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Pohnpei Primary Health Care Manual

Pohnpei Primary Health Care Manual by Roberta Lee, Nieve Shere, Michael J. Balick, Francisca Sohl, Andrew S. Roberts, et al. Bronx, NY: Create Space/The New York Botanical Garden; 2010. Paperback; 188 pages. ISBN 9781453658659. $39.95

Situated approximately halfway between Australia and Hawaii, Pohnpei is one of the 4 widely dispersed islands that comprise the Federated States of Micronesia. In addition to boasting pristine waters and a genuinely friendly population, this small island state is known for its biodiversity.

I was delighted to read and review the Pohnpei Primary Health Care Manual written by a diverse interdisciplinary team of botanists, medical doctors, ethnobotanists, local healers, and national heathcare officials of Pohnpei. This book provides an excellent template for any research team working in public health, traditional medicine, biodiversity conservation, or basic botanical inventories.

It truly is a primary healthcare manual, and—as the authors state—was created as a reference manual for medical professionals and other people knowledgeable on the use of plants for healing. The book is based on more than 400 interviews with Pohnpei community members, 1,300 plant collections made between 1998 and 2008, and interviews with almost 200 others.

The book is divided into 11 chapters focusing on treatments for the most common health problems experienced by the people of Pohnpei, including: bites and stings, diarrhea and gastric disorders, skin disorders, cuts and wounds, cold and flu, pain, stress, infectious diseases, culture-bound syndromes, women’s health, and men’s health.

The layout and content of each chapter is crisp, clear, and highly relevant. The general condition is described first. For example, the chapter on diarrhea and gastric diseases begins with an introduction to the condition in direct, non-technical language. It also includes cautions and emergency actions required if a person has had diarrhea for more than 72 hours or if there is blood in the stool. The authors then present an overview of the most common causes of diarrhea and clinical signs of dehydration. This is followed by general medical advice on how to treat and manage dehydration. In this chapter, the authors describe how to prepare and administer a simple oral rehydration solution. From that point, the botanical treatments for diarrhea and gastric disorders are described.

The information on each treatment includes the local and botanical names of the plant, a description of the plant and its range of distribution, traditional uses, pharmacological properties, and any reports of toxicity. In all cases, a photograph of the entire plant or a detail of the plant is included. The images are black and white and, in most cases, clearly identify the plant beyond any doubt. There are few cases where the photograph is a bit hard to interpret, but the majority is very clear and dramatically enhances the utility of the manual.

In the back of the book, there is a useful glossary of terms that includes botanical, medical, and Pohnpeian terminology. I believe this is a first for this kind of manual, and the authors should be congratulated for this integrated glossary. There is also an extensive 12-page bibliography and, finally, an appendix providing the voucher numbers used to document the collections made as part of the research. This inclusion is extremely useful, and all volumes focusing on traditional medicine should have such an appendix.

I found this book to be remarkable for several reasons. One of the aspects that I greatly appreciated was its overall tone of respect, utility, and humility. This is a complex undertaking to provide basic medical descriptions of commonly experienced medical conditions along with diagnosis, prevention, and basic treatment before starting the presentation on plants used in local traditional medicine to treat the condition.

Main authors Michael Balick, PhD, an ethnobotanist, and Roberta Lee, MD, are well known leaders in the fields of ethnomedicine and integrative medicine. This is a part of what makes this manual so rich, yet humble. There is also no doubt that the local healers, ethnobotanists, and botanists greatly influenced the tone and utility of this work as well.

It is still rare, however, to find such an integrated approach that maintains the integrity of the disciplines while paying homage to traditional healers and biological diversity. The authors clearly have a deep respect and empathy for the community they are working with. They thoroughly accomplish the stated purpose of the manual: to create a primary healthcare manual for the people of Pohnpei. Appropriately, the copyright bears the names of both the Pohnpei Council of Traditional Healers and The New York Botanical Garden.

I would strongly recommend this book for a wide range of healthcare professionals, botanists, ethnobotanists, and public health workers. It would also be of use for university librarians and those focusing on international development or bio-cultural diversity conservation. In many ways, this volume sets a new standard for healthcare manuals because of the excellent integration of practical information.

This book is only one of many products of the Plants and People Project of Micronesia from 1998 to 2008. It would be wonderful if all such projects resulted in the production of a primary healthcare manual. This, however, would require a significant amount of funding and the creation of a team of scientists and medical professionals with similar credentials to those of the authors of this book.

The people of Micronesia and the international ethnobotanical research community are grateful for the fruits of this project, and I hope to see and review many more such primary healthcare manuals for other parts of the world based on this excellent example.

—Steven R. King, PhD Sr. Vice President Sustainable Harvesting and Ethnobotanical Research Napo Pharmaceuticals, Inc.