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The starting point in defining the Trans-Cultural Healthcare program is the question if health can be defined as a universal agent or not. A universal agent is something that remains of value throughout different cultures. the question we face then is: is health in all cultures defined in the same way? The answer ofcourse is obvious, it is “No”.
Different cultures describe personhood, the body and treatment modalities in different ways. One cannot say one cultural view is better than another without becoming a discriminating voice. Even modern western bio-chemical medicine is not in any way to be determined as better because it is instrumental, more accurate or any other argument. Different medical systems are at best just “different-from-each-other”. mutual understanding is at best partial. Bio-medicine is not able to comprehend Zhongyi and Zhongyi cannot comprehend bio-chemical medicine in return. All judgement co or con the presumed understanding is from personal affinity or aversion and certainly unscientific. A proof in case is for instance the book “Dao if Chinese Medicine”by Donald E Kendall, published by Oxford University press a few years back, but i could point also to most learning courses and researches of Chinese medicine according to “bio-medical standards” , research of meditation through bio-feedback equipment, attempts to define yoga through body building and glandular theory. some solutions are brilliant in themselves, but also missing the point if not based on self immersion in original skills, like the 19th century inventors of f.i. modern yoga and yoga theory never did.
It is not as easy to find universal agents as it seems to be. For instance traditional cultures describe family, but not in the same way, they describe different kinship relations and transference of power structures through patrilineal or matrilineal routes. Health is also one like that. Although cultures recognize health and/or disease, normalcy or abnormalcy, the “biologies” and description of disease and its causes vary widely. All cultures have systems of health beliefs to explain what causes illness, how it can be cured or treated, and who should be involved in the process. some use magical bullets like anti-biotics or herbal cures, others use ceremony to reconnect the person with natural powers. The extent to which patients perceive patient education as having cultural relevance for them can have a profound effect on their reception to information provided and their willingness to use it. Western industrialized societies such as the United States and the EU, which see disease as a result of natural scientific phenomena, advocate medical treatments that combat micro-organisms or use sophisticated technology to diagnose and treat disease. Their model is that of micro warfare taking place in the body. Other societies believe that illness is the result of supernatural phenomena and promote prayer or other spiritual interventions that counter the presumed disfavor of powerful forces. Cultural issues play a major role in patient compliance. Education of clients in using a medical system is therefore the most important aspect of using medicine properly. Knowledge according to the Indian 18th century yoga philosophy is what makes the self permanent and free from suffering. suffering ofcourse is not only caused by medical conditions, our beliefs can be the reason, as can be the system of governance of our country or family.
Cultural differences affect patients’ and student’s attitudes about personal cultivation, self- and medical care and their ability to understand, manage, and cope with the course of health, an illness, the meaning of a diagnosis, and the consequences of medical treatment or things being learned or qualities acquired. Patients and their families bring culture specific ideas and values related to concepts of health and illness, reporting of symptoms, expectations for how health care will be delivered, and beliefs concerning medication and treatments. In addition, culture specific values influence patient roles and expectations, how much information about illness and treatment is desired, how death and dying will be managed, bereavement patterns, gender and family roles, and processes for decision making.
In learning it is no different. A process of accumulation, analysis, experience and understanding has to be allowed for before a student starts developing the tools that a culture suggests as means to solve problems.
What if you do not develop cultural understanding? When not developing cultural understanding one develops universalist approaches. Universalist approaches are approaches that sound different from what you know, but seem to represent what you think you already know. Cultural elements are categories of things and ideas that identify the most profound aspects of cultural influence. cultural definitions make things specific. Universalism makes them diffuse and blurrs the boundaries of meaning and meaningfulness, the directionality of knowledge. Catholicism is the founding father of Universalism, but only through the development of New-Age medicalized spiritual discourse we came to understand the full value of Universalism as non-scientific and culturally diffuse.
Muneo Yoshikawa conceptualizes how individuals, cultures, and intercultural notions can meet in constructive ways. Communication is understood as an infinite process where both parties change in the course of the communicative or translational exchange. His idea of the double-swing model is called ‘Möbius integration philosophy’ is model of intercultural communication, emphasizing that both communication parties play the role of addresser and addressee.
This dialogical mode draws upon the Japanese Mahayana Buddhist philosophy (the logic of ‘soku hi’ (The logic of soku-hi [JP] or jifei [CN] 即非) “the immediate and its negation” represents a balanced logic of symbolization reflecting sensitivity to the mutual determination of universality and particularity in nature, and a corresponding emphasis on non-attachment to linguistic predicates and subjects as representations of the real) and the ideas of the Jewish philosopher Martin Buber (who discussed the the I-Thou relationship) in seeing human beings as complete only in relationship. Whilst the dialogue is between two people who are separate and independent, they are simultaneously and inevitably interdependent. The model is graphically presented as the infinity symbol (∞), also as a Möbius strip, visualizing the twofold movement between the self and the other that allows for both unity and uniqueness.
This vision, although popular is primarily deterministic universalist because from all perspectives it claims that people only can understand someone from their own perspective and the personal relationship of the person. So if something is valid for the perceiver than it is valid for all of the world. In classroom I use the metaphor of ‘liking the cooky’. In this metaphor I show that people often use the reasoning of inner wisdom when they ‘feel’ something is good for them. I refer to the fact that their feelings can be misleading and give them false pretense on the truth, after all, when we ‘feel’ for cookies then are they good for us too? The reality of this can be learned and for this learning process patterns of knowledge need to be developed to learn discern between seemingly right and relative right situations or facts or feelings.
This blog is an excerpt from the textbook on “problems in transcultural learning” of which parts are also assimilated in the online program for transcultural education. If you sign up for the modular text courses this subject is included. it is core and starting point for all IOC courses
 Smith, G. (1966). Communication and culture (Ed.). New York: Holt, Rinehart and Winston
 professor, author, researcher and consultant in the fields of intercultural communication, human development, human resource management, and leadership. Born in Japan but graduated in the USA.
 Martin Buber 1923: Buber’s main proposition is that we may address existence in two ways:
1) The attitude of the “I” towards an “It”, towards an object that is separate in itself, which we either use or experience. 2) The attitude of the “I” towards “Thou” in a relationship in which the other is not separated by discrete bounds.
One of the major themes of the book is that human life finds its meaningfulness in relationships. In Buber’s view, all of our relationships bring us ultimately into relationship with God, who is the Eternal Thou.
In my previous blog article I did write about yin yang theory and the Chinese cultural goal of achieving perfection as a foundation for understanding Chinese medicine and Wudang Taiji Gongfu. Ofcourse, it goes to far to discuss what is the nature of perfection. this is an extended topic throughout our courses.
For this article we will 咯哦可at another aspect of Yin Yang Theory (yinyangxue 阴阳学). We will start with a simple thesis:
The Yin Yang Theory follows a number of simple principles that arise from the concept of Dao.
In Chinese medicine and Gongfu in pre-modern times the concept of culture was equal to the concept of science. Knowledge accumulates like the grains of sand on a riverbank (A Buddhist metaphor). eventually it shapes wisdom.
Dao is an often mystified concept. The concept of Dao stands at the core of everything the Chinese culture produced over time. Dao is considered to be the guiding principle along which reality manifests itself. In the following passages I will first try to give a general outline of Dao up to the point where Dao as idea merges with the ideas of yin and yang.
As a plant emerges from hiding within the seed beneath the earth and wrestles itself from the dirt into the sunlight, adapts to the environment and grows strong and lush, flowers, dies, and rots away and is being eaten by bugs or turns to fungus or dust, so all things in nature are continually in processes of coming into existence and dying away. This process in its natural patterning is often named to resemble Dao. In western sources it sometimes called ‘Dao of nature’, way of emerging and returning.
Dao is commonly translated with path or way or way-making, the course, the way all things happen, including both advance and decline, growth and diminishment. Dao seems to move like pulsation, the eternal path of alternation between flow and ebb, opening and closing. Dao seems to be the guiding principle of a sort of pendulum swing between being and nothing, growth and decay, living and dying, activity and passivity, motion and rest. At the same time as Dao seems to dictate that things need to change, will change, so Dao is sometimes compared with being a ‘natural law of change’, but it is also recognized as the sum total of all that changes. Furthermore, it is considered equally the non-being -out of which beings arises as well as being itself. Dao is a three-sided coin: one side is non-being, another side is being (which in Chinese cultural lore is often described as the ten thousand things due to its many variations). The third side is the manifestation of Dao, the functional relationship between things, the Qi of it all.
From non-being things spontaneously and un-programmable come to be in the natural way an infant is born of its mother: it just happens, cannot be stopped and might or might not be a painful experience. This natural process is called ‘without acting things out’ (wuwei). Wuwei does not mean “doing nothing” and is thus not a nominator for passive presence of people in life, but of consciously participating and supporting the proper naturalness of the situation.. Wuwei in a way therefore can mean unforced, spontaneous, natural action.
The strongest trust in Dao is being expressed by what are called daoists. Daoists can be of different kinds: philosophers, swordsmen, religious people, doctors or a combination of those -and more. What daoists try to do is to emulate Dao and become like dao as to become immortal or to be successful in what they do: accumulate Gongfu. Daoist thus try not to form or make their characters, skills or actions according to some artificial standard, but allows the true nature belonging to themselves, their skills or actions to emerge. To do so they discipline themselves by working mind and body as to rid them from the artificial that has clung to them. Daoist, not unlike the Confucian Ru, does consciously cultivate their character, but does not necessarily “form” their nature according to moral principles or ‘li’ like Ru do. Likewise, the Daoist artist does not manipulate or form their material, but lets the art-work emerge from the basic nature of the medium. As a sculptor of personality and life, Daoists use the nature of being human work itself out so that the best of qualities within can come out.
Dao is commonly expressed through the taiji emblem, that is generally known as the yin yang fish symbol. The diagram represents the interaction of two basic sides or “polarities” within being that are the either/both yang and/or yin. Both yang and yin complement each other, flow into each other in forever equal importance. According to Daoism, yang and yin, activity and passivity, cannot exist without one another; they depend on one another. Simply stated, creation is the result of the interaction of positive and negative events such as form and formlessness, being and emptiness.
For Confucianism, action begins in balance, but with emphasis on the active yang principle, manifested as the will of Heaven. A person or civilized person ought to take charge, do something, work out human relations, rectify one’s character, give proper example and help others to become civilized too. Therefore being receptive to oncoming impulses from our surroundings is always necessary, but the active is primary. For Confucians, there is a time to act and a time to refrain from acting, a time to speak and a time to refrain from speaking, a time to move forward and a time to hold back; but one needs to act, not doubt, not waver. Human beings and Nature need in that way of thinking to be cultivated and polished. Unformed human nature is good; but consciously formed and “disciplined” or refined human nature is even better.
For Daoists, “action” begins in balance too, but with emphasis on the receptive, on earth or yin. The receptive applies wuwei. The Daoist does not rush ahead according to some “principle.” He waits, readies himself, and adapts to the arising necessities the situation or Dao brings up. The Daoist also doesn’t doubt, but also even when questioning and investigating, tries not to interfere with the natural sponaeous occurrence of phenomena so tha the situation can act itself out and show the workings of Dao and not of human acting or interference, since that one is considered potyentially hazardeous for the future developments of affairs. Daoists stress non-interference in life and in relationship to nature. If you have a garden that would mean you would not garden it, but you let the garden become itself. Too much wilful activity can interfere with the process of becoming that is commonly called the world and its manifestations.
The up and down path of Dao can be called the ‘principle of reversal’. Laozi writes in the Daodejing: ‘Dao is known through reversal”. Any extreme is in this vision about reality seen as a turning point, a threshold, a limit. This limit is called Taiji. When a thing has reached its limit, it changes into its opposite. As summer progresses and the days grow longer, while the nights grow shorter, finally there comes the longest day. With its arrival, the reverse process begins. So, Dao seems cyclical too. Cyclical and reversing, how is that possible? This is a question that easily comes up when studying the rules of yin and yang, of Taiji and Dao. Life is a paradox someone once said. Well, the study of Dao, or Taiji and Yin and Yang might show us many paradoxes. It is through paradoxes we can recognize extremity, and thus envisage the workings of Dao.
People sometimes experience a sense of a constant pulsating within nature, a kind of “inhaling” and “exhaling” of beings, but also a movement like of dragons, a spiralling movement present in all things animated. ‘All things are animated’ states the core of Chinese culture. So in a way, to study the yin and yang of life and things we study the animated aspects of life and things.
Dao is birthing yuanqi
Yuanqi is birthing jingyangqi and jingyinqi
Jingyangqi and jingyinqi mingle with each other to create zhongqi
Zhongqi is the state where jingyin and jingyang qi commune without conflict
Jingyangqi and jingyinqi and zhongqi are birthing the ten thousand things
And become contained in the ten thousand things
Therefore: all things support yin and embrace yang
Opposition and unification are on friendly terms (balanced)
The above is a re-translation from a creation myth from China. This one originates from a modern Chinese interpretation by a Chinese author. In his introduction he explains the alchemical foundation of Daodejing use. In doing so he uses so called dictionary terminology. By re-translating to original terminology to pinyin more of the original flavor of his intent is recognizable. What is elemental in this text is the different kinds of qi being discussed, all being sub-defined by additional terminology, betraying a highly technical use of language. this is relevant for anyone wanting to study Chinese medicine or Wudang Taiji Gongfu and additional aspects of health and skill building as offered at the Oriental College Academy of Health. this piece of text is a reworking of content from the second subject in Chinese cultural theories. It discusses Yin Yang theory from beginning to end. From this part you will already notice it is different from what you read in popular publications. Oriental College doesn’t do popular, or political, and is therefore free to do its own research with the help of its students towards original values of Chinese culture of Health and beauty development, and re-validation and disease treatment.
In discussions with my colleges I usually draw the short straw, because i think original values are more important than interpretations based on our western (Christian-Islamic) culture and its science. But what do we want? we want to practice a form of colonialism or do we wish to study Chinese medicine? If we want to study that we need to study its theory and learning methods and practice these in their original context (we have this from cultural Anthropology, a most colonialist science), becasue as a student of Chinese we do not learn hands on techniques, but we learn a different science. We need to think along other ways, organic and aesthetic as both Daoist and Confucian philosophies propose. Any form of thinking such as “if this -than that” is bookish and mechanical, and therefore unsuitable to understand China’s Original Culture. New China falls in the same category as USA and Canada. They are new and different from the past. As a source they should be taken with a pinch of salt, and be judged as a form or=f renewal that sometimes is helpful, at other times is just an outright insult of the past.
for this article we take the Chinese cultural theory as being a defining idea about achievement of perfection. Yin Yang, Qi and other aspects all are terminology of achievement of perfection. In medicine we aim to restore perfection, not cure diseases. curing diseases is just a stage. Chinese medicine is more educational than it is curative, even though its methodology is very suitable to achieve cures.
The technical use of language in Chinese culture contains a classification system which has the perfect and non perfect implied, but also yin and yang. Showing us a division of four:
What we see here is a theory of ‘perfection in levels’ and an ‘either this or that division of things’. The either this or that division of things as yin and yang seems to be continuous and have a foundation in qi. The division in layers of perfection seems to be a subdivision within each category of things. So again we might analyze the text as such:
Level of Perfection
The combination of these layers are the foundation of what we will from here forward call the ‘yin yang theory’. The Yin Yang Theory is a central concept within Qigong, personal cultivation, the Chinese medicines and psychology, Wudang Taijiquan martial arts, Chinese social theories and Chinese philosophy as a whole. Many great thinkers have tried to find applications in daily life subjects. Most renowned examples are the oracular theories of the Yi Jing and the Tai Xuan Jing. But it also certainly is the foundation of cultivation of life techniques such as medicine and immortality achievement methodologies from China.
The first one –Yijing, book of (ex)change- was commented on and noted down by Confucius and some centuries before that supposedly groundwork for that was laid out by the legendary godperson Fuxi and a rebel against the Shang dynasty, the later Zhuo dynasty first ruler Wen Ti and his son.
The second text –Tai Xuanjing, book of great darkness- was a reaction and criticism at the Yijing corpus that had come into being organically and was because of that apparently not completely perfect and symmetrical. The criticism was started by Yang Xiong. Yang Xiong didn’t like the asymmetry of the yijing and decided to make a body of information of perfect symmetry according to which he thought everything happening in he world could be predicted. He assumed the world itself is perfect in its symmetry. But, it never came even close to challenging the yijing, although it is still in use today.
Both books attempt to give a handle in studying the rule of yin and yang. This rule tries to explain why the world is as it is and how we can harness an understanding as to guide ourselves towards a more successful life.
But books are but books. However important text material is to create continuity in history and can serve as a foundation for progress, books have no meaning if what is written there cannot be applied in life. Medicines and immortality techniques are methods for life preservation, survival techniques if you may. The survival techniques in themselves might be of value, but maybe cannot be properly understood by understanding the underlying theory behind them. A theory defines the purpose and direction of a technique. A proper theory can help to apply a method in everything relative important to our goals. In the following of part I we will guide you through a couple of basic concepts that are in use for discussing elements of the Yin yang theory. The source of this discussion is in oral transmission as well as common use in ancient textbooks. In part II we will go deeper into the construction and background of the theory.
If anything Chinese medicine is a mingle of practice of oneself and learning skills from its onset. Courses that do not start with determining what and who you are are to be considered as bookish and mechanical because they do not allow a student to become one with what he or she professes. Becoming one with what one practices is the core of Chinese medicine ethics. from the Song dynasty onward medicine ethics has been the first subject to study for anyone to become a practitioner or a teacher of students. Better, being ethical is the same as being beautiful and pure, perfect. it is a root that every traditional teacher is looking for in a student to see if they are worth offering them the responsibility of the life of clients and students.
exams than are not just about one’s knowledge, but about who one is as a person…
 Yuanqi 元氣 means first qi
 Jingyang and jingyin are both preceded by the character jing精, which means both perfect as well as essential and skilled. The first part of the character is rice. Rice is seen as a form of perfection because rice always looks the same says Karlgren in his dictionary of etymology. In qigong we commonly translate jing as construction, based on the meaning skilled and perfect because skilled also implies proficient action that makes skilled.
 Zhongqi, 中氣 means mean qi or central qi, a base qi from which things come forth.
 With Chinese we here intend the theories from before the influence of the west on Chinese mainstream culture and predominantly those stemming from the formative periods of Chinese culture of which the later history can be seen as a commentary or an innovation upon but never totally a break away from it.
The Oriental College is currently taking part in an international project in the Leonardo Da Vinci’s life long learning program.
The main goal of this project is to develop an ethical code/ guidelines for alternative medicines. Within the Oriental College ethics is a constant point of attention and we try to install in our students the importance of ethical behavior. Below is our contribution to the poject. We hope to take it further through professional organizations and educational institutes.
In the purpose/objectives of the LDV project especially awareness and promotions of cooperation between educational institutes was mentioned. Therefor it seems a logical step that we first look at educations and educational institutes regarding ethical behavior, followed by looking at what students are being taught about ethics within the cultural context of their education.
Ethics and morally sound behavior has become a subject which gains importance now that all of our societies become more international and culturally diverse. What seems perfectly normal and ethical in one culture is absolutely “not done” in another. So this should lead to increasing awareness of ethics, culture and cultural ethics and in this way promote the coherence of international societies with respect for each other’s moral judgments.
Ethical behavior in a medical profession is even more important. Healers, doctors, and other people who are working in medical professions have to deal with illness, with death and most important with people from different cultures. To make things more complicated in alternative and Complementary medicine often other cultural medicines are employed (take for instance Ayurvedic or Chinese medicine, but also Shamanistic, Buddhist and South American Indian or African native medicine). Which ethical code is then applicable? The code from the country of origin; Or the code from the country where the professional works?
To be able to ask of any medical practitioner sound moral behavior the first thing we should ask ourselves is: what has he or she been taught at school, at the university or other institute where he or she learned his or her profession?
Should not this moral code start at schools, at educations? And what about the schools themselves. Do they abide by a certain moral code?
So in order to get to an ethical code there are more steps to take:
In order to help schools and educational institutes develop ethical material a guideline regarding the ethics of their own behavior is necessary. This guideline should be applicable for all cultures and methods and should contain references to organizations like the WHO to show that these educations take medicine seriously and the behavioral standards of the future practitioners can be expected to have a level of universally accepted morality.
So this guideline by necessity has to be non-specific, yet at the same time leave room for educations to fit in cultural ethics according to the system taught.
A guideline could consist of the following:
Making sure that (future) therapists are ethical in behavior starts with their education. It is remarkable for instance that in western medical educations more attention to ethics is given in the training of nurses than in the training of doctors. In complementary medicine the modern TCM almost never has in its curriculum ethical behavior, while in classic China this was one of the most important subjects in any profession but in medical profession in particular. In other healing methods it was taken for granted that ethical behavior was a part of growing up to be a useful member of society. The fact that we now feel we need codes and guidelines shows how far we have strayed from the path of original thinking and behavior.
Ethics therefor are a necessary subject in every medical professional education, whether eastern or western, whether alternative or regular, whether modern or classic, and whether for assisting functions (nurses, doctors assistant a.s.o.) or directly responsible functions (therapists). We have to keep in mind that ethics can differ in different cultures. For instances shamans are in native American societies and tribes seen as useful but not ethical, while in modern Europe shamans have in some circles a certain standing. Hypnosis is in Chines medicine view out of the question from ethical point of view, while in modern western psychology it is sometimes used and seen as ethical.
Far be it from us to have a judgment; that is not the object of this paper. Ethical curriculum guidelines should leave room for all of these viewpoints.
A guideline for incorporation of ethics in curricula could be:
The ethical code below can be seen as an example, but can be adjusted to the cultural and specific needs of any education:
CODE OF ETHICS
Complementary and Alternative Medicine
All CAM professionals working in European Union must be
committed to the growth of profession’s role in the Health
Care systems of individual countries
COMMITMENT TO THE PATIENT
Respect the rights and dignity of each treated person
Keep the patient informed by explaining treatments and outcomes
Maintain professional boundaries in relationship with patients
Keep records of each patient’s history and treatment
Render the highest quality of care and refer to other health care provides if needed
Bill patients accurately and fairly
COMMITMENT TO THE PROFESSION
Continue to work to promote the highest standards of profession
Engage whenever possible in professional organizations working in CAM
Continuously educate yourself
Treat your Teacher/Master with highest respect
Use promotional tools with honesty
COMMITMENT TO THE PUBLIC
Provide accurate information regarding your education, training and experience
Respect the integrity of other forms of health care and other medical traditions
Ethical behavior in medical professions gets more important every year. Alternative and complementary medicines in many ways can help improve healthcare and reduce the cost of healthcare. In order to do so it must shed the image of being a healthcare that is nice but not really worthwhile, a bit floating on clouds, not scientific a.s.o. It is up to schools to make clear that also these medicines deserve a place in the world of medicine. This means that the starting point is that schools take themselves and their educations serious. This also means that they want to take great care that their students will be advocates of the quality of their profession and therefor also exhibit excellent ethical behavior.
To start with ethics therefor the schools/ educational institutes first must be addressed, then the curricula, resulting in an ethical code for graduates. With this we also hope to show that we respect all different medicines and that non should be judged as better than another, but also not as of less value.
 For more information about this subject: “Other people’s worlds” by Joy Hendry. Mac Millan Press.
 See also “An ethical code for everybody in healthcare” by Donald Berwick, president of the institute for healthcare improvement an Howard Hiatt, professor of medicine and Penny Janeway, executive director And Richard Smith, editor BMJ. BMJ 315. http://jme.bmj.com/
 See also “professionalism must be taught” Sylvia R. Cruess, Richard L. Cruess. BMJ 1997; 315 http://jme.bmj.com/
The following book news shows how transculturalism already is presented as a pop phenomenon. We see ofcourse the interest in science also growing. Interesting though how science and pop culture have some strong disagreements on how to use the word transculturalism:
Transculturalism: How the World Is Coming Together
the release date was January 1, 2004 | ISBN-10: 1576872181 | ISBN-13: 978-1576872185. Amazon.com describes it as such:
Transculturalism goes beyond race, religion, sexuality, class, and every sort of classification known to sociologists and marketers. Transculturalists lead lives some may consider unusual. They often think, consume, date, or marry outside of their race, religion, or nationality. They travel on a whim to a faraway lands, dress unconventionally and codify their own styles. They live in areas their parents were once barred from and take jobs previously considered outside of their leagues. They are comfortable listening to, creating, and criticizing music outside of their original cultures and often display high levels of creativity in various progressive disciplines. Some call transculturalists heretics; many call them the future.
Transculturalism: How the World Is Coming Together features contributions from such transculturalist visionaries as photographers Jamel Shabazz, Larry Clark, and Ellen von Unwerth; writers Alix Sharkey, Stephen Greco, and Anicee Gaddis; and includes profiles of celebrity transculturalists Alicia Keys, Rosario Dawson, and Tiffany Limos.
The Author is Claude Grunitzky, the Chairman and Editor-in-Chief of TRACE magazine, has unparalleled experience in pubishing a magazine and creating youth-oriented marketing programs on both sides of the Atlantic. TRACE magazine, based in New York City and printed in Italy, relies on satellite offices in London and Paris, as well as on a global network of first-rate writers and photographers for the production of a universally praised bimonthly lifestyle magazine which has become the hip cosmopolitan reader’s bible of new ideas. TRACE fuses aggressive reporting, arresting visuals, and savvy promotion to support an editorial vision that is unafraid to question the most trendy breakthroughs in global youth culture. Last year, Grunitzky and his business partners completed a multimillion dollar financing led by the Goldman Sachs Group. As a result, the TRACE brand is now being leveraged globally across various magazine and television platforms, with various editions of TRACE around the world. In April 2002, Grunitzky and business partner Richard Wayner launched TRUE Agency, a specialized advertising and marketing shop partnered with Omnicom’s TBWA\Chiat\Day, which became the African-American agency of record for Nissan in July 2002, with 2003 billings estimated at more than $22 million.
Why is this published in our news: the continuity of its presence makes it for other cultures newsworthy. Contacts with the American Indian Movement complain about such productions as colonialism of the mind. compare the review for instance with:
Transculturalism – A New Vision Of Culture And Its Management
author Gebhard Deissler, GRIN Verlag, 2013 - 164 pagina’s
Anthology from the year 2010 in the subject Business economics – Business Management, Corporate Governance, grade: -, -, course: Intercultural Management, language: English, comment: Collected Essays, abstract: Transculturalism is the complementary aspect of interculturalism. Both together provide a more complete picture of culture and thereby enhance its management. While the intercultural approach represents the past, the transcultural approach represents the future. At their convergence point they synergize as the living presence of culture to respond effectively to the cultural challenges of our time.
Anthropology of transculturalism: understanding context & diversity in health care, authored byAntonio J. Montalvan at Capitol University Press, 2006 - 244 pagina’s, but with no reference on background or content in sales pages….
Policy on herbal medicines are a hot item in the European Union. Everybody should know that TCM herbs are high on the PRC export wishlist because of its tax income revenues. The current TCM herb production and sales scheme is counter intuitive towards the way herbs are approached in CM over the last millennia. All great medicine masters took to herbs and minerals as a last resort, while emphasizing food and dieting practice for gradual influence of health. Herbs were also to be grown under particular conditions and its industrialization skews that approach at the expense of quality and commitment towards a more laboratory approach, favoring modern pill making approaches that undo almost all of the important aspects of herbal medicine such as the qualities of natural taste and flavor. As a result consumers in need for natural approaches are facing a continuous batter of misinformation. EU policy for herbal medicines import from Asia or anywhere in the world also is strict enough to confront herbal producers and sellers. The belief in natural medicine keeps for many the eyes closed on actual reality. iOC Academy of health certainly is not a skeptic towards herbs but actually beliefs that herbs should be taken within the context of their own theory and original production cycle, which ofcourse and unfortunately would make herbs to sparse to actually export and put responsibility on westerners who like the Chinese medicine approach to develop their own production cycle.
A few years ago PRC authorities were very happy with the sales contract for patent medicines with the French government. A few years ago in a secret meeting with top officials in Beijing I was asked my ideas on the EU regulations. My opinion was and will be always that CM should go back to its natural approach of food first and medication as a last resort. In that case they do not need the predicate medicine on their products and many regulations do not apply. It is pride that is in the way. Ofcourse this idea was not appreciated, and this lack of appreciation is costing dearly.
New quality and safety rules may stifle sales prospects of TCM in the European market, as Zhang Chunyan reports in London. In London’s Chinatown, a poster in Chinese urges customers to stock up on traditional and other patent Chinese medicines before an impending ban on patented TCM products from next year.
At TCM clinics in London, patients still keep trickling in for acupuncture and massage services. However, there is a lull in demand for various Chinese herbal and patent medications because customers seem to be wary of the Medicines and Healthcare Products Regulatory Agency’s forthcoming decision.
Therein lies the twist in the tale. Just as traditional Chinese medicine makes waves in the UK and the rest of Europe with alternative therapies such as acupuncture and massage, it finds itself being denied market access for medications. Traditional Chinese medicine, which has evolved over the last 200o years from a witchcraft skill with curses and prayers towards a full grown industry, currently relies largely on patented and herbal medications to prevent and help the human body fight ailments, and treatments to relieve pain and restore balance in the body. According to the proposal the MHRA floated on July 9, the sale of all unlicensed manufactured herbal medicinal products will be halted in the UK from next year. The MHRA is a British government agency that is responsible for ensuring that medicines and medical devices used in the UK are safe.
The proposal is not targeted specifically at TCM. Andrea Farmer, MHRA’s herbal policy manager, says: “The decision was taken on the basis of the Traditional Herbal Medicinal Products Directive, incorporated by the EU in 2004, which stipulates that all the manufactured herbal medicines in the EU market should have a suitable product license.” This licence is not the same when produced in the EU.
The directive also introduced the so-called simplified registration procedure with a seven-year transition period for traditional herbal medicinal products to be licensed, including Chinese and Indian traditional medicines.
That period ended in April 2011. After that, the MHRA allowed products that were lawfully in the market before April 2011 to continue being sold, so retail businesses holding huge inventories were not unduly affected. Many production houses did not go through the regulatory testing due to the high costs of this testing (much going to the intermediaries!).
Although the regulator is yet to finalize its proposals and is still studying the various responses, TCM practitioners hope that a favorable decision will help rejuvenate it in Europe. But the real problem as most experts say is TCM’s difficulties in getting licensed in the UK and Europe.
A decade ago, China was becoming better known globally and demand for its products was at its peak. “It was a golden period. TCM was enjoying a surge of popularity in the UK and there were more than 2,000 clinics,” says Man Fong Mei, chairman of the Chinese Medical Council UK and president of London-based Mei’s Group, which operates a series of herbal clinics and TCM shops across the UK. In the Netherlands we see a similar peaking which now due to the economic crisis is leveling off. Most clinics have fired their staff and are in the process of lowering their prices. In our own backgarden we are proposing already for years a more tight organization of prices and clinics towards a real CM healthcare system. That way it is easy to deal with regulation and organization, financing staff etc, while keeping concerned with the needs of clients. Right now it is to much based on free enterprise principels, which are harming the clients.
Mr Mei, in his 60s, has witnessed first-hand the ups and downs of the TCM industry in the UK: “TCM practitioners earlier faced rough weather first because there were some concerns that TCM would result in kidney and liver failure. However, those doubts were redressed after the European Union implemented the Traditional Herbal Medicinal Products Directive in 2004,” he says. Since TCM is developed through empirical testing and refinement of herbal mixtures and relies mostly on clinical experience, it is often viewed with mistrust in the West, he says.
Bo-ying Ma, president of the Federation of TCM UK, says the 2008 economic crisis nearly crippled the TCM industry. “Several TCM clinics and herbal chains had to shutter operations because of economic problems. “Chinese medicine has also not been included in the UK’s medical insurance system. As a result, British people whose incomes have fallen are reluctant to buy Chinese medicines.”
The latest proposal will act as a knockout blow to the industry, Mei says. “According to my estimates, there are only 1,000 TCM clinics in the UK now. Most of them may find the going even more tough, especially as they try to cope up with the new standards, registration norms and so on.”
Typically a TCM business consists of three parts, acupuncture and associated treatments, herbal medicines and industrially manufactured herbal products. The correction they need ofcourse is towards what we call the iOC-Daoland model, something that actually differs from the current regular healthcare system. Here the emphasis is not on dispersing medication but on teaching. CM is a self-experiencing based system with a language reflecting self-experience and not a particle based physics that requires a highly specialized language. Therefore it is best suited to make people more independent in taking care of themselves. Moreover, many ingredient qualities intended in herbal medicine can be easily found in their own kitchen too, similar like this happens in China itself. This generates a safety net that prevents the collapse of Chinese medicine development in the EU and helps to create a new authenticity and reliability as an independent true healthcare system that can be self-regulating.
If the MHRA proposal is implemented from next year, it will not affect the sales of loose or individual herbs and other self-made products. But TCM practitioners will be in a fix, Mei says, because they can no longer prescribe industry based commercialized patent medicine. “More than 40 per cent of our patients take TCM capsules. If this regulation is implemented, then that section will lose access to their medication. “A lot of the patients are frequent travelers and find it convenient to carry the medicines with them.” Mei says that although several TCM companies had attempted to complete the registration process, they failed to do so because they did not have the documents and money needed. “TCM companies want to be licensed in Europe and the UK. But things are not that easy.”
A big area of concern for most TCM companies is the mandatory stability studies for end products. Mei says that while these studies are possible for single ingredients or herbs, it is not easy for multi-herbal products. Ofcourse there is a general discrepancy between biomedicine testing and herbal testing that is not addressed in the regulatory testing. This is the result of non-emancipatory knowledge cultures of the EU advisories and local governments.
“TCM companies also need to conduct toxicology tests to get a license. All the necessary tests and arrangements will cost upwards of 1 million pounds ($1.6 million) – and that too for just one TCM product.” Mei, who is also a participant in the MHRA consultations as a stakeholder, says that “although some companies have the money and means to get the stipulated tests done, it is often difficult to satisfy Western authorities on the stability and toxicology test results”.
The EU directive was originally drafted in 2004 by MHRA and then proposed to the European Parliament, he says.
The directive stipulates that applicants must provide documents showing the product is not harmful in the specified way it is used, as well as evidence that the product has a 30-year safety record, including 15 years in the EU. Although as a principle CM dates back millennia (patent medicines are often newly created and thus not that old), TCM did not enter the EU market until the mid-1990s. Even then, TCM drugs were largely sold to EU customers as food supplements, rather than as drugs.
Chinese drug makers and importers did not preserve the customs papers from a decade ago, and are thus unable to prove the 15-year use record in European markets.
Robert Verkerk, founder of Alliance for Natural Health, an international campaign working in the natural health field, says: “In 2008, the European Commission provided a report on traditional herbal products. In its last paragraph, it indicated that the EU directive was not suitable for traditional medicine systems such as TCM.” The regulation had indicated that it would consider a new framework for traditional products if there was sufficient demand, Verkerk says. “We have been doing a lot of work with the European Parliament. We created a strong core group of 40 to 50 parliamentarians to canvass support for our cause. However, it is frustrating to note that a change of guard at the top has pushed the whole issue onto the backburner.”
However, the predicament of TCM professionals appears in stark contrast to the various government initiatives that encourage and urge them to get registered in Europe. Various government and public research institutes have frequently encouraged TCM companies and clinics to register by creating expert teams, holding national meetings and publishing EU registration handbooks, according to sources from the China Chamber of Commerce for Import & Export of Medicines and Health Products.
Although the April 30, 2011, deadline has long passed, there were no efforts on the part of the TCM industry to step up the registration process, they say. However, industry sources maintain that the relatively small sales volumes in European markets were a big disincentive for companies to spend huge amounts on product registration. In the meetings I earlier mentioned the reason for that was the enormous financial burden faced. The many companies that are scattered all over China and that each work alone cannot provide the required funds.
In 2010, China’s TCM exports to the EU were valued at 152 million pounds, accounting for 13 per cent of total TCM exports. However, Ma says, the average cost for certifying and registering a TCM consisting of six herbs is about 300,000 pounds. Ma says he has on several occasions urged TCM practitioners in the UK to jointly petition the MHRA to drop the plan. Mei says: “Personally, I think the MHRA should give us an extension of two more years so that we can sell our stocks.”
Part of the problem is that Europe is one of the toughest drug markets to break into because of the stringent rules and regulations on safety. The TCM industry and practitioners need to understand what is actually happening in both the European and UK laws that affect them, Verkerk says, adding that they also need to be proactive in trying to protect their future.
Although industrially manufactured herbal products are facing problems, TCM clinics are banking on acupuncture, massage and other treatment procedures to further expand in Europe. Nick Pahl, chief executive officer of the British Acupuncture Council, the leading self-regulatory body for the practice of traditional acupuncture in the UK, says it has been estimated that the demand for acupuncture treatment has almost doubled in the past decade to more than 4.5 million treatments every year. “This indicates that acupuncture is one of the most popular forms of treatment in the UK.
“British patients believe that acupuncture is effective and has no side-effects,” Pahl says, adding that acupuncture also falls under the British National Health Service. “The increasing research evidence base for acupuncture and the recommendations from the National Institute for Clinical Excellence, especially for lower back pain, headache and migraine have also spurred demand,” Pahl says.
“There have been several studies that have proved the effectiveness of acupuncture treatment of chronic ailments such as depressions and osteoarthritis.”
Dominique Joire, the service manager and senior practitioner at the Gateway Clinic in London, says his clinic accepts TCM referrals from general practitioners and provides acupuncture for more than 300 patients a week, mainly for long-term conditions. Body acupuncture at Gateway Clinic is used to treat problems such as musculo-skeletal pain, headaches, migraine and cancer symptoms. The work at the Amsterdam Yin Yang Poli-clinic shows a similar effect. Belief and use of acupuncture is increasing. The YYC has an added value of an exercise program that includes many forms of exercise to promote or restore health, reinvigorates the elderly and so on. Such programs lead to gradual lessening of medicine burden on clients. The larges obstacle to the success of such programs is that people have learned for over a hundred years to allow treatment dependency. What I see in clinic is that “people have become so much used to practitioners solving problems that they have forgotten how to take care of themselves. People live lives of luxury with abundant food and sleep, while our body requires a certain level of minimal intake to help it develop properly. That is what Chinese medicine has as its main message and that help modalities such as acupuncture and massage to be at their most effective”. I can add to that, that that is also what makes Chinese Medicine so cost effective. Patent medicine classifies it as the same level of costumer exploitation as Biomedicine does. No matter how helpful its presence on the market is.
Gateway Clinic is 100 per cent funded by the NHS, Dominique says. Usually the GPs send the patients to a physiotherapist and only when the physiotherapist cannot solve the problem will they be sent for acupuncture. “On average the waiting period for acupuncture treatment is about three months,” Joire says. In The Netherlands it is not so dramatic. In the YYC clinic urgency treatment waiting list usually is one day. Ofcourse that is in line with the prerogative of Chinese medicine: namely to treat when a problem still is in an early stage of development. Waiting lists persé are counter effective in Chinese medicine and should be addressed early on by improving policy for treatment. We see that clinics in different countries now are developing different strategies. If regular healthcare is satisfied or tolerant to waiting list then that is their problem. Chinese medicine should at all times aim to prevent the errors of judgment general healthcare makes. It is part of their ‘raison d’etre’.
Apart from acupuncture, massage and cupping are also becoming more popular, Pahl says. But fact is that the amount of viable clinics is going down, partly due to the enterprising nature of individual clinics. They lack mutual co-operation. Even though they have wind in their sails. Acupuncture research and studies are other areas that are gaining ground in Europe. There is already huge demand for courses that are certified by the British Acupuncture Accreditation Board. There are also universities and colleges that offer degree level courses in London and four other towns. Ofcourse it reflects the lack of trust in a healthcare that is top heavy from disadvantages.
After students complete a BAAB accredited course they can opt to join the British Acupuncture Council, which has more than 550 students on its rolls. Other countries in the EU do not give as many options. In fact, even in the Netherlands, known for its practitioner freedom, regulation is gradually tightening the options of membership of professional organizations. “That is a pity,” says I would say, “because it stifles the development of Chinese medicine as an independent alternative for regular healthcare.” Chinese medicine ethics dictates that medicine should not be business and should keep the needs of clients at heart!
Wang Mengzhen and Wang Mingjie contributed to the story. It has been adapted and added to serve the purpose of this article, namely to diversify the understanding of Chinese medicine developments. The original article can be found at http://news.asiaone.com/news/yourhealth
BY TAKESHI NISHIDE and reworked by René Goris
Japan, KYODO, NOV 27, 2013 Amsterdam dec 3 2013
The Academy of Health has opened up its official Yoga teacher program this autumn. Before the Yoga was a standard aspect of the teacher program, but upon long consideration we decided to also offer a speparate program. That makes news on Yoga also more important for us.
In our classes we often emphasize the importance of getting your historical context straight. As a former student of history of western esoterics at the university of Amsterdam proff. Wouter Hanegraaff I had this message embedded at the core of all his classes. Modern Yoga with all its benefits is a nice example of being right about that. Without being negative over the beneficial effects from practicing yoga, the problem ofcourse is that it is a rebirth of aspects Heil Gymnastcs and Acrobatics. Current yoga has had really good and over 150 years of marketing, but it has altered its practices and nature to be able to do it. Yoga is everywhere and leads to all kinds of new fads, fashions and forms of socialization. Practicing yoga on a mat has become common but was not part of yoga, particular yoga dress codes have become common, while that was not common for yoga too. Yoga nowadays is mostly practiced by women, while female yoginis were frowned upon in the past. The following is from a news item in Japan. It says that there is a “natural” convergence among yoga practitioners in Japan: Those who have practiced it primarily for slimming or health are becoming more interested in its spiritual aspects, while those who have approached it as a philosophy are more actively engaging in physical exercise, according to an experienced yoga instructor.
“When you have a dialogue with your body as a real object, you have to face yourself,” Mamoru Aizawa said. “This is an awakening. Lots of people practice Ashtanga yoga early in the morning before going to work.” Ashtanga yoga is a modern form of classical Indian yoga increasingly practiced in the United States, Europe and Japan.
Aizawa, whose yoga name is Chama, is an instructor at TOKYOYOGA, which offers a large number of classes in the capital. Following his instructions, students perform a series of poses ranging from the basic to the complex. “I feel refreshed and cannot experience it in other exercises,” a female student said. “I am able to maintain a good balance between my body and mind.”
With the yoga boom spreading, what organizers called the biggest yoga event in Asia was held in Yokohama in late September. The 10th Yogafest Yokohama offered various yoga classes, including those for children and physically disabled people.
At an outdoor class, an instructor told participants to “accept gradually continuing changes in the feel of your body,” and practitioners in another class were told, “Gaze at yourself being here” and “Don’t compare yourself with others but look into yourself.” With women driving the boom, the festival had a large number of booths selling fashionable yoga wear. Yoga is also being practiced outside of classes. For example, Enyuji, a Buddhist temple of the Tendai school in Meguro Ward, Tokyo, holds a monthly seminar called “Zen x Yoga x Ayurveda” covering Zen meditation, yoga and traditional Indian medicine. “The theme of Japanese Buddhism is harmony of the body and mind,” said Junsho Oka, deputy master of the temple. “The seminar is an extension of it. The three (Zen, yoga and ayurveda) originated from the same source and share an essence because they help (people) exercise their latent power and find themselves as they are.” According to Masayuki Ito, an associate professor at Aichi Gakuin University, who is familiar with the development of yoga over several thousand years, modern forms of yoga, such as Ashtanga, combine Western physical exercises and traditional Indian martial arts. They were given spiritual meaning while spreading in the West and brought to Japan via Britain and the U.S.
Chinese Medicine has been developing rapidly over the last few years, resulting in a billion dollar industry with much profits to be made. That need leads to scamming. The abuse of health by policy makers is one thing, but if Medical staff is on the take than that is ofcourse the worst.
A new string of scandal is developing in healthcare in China, involving both biomedicine and Chinese traditional medicine.
For instance it is found out that for economic purpose costumers in Chinese hospital receive a rehydration drip infusion with or without medication no matter if it is required. The medication does not neccesarily contribute to the solving of health problems like for instance common cold and other conditions for which people ask medication. None the less the blogg newswires of China are full of stories that medical staff are routinely giving them to up the hospital or clinic income. These messages were taken from Wechat, that was also recently presented to western audiences.
I mention more often that modern TCM education is flawed both in the west as well as in China itself due to the way of association with biomedicine. Nothing wrong about biomedicine, but it has a knowledge culture of itself that does exclude anything but itself as valid. That attitude I consider irresponsibly discriminatory and un-scientific. I also think Chinese medicine does itself bad service by not validating its own treasures as they ought to be valued.
There are though two scandals that are brewing which will have far reaching effects but should be standard teaching material when discussing Chinese medicine in training centers.
One scandal is about the cultivation of herbs. This has so much become industrialized that herbs are not by far given the time to develop the qualities they ought to develop before allowed to be harvested. Many herbs need a three year or longer growth cycle before developing their properties. But for commercial purposes they are treated like how we treat chicken en cow for consumption in Europe: They are over fertellized and harvested within a year. selling them is because of that a scam, since they lack the proper qualities to be effective enough as medication. They are still prized as properly graded herbs, but to reach a similar effect you will need much higher dosages, upping the profits. This practice is what herbal medicine is known for about a thousand years or more. As I believe medicine of any sorts should always be guided by service and not by profitability. Every company in healthcare running a profit or having space for bonusses should become nationalized for the reason that they endanger public health. That includes chemical medicine makers in east and west.
The second scandal is about how in Chinese hospitals herbal concoctions are prepared. For many concoctions a simmering of one or more hours is required to generate the potency of the medication. Due to reasons of cost-effectiveness and lack of time too often the concoctions get bolied for only ten minutes. As a consequence the brews are less effective which keeps people longer on medication and paying for hospital beds.
If you think only western medical institutes scam their costumers, think twice. scamming seems to be the trend in many industries and countries these years, not only in insurence companies and banks we find these. The political need to make all financial dealings accountable leads to too often irresponsible behaviors in many branches of industry and service as to up the profits. That is capitalism for you.
We have recently updated some of our research pages to benefit our students and costumers, press and witers. Also as part of outcomes of our participation in research in educational ethical codes on behalf of the leonardus program of the European Union. please investigate these pages and if you feel like participation in researcdh let us know. all our instructors are part of the investigation that is ongoing to finetune outcomes every few years.
Students are currently completing the formation of the student council. The Academy of Health is the first Holist university program where students can contribute to the growth of their learning organisation through their own contributions and intiatives. This is a very welcome contribution because it finalizes the proces preceding official accreditation. At this moment we are finalizing the acreditation application textbook for the nederlands-Vlaamse Acreditatie Orgaan. It is nice to underscore this through opening of learning locations in Amstelveen, Breda and Antwerpen.
Another news is the preparation for opening the Temple Tree Program that was intended for Wudang area might find a better housing in a Daoist monastic university south of Beijing. Please keep yourself informed. sign up today for the newsletter or get convinced to support our program by coming to study, online or on site!