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 International CAM: India Hosts IM Group, Homeopathy Challenged in UK, Integrative Care in Haiti 
The following is one in an ongoing series of columns entitled Integrator Blog by . View all columns in series
Summary: Welcome to this Integrator travelogue, linking you to international policy developments in traditional medicine and complementary and alternative medicine practices ... A citizen's referendum in Switzerland forces inclusion of CAM practices in healthcare planning ... In England, a report from the King's Fund concludes that we need both new methodologies and new attitudes, thank you, to optimally research complementary medicine and health ... A report on non-conventional medicine (the preferred term) in Italy calls for an end to 20 years of procrastination, and shares what's already covered in Tuscany and parts north ... Actuary Heather McCloud, a CAM leader in the International Association of Actuaries, is setting up a similar group in a new African health economics organization ...

Navin Shah, MD - headed the delegration for the Indian government
1.  Indian Health Ministry hosts delegation of 6 integrative medicine academics to help bring Ayurveda to US

At the request of the India Health Ministry, a group of six academic leaders in integrative medicine visited India in January 2010 "to explore the possibilities of introduction of evidence-based Ayurveda, Yoga, meditation, and oil massage treatment in the United States medical education, research, and patient care areas," according to this article in the India Journal.
The US team consisted of leaders associated with the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM): David Eisenberg, MD, Anastasia Rowland-Seymour, MD, Johns Hopkins University, Benjamin Kligler, MD, MPH, Albert Einstein College of Medicine, Aviad Haramati, PhD, Victoria Maizes, MD, MPH, and Anne Nedrow, MD, Oregon Health & Science University. India has 150 Ayurveda colleges, 50 post-graduate Ayurveda institutions, 70,000 students, 10,000 faculty members and 3,000 Ayurveda hospitals. One focus was on the possibilities of joint Indo-U.S. research. The group was led by urologist Navin Shah, MD.

Adi Haramati, PhD: part of US team
Haramati, the founding vice chair of CAHCIM and an organizer of the team, told the Integrator that the delegation heard presentations on evidence, visited an Ayurvedic medical school and toured an Ayurvedic products factory. The team was received by high-level policy makers in India. Included, said Haramati, was a meeting with "the Indian equivalent of the US Secretary of Health." Presentations focused on the treatment benefits of Ayurveda in major conditions and specifically on the role of diet in both health and diseases. In October of 2010, two professors of Ayurveda from India will follow-up by coming to the United States and visiting the 6 institutions represented by the US delegation.

Comment: Haramati noted that the individualized, lifestyle and health-oriented Ayurvedic approaches are often less focused on quick disease cure than on health creation. One wonders whether partnering with the NIH, an agency which does not typically focus on health creation, is the Indian government's best strategy. Ayurdevic medicine is likely to get tangled, as "complementary and alternative medicine" has, in a web of questions that hardly touch on the parallel functionality, satisfaction and lowered cost claims that practitioners make. To the extent that the Ayurvedic approaches focus on creating health, the Indian Ministry of Health and Family Welfare might better by form alliances for research with US employers through the Corporate Health Improvement Program run by Ken Pelletier, PhD, MD (hc) or the Institute for Health and Productivity Management where the focus is on functionality and health. Such a strategy might yield more bang for their bucks.

NCH's Gahles: Raising questions about implications for the US
2.   Storm over homeopathy: Controversial recommendation to drop UK recognition raises questions about impacts here

"Homeopathy in United Kingdom (UK) has long stood as a model for the United States," begins Nancy Gahles, DC, CCH, RS (Hom), president of the National Center for Homeopathy in her column in the Spring 2010 issue of Homeopathy Today. Gahles references
work of Parliament's Science and Technology Committee (STC) leading to a February 2010 report entitled Evidence Check 2. Gahles adds, referencing the report's recommendation against covering homeopathy in the National Health Service: "But we're sorry to say - this is no longer the case." However, as author and homeopathy advocate Dana Ullman, MPH points out in this March 3, 2010 Huffington Post column, Parliament as a whole has not acted against homeopathy and may not. The STC action was only advisory, in the form of recommendations in a committee report. And for reasons not explained, the recommendations were endorsed by just 3 of 14 STC committee members. (Just 4 members 4 are on record as voting on the issue.)

Pro-homeopathy supporters immediately organized a
"mass lobby" as shown in this video . The campaign delivered 28,112 signatures against the report's recommendations on February 24, 2010. Ullman reports that leading UK policy makers appear reluctant to wrestle with an issue which reflects, as he told the Integrator, a "homeopathic portion" of the UK's health budget. The prevailing, hands-off homeopathy view may have been captured in a March 13, 2010 editorial in the Lancet entitled: "On Reflection: Magic is acceptable." The British Homeopathic Association has filed a series of reports and rebuttals to the STC report.

Ullman: Downplays likely impact
The National Center's Gahles, in her Homeopathy Today column, asks if "the long arm of the UK anti-homeopathy coalition (will) reach across the pond to the United States."
Notably, the STC report and its conclusions were seized upon here by Stephen Novella, MD, the Yale school of medicine faculty member and anti-CAM blogger at Science-Based Medicine. Novella exults in the report as an exemplary governmental approach not just to homeopathy but for all of complementary medicine. (Notably, the force behind the STC investigation in the UK was, according to both Gahles and Ullman, a similarly anti-CAM blog-site called Sense About Science.) Novella argues that it is time to put the US recognition of homeopathic products under similar scrutiny. Gahles believes that a trans-Atlantic anti-homeopathy campaign has already begun. She cites a November 2009 commentary published in the American Journal of Medicine by Edzard Ernst and Michael Baum, principle scientists behind Evidence Check 2, who state that they are "happy to confess that our minds have closed down on homeopathy." Gahles writes that the commentary was "the first U.S. salvo of a highly determined, sophisticated and well-funded alliance that aims to eliminate homeopathy whereever it is practiced."
Comment: A brief interview with Ullman leads me to believe that governmental action to make the STC recommendations law is unlikely in the UK, as it is any off-shoot of federal policy action here. These developments do remind us again how infinitesimal doses, whether or not one values their clinical effects, can be immensely powerful in potentizing the politics of science. Ullman's last two Huffington Post columns, relating to homeopathy, have generated over 3000 comments. (Thanks to Integrator reader Paolo Roberti de Sarsina for keeping me abreast of developments.)

Acupuncturist Van Voast: An exceptional account of his experience
3. Integrative practice in Haiti: Report from a returning LAc, Tzu Chi Foundation, assessment efforts for long-term LAc and ND strategies

The journal of Jordan Van Voast, LAc on his February 2010 trip to Haiti is a remarkable internal and external look at the extreme experience of care-giving. Van Voast reflects on the limits of his tools, the desire for medicines in the population he served and his wrestling with the use of placebos. A community acupuncturist who runs the Communi-Chi clinic in Seattle, Van Voast was sponsored through the Buddhist Compassion Relief Tzu Chi Foundation. Tzu Chi has established a steady foothold in Haiti. Seattle healthcare practitioner and Integrator reader William Wulsin, ND, LAc, MPH, who begins a care trip through Tzu Chi on March 26, 2010, shares that a key part of his decision to work through Tzu Chi is the quality of its presence. One issue, according to Wulsin,
is basic security. Wulsin has been involved with the Haiti Disaster Relief Collaborative that represents over a dozen stakeholder organizations "committed to the wise and effective applications of natural medicine in Haiti and beyond."

Both Acupuncturists Without Borders (AWB) and Natural Doctors International (NDI) a naturopathic physician-led organization, have each sent individuals or teams to Haiti to assess strategies for their organization's long-term efforts. Perhaps the key question is how to best ground them locally. AWB, which has partnered with Boston-based Pathways to Wellness, had its Haiti visit documented by Sarasota-based SNN Local News 6. The news clip is available here on the AWB site. A March 24, 2010 report sent to AWB's e-list provides a look at the variety of hospital and tent encampment sites where the organization's teams deliver care.

Sabine Thomas, ND, LMT, a Haitian-American who is heading up NDI's exploration, shared with the Integrator that he combination visit to her family (two members were killed) and fact-finding has led her to caution against anyone coming down who might be adding to the chaos. Thomas set up relationships with key Haitian officials who are helping guide NDI which is planning to clarify its strategy in an April 10, 2010 meeting in Portland, Oregon.
Wulsin, who has been in dialogue with Thomas and other naturopathic physicians looking into care giving anticipates undertaking some exploration which may be of use to his ND colleagues.
Comment: I particularly recommend the account from Van Voast, whose clinical services I have used, as an honest, internal reflection on the experience. Additional note: Functional medicine leader Mark Hyman, MD continues to offer perspectives based on his early journey into the disaster. Hyman's March 1, 2010 posting in here.

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Resumes are useful in employment decisions. I provide this background so that you may understand what informs the work which you may employ in your own. I have been involved as an organizer-writer in the emerging fields......moreJohn Weeks
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