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Green medicine" and other "alternative" treatments.
"Historically, community based practitioners not trained in medical schools have offered alternative therapies based on traditionally used herbs and other plant materials, especially in the Afro-Cuban population. In some instances, Cuban scientists have investigated the pharmacologic basis of traditional herbal remedies. During the 1990s, after extensive controversy and against the background of decreased availability of many medications due to the U.S. embargo and loss of trade advantages with eastern Europe, "green medicine" (medicina verde) has flourished.
The Ministry of Public Health has distributed a national formulary and educational materials on green medicine, compiled by 17 prominent scientists in medicine and biology, to practitioners throughout the country. For each "medicinal plant," the formulary provides the following information: common names, scientific name, botanical family, physical description of the plant, worldwide geographical origin, location in Cuba, part of the plant to be used, instructions on collection and storage, clinical properties validated experimentally, pharmaceutical description, mode of administration, other attributed properties, side effects, other uses, chemical composition, cultivation, and preparation and dosage. In most local clinics and hospitals, an illustrated list of recommended herbal treatments, posted in a prominent location, guides patients and physicians in obtaining remedies for conditions ranging from gastritis to musculoskeletal pain. In disseminating this information, the Ministry of Public Health has restricted its recommendations to herbal treatments that have proven safe and, based on a consensus judgment of leading physicians, are effective in the primary care setting.
Family doctors whom we interviewed described their initial reluctance, based on their training and clinical experience, to recommend treatments in green medicine. Over time, they reported, they have begun to initiate such treatments, especially when allopathic medications could not be obtained because of shortages, and generally have achieved satisfactory results.
"Thermalism" has emerged as another major arena of Cuban traditional medicine that has returned to favor under recent conditions of austerity. The recuperative characteristics Cuba's more than 40 thermal sites became known to Spanish colonizers as early as the first part of the seventeenth century. Attitudes favoring this traditional therapy have been fostered by the recent economic crisis. The medical curriculum now includes principles of thermalism. In several provinces, certified physicians coordinate clinical services and research on the mineral properties of thermal sites. The specified indications for thermal treatment almost always include chronic conditions, especially rheumatologic and dermatologic disorders.
Under the purview of the Ministry of Public Health, research to evaluate the clinical efficacy of herbal treatments and thermalism for specific diseases is in progress, both in Havana and in regional centers. The published and widely distributed lists of indications for certain plants to be used in specified diseases, however, are based on the consensus judgments of health professionals considered expert in the field, rather than extensive, laboratory-based tests of efficacy."
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