Brunei Darussalam – The Abode of Peace
Brunei Darussalam is situated on the north-west coast of the island of Borneo and lies in the heart of South East Asia. It is a peaceful and beautiful country close to the equator between east longitudes 114º 04’ and 11º 23’ and north latitudes 04º 00’ and 05º 05’. It has a total land area of 5,765 square kilometers and a coastline of about 161 kilometers and bounded on the north by the South China Sea, on the other sides by the Malaysian state of Sarawak. It comprises of four districts namely the Brunei/Muara, Tutong, Kuala Belait and Temburong (Figure 1).
(Map by ©K. Becek, Geography Department, University of Brunei Darussalam, 2005 published in the Brunei yearbook 2006, Borneo Bulletin). This map is intended for use to illustrate the geographical location only).
The National Heritage of Brunei Darussalam
Brunei Darussalam has a tropical climate with uniform temperature, high humidity and annual rainfall ranges from around 2,790 millimeters in many parts of the interior with daily temperature ranging between 22ºC and 28ºC. Tropical rainforest covers 80% of the country’s total land area. Of this figure, 70% are virgin, primary forest, one of the most diverse and unique vegetative assemblages in the world, comprising more than 5,000 species of plants, including 2,000 species of forest (Department of Information, 2003). The conservatorium of plants biodiversity under the Forestry Department, Ministry of Industry and Primary Resources, Brunei Darussalam was developed to protect the plants species from their extinction for the benefit of the future generations ahead. The untapped Brunei Darussalam’s rich biodiversity serves as sustainable bio-resources for natural health care and the Government of Brunei Darussalam is now addressing its potential in the initiatives to diversify the economy beyond oil and gas as a sustainable alternative.
TM/CAM in the Primary Health Care of Brunei Darussalam
The Ministry of Health Report of Brunei Darussalam (MOH, 2000) stated that the population growth is at an approximate annual rate of 3%. The estimated population of Brunei Darussalam is about 390,000 (2007) and projected to be over 436,000 by the year 2011. There are many ethnic communities comprising of the majority Malay (66.6%), followed by Chinese (11.0%) and others (22.4%) living in harmony.
The practice and use of traditional medicine by local communities in Brunei Darussalam goes back as early as the 14th century and has become a part of our national & cultural heritage. The Traditional Medicine Practitioners include the Malay ‘herbalists’, the Chinese ‘sin seh’ and the Indian ‘ayurvedic healers/guru/yoga therapists’, the religious and spiritual healers & others, all delivering contemporary primary health care in one form or another to members of the public.
These traditional healers are allowed to practice their long term trades of traditional/complementary/alternative medicines provided they do not contravene the existing legal and regulatory framework on the control and practices of allopathic medicine and some guidelines endorsed by the Ministry of Health Brunei Darussalam.
As there has been a resurgence of interest in Traditional/Complementary & Alternative system of medicine in many developed as well as developing countries, from the consumer’s standpoint, the increased in the self-care approach continues to expand locally, national, regionally and internationally. The escalating medical cost and managed care restricts the access to conventional medical care, the choice towards using traditional medicines & health supplement products and other non-prescription medications have also increased which is a worldwide trend. The simple reason which perhaps accounts for the popularity of traditional/complementary medicine is affordability and accessibility.
With the adoption of Primary Health Care delivery system to all, the alternative is TM/CAM which is widely practiced in all communities. Currently, this practice plays an important role in the health systems but it is required to be defined clearly by conducting more research and development of T/CAM activities to evaluate the emerging patterns/trends of TM/CAM usage and the outcomes of these alternative therapies in each country. It is also widely acknowledged that the practice and use of Traditional/Complementary & Alternative Medicine (T/CAM) is both revolutionary and evolutionary, couple with the emerging beauty and health care, such Wellness Industry which is now widespread globally due to the increasing demand & its popularity among the educated community who are embracing and practicing healthy lifestyle to maintain the wellness of each individual of the community.
The Ministry of Health Brunei Darussalam has established and developed a modern healthcare system, which all Bruneians have benefitted all these years. Meanwhile, alike many countries, Traditional/Complementary & Alternative Medicine have its roots in Brunei Darussalam and form an integral part of the tradition, culture as well as community-based population an integrated & harmonious society. The growing global interest and demand for wellness through natural health care and the widespread practice & use of Traditional/Complementary & Alternative Medicine in this country, requires a new holistic approach to the development of T/CAM & healthcare system. This global momentum and synergy is in fact consistent with the paradigm shift in healthcare that is taking place throughout the world which are of health care benefits, socio-economic importance and commercial significance.
Traditional medicine practice & use in the ASEAN Countries has undoubtedly played a remarkable & important role in primary health care needs and made significant contributions to the health care system, improving the socio-economic status of the many communities locally, nationally, regionally as well as globally. Traditional medicine continues to be practiced by the communities to treat disease and maintain health, promoting the well-being and wellness of the population at large.
The Global Strategy of World Health Organisation (WHO) emphasizes on TM/CAM’s important role in the preventive, promotive and curative aspects of health for the well-being and wellness population, especially in developing countries, and advocates tapping its usefulness for beneficial health outcomes. Therefore, WHO encourages all Member States to support Traditional/Complementary & Alternative Medicine and the continuous evaluation, formulation of national policies with appropriate structure & approach for Traditional/Complementary & Alternative Medicine practices and uses which are best fit and most suited to their specific national health care systems for healthcare benefits, socio-economic advancement and commercial importance in line with Brunei Darussalam’s goal for Nation Building. With the establishment of the new Vision 2035 and Health Strategy-Together Towards A Healthy Nation as one of the strategic themes is for the Nation to promote, embrace and practice healthy lifestyle through active community participation.
Organisation Structure of Ministry of Health Brunei Darussalam
T/CAM Unit, Department of Medical Services Ministry of Health Brunei Darussalam
The Ministry of Health Brunei Darussalam has initiated the establishment of T/CAM Unit under the Department of Medical Services, Ministry of Health on 26th Mei, 2008 to spearhead the integration of T/CAM into the mainstream healthcare services. The Ministry of Health is working on the gradual and incremental integration & harmonization of T/CAM into Brunei Darussalam health care system with the aim to ensure standard, quality and safe uses and practices of T/CAM to attain optimal healthcare, quality of life, well-being and wellness of each individual and communities-Together Towards A Healthy Nation.
National Policy on Traditional/Complementary & Alternative Medicine (T/CAM), Ministry of Health Brunei Darussalam
In tandem with rapid economic growth and development, health, social, cultural, mutual respect among various communities for sustainable harmony, psychological & mental as well as mind, body and spiritual aspects, positive outlooks & confidence of each individual and participating communities are equally important and these paradigm shifts need to be addressed.
Currently, there is no policy on T/CAM but related integrated healthcare approach to achieve the wellness and well-being of the participating community are endorsed in the Vision 2035-Together Towards A Healthy Nation:-
- To drive at the national level;
- Focus on obesity, cancer, heart diseases, diabetics, tobacco control, oral health, emerging and re-emerging infectious diseases and other preventable risk factors;
- Promote and empower wellness including physical & mental health;
- Advocate for conducive environmental health;
- Education of healthy choices through effective communication-make it easier, accessible & affordable;
- Promote healthy setting (villages, homes, workplace and public places);
- Community participation, intersectoral partnership;
- Healthy ageing.
Traditional/Complementary & Alternative Medicine (T/CAM) System shall be a very important component of the healthcare system in Brunei Darussalam. It will always co-exist with modern medicine and contributes towards enhancing and advancing the health and quality of life of the population in Brunei Darussalam to attain optimal health, quality of life, Wellness and Well-being of each responsible individual and participating community.
Therefore, Ministry of Health Brunei Darussalam encourages all T/CAM, Beauty and Health Establishments/Premises to carry out Bona-Fide businesses/services through Public and Private joint collaborative and cooperative efforts in the promotion of Wellness and Well-being of each responsible individual of the participating communities at national level.
All legislations/regulations/rules/guidelines and related procedures implemented requires “Holistic Approach” in the formulation of national policies, continuous evaluation, revisions and updates with appropriate structures and must be dynamic but not static.
The Brunei Darussalam Government through Ministry of Health Brunei Darussalam will facilitate the development of T/CAM in the country and ensures the standards, safe practices and uses of T/CAM, Beauty and Health. It will support the identification and strengthening its healthcare, socio-economic benefits & commercial importance of our nation, in line with the global developments of T/CAM.
Education & Training System & Regulation of Traditional / Complementary & Alternative Medicines (T/CAM) Practitioners
At present there is no formal T/CAM education & training system in Brunei Darussalam. Foreign practitioners are mainly from overseas such as Malaysia, Singapore, Thailand, Indonesia, China, UK, Australia and others.
Practitioners/Professionals are either registered with their practitioner bodies from the country of origin or through Trade Certification. Local practitioners / professionals are normally trained from China, Malaysia and Singapore & set up their practice in Medical Halls, Dispensaries & some home-based practices setting. Based on market analysis, majority of the practices are massage, spa, beauty care which comes under the Manipulative and Body Based Method category. Trade practices such as Traditional Malay Medicine (perubatan traditional malay medicine & urutan tradisional Melayu) and Traditional Chinese Medicine such as acupuncture, moxibustion, tuinalogy, Chinese Foot Massage are carried out by both locals & foreign practitioners. The Traditional Thai Massage, Healthy Lifestyle & Fitness, TaiChi, Qigong, etc (Mind Body Interventions) and Traditional Medicines & Dietary/Health Supplements (Biological Based) are getting popular among the communities & others such as Energy Therapy and TM system are also co-existing. Currently, the total number of the Wellness trade & industry is estimated to be around 82 premises (year 2011) based on the listing obtained from mapping the private sector. The government does not provide any funding for the T/CAM services/practices in Brunei Darussalam.
International Networking, Cooperation and Collaboration
The Ministry of Health, Brunei Darussalam recognizes the important role of Traditional/Complementary Medicines (T/CAM) on enhancing the quality of life and the health of the nation in the prevention of diseases, promotion and curative aspects of holistic integrated healthcare system. T/CAM forms a major part of our national and cultural heritage, and we should work together to ensure that T/CAM continues to benefit our societies from generation to generation. Recognising the important widespread use and benefits of TM/CAM, currently, there are concerted worldwide efforts by governments including the Ministry of Health of Brunei Darussalam to encourage the formalisation of T/CAM with the aim of achieving optimal integrated holistic healthcare system. T/CAM) is widely practiced, used and acceptable throughout Brunei Darussalam in line with the momentum of T/CAM development globally.
Therefore, in line with the global trends of T/CAM harmonisation and integration into the National Health care system through international cooperation and collaboration, the Ministry of Health Brunei Darussalam continues its support for the harmonisation and integration of T/CAM with western medicine approach is based on the incremental process with better understanding between both systems which develops mutual respect among key players and consumers.
The ASEAN Countries are encouraged to constantly working together on facilitating the international network on the collaboration and cooperation on four main components of T/CAM focusing on 4 important challenges:-
- Education and Training
- Raw Materia
- Research and Development
Key areas of TM/CAM Cooperation & Collaboration among ASEAN Member Countries are proposed to be streamlined into four major aspects for facilitation process:
- Sharing and Exchange of Updated Information
- Capacity Building
- Research & Development
- Networking Collaboration & Cooperation
Report updated by Dr. CHUA Kui Hong (updated-23rd July 2012)
Official Body/Administration Unit/Focal Point in TM:
Dr. CHUA Kui Hong (PhD), SENIOR PHARMACIST, FOCAL POINT IN THE FIELD OF TRADITIONAL MEDICINE/ HEAD OF TRADITIONAL/COMPLEMENTARY & ALTERNATIVE MEDICINE UNIT, DEPARTMENT OF MEDICAL SERVICES, MINISTRY OF HEALTH, 1st FLOOR HEALTH PROMOTION CENTRE, COMMONWEALTH DRIVE BB3910.