To integrate traditional medicine in the national health system
  2. To promote safe and effective use of traditional medicine
  3. To increase access to safe and effective traditional medicine
  4. To promote protection and sustainable use of traditional medicine resources
  5. To strengthen cooperation in generating and sharing traditional medicine knowledge and skills

Education & Training

National Center of Traditional Medicine collaborated with Cambodia Traditional Medicine Organization (CaTMO) continues the short course training to TM healers (Kru Khmer) that come from Phnom Penh and provinces. The training program is supported by The Nippon Foundation.

The curriculum of the course covers 65% of Traditional Medicine (TM) subjects and 35% the basic concept of western medicine.

The aim of the course as follow:

1. To prevent unqualified of TM practitioners.

2. To prevent misinformation and misunderstanding about traditional medicine health care.

3. To carry out modernization concept to TM practitioners

It has 2 kinds of training course:

  1. 6 month course is for TM healers that have advanced knowledge of TM, long practices more than 10 years and never attend any official course.
  2. 10 month course is for TM healers that have knowledge medium level and practice more than 5 years.

After finish the course students that passed the examination they will get Certificate of Attendance on TM Training Course. With this Certificate they have official right to open TM clinic or TM drugs store after they got approval from Municipal Health Department or Provincial Health Department.

Every year around 100 students that passed examination and get certificate.

Raw materials and products

4.1 Cultivation of Medicinal plants and Botanical Gardens

Currently we have 3 botanical gardens and cultivate around 1950 herbal plants and 500 species that collected from many places in the country.

Our objective is:

  • To conserve rare and endangered species of herbal plants.
  • To educate people to appreciate the value and significant of herbal plants.
  • To teach students and TM healers get more knowledge on herbal plants.

4.2 Traditional Medicine Products

Traditional Medicine products widely use among Cambodian people since centuries. We can find TM products in everywhere from city to villages. It's the first choice of Cambodia people before they go to modern hospital because it's cheaper and easy to find although at their villages. Some time they go to consult with TM healers or do TM drugs self-medication base on the family knowledge from older to younger.

Nowadays TM products have still keep in raw form, traditional or modern packaging base on the demand of the market.

Publication traditional medicine books

To strengthen knowledge and capacity of TM healers on the treatment of diseases in year 2011, National Center of Traditional Medicine (NCTM) published and dissemination some Traditional Medicine books:

  1. "600 Formulas of TM drug for Treatment" the formulas were collected from the experiences of TM healers around the country and compiled to the book.
  2. "Treatment diseases by Traditional Medicine from Palm leaves ", Recently NCTM published another book that translated from ancient palm leaves, although it doesn't confirm on scientific evidence but it's a tools for our TM healers consult and find some interests in the book.

International cooperation

NCTM is cooperating with ASEAN, International NGOs and other countries to learn, to strengthen and to share experiences on TM development:

  • WHO-WPRO:
  1. Supported on development of draft Cambodia Traditional Medicine Strategy 2011-2020
  2. Participated intercountry consultation on the Regional Strategy for Traditional Medicine in Western Pacific 2011-2020 on 16-17 March 2011 at Deojon, Korea.
  • ASEAN: 1st and 2nd ASEAN Conference on Traditional Medicine
  • The Nippon Foundation: supported short course training on TM for "Kru Khmer" Cambodian TM healers since 2009.
  • Koica (Korea): International Training Program 2011 "Modernization of Traditional Medicine"
  • Vietnam: Share on the curriculums of TM School
  • Myanmar: Study Tour program to Department of Traditional Medicine, University of Traditional Medicine, Traditional Medicine Hospital, Traditional Medicine factories and Department of Medical Research Upper Myanmar.
  • France:
  1. Pharnext (France ONGs): MoU on research of medicinal plants and produce some commend TM products and health supplement.
  2. BioMerieux collaborated with University of Health Sciences on Medicinal plants research.

Current Issue on development of TM

To integrate TM in the National Health Care system we are facing many difficulties because our National Center of Traditional Medicine has following problem:

  • Lack of technical and financial support on the development of TM (Government and International NGO's)
  • Lack of law and regulation to implement TM
  • Lack of human resources (competence staffs)
  • Lack of equipments and tools to improve the work condition
  • No laboratory research (to improve evident base on TM)
  • No TM Institute or University
  • No traditional medicine manufactures (with GMP standard, mostly our TM healers produce TM products by their traditional ways)
  • International Cooperation with other ASEAN countries and developed countries on the research program on TM very low progress
  • Not yet started to integrate TM into National Health Care system.

Future Plan 2012-2015

Activities

Objective

Time Frame

Expected outputs / Indicators

I. Legislation

Develop Traditional Medicine Law.

To promote, develop, control and regulate Traditional Medicine (TM practitioners) TM Manufacture and TM products).

Just in proposal

Traditional Medicine Law approved promulgated by parliament.

II. Traditional Medicine Profession

Survey on the number of TM clinic, TM drugs store, and TM Healers in Cambodia (In Cambodia has 186 districts and 1,621.00 communes).

Manage the statistics of traditional medicine service providers and products sellers of any kinds.

Looking for funding support

Data base of TM clinic, TM drugs store and TM healers in Cambodia.

Establish National Traditional Medicine Practitioners Association.

To promote, develop, exchange knowledge and skill of TM practitioner.

2013-2015

National Traditional Medicine Healers Association established.

Development of training model for volunteers health worker & assistant doctors on application of TM in PH.

To develop the training model for responsible personnel on the application of TM in PHC among AMS.

To disseminate the developed models.

Looking for funding support

Model developed

Model disseminated

III. Education and Training

Develop curriculum for under-bachelor degree and bachelor degree for TM.

Prepare and promote traditional medicine in the formal academic system as having been done in many countries in the region.

2011-2012

Implementation of curriculum for under-bachelor degree and bachelor degree.

Set up Institute of TM.

2012-2013

Institute of T M   established

Provide scholarship for 2 or 4 TM Bachelor degree student to Thailand.

Provide trainings on traditional medicine research and development.

2012-2013

TM Bachelor degree student graduated from Thailand.

Provide scholarship for 2 or 4 TM Bachelor degree student to Vietnam.

2012-2013

TM Bachelor degree student graduated from Vietnam.

Provide scholarship for two PhD degree students to China, Japan and Korea for research medicinal plants oriented.

Not yet confirmed

PhD students graduated from China, Japan and Korea.

IV. Research

Set up medium size of laboratory research.

Approach to research including laboratory, clinical and manufacture research shall be adopted based on the standards and guides on traditional medicine products of international organizations.

Looking for funding support

Medium size of laboratory research was set up.

Set up a model of TM manufacture.

Looking for funding support

Model TM manufacture was set up.

Develop Cambodia Herbal Pharmacopoeia.

Provide evident base on quality, efficacy and safety of TM products.

Looking for funding support

Cambodia Herbal Pharmacopoeia developed.

V. Raw Materials and Products

Develop Botanical garden as ASEAN standard.

Protection, conservation and sustainable of raw materials and products.

Looking for funding support from ASEAN

Botanical garden in Bokor developed.

Develop GACP (Good Agriculture and Collection Practice) Guideline.

2012

GACP Guideline developed.

Distribute of TM kits program.

Access to command TM products with low cost for low income and rural area people.

2012-2015

Looking for funding support

TM kits distribute to 10,000 households in northern and eastern region.

VI. International Cooperation

Workshop or study tour to ASEAN and developed countries

Improved Capacity of staffs and sharing knowledge and exchange data research.

Participated workshops and study tours

Join research with ASEAN countries and developed countries

Joined research program.

Shared research data