Implications of the one-medicine concept for healthcare provision

Human and veterinary medicine have many commonalities. The split into distinct disciplines occurred at different times in different places. In Europe, the establishment of the first veterinary universities towards the end of the 18th century was triggered by ravaging rinderpest epidemics and the increasing importance of livestock for draft, food supply, and war fare. Given this background, would it make sense to combine human, animal, traditional and modern medicine in healthcare provision, especially in less developed countries? Such a “one-medicine” approach could enhance biomedical progress, improve the outreach of medical and veterinary services especially in remote areas, offer greater choices to patients, and make healthcare more culturally appropriate. On the other hand, it would require generalists rather than specialists and rare diseases may go unrecognized. The commonalities of human and veterinary medicine and the financial constraints many governments are presently facing are arguments in favor of a “one-medicine” approach, while status thinking, education systems, administrative structures, and legislations hinder its implementation. There are no instant recommendations for the application of one medicine but governments and development professionals need to generate fine-tuned, location-specific healthcare solutions. Advocacy, changes in education and training, the creation of institutional linkages, and the removal of legal barriers could help overcome obstacles.     

Parallels and potentials in animal and human ethnomedical technique

In all cultures, ethnomedical practices are largely the same for animals and people, whether in mode of administration of materia medica, in the materials themselves, or in surgical, mechanical, behavioral, medico-religious, and other realms. Below, parallels between veterinary and human ethnomedical techniques are outlined. Taken together, they suggest that a number of benefits could be gained by closer collaboration between veterinary and human medicine in the delivery of basic healthcare information and services.     

Etiology in human and animal ethnomedicine

It can be shown that considerable common ground exists between indigenous or traditional theories of contagious disease in Africa, and modern medicine, whether human or veterinary. Yet this is not recognized because of the generally low regard in which the medically trained – whether African or expatriate – hold African traditional medicine. This attitude seems to result from the assumption that African health beliefs are based on witchcraft and related supernatural thinking. I argue that this may not be so in the important domain of diseases biomedically classified as contagious; such diseases tend to be understood naturalistically. An accurate understanding of how Africans traditionally interpret contagious diseases of humans and livestock is the foundation for the design and implementation of more effective health programs.     

LEVERAGING LIVESTOCK TO PROMOTE A CIRCULAR FOOD SYSTEM

Livestock provide multifaceted services to human societies worldwide. In developing countries, they are crucial assets and safety net for rural poor, and they provide nutrients-dense food to nourish people. In developed economies, growth in demand for animal-derived food is slowing while attention is growing over the role of livestock farming in an enhanced circular food system for sustainability. This analysis, focusing on the modern food systems in developed countries, aims to highlight the unique function of livestock that helps people re-harvest and upcycle crop and food residues generated along the food chain that are otherwise unfit for human consumption. First, human-unusable crop and food residue materials are described in three broad categories based on their characteristics and potential feeding attributes; the magnitude of biomass materials that are already used in routine animal feeding as well as residues that remain as underutilized resources are illustrated using the USA as an example. Then, the research and technology development critically needed for the future is discussed. As the world strives to produce more food with smaller environmental and climate footprints, upcycling the residual biomass via livestock for food production presents a viable pathway toward improved resource use, reduced pollution and enhanced food system efficiency.     

Back to the future: Lessons from ethnoveterinary RD&E for studying and applying local knowledge

Ethnoveterinary research, development, and extension (ERD&E) has emerged as a rich field for discovering, adapting, and transferring appropriate and sustainable animal health technologies to rural and peri-urban stockraisers, especially in Third World countries. This field is defined as the holistic, interdisciplinary study of local knowledge and practices, together with the social structure in which they are embedded, that pertain to the healthcare and healthful husbandry of animals used for a multitude of purposes. Especially in the Third World, livestock play a large number of important roles that are little understood or appreciated in today's First World. Study of these benefits and their role in Third World livelihoods offers numerous lessons that span not only the virtues but also some of the technical, ethical, and methodological challenges of working with local knowledge. ERD&E emerged as an internationally recognized branch of research in the mid-1970s largely in response to an increasing concern with animal health in the context of practical, field-level projects in animal agriculture. As many as 90% of the world's population continue to rely mainly on their own localized ethnomedicine for the bulk of their personal healthcare as well as their veterinary needs. With the escalating costs of Western healthcare technologies, it is essential to build upon this local knowledge. Of course, ethnoscience is not perfect, and recognition of the immense value of ERD&E does not imply that conventional science is to be abandoned. Rather each has much to learn from the other. Making knowledge by judiciously drawing upon insider and outsider, site-specific and universalistic, and both old and new understandings can take us back to a brighter development future.Constance McCorkle is an ecological anthropologist (PhD Stanford) specializing in agriculture, environment, and rural development. As a faculty member in the Department of Rural Sociology at the University of Missouri-Columbia, between 1980 and 1990 she served as Research Scientist and Coordinator for the Sociology Project of a worldwide (Bolivia, Brazil, Indonesia, Kenya, Morocco, Peru) 18-year $100+ million R&D program in sustainable animal agriculture. From 1990 to 1992, McCorkle was Director of the U.S. Agency for International Development's (USAID) staff environmental training program in Washington DC. Thereafter, she served as Director for Research and Evaluation for USAID's global GENESYS Project (Gender in Economic and Social Systems). The sole or senior editor of three volumes and some 30 articles on livestock development, Dr. McCorkle currently works as an independent researcher, author, and public speaker; and she consults for such organizations as USAID, FAO, the African Development Bank, the World Bank, and various private voluntary organizations that promote grassroots rural development.     

农村畜牧卫生防疫工作的重要性及措施

通过对农村动物防疫工作中存在问题的分析,阐述了加强农村动物防疫工作,有效预防和控制动物疫病,不仅是畜牧业健康发展的重要手段和重要保障,还是维护食品安全、畜产品贸易和人类健康的需要,是加快畜牧业发展的前提条件,也是保护和增进人类健康及财产安全的重要措施。同时,提出了兽医卫生防疫工作的发展对策和措施。     

减抗背景下养殖场如何规范使用兽药

随着人们生活水平的提高,人们对畜产品肉、蛋、奶的质量要求越来越高,如何规范养殖场兽药的使用,发展健康绿色养殖,减少兽药残留和违规违禁药物对人体健康的影响,确保舌尖上的食品安全,成为养殖过程中的重要环节。     

Integrated delivery of primary health care for humans and animals

Partially because of the high cost of developing and maintaining cold chains, systems needed to keep heat-labile vaccines under adequate refrigeration from their points of manufacture to their administration in the field, the Joint WHO/FAO Expert Committee on Zoonoses (i.e., the approximately four fifths of all described human infections that people share with other vertebrate animals) recommended in 1982 operation of common cold chains by health and veterinary services in rural areas. Following this recommendation, a 1984 pilot level initiative in medical-veterinary intersectoral cooperation should be regarded as a practical way to deliver human primary health care to currently neglected African pastoralists, and as a potential core program for development efforts overall within arid and semiarid areas of the African continent.     

中国畜牧业的“动物福利”

畜牧业中的动物福利影响着动物源食品的质量安全,进而影响人们的健康。中国的动物福利发展落后于西方发达国家,体现在人们对动物福利的态度、立法、科学研究、教育及生产实践等诸多方面,这与中国现阶段的畜牧养殖发展水平有关,也与中国国情现状有关。近年来,随着广大消费者对畜产品质量安全的关注,政府、学界及企业界开始重视养殖过程中的动物福利问题,以动物福利理念为指导的健康养殖快速发展,建立健全的福利标识机制和法律规范,引导人们重视动物福利。     

An assessment of animal health projects: U.S. Agency for international development, 1960–93

What are the more significant broad-based needs of animal health programs in developing countries? Essentially they are: health management programs, delivery systems, disease surveillance and monitoring of livestock movements, and improved technologies that are cost-effective and environmentally sound. Responsible program planning elicits important considerations that strengthen final results if integrated early into project design. Examples of these considerations include

?the potential for intervention;

?producers' requirements for animal health services;

?present and future effect(s) of disease;

?trends in livestock production and marketing;

?affect of improved animal health technology on traditional production practices;

?recurrent costs; and

?affect of government policies on development and application of the technology.

For what reasons do some project activities need to be redirected or continually sustained with donor support? A review of the case studies reveals that five major factors critically impact on project longevity. They are 1) initial expense and recurrent costs, 2) labor required, 3) long-term effectiveness, 4) difficulty in achieving objectives, and 5) government policies or civil strife. The U. S. Agency for International Development (USAID) has funded animal health projects for 30 years. Unlike most other bilateral projects, nearly one-third have continued for at least a decade. Given the nature of the biological cycle of livestock, animal health projects and programs require long-term commitments. USAID's investments in animal health projects continue to pay dividends despite continuously changing global political priorities and the redefining of development issues.     

Human and horse medicine among some Native American groups

Because Plains Indians, as well as some other groups of Native Americans, generally perceived people and animals as closely related, medical therapies and preventive regimes in human and veterinary medical practice often overlapped. The sense of partnership that mounted people shared with their horses dictated that it was appropriate for certain equine remedies to be similar to those used for themselves. Horses, as well as people, could possess useful knowledge in the realm of curing. Reciprocity between humankind and nature was expressed by the interactive healing powers of people and horses as well as by recorded examples of the connection that existed between human and equine health maintenance measures and medical procedures.     

推进江苏省城乡公共医疗服务一体化建设的路径探析

针对目前广泛存在的＂看病难、看病贵＂问题,从4个方面提出了推进江苏省城乡公共医疗服务一体化的对策：要树立以人为本的理念,推进改革创新,构建城乡一体的公共医疗服务管理体系;建立健全规章制度形成城乡一体的公共医疗服务长效机制;加大统筹规划力度,完善城乡一体的医疗卫生资源配置体系;推广网络信息技术,建立城乡一体的医疗服务信息共享平台;推进江苏城乡协调发展。     

Medical problems of the developing countries

There can be no immediate solution to the medical problems of the developing countries. Priorities are demanded, and it must be acknowledged that in allocation of medical priorities certain compromises are required. It can be hoped that the least detrimental compromises will be selected. Careful planning of health services and also of training programs for various medical personnel must not rely on what exists in developed countries, because those facilities and programs may be completely inappropriate to other situation. At the same time as inroads are made into the preventable conditions which now claim thousands of young lives, programs of birth control and improvement of agricultural methods must be emphasized. The reduced morbidity and mortality which results from immunization against childhood infectious diseases, smallpox, and tuberculosis must be borne in mind in overall planning for schools and general health services. Inexpensive and practical programs that could be managed by medical personnel who are not highly trained should be considered. As the benefits of technical development gradually reach the urbanizing population living under poor social and hygienic conditions, changes in the disease picture must be anticipated. Those involved with planning and training must understand various cultural influences so that the transition period can be made as painless as possible. Certain seemingly attractive Western procedures should be guarded against if they are not practical. For instance, a common tendency is to build large modern hospitals throughout the land with disregard for the fact that these hospitals cannot possibly be staffed, equipped, or maintained because of shortages of trained people and available funds (14). This has been called an "edifice complex" and is unfortunately found in many developing regions, stimulated often by ill-considered advice from overseas experts. At the same time as medical services are being improved, it is extremely important to document the improvements by means of carefully recorded statistics. Guidance in necessary methods for documentation should be sought early in the development of medical care (15). Obviously it is vital to determine what and where the major medical problems are so that programs will.be designed to attack them. Once the problems are sorted out, available resources can be allocated and preventive measures and health education can be aimed at specific aspects of public health. Many general statements have been made to describe the medical problems in the developing countries of the world. There is a need to particularize the problems and approach the specific manifestations of disease with knowledge of local conditions and resources. Accepted textbook solutions no longer apply in the field, and the ultimate solution may be along lines which are completely unique and nontraditional. To break the usual rules may be the only practical means to solve the problem at hand, and modified common sense must often replace modern technology. The practical variations on the general theme described here make medical work in developing countries interesting, exciting, and rewarding.     

农村兽医队伍存在的问题及对策

随着畜牧业产值在农业中的比重大幅提高,农村畜牧兽医队伍对畜禽生产的重要性越来越突出.而目前农村兽医工作出现的问题越来越多,严重制约着畜牧生产的健康发展,因此,加强畜牧兽医队伍建设有着十分重要的意义.     

秦汉时期牲畜常见疾病与医治方法考论

秦汉时期,兽医学的长足性发展推动了牲畜养殖业的繁荣。与前代相比,秦汉兽医群体的规模更大,医术也更为精湛。秦汉牲畜常见疾病大致包括瘟疫、"病中""咳涕"等内科疾病和创伤、眼疾、皮肤病等外科疾病。鉴于病症的多样性和复杂性,兽医们坚持传承与创新并重、实践与理论并重、多样性与灵活性并重的原则,主要采取药物法、手术法、熏烤法及巫术法保障牲畜的生命健康。兽医数量的增加、医术的进步和医理的发展表明,秦汉兽医学已成为一门较为独立、系统的学科。     

我国农村人力资本投资优化对策分析

根据相关统计公报数据,分析了我国农村人力资本投资现状,总结了我国农村人力资本投资存在的问题,提出了我国农村人力资投资的优化对策:一是强化对农村人力资本投资的认识;二是发挥政府在人力资本投资中的主体作用;三是增加农村基础教育投入;四是加大对农民的培训力度;五是增加对农村医疗卫生保健事业的投资。     

2002-2013年全国中医类医院卫生技术人员变化趋势分析

目的 研究全国中医类医院卫生技术人员的变化趋势。方法 根据2002-2013年全国中医药统计摘编数据库,针对中医类医院的卫生技术人员进行统计分析。结果 中医药卫生技术人员总量不断增长,但中医执业资格占比仍有待提高,医院床位数和人员配比较低。结论 中医药人力资源是保障中医药服务最基本的生产要素,对其培养的研究与规划,关系到中医药事业未来的发展。     

新乡村主义与农村生态旅游发展探析——以浙江临安“绿色家园,富丽山村”的建设实践为例

立足于新乡村主义的研究视角,解析了新乡村主义蕴涵的核心理念,探究了新乡村主义的和谐发展模式,并介绍了国外的相关发展实践,总结了新乡村建设的经验与启示。结合浙江省临安市农村经济发展的典型案例,着重探讨了城乡一体化发展过程中建设现代新农村,培育特色农业,促进传统农业转型升级的问题,提出了拓展农业的多种功能,发展现代生态旅游农业,依托先进科学技术推动农业资源复合发展的观点;同时借鉴西方国家在这方面的成功经验,提出了在这一领域的创新发展中必须充分发挥政府主导和引领作用的相应政策建议。     

农村社区卫生服务站存在的问题及对策研究——基于江苏省3区9村调查

通过对江苏省苏南、苏中和苏北的实地调查,发现当前农村社区卫生服务站存在发展不平衡、医疗条件差、服务质量低下、重医疗轻预防、医务人员不足、与新农合制度不能衔接等问题。为了促进农村社区卫生服务站的健康发展,必须转变思想观念,正确认识农村社区卫生服务站的地位;强化政府责任,加大公共卫生投入;完善新型合作医疗制度,增加医疗服务的可及性;加强农村医疗队伍建设,提高医务人员技术水平。     

中国传统中兽医创新工具的应用研究

创新工具是中国传统中兽医学科技发展的核心,对其进行系统梳理和应用研究能够为现代中兽医的发展提供创新思路。笔者通过对中国传统中兽医形成和发展历史的梳理,对工具的创新演变及其对学科发展的推动作用进行了挖掘与分析,并探讨了历史成就对现代中兽医发展的启示。结果表明,作为中间杠杆,创新工具有力的撬动了传统中兽医发展的历史跃迁,其中蕴含的创新思想对现代中兽医的发展仍具有重要的启示作用。通过对中国传统中兽医工具创新历史的梳理和研究,彰显了中国中兽医独特的智慧和创造力,深刻揭示了创新方法在科学进步中的推动力。