Journal of Sustainability Science and Management eISSN: 2672-7226

Volume 19 Number 3, March 2024: 10-25 © UMT Press

ROLE OF TRADITIONAL AND COMPLEMENTARY MEDICINE

IN SUSTAINING HEALTH AND WELL-BEING OF MALAYSIANS

SHARIFFAH SURAYA SYED JAMALUDIN*, BOO HARN SHIAN, PREMALATHA

KARUPIAH AND RACHEL TEH PIK JING
School of Social Sciences, Universiti Sains Malaysia, 11800 Gelugor, Pulau Pinang, Malaysia..

*Corresponding author: [email protected] http://doi.org/10.46754/jssm.2024.03.002

Submitted final draft: 21 September 2023 Accepted: 29 October 2023 Published: 15 March 2024

Abstract: Traditional and complementary medicine (TCM) is widely known among

Malaysians for its practices. This paper aims to examine users’ experiences and perceptions
of TCM on its role in sustaining the health and well-being of Malaysians. To achieve the
objective of this study, a qualitative study was conducted with the respondents by using
an online in-depth interview through the video conferencing platform. Fifteen respondents
residing in Penang, Malaysia who used TCM including Traditional Malay Medicine,
Traditional Chinese Medicine, Traditional Indian Medicine, and Islamic Medical Practice
were recruited for this study. The data from the interviews were recorded and transcribed
verbatim. Thematic approach was used for data analysis to identify emerging themes and
sub-themes. Results indicated five core themes: (i) Strength of traditional beliefs on TCM,
(ii) Personalised patient-practitioner relationship, (iii) Perceived effectiveness of TCM (iv)
TCM provides better preventive measures, and (v) TCM promotes a holistic approach to
health and well-being. Here, it concludes that TCM impacts Malaysians’ health and well-
being. Therefore, its potential for growth and importance, especially for sustaining health
and well-being cannot be denied. Further research with a larger sample of respondents
is needed to represent the population better while deepening the understanding of users’
experiences and perceptions.
Keywords: Sustainability, traditional and complementary medicine, health, well-being.
Abbreviations: Traditional and Complementary Medicine (TCM)

Introduction
Traditional and Complementary Medicine outside of the family sector and are managed
(TCM) is an ancient medical practice that existed through household means (Payyappallimana,
before modern medicine in human society 2010). Users include using herbal medicines
and undoubtedly plays a remarkable role in apart from over-the-counter medicines.
sustaining Malaysians’ well-being (Kaur et al.,
Malaysia is a multicultural society in
2019; Marican et al., 2021; Teow et al., 2021).
Southeast Asia, well-known for its rich tropical
Concepts of well-being are closely related to
biodiversity that has been the major producer
health and quality of life, where the World
of traditional and complementary health
Health Organisation (WHO) defines health as
products (Hasneezah et al., 2016). Though the
“the full physical, mental and social well-being,
present healthcare system in Malaysia is based
not merely the absence of disease or infirmity”
on modern Western medicine, traditional and
(World Health Organisation, 2019). Malaysians
complementary medicine has built its roots a long
practice various ways of maintaining health and
time ago and undoubtedly plays a remarkable
well-being with TCM. According to Kleinman
role in primary healthcare. The diversity in
(1986), health-seeking behaviour is classified
traditional medical systems in Malaysia reflects
into three sectors: popular (home level) sector,
the diverse population of Malay, Chinese, Indian,
folk (informal) sector, and professional sector.
and indigenous heritage. Malaysia recognises
Of this, the popular (family) sector covers 75%
traditional Malay medicine, traditional Chinese
of every 1,000 illness episodes, 750 never get
medicine, traditional Indian medicine, Islamic
TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICES 11

medical practices, chiropractic, osteopathy, and the users’ experiences and perceptions of TCM
homoeopathy under Malaysia’s Ministry of in enhancing their well-being.
Health. The World Health Organisation (WHO,
2019) defined traditional medicine as the ‘‘sum
Literature Reviews
total of the knowledge, skills, and practices
based on the theories, beliefs, and experiences, TCM remains a leading source of healthcare in
indigenous to different cultures, whether many developed and developing countries (Tahir
explicable or not, used in the maintenance of et al., 2015; Abdullah et al., 2018). Worldwide,
health, as well as the prevention, diagnosis, it is used for disease prevention and sustaining
improvement or treatment of physical or mental well-being in both countries (Abdullah et al.,
illness’’ while complementary is defined as a 2018). Moreover, some countries provide
‘‘broad set of healthcare practices that are not part traditional methods in their primary health
of a country’s tradition nor part of a conventional services (Mordeniz, 2019; WHO, 2019). As
medicine and are not fully integrated into the seen from the World Health Organisation’s 2019
dominant health care system’’. Both include report, the progress on TCM, indicated for the
products, practices, and practitioners of TCM last two decades by 179 WHO Member States
(WHO, 2019). Hence, Malaysia’s TCMs are from policies, national laws, and regulations
valuable and rich in the cultural heritage of its on TCM, which includes herbal medicines in
people reflecting diverse cultures and traditions tackling unique health challenges (WHO, 2019).
(Farooqui, 2013; Jamaludin & Aloysius 2019; Studies in neighbouring countries support
Zaki & Hussin, 2019). the prevalent use of TCM. Traditional systems
The significance of using TCM across of medicine that exist in other East and South
societies cannot be overemphasised with Asian countries are influenced mainly by TCM,
roughly 80% of the world population and each one has developed distinctive features
depending on TCM for their health upkeep, of its own (Mordeniz, 2019). Such countries
treatment, and prevention of minor ailments include a high prevalence of TCM use in
and chronic severe diseases (Adebisi, 2019). Indonesia as reported by Nurhayati & Widawati
As for most developing societies, in Malaysia, (2017) and Pengpid & Peltzer (2018). In Japan,
many individuals depend on these alternative Kampo, a system of traditional herbal medicine,
medicines, whether as complementary medicine is even covered by the national health insurance
to be taken together with conventional medical plan and is practised by many licensed medical
treatments or as alternative medicine, for their doctors (Motoo et al. 2021). In India, Ayurveda
primary healthcare (Doolan & Carne, 2020). The is practised within the national federal health
combined use of Western medicine and TCM is system (Suhail & Srinivasalu, 2021). On the
common, reflecting the increasing popularity of other hand, Africa’s traditional medicine remains
TCM in Malaysia (Marican et al., 2021). TCM the primary source of healthcare as it has been
is gaining popularity across Malaysian regions throughout the continent’s history (WHO 2019).
owing to its accessibility, low cost, and low side Malaysia’s mainstream healthcare delivery
effects and it has become a vital component system is based on conventional medicine,
in our healthcare system that will improve the and there is growing interest in TCM (Suhami
level of health and quality of life of Malaysians et al., 2015). The popularity of TCM among
(Chandran et al., 2018). Since people regularly Malaysians urged the Ministry of Health
use them to enhance health and well-being, (MOH) to launch the TCM National Policy in
examining Malaysian users’ experiences 2001. It was later revised in 2007 in accordance
and perceptions of TCM is crucial. As most with WHO guidelines on integrating TCM into
previous studies used cross-sectional studies the modern healthcare system. Presently, the
employing a self-administered questionnaire, ministry is slowly integrating TCM into the
this study used in-depth interviews to explore national healthcare system. This step ensures

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Shariffah Suraya Syed Jamaludin et al. 12

both traditional and conventional medicine co- The interview schedule was assessed and
exist with modern medicine while enhancing amended for flow, wording, and ease of use
Malaysians’ health and quality of life (Jasamai by the university research ethics panel in its
et al., 2017). Hence with a history of the co- initial stages. It included a broad outline of
existence of both medical fields, the integration topics to be discussed, allowing respondents
into the mainstream conventional healthcare to describe and explain their experiences and
system is still very much in its infancy (Kaur et perceptions using their terms while introducing
al., 2019). Though myriad studies focused on new topics for discussion. Questions were
patterns and utilisation of TCM use (Silvanathan based on the following key areas: respondents’
& Low, 2014; Othman & Farooqui 2015; demographic data, TCM modalities used, and
Ridzuan et al., 2021; Teow et al., 2021), the reasons for using traditional and complementary
importance of knowing the personal experiences medicine. Moreover, relations of preferred
and perceptions of users as the integration of medical treatment are shared, while perceptions
TCM into the mainstream conventional health and experiences of TCM in particular and the
care system is needed during its developing general growth of TCM were discussed. Due
stage. Therefore, the study documents the to COVID-19 unprecedented change and
users’ personal experiences and perceptions in disruption, online interviews were conducted
representing the public’s voices in assisting the using the videoconferencing platform.
integration of TCM into the national healthcare
system in Malaysia. Sampling Procedure and Respondents’ Profiles
Respondents recruited are based on treatments
Materials and Methods received, recognised as TCM in Penang under
Research Location the Ministry of Health through posters shared
on social media and practising practitioner’s
Penang was chosen as a study location due to its clinics. The inclusion criteria are as follows:
renowned and bustling melting pot of races and 1) the respondents must be above 18 years
religions, including Malays, Chinese, Indians, old; 2) Users of traditional and complementary
and other ethnic groups of different religions. medicines (Traditional Malay Medicine,
Penang’s multiculturalism position indicates Traditional Chinese Medicine, Traditional
grounds to study the population’s experiences Indian Medicine, Islamic Medical Practice) 3)
and perceptions of TCM usage. In addition, Malay or English language speakers, 4) Received
Penang is home to many TCM practitioners TCM treatments in Penang, Malaysia. Those
whose recognised practice areas are Traditional who fulfilled the criteria and responded to the
Malay Medicine, Traditional Chinese Medicine, posting were contacted, and online interviews
Traditional Indian Medicines, and others. using the video conferencing platform were
arranged based on the respondents’ convenience.
Data Collection Methods Fifteen respondents who used TCM, including
Qualitative is used to gain a more profound Traditional Malay Medicine, Traditional Chinese
and rich understanding of experiences and Medicine, Traditional Indian Medicine, and
perceptions of TCM on its roles in enhancing Islamic Medical Practice in Penang, Malaysia,
Malaysians’ well-being. Information was were recruited for this study. Information
extracted from respondents based on their obtained was deemed sufficient until no new
personal experiences and perceptions using in- information was added. This is synonymous
depth interviews guided by a semi-structured with the methodological principle of saturation
interview schedule. This technique allowed a in most qualitative research (Saunders et al.
deeper understanding of their perspectives. 2018).

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TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICES 13

Data Analysis and Concept of trustworthiness throughout the research. Before the interview,
Thematical analysis through Atlas ti. identified consent forms were sent to the respondents via
themes, conceptual categories, commonalities, email and social media messaging platforms.
and differences in the respondents’ responses Respondents’ signatures were a form of
through qualitative data. Recordings of the agreement and inclination to participate in the
scheduled interviews ensured the accuracy and interview. Moreover, respondents were informed
completeness of data. The initial step began with that their anonymous narratives might be used in
listening to the recorded audio and reading the the published work later and that they had the
transcripts. The familiarisation and immersion right to terminate the interview at any time or not
of data assisted researchers in reflecting on data to answer any irrelevant or disturbing questions.
and better understanding and interpreting the The Malay and English languages were used
views shared. Secondly, codes were generated according to the respondents’ preferences.
using Atlas.ti to produce a concise matrix of key Interviews lasted 60 to 90 minutes, with a token
emerging ideas. Lastly, a coding summary and of appreciation given upon completion.
report were produced with the themes and sub-
themes that make meaningful contributions to Socio-demographic characteristics of the
answering the research questions. respondents
Data validity was established using Lincoln A total of fifteen TCM users were interviewed.
& Guba (1985)’s concept of trustworthiness. Table 1 summarises the socio-demographic
This comprised credibility, transferability, characteristics of the respondents who
and dependability. Data collection and participated in the study. Malay respondents
analysis methods were well-established to were the highest number, predominantly from the
enhance credibility. The involvement of 25-45 age group. All the respondents have used
researchers was experienced in conducting the more than one type of TCM modality. Among
interviews. Moreover, respondents voluntarily them are Chinese acupuncture, traditional Malay
participated with encouragement to share massage, Islamic medical practice, wet cupping,
honestly throughout the interviews to achieve herbal medicines, and Ayurveda. The reasons
credibility. Dependability was ensured by using for varied medicine are maintaining well-being,
a consistent data collection and methodology treating illness, and preventing chronic or acute
approach. To maintain confirmability, the illness. Anonymity is used to protect the identity
researchers held frequent meetings, reflexive of the respondents.
and critical discussions and debriefings during
the entire data collection and analysis period. Results and Discussion
Data collected and analysed were described as
detailed as possible to enhance the transparency Thematic analysis identified five core themes
of the research design used while transferability focusing on users’ experiences and perceptions
among researchers. of TCM in enhancing their well-being. They are
(i) Strength of traditional beliefs on TCM, (ii)
Research Ethics Personalised patient-practitioner relationship,
Ethics approval was obtained from the Human (iii) Perceived effectiveness of TCM, (iv) TCM
Research Ethics Committee (JEPeM), Universiti provides better preventive measures, and (v)
Sains Malaysia (USM/JEPeM/20120707). TCM promotes a holistic approach to health
Interviews started upon confirmation of the and well-being. Seven subthemes investigated
respondent’s understanding of the study include family influence, awareness of TCM,
information with their informed consent. The safety and nature, halal image, well-being,
consent letter contained the nature and objective pluralistic medical practice, and TCM used
of the study and ethical considerations followed during COVID-19.

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Shariffah Suraya Syed Jamaludin et al. 14

Table 1: Socio-demographic characteristics of the respondents

Respondents Gender Age Ethnic TCM modalities used Reasons using TCM
Acupuncture, Islamic wet
To treat illness, to
Respondent 1 Male 51 Malay cupping, Malay massage,
maintain well-being
herbal medicine
To prevent illness; to
Respondent 2 Male 20 Malay Chinese herbal medicine
maintain well-being
To prevent illness, to
Respondent 3 Female 23 Malay Chinese herbal medicine
maintain well-being
Malay massage, Malay
Respondent 4 Female 35 Malay To maintain well-being
herbal medicine
Acupuncture, Malay
Respondent 5 Male 36 Malay To maintain well-being
massage, Chinese herbs
Respondent 6 Male 25 Chinese Chinese herbal medicine To treat illness
To treat illness, to
Respondent 7 Female 21 Chinese Chinese herbal medicine
maintain well-being
Malay massage, Malay To maintain well-being;
Respondent 8 Female 44 Malay
herbal medicine to prevent illness
Malay massage, Malay To maintain well-being;
Respondent 9 Female 38 Malay
herbal medicine to prevent illness
Acupuncture, Malay
Respondent 10 Female 40 Indian massage, Chinese herbal To treat illness
medicine
Islamic medical practice,
Respondent 11 Female 20 Malay To treat illness
herbal medicine
Malay herbal medicine, To treat illness; to
Respondent 12 Male 40 Malay
wet cupping maintain well-being
Ayurveda, Ayurvedic To treat illness; to
Respondent 13 Male 45 Indian
medicine maintain well-being
Malay massage, Malay To maintain well-being;
Respondent 14 Female 32 Malay
herbal medicine to prevent illness
Ayurveda, Ayurvedic To prevent illness; to
Respondent 15 Male 39 Indian
medicine maintain well-being

Strength of Traditional Beliefs on TCM

TCM is an ancient practice handed down by maintain good health and treat illness. Many
generations. Hence, two sub-themes identified respondents acknowledged this. Information
are family influence and creating public and recommendations from family members,
awareness of TCM. especially elders such as grandparents, parents,
and older relatives, are often obeyed and not
Family Influence questioned. Quotes below provide examples of
knowledge handed down from family.
Family influence is the most common
reason for TCM use, with many respondents “My parents taught me to use herbal
disclosing knowledge on traditional medicine medicine since young. Whenever I
usage was passed down from family to got fever, my parents will not give me

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TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICES 15

Panadol, but he will go to the sinseh there for her health problem, and he
shop and buy for me the herbs medicine has helped her to treat her illness”
to consume. I feel better after that” (Respondent 7).
(Respondent 1).
“Well, I mean this started when we were Creating Awareness of Traditional and
still kids. If you were ill, then you just Complementary Medicine (TCM)
get your herbal tea to easy sweating Most respondents voiced concerns about
and drink coconut water to reduce the the government’s role in promoting TCM in
heat and to prevent dehydration. This Malaysia. A respondent shared, “We have the
is something you bring along with natural source(s), we have the unique cultures
you when you got older and for own from various ethnicities in Malaysia, why not
children. This is thing you learned from we use it? Others in the study supported this
one’s own parent” (Respondent 9). view.
Some respondents exposed their children to Respondent 1 also expressed his thoughts
TCM after experiencing it. “What my parents on the younger generation not being exposed to
taught and practised on me; I will pass it to my the TCM due to scepticism. He suggested the
children” were mentioned by the respondents. role of government in creating more awareness
The interviews with respondents affirmed of TCM, or the heritage and knowledge from the
this. Respondent 2 said his family practised older generation will likely vanish.
traditional Chinese medicine. When he has
“Most people do (are) not aware
a cough or fever, his dad will get powdered
of the benefits of TCM. If it were not
substance (herbal medicine), which has a weird
because of my parents who introduced
smell but is very effective. When he finishes the
it, I wouldn’t have known about it.
packet of herbal medicine, he will feel better
The government should play a role.
quicker than modern ones. Another respondent
Ministry of Health should recognise
also mentioned that her family and relatives
the TCM practitioners, gave them
suggested herbal medicine, which is beneficial
more priority as to the conventional
depending on the illness.
medicine” (Respondent 1).
“Modern medicine does not work for
my gastric problem. So, I try herbs Personalised Patient-practitioner Relationship
and all these kinds of TCM suggested
by my family and relatives. I found it The desire for closer patient-centered and
works better than modern medication” supportive relationships is one of the reasons
(Respondent 3). users choose TCM. Most respondents perceived
their relationship with the TCM practitioners as
The respondents also mentioned a critical component of the treatment process.
recommendations by relatives on the TCM Key characteristics of a supportive patient-
practitioner. For example, Respondent 7, practitioner relationship consist of trust,
who had cramps from her menses, received acceptance, and feeling cared for. Respondent 2,
recommendations from her aunty to get who has used traditional Chinese medicine since
treatment from a Chinese medicine practitioner he was young, shared:
in Ayer Hitam, Penang.
“We (family) went to the same
“I have tried other practitioners, sinseh (traditional Chinese medicine
but it did not help. Then, my aunty practitioner). Grandma used to see
recommended the Chinese practitioner sinseh before I was born. He (sensei)
in Ayer Hitam. My aunty said the explains everything in detail, and he
practitioner is good as she has been mentioned if the medicine does not

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Shariffah Suraya Syed Jamaludin et al. 16

work just come back to him and he will Respondent 7, who sees a TCM practitioner
prescribe another medicine. For now, for her menses cramps, shared her experience
everything he gave is effective. He’s with the practitioner.
very nice and doing his job very well “I had a good experience with my
and makes us trust him” (Respondent TCM practitioner. He is very nice. He
2). can communicate well and understand
Respondent 14, who had just given birth, my condition and know the problem”
felt cared for when her midwife listened to her (Respondent 7).
problems. Respondents also mentioned the qualities
“I’m going back to my hometown for of the TCM practitioner, including friendliness
‘berpantang’ (confinement period) after and niceness. The following quote provides an
delivered my baby. Makcik Miah, who example of respondents’ perspectives on TCM
has been our family midwife took care practitioners.
of me and my baby. I was down when “I went to the Chinese physicians for
my baby was diagnosed with jaundice. my knee problem. I got the contact
But my traditional midwife calms me from Google search based on good
down and advise me to breastfeed my reviews. The uncle is very experienced,
baby frequently. She also massaged my knowledgeable person. He is very
body to make me feel better. She gave friendly, very kind and likes to talk and
me the opportunity to talk about what share knowledge about health. The
I was going through. ‘You really felt way he handles patients, we feel easy
that somebody was listening to you and with him. The premise environment
cared for you” (Respondent 14). also very nice, homely and we feel
Interviews also showed that TCM peace when we are at the premise”
practitioners’patients’sociocultural backgrounds (Respondent 10).
and patient’s ideologies determine the choice of
TCM. With TCM, usually community-based, Perceived Effectiveness of TCM
practitioners who are well-acquainted with
Respondents’ most cited reason for TCM use
patients’ backgrounds, lifestyles, and cultural
is the perception of TCM to be more effective
beliefs live in the same community. Moreover,
than conventional medicine. Using efficacy as
respondents felt it is easier to communicate with
the ability of TCM to produce the desired effect,
the practitioners than with medical doctors.
sub-themes emerged involving beliefs that TCM
Here, the relationship is built with time, and
is generally safe, natural, and halal. Belief in the
listening skill is crucial to healing.
effectiveness of the TCM is a reason for their
“I feel easy to talk about my diabetic’s treatment choice. Respondent 10, who has tried
illness to my practitioner. He Traditional Chinese Medicine, is very satisfied
understands my health beliefs and with the practitioner’s treatment, whom she
condition. My practitioner will hear called uncle. She also brought her mother and
me patiently and advise me to take aunty to receive treatment.
care of my food and take my medicine.
“The traditional medicine is very
Compared to the conventional doctor,
effective. My aunty can’t bend her
they don’t have time for me. They
pointing finger. I think because of the
just ask me to follow the food intake
calcium problem. I brought her to
and scold me when my glucose level
uncle (sinseh) to check. For the first
increased” (Respondent 13).

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TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICES 17

time, uncle do the acupuncture. But Respondent 1 also shared a similar

she can’t stand the pain. So, for the experience.
second meeting, uncle doesn’t do the “I went for acupuncture for my gout
acupuncture. He just massage and put problem. The acupuncture treatment
the medication (herbs) and then wrap is quite expensive you know. With a
it and leave it for 24 hours. After the thorough check up and treatment, it
fourth time meeting uncle, she can see will cost around six to seven hundred
the changes to her finger. She can bend per treatment” (Respondent 1)
her fingers now” (Respondent 10).
Another respondent, Respondent 6, who Safe and Natural
seeks Traditional Chinese Medicine for his skin
All respondents perceived TCM originated from
condition, also mentioned the effectiveness of
natural sources without harmful additives such
the medicine.
as chemicals or drugs as it is not chemically
“I suffered from eczema. My skin will invasive compared to Western medicine. Hence,
be red, itchy and my nail is in bad their belief that TCM is relatively safe suggests
condition. I have tried many treatments Respondent 5, who has been using TCM since
including the skin specialist, but age, shared, “I don’t think it will do any harm if
not successful”. With this TCM you take it because it’s all-natural”.
practitioner, I feel like my disease got
Respondent 14, who had just delivered
cured. Of course, it takes time, every
her second baby, believed in the safety and
week has to go see him and get the
efficacy of TCM during her postpartum period
medicine. What I can say, TCM takes
in restoring energy after childbirth.
time, but it’s effective” (Respondent 6).
“I used traditional Malay massage and
Respondent 7, one of the female
consumed herbal medicine to improve
respondents also shared her experience of taking
blood circulation and to restore my
the herbal medicine given by the Traditional
energy. I have been practicing it since
Chinese Medicine practitioner.
my first baby. It helps me to recuperate
“I received treatment for my faster after delivery” (Respondent 14).
menstruation problem. The practitioner
However, a few mothers expressed their
gave me herbal medicine where it needs
concerns about the consumption of herbal
to be boiled in water. The taste is not
medicine during the early weeks of their
very nice, but it helps to improve and
postpartum period, as one shared:
regulate my menses” (Respondent 7).
“As I fully breastfed my baby, I will
Respondents refuted the assumption of
avoid taking herbal medicine, for
TCM being cheap depending on the type of
example jamu (herbal concoction)
TCM used, as it can be expensive, as shared by
during the first week after delivery as
Respondent 6:
jamu is considered ‘hot’ as I’m afraid
“The medicine cost me around RM220 my baby will get jaundice. I will slowly
to RM300 per week. Every week I consume jamu with a small amount
need to go to the premise to get the depends on the effect to my body
medicine. So yeah, I think it costs me after the second week or third week
around RM10k – RM20k for two years after delivery. Jamu is very good for
treatment. But it worth as it cured my recovery of new mothers after gave
disease” (Respondent 6). birth” (Respondent 4).

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Shariffah Suraya Syed Jamaludin et al. 18

Respondent 1, who received TCM treatment Halal Image

for gout and joint pain, also emphasised the In Malaysia, the Islamic halal principle is
nature and safety of the medicine. essential for Muslims before consuming edible
“I have got the treatment from the products. Halal food consumers (Muslims)
modern medicine. The doctor gave who use TCM shared their concerns on the
me painkillers and inflammation halal authenticity of products sold under TCM,
to reduce swelling. This modern which was raised by Muslim respondents who
medicine had drugs, have side effects. used Traditional Chinese Medicine. Due to the
Herbal medicine is something benefit complete code of dietary laws presented in the
you, it made from natural remedies, Holy Qur’an for Muslims, halal products should
and we feel safe to consume them” be mentioned clearly in the ingredient list apart
(Respondent 1). halal certification.
Many respondents argued for avoiding the “Ingredients of Chinese medicines
side effects of technology or chemicals with the ingredients all writings are in
thought of TCM as “more natural products”. Chinese. Malay users cannot read and
However, one of the respondents who had given understand the ingredients used, that
birth to her third child shared her concerns. is the barrier. Must break the chain”
“I’d use complementary medicine (Respondent 1).
during my postpartum period. I used Another respondent also shared his concerns
TCM to improve my well-being. I used about this matter.
massage, heat therapy, belly binding, “I used to take Chinese herbs for my
herbal bath, and consumed herbal fever and cough. Usually, I will ask
medicine. TCM just more natural the sinseh about the ingredients used.
things and eating well and generally It will be easier for the Muslims if
looking after yourself” (Respondent 4). the ingredients were written in dual
Leading to concerns about approval from language (Mandarin and English). If
trusted sources, various acts regulate natural obtained from plant origin would be
products and go through approval, registration, considered as halal, but if obtained
and Good Manufacturing Practice (GMP) from animals then it has restrictions by
before being approved by regulatory authorities Islamic principle” (Respondent 3).
such as the Ministry of Health, Drug Control
Authority (DCA), and National Pharmaceutical TCM Provides Better Preventive Measures
Regulatory Agency (NPRA). Natural products Than Conventional Medicine
used in traditional and complementary medicine
When asked whether TCM provides better
practices are deemed safe and quality-assured
preventative measures, all the respondents
once these regulatory bodies approve. Hence,
agreed. Sub-themes unravelled are well-being,
respondent 8, who received traditional Malay
pluralistic medical practice, and TCM used
medicine to maintain well-being and prevent
during the COVID-19 pandemic.
illness, shared that she only trusts products
approved by the Ministry of Health for T&CM
products. Well-being

“I think just to be cautious and to Besides using TCM to treat illness, respondents
avoid any dangers, check the label and also identified preventive measures while
ingredients of the TCM products, check maintaining well-being as the most common
the Ministry of Health approval before reasons for using TCM.
you take/consume them” (Respondent 8).

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TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICES 19

“Not necessarily because I’m sick, illness like appendicitis, I will go to the
but also as a prevention strategy and hospital to remove it to do operation”
for well-being. As my grandparents (Respondent 1).
and parents have diabetes, I took From the interviews, most respondents
bitter gout capsules to reduce blood have used more than one type of TCM modality.
sugar level and to prevent me from Due to Malaysia’s multi-ethnic, multi-cultural,
getting diabetes apart from reducing multi-religious developing country, knowledge
my carbohydrate intake. Just for of TCM has been embedded into the health belief
precaution” (Respondent 12). system and deeply integrated into their lives.
Consequently, dissatisfaction with Therefore, it is common for other ethnicities to
conventional medicine and looking for an use the healthcare system belonging to their own
alternative treatment method were shared among or other ethnicities. Moreover, views originating
the respondents for using TCM. from surrounding culture and health beliefs due
“In the past, I have always suffered to upbringing may increase trust in trying TCM
from the cough. My throat will be apart from conventional medicine.
itchy, and I can’t stop coughing. It “I used few types of TCM. For my
was very embarrassed especially gout, I used to do acupuncture by the
when I’m conducting class. I tried Chinese practitioner, I also do Islamic
the conventional medicine, the cough wet cupping to remove toxic waste from
medicine given by the clinic, but the blood stream, and for body ache I
nothing helped. Then, I heard about used to do Malay massage at least once
honey and lemon mixture from my a month” (Respondent 1).
close friends. When using specific
mixture, for maybe two weeks, it can TCM Used During COVID-19 Pandemic
prevent such issues. I did it and all my
Since interviews were conducted during the
cough problem, suddenly became less
COVID-19 pandemic, respondents were
pronounced” (Respondent 8).
asked on the intake of alternative food to
prevent COVID-19. Many Malaysians shared
Medical Pluralistic Practice to consume herbal medicine for prevention
Some of the respondents in this study also as shown below. Herbs, healing oils, honey,
mentioned the belief in combining TCM and and homemade concoctions were among the
modern medicine to cure disease quicker than alternative food they take to boost their immune
using TCM alone. Few shared system.
“For my high blood pressure, I used “I used to take habbatus sauda’ oil
to consume the hospital medicine, but (black cumin oil) early in the morning
at the same time I also tried herbal and night half hour before taking
medicine product such as buah tunjuk meal. Habbatus sauda’ is very good as
langit (sky fruit) capsule. Its benefit is to antioxidant, anti-inflammatory. It also
lower the blood pressure” (Respondent encouraged to take as it is considered
12). as makanan sunnah (prophet’s food)”
“I used both conventional medicine (Respondent 8).
and TCM, depends on illness. For the “… my family used to boil some cloves
minor illness such as body heat, fever, in a hot water for a few minutes, and
neck pain and body ache, I usually go then breath in the steam in and out. It
to TCM practitioners. But, for major was said it can clear the lung for better
breathing” (Respondent 9).

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Shariffah Suraya Syed Jamaludin et al. 20

“With the increase in COVID-19 cases, Respondent 11, who gets her treatment
my family has taken a few precautions. for her asthma from an Islamic medicine
Apart from getting vaccinated, my practitioner, mentioned that Islamic medicine
wife used to make rasam, a spicy and promotes faith healing through prayer and
tangy soup made with tamarind and reciting Quranic verses. It treats physical illness
herbs such as garlic, pepper, cumin, while helping patients to eliminate negative
mustard seeds and coriander. It has emotions. Using holistic wellness considers
been used traditionally as a treatment external environments and spiritual well-being.
for flu, or cold and as a remedy for sore Confidence in the practitioner seemed to
throats and fever. Rasam is thought determine the patient-practitioner relationship,
to have antioxidant and antibacterial which depends on several factors. The feeling of
properties” (Respondent 13). being in a specific and individualised relationship
“After much misinformation read in with the practitioner was related to the
messages, I have taken into account practitioner’s interpersonal and communication
of checking the validity and come to skills, including the ability to adopt a holistic
the knowledge of few of Traditional approach to the patient.
Chinese Medicine in preventing “The practitioner asks questions about
me from contracting COVID. Some my family, about my home. He is very
of which I consume are Lianqio nice. The relationship with the TCM
(Forsythiae Fructus), Japanese honey practitioner is longer, deeper and
suckle also known as Jiangyinhua makes more sense” (Respondent 10).
(Lonicera japonica) and Chinese
Liquorice also known as Gancao.
… they’re for increasing the body’s Discussion
immune system in combatting viral Examination of the users’ experiences and
infections” (Respondent 7). perceptions of TCM in enhancing the well-
being of Malaysians using in-depth interviews
TCM Promotes a Holistic Approach to Health conducted with TCM users showed personal
and Well-being views of TCM users. The study confirmed
Integrating physical and mental health as an findings from previous studies of families
integral part of well-being is part of the TCM playing an essential role in healthcare decisions
healthcare systems. The following provides (Silbermann & Hassan, 2011; Suhami et al.,
examples of perspectives on the holistic 2015; Shewamene et al., 2020). In Asian
approach of TCM. countries, family members who are mainly
providers of care for family members play an
“It’s (TCM) very holistic, so it treats essential role in healthcare decisions. Most
person as a whole…When I see my respondents disclosed that information and
TCM practitioner, he’s looking at knowledge on traditional medicine were passed
my health and well-being overall” from their families to maintain good health and
(Respondent 12). treat illness. Recommendations are passed by
“Ayurveda is a holistic system of the elderly such as parents and relatives, as seen
healing. The method of Ayurveda in “it was always done this way”, stated several
is unique and universal. Instead of times by respondents who use TCM treatment.
treating the symptoms of a disease, it Moreover, respondents voiced their
treats the individual and caring is given concerns about creating TCM awareness as
for the entire body” (Respondent 15). it improves Malaysia’s health and quality of
life. With Malaysia’s multi-ethnic hub, TCM

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TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICES 21

showcases Malaysia’s unique healthcare side effects and chemicals. The findings persist
comprising three major ethnicities- Malay, with previous studies (Silvananthan & Low,
Chinese, and Indian- in the Traditional and 2014; Ali et al., 2018; & Zheng et al., 2020).
Complementary Medicine Division under the The respondents raised a halal image in
Ministry of Health. Its underdevelopment will this study as Malaysia is a Muslim country
be a waste for the Malaysian government if it is with Islam as the official religion of Malaysia
not utilised accordingly (Chandran et al., 2018). halal authenticity of TCM products. It became
The personalised patient-practitioner a concern as consumable items should be halal
relationship is a factor in respondents’ choice of and deemed fit, clean, and wholesome for health
TCM treatment. All respondents perceived their (Zeinalian et al., 2017). Similar considerations
relationship with their practitioners as essential apply to halal issues reported by a study on
to healing. They reported a good relationship traditional Chinese Medicine among postpartum
with their practitioners as they were cared for women in Malaysia (Jamaludin & Aloysius,
and welcomed by the friendly personalities 2019). Besides treating illness, the respondents
of TCM practitioners. These findings support shared that the most common use for TCM is
the work by Foley et al. (2021), whereby the preventing and maintaining well-being. This
desire for a more patient-centred and supportive is consistent with the previous finding among
relationship was a reason for choosing to Malaysians who primarily sought TCM services
favour TCM. Patients value caring, empathic, to maintain wellness (Siti et al., 2009; Kaur et
and therapeutic relationships with their TCM al., 2019).
practitioners. The combined use of conventional medicine
The majority of the respondents believed in and TCM is common among the respondents in
the effectiveness of the TCM treatment. Similar this study. It is due to the belief that combining
findings were also reported by Ali et al. (2018) TCM and modern medicine complements one
and Ridzuan et al. (2020). Furthermore, despite another, curing and healing faster. Previous
expensive TCM treatments similarly reported in research asserted that the main users consist of
the previous studies by Siti et al. (2009) and Tahir TCM and conventional medicine rather than
et al. (2015), respondents in this study continued using TCM alone (Tam, Chang & Norazah,
their treatments due to its effectiveness. This 2014; Othman & Farooqui, 2015).
finding also aligns with Jasamai et al. (2017) on Another important finding is using different
attitudes toward Complementary and Alternative race TCM modalities by other races. Although
Medicine (CAM) among Malaysian adults, TCM modalities are synonymous with race/
whereby CAM is usually more expensive than ethnicity, the study showcases the openness
conventional medicine with the public willing of other race modalities. Teow et al. (2021)
to pay. reported that the evolution of TCM modalities
Despite the assumption that TCM is in Malaysia is unique due to the amalgamation
generally safe to consume, postpartum women of different Asian cultures over many decades.
have concerns regarding the herbal concoction Through amalgamation, myriad complementary
regarded to be heaty. Heaty is assumed to be alternative medicine modalities build openness
“hot” which could cause jaundice in their baby. stemming from the traditions of one ethnic
The findings show similarity in the previous group. It is also consistent with Mohiuddin et
studies by Fuad et al. (2020) and Teoh (2013) on al.’s (2021) research on using traditional Chinese
the use of CAM among postpartum women who medicine in Malaysia among the ethnicities,
consumed herbal medicine, where it showed whereby the Malay population preferred
that more than half of the respondents reported traditional Chinese medicine. Therefore,
neo-natal jaundice in their newborns. Moreover, showing the commonality of other ethnicities in
respondents perceived TCM as natural, without using other ethnic TCM modalities.

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Shariffah Suraya Syed Jamaludin et al. 22

Since the COVID-19 outbreak, many be said that TCM plays a part in complementing
complementary medicine herbal prescriptions Malaysia’s national healthcare system.
have circulated in the community as Malaysians The national government and international
intake herbal medicine to prevent contracting organisations recognise TCM’s role. World
the disease. Most respondents showed to Health Organisation (WHO) acknowledges
consume TCM such as Chinese herbs, honey, TCM’s long history of use in health maintenance,
Malay herbs and homemade concoctions due disease prevention, and treatments. In terms of
to the perception of strengthening the immune theoretical perspective, TCM is an important
system. A study by Lam et al. (2021) in Hong tool to achieve the United Nations Sustainable
Kong found the public commonly used TCM Development Goals, listed under SDG3, where
during the pandemic. Intake of vitamins, dietary health is central to ensuring healthy lives and
supplements, and Chinese herbal medicine were promoting well-being for all ages which cannot
consumed to strengthen immunity and prevent be achieved through modern medicine alone. A
virus contraction. While vaccination and social comprehensive approach is needed, where TCM
distancing were used to control the pandemic, approaches to health and well-being are holistic.
professional bodies should proactively consider This approach makes the TCM an appropriate
public preferences and provide information tool for sustainably achieving universal health
regarding the effectiveness and safety of TCM and well-being (James & Bhatnagar, 2020).
for COVID-19 prevention and treatment. Now, TCM is on par with the modern medicine
The holistic approach of TCM is reported sector. While the TCM systems are gaining
to have been practised and promoted over popularity, they are crucial for recognition as
time. Treatments include the patient’s social legitimate healthcare systems. Over the last 20
life, relationships, external environment, and years, the Malaysian government developed
spiritual well-being while combating the policies to institutionalise and incorporate TCM
disease (Simwaka et al., 2007). Similarly, a into the national healthcare system through
study by Warriner et al. (2014) on women’s regulatory measures for its practitioners and
attitudes toward the use of complementary services. Malaysia is evaluated as an ‘in-process
alternative medicine in pregnancy revealed that country” in which the integration of TCM into
complementary alternative medicine is very the national healthcare system is most actively
holistic through its wholesome treatment. underway, considering cultural, political, or
economic diversity (Park, Yi & Kwon, 2022).
Conclusion Integrating TCM into the national health
care system should include the voices of the
This study aims to understand the experiences
public, the TCM practitioners, and the TCM
and perceptions of Malaysian users on TCM
associations for their public interest. The
treatment. Here, it concludes that TCM
primary concern is to regulate and ensure the
impacts Malaysians’ health and well-being.
safety of TCM services and products through
Despite modern health services, Malaysians
more research. The findings can be a stepping
still use various traditional healthcare systems.
stone for conducting systematic and in-depth
Furthermore, the potential for growth and
studies to gain more information on the public’s
importance, especially for maintaining health,
experiences and perceptions of TCM. The
cannot be denied. In addition to its popularity,
main limitation of this study was the small
it is deeply rooted in strong cultural beliefs. In
sample of respondents, including respondents
terms of practical perspective, TCM is often seen
from one state in Malaysia, hence creating
as more accessible, affordable, and acceptable to
bias upon extrapolating the results to reflect on
local populations and can therefore be a tool to
TCM experiences and perceptions in Malaysia.
help achieve universal health coverage. It can
Furthermore, the TCM modalities used were

Journal of Sustainability Science and Management Volume 19 Number 3, March 2024: 10-20
TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICES 23

not equally proportionate among respondents. 12(2), 318-331. DOI: 10.47552/ijam.v12i3.

Therefore, it cannot fully conceptualise the 1874.
overall experiences of the TCM users. Further Chandran, S. D., Puteh, F., Zianuddin, A., Azmi,
research is needed with a larger sample A., & Khun, W. W. (2018). Key drives of
of respondents to better understand users’ medical tourism in Malaysia. Journal of
experiences and perceptions. Tourism Hospitality and Culinary Arts,
10(1), 15-26.
Acknowledgements Farooqui, M. (2013). The current situation
The author would like to thank the Ministry of and future direction of traditional and
Higher Education Malaysia for the Fundamental complementary medicine (TCM) in
Research Grant Scheme with Project Code: Malaysian Health Care System. Alternative
FRGS/1/2020/WAB13/USM/02/2. and Integrative Medicine, 1(1). DOI: 10.
4172/2327-5162.1000e101.
Conflict of Interest Statement Foley, H., Steel, A., Mc Intyre, E., Harrett, J.,
Sibbritt, D., & Adams, J. (2021). Disclosure
The authors declare that they have no conflict of conventional and complementary
of interest. medicine use to medical doctors and
complementary medicine practitioners:
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