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Although Tibetan Medicine is
held in high esteem throughout Asia, it also faces real and
present danger of extinction, even by its very popularity, with
the breakdown of traditional Tibetan culture. Preservation of
the highest standards of medical scholarship, training and practice
are in urgent need of support. Rokpa
International, a Swiss-based humanitarian organisation,
already has a number of on-going initiatives for Tibetan medical
education, preservation of medical knowledge and provision of
clinics in remote areas. Tara Rokpa Edinburgh propose to support
a factory for the production of purely herbal Tibetan Medicines
which will meet UK and European Good Manufacturing Process (GMP)
standards as well as the traditional Tibetan ones (see
below - section on Good Manufacturing Process).
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TARA
ROKPA COLLEGE OF TIBETAN MEDICINE, EDINBURGH
The Tara Rokpa College of Tibetan
Medicine in Edinburgh, Scotland, was established in 1993 by
the Rokpa Trust, in conjunction with the Institute of Tibetan
Medicine in Lhasa. Rokpa Trust was founded by Dr. Akong Tulku
Rinpoche and is based at Kagyu Samye Ling Tibetan Centre, Dumfriesshire,
Scotland.
Dr.
Akong Tulku Rinpoche is a Tibetan lama and doctor who came
to the West in the 1960's. He was recognised at an early age
for his gifted qualities and was trained and educated to become
abbot of Drolma Lhakhang, a small but distinguished monastery
and retreat complex in a very high and desolate part of eastern
Tibet. He was also educated as a doctor of Tibetan Medicine,
as the previous abbot, the first Akong, had been known for his
healing ability.
Once in the West, Dr. Akong
Tulku Rinpoche co-founded Kagyu Samye Ling Tibetan Centre, which
has since grown to become a large monastery and retreat. From
there Rinpoche developed the Rokpa Trust, a charity with three
major activities:
 the
preservation of Tibetan Buddhism,
humanitarian
aid at a wordwide level, and
Tara
Rokpa.
Tara Rokpa is concerned with
the healing arts, both in terms of psychotherapy and medicine.
The Tara Rokpa College of Tibetan Medicine offers both training
and clinics.
The College has taken two groups
of health care professionals through a 6-month in-depth introduction
to the principles underlying Tibetan Medicine, with some of
the most knowledgeable and prominent teachers visiting from
Tibet, chief among them Khenpo Troru Tsenam, one of the most
highly respected and eminent masters of Tibetan Medicine in
Tibet.Over a period of four years the students spent six weeks
each year at Samye Ling, where they were taught by the highest
qualified Tibetan doctors.The teachings were translated into
English.The doctors were seconded from their teaching posts
at the University Hospitals.
Currently the curriculum is
being revised.A possible format for the next courses might include
two condensed 10-day modules per year over a two-to-three year
period.Alternative and orthodox health care practitioners will
be invited to attend.There will be a written core text which
will be taught in English and given to the students beforehand.Each
day there will be extensive question and answer sessions with
the teaching Tibetan doctor and a translator regarding the topics
covered that day.Each module will cover a specific topic from
the vast source of knowledge and practice of Tibetan Medicine.
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TTM
CLINICS
Tara Rokpa also holds clinics
with visiting doctors of Tibetan Medicine inEdinburgh, Glasgow,
Dundee, Kagyu Samye Ling (Dumfriesshire), and London. Doctors
working in the UK have chosen a special set of purely herbal
remedies fromthe whole tradition which are appropriate for use
within the legal framework.The present doctor, Dr. Lobsang Dhonden,
was trained at the Tibetan Astrological and Medicinal Institutes
in Lhasa, Tibet, and in Dharamsala, India, the foremost institute
outside of Tibet. The Tara College of Tibetan Medicine is concentrating
on refining the translation of core texts in the light of the
academic and clinical commentaries given by visiting doctors
of Tibetan Medicine.While the work is going on, the Tara College
of Tibetan Medicine is not offering courses, and the Clinics
of Tibetan Medicine, which are being promoted and administered
by Tara Rokpa Edinburgh, have become our main focus.
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STATUTORY
SELF-REGULATION
The Report of the House of Lords
Select Committee on Science and Technology on Complementary
and Alternative Medicine(CAM) is the first comprehensive enquiry
into complementary and alternative medicine in the UK.Tara Rokpa
Edinburgh fully supports the conclusions of this report. In
particular Tara Rokpa Edinburgh supports Statutory Self-Regulation
(SSR).This must include training standards which ensure a very
high quality of training for doctors of Tibetan Medicine working
in the UK/EU. This should include the necessary training in
Western clinical science and clinical treatments so that the
practice of Tibetan Medicine can happen within the proper context
of practice within Western society. Tara Rokpa Edinburgh supports
the integrated approach envisioned in the document, where conventional
and CAM can work side by side.In order to meet the standards
set in House of Lords Report, TRE plans to address such key
issues as training, research, self-regulation and appropriate
accreditation. We see herbal Tibetan Medicine fitting within
category 3a. Tara Rokpa Edinburgh is already beginning to address
necessary parts of SSR, including the establishment of a Tibetan
Medical Association which would have an accreditation as one
of its subcommittees.This will set standards of training, continuing
professional development and will oversee standards of clinical
practice and ethics.
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TRAINING
Training in Tibetan Medicine
traditionally took a full twelve years.Students studied grammar,
astrology, philosophy, ethics, and Buddhist studies as well
as the theory and practice of Tibetan Medicine.In recent times
shorter three-year courses at provincial colleges have been
a common form of training in Tibet, as the infrastructure within
Tibet broke down during "The Cultural Revolution".Those who
have the resources can go on to the universities and study for
a further five years.While there is extensive training of doctors
within the Tibetan Medicine system, there is a need for it to
integrate fully in the UK and EU.With this in mind, Tara has
been working closely with the EPHA and is in agreement with
the setting of a core curriculum for all practising herbalists
in the UK/EU situation.We support the suggested Core Curriculum:
1. Human Sciences
2. Nutrition
3. Clinical Sciences
4. Plant Chemistry and Pharmacology
5. Pharmognosy and Dispensing
6. Practitioner Development and Ethics
7. Practitioner Research
8. Module specific to each herbal tradition
9. Clinical Practice
Tara Rokpa Edinburgh is committed
to bringing its core curriculum in line with new regulations
being formed at UK and EU levels.It is clear that some grandparenting
procedures will be required for medical herbalists currently
practising within the UK.Tara Rokpa Edinburgh will work with
the UK Government, the European Herbal Practitioners Association
(EHPA) and other concerned bodies to bring about core training
standards which will be essential to proper Statutory Self-Regulation
(see above).
Tara Rokpa Edinburgh has hosted
some twelve different forms of psychological and physical therapies
at our headquarters in Edinburgh.These therapies have been offered
by therapists properly trained and accredited in their respective
disciplines. We have also offered two six-month modules of introductory
training in the foundational theory of Tibetan Medicine. All
of this work has as its underpinning a commitment to the highest
standards of clinical care for our patients. All practitioners
at Tara must adhere to our code of ethics and standards of best
practice. Any Accreditation Committee set up by the Tibetan
Medicine Association will maintain and oversee the clinical
practice of doctors of Tibetan Medicine both in terms of ethics
and best standards of practice. Continued Professional Development(CDP)
is seen as essential for all healthcare professionals.We will
require CDP as part of continued practice of Tibetan Medicine.
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RESEARCH
We envision three tracks for
research into Traditional Herbal Medicine.The first of these,
which has already begun, is basic data collection for patients
attending Tara Rokpa's clinics.This includes: 1. Side-by-side
comparison of Western diagnosis, where known, with the Tibetan
diagnosis, and 2. Tracking of changes in patients' condition
over the course of treatment. The second track is continued
monitoring of patients during and after treatment.At present
this is happening with an eye to safety, but only based on patient
self-reports.In future, we would like to establish research
protocols which confirm both safety and efficacy of treatment.Particular
attention might be paid to fluctuations (laboratory assessed)
in the function of major organ systems (eg. liver and kidney)
during the period of treatment. The third track will be rigorous
efficacy studies which aim to prove effectiveness for Tibetan
Herbal Medicine beyond placebo.For example preliminary research
indicates diabetes might be a good place to begin.Once we have
achieved an adequately stable organisational structure we aim
to begin randomised clinical trials.We also intend to establish
procedures for monitoring possible drug interactions between
Tibetan Medicines and Western prescribed medications.
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GOOD
MANUFACTURING PRACTICE
Tara Rokpa Edinburgh is cognisant
of GMP and to this end is concerned with best practice in the
cultivation and harvesting of herbs and the compounding of herbal
medicines.In Tibet, meticulous attention has traditionally been
paid to the particular growing conditions and harvesting times
and techniques for herbs and plants.However to bring this into
line with contemporary manufacturing standards we are currently
setting up a specially designed factory in Xining under the
direction of Dr Karma Tso-nyi, who is one of the Tibetan doctors
who has taught and practiced under the auspices of Tara Rokpa
Edinburgh in the UK. Attention will be paid to the organic growing
conditions of herbs, ensuring that there are no contaminants
from fertilisers, insecticides, chemical waste nor any incidental
contamination which might occur during the grinding or compounding
of medicines.Hygiene is a modern insight which is now being
incorporated and vigorously monitored for all stages of the
manufacturing process.We feel that it is very important to set
up laboratories, both in Tibet and in the UK, using gas chromatography
to ensure the purity of our herbal preparations.We also intend
to follow and incorporate storage, packaging, labelling and
distribution guidelines as laid down by European Directives.
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