Ethnobotany and its role in improving primary health care delivery: An example from the pacific islands of Micronesia

Ethnobotany, through the study and analysis of traditional medical practices based on natural substances-primarily plants but also animal and mineral products–can have a role in improving primary health delivery. This presentation considers two examples from a remote region of the tropical Pacific; however, there are great possibilities for using this approach in the urban setting. The model that has been developed first involves an inventory of the plant resources of a specific region. In the case of a small island, a geographically limited environment, the inventory work must be very precise and comprehensive, capturing knowledge of what is available both in nature as well as cultivated by local people. Next, or in parallel, an inventory is made of plants used for healing and wellness, interviewing as wide and diverse a sample of the population as possible, while establishing parameters for the information to be gathered-in our model limiting this to “common” or “generalist” knowledge and avoiding information that is considered secret or the property of a specific family or clan. These parameters are set by the traditional leaders of each island, working together with the local health care providers and strive to achieve local goals. The next step is to format the information into a condition-based primary health care manual: including general information on how to treat the conditions from a clinicians' perspective but presented in layperson's terms; when a trip to the State hospital or emergency room is mandated; how pharmaceutical products that may or may not be available can be used; and then for each condition (chapter) a series of plant-based remedies, including a photograph and description of the plant for positive identification, information on preparation, and pharmacological and toxicological data as available. Finally, the document is copyrighted in the names of the local traditional leaders' organization and/or Ministry of Health, as well as the research organizations involved as a clear statement of the ownership of the contents and rights to its utilization. To date we have published two manuals, one for the island of Pohnpei in the Federated States of Micronesia, and one for the Republic of Palau. The model has been endorsed by the Pacific Basin Medical Association as a contribution to a more sustainable and holistic approach to health care, particularly in helping to treat the current epidemic of non-communicable diseases (NCD's) on the small islands of Oceania. This work requires the active participation of a large team from many disciplines-both local and international–including traditional healers and their families, physicians, botanists, pharmacologists, toxicologists, linguists, social scientists, primary health care specialists as well as others.