Sağlık Turizminde Geleneksel ve Tamamlayıcı Tıp: Kupa ve Sülük Uygulamaları Kayseri Örneği

Year 2024, , 149 - 164, 23.12.2024

Nihat Çeşmeci , Fadime Demirtepe

https://doi.org/10.51525/johti.1552728

Abstract

Bu araştırmanın temel amacı, başta kupa (hacamat) ve sülük tedavileri olmak üzere, geleneksel ve tamamlayıcı tıp uygulamalarının sağlık turizmi bağlamındaki potansiyelini araştırmaktır. Araştırma, bu iki uygulamayla ilgili ulusal ve uluslararası düzeyde turist hareketliliğinin boyutunu tespit etmeyi ve bu alanda gelecekteki potansiyel eğilimleri belirlemeyi amaçlamaktadır. İlk olarak, kupa ve sülük tedavilerinin sağlık turizmindeki rolünü belirlemek için literatür taraması yapılmış ve buna dayalı olarak nitel araştırma tasarımı geliştirilmiştir. Daha sonra, çoğunluğu Kayseri'deki hastanelerin geleneksel ve tamamlayıcı tıp (GETAT) birimlerinde çalışan on iki sağlık profesyonelinden yarı yapılandırılmış görüşme tekniği ile birincil veri toplanmıştır. İçerik analizi sonrasında elde edilen bulgular, özellikle COVID-19 pandemisi sonrasında sağlık turizminde geleneksel ve tamamlayıcı tıp uygulamaları olan kupa ve sülük tedavilerine artan bir ilgi olduğunu göstermektedir. Ancak, bu tedaviler için Kayseri'ye gelen sağlık turistlerinin çoğunun, bu tedaviler için özellikle seyahat eden uluslararası turistlerden ziyade, gurbetçiler veya yerli turistler olduğu belirlenmiştir. Bulgulara dayanarak, bu alandaki gelişmenin, somut olmayan kültürel miras olarak da görülebilecek bu iki terapinin daha iyi tanıtılmasına bağlı olduğu tespit edilmiştir. Ayrıca bulgular, akupunktur, ozon tedavisi, homeopati ve fitoterapi gibi geleneksel ve tamamlayıcı tıp uygulamalarının da sağlık turizminin gelişimine katkı sağlayabilecek önemli potansiyele sahip olduğunu göstermektedir.

Keywords

Sağlık Turizmi, Geleneksel ve Tamamlayıcı Tıp, Hacamat, Sülük Terapisi, Kayseri

Traditional and Complementary Medicine in Health Tourism: Cupping and Leech Therapy Case from Kayseri

Abstract

The primary objective of this research is to investigate the potential of traditional and complementary medicine (T&CM) practices, especially cupping and leech therapy, in the context of health tourism. The research aims to ascertain the extent of tourist mobility on national and international levels related to these two practices and identify potential future trends in this field. First, a literature review was undertaken to figure out the role of cupping and leech therapies in health tourism, which informed the development of the qualitative study research design. Subsequently, a semi-structured interview was employed to collect data from twelve health professionals, mostly working in T&CM units within hospitals in Kayseri. Findings obtained after content analysis, demonstrate a growing interest in cupping and leech therapy as T&CM practices in health tourism, particularly after the COVID-19 pandemic. However, the study noted that most health tourists coming to Kayseri for these therapies are expatriates or regional tourists rather than international tourists traveling specifically for these treatments. Based on findings, the study suggests that growth in this area depends on better promotion of these therapies which can also be seen as intangible cultural heritage. Additionally, the findings indicate that T&CM practices, including acupuncture, ozone therapy, homeopathy, and phytotherapy, could have significant potential to contribute to the future development of health tourism.

Keywords

Health Tourism, Traditional and Complementary Medicine, Cupping, Leech Therapy, Kayseri

References

• Akın, M. H., & Orhan, H. C. (2024). Evaluation of health tourism awareness of employees in the tourism industry: The case of Kayseri. Turizm ve İşletme Bilimleri Dergisi, 4(2), 257-278.
• Al-Bedah, A. M., Elsubai, I., Qureshi, N. A., Aboushanab, T., Ali, G. I. M., El-Olemy, A. T., … & Alqaed, M. S. (2019). The medical perspective of cupping therapy: Effects and mechanisms of action. Journal of Traditional and Complementary Medicine, 9(2), 90-97. https://doi.org/10.1016/j.jtcme.2018.03.003
• Al-Bedah, A. M., Khalil, M., El-Olemy, A. T., Elsubai, I., & Khalil, A. (2011). Hijama (cupping): a review of the evidence. Focus on Alternative and Complementary Therapies, 16(1), 12-16. https://doi.org/10.1111/j.2042-7166.2010.01060.x
• Al-Bedah, A. M., Khalil, M., El-Olemy, A. T., Mudaiheem, A. A., Eidi, S. A., Al-Yahia, O. A., … & Henary, B. Y. (2013). The use of and out-of-pocket spending on complementary and alternative medicine in Qassim province, Saudi Arabia. Annals of Saudi Medicine, 33(3), 282-289. https://doi.org/10.5144/0256-4947.2013.282
• Al-Bedah, A. M., Khalil, M., Posadzki, P., Sohaibani, I., Aboushanab, T., Alqaed, M. S., … & Ali, G. I. M. (2016). Evaluation of wet cupping therapy: Systematic review of randomized clinical trials. The Journal of Alternative and Complementary Medicine, 22(10), 768-777. https://doi.org/10.1089/acm.2016.0193
• Al-Rubaye, K. Q. A. (2012). The clinical and histological skin changes after the cupping therapy (al-hijamah). Journal of the Turkish Academy of Dermatology, 6(1). https://doi.org/10.6003/jtad.1261a1
• Archibald, M. M. (2015). Investigator triangulation. Journal of Mixed Methods Research, 10(3), 228-250. https://doi.org/10.1177/1558689815570092
• Ayhan, H., & Mollahaliloğlu, S. (2018). Tıbbi sülük tedavisi: Hirudoterapi. Ankara Medical Journal, 18(1), 141-148. https://doi.org/10.17098/amj.409057
• Baran, Y. (2013). The leech craze: The medicinal use and commodification of leeches in the nineteenth century Ottoman Empire. Tarih, 3, 49-75.
• Bayram, H.S., & Akkülah, A.U. (2020). Kayseri sağlık turizminin geliştirilmesi. Mevcut durum analizi ve 2021–2030 eylem planı. Retrieved 25 April, 2024 from, https://www.oran.org.tr/images/dosyalar/20200910102654_0.pdf
• Biçer, İ., & Yalçın Balçık, P. (2019). Geleneksel ve tamamlayıcı tıp: Türkiye ve seçilen ülkelerinin incelenmesi. Hacettepe Sağlık İdaresi Dergisi, 22(1), 245-257.
• Buluk Eşitti, B., & Güzel, T. (2020). A different way of increasing the variety of wellness and health tourism: Cupping therapy (hijama). Turkish Studies, 15(8), 3429-3444. https://dx.doi.org/10.7827/TurkishStudies.46868
• Burton, A., Smith, M. L., & Falkenberg, T. (2015). Building WHO's global strategy for traditional medicine. European Journal of Integrative Medicine, 7(1), 13-15. https://doi.org/10.1016/j.eujim.2014.12.007
• Çeşmeci, N. (2022). A tour program proposal for promoting Kayseri province as a cultural destination. In: E. İ. Şahin & M. L. Emek (Eds), 3rd International Anatolian Congress on Scientific Research Proceedings Book Volume-III (pp. 401-403), IKSAD International Publishing House.
• Çeşmeci, N., & Ertan, F. (2023). Kayseri turizmi üzerine hazırlanmış lisansüstü tezlere yönelik bibliyometrik bir inceleme. İçinde: D. Köse (Ed), Sosyal, beşeri ve idari bilimler alanında uluslararası araştırmalar 2 (ss. 233-259), Platanus Publishing.
• Çiftci, M. M. (2019). Kupa tedavisi ve klinik uygulamalar. Journal of Biotechnology and Strategic Health Research, 3, 22-28. https://doi.org/10.34084/bshr.537972
• Deniz, D., Sevimli, E., & Ünlü, T. N. (2021). An overview of traditional and complementary medicine initiatives and strategies. Sağlık Akademisyenleri Dergisi, 8(1), 85-89.
• Ebrahim, A. H., & Ganguli, S. (2019). A comparative analysis of medical tourism competitiveness of India, Thailand, and Singapore. Tourism: An International Interdisciplinary Journal, 67(2), 102-115.
• Elassal, I., Elmallwany, E., & Hammad, A. (2024). Practice cupping therapy as a sustainable medical heritage from Andalusian and Ottoman surgery: a case study of Kitāb al-Taṣrīf and Cerrahiye-i Ilhaniye manuscripts. Journal of Cultural Heritage Management and Sustainable Development. https://doi.org/10.1108/jchmsd-07-2023-0111
• El Sayed, S.M., Mahmoud H. S. & Nabo M. M. H. (2013). Methods of wet cupping therapy (Al-hijamah): In light of modern medicine and prophetic medicine. Alternative & Integrative Medicine, 02(03). https://doi.org/10.4172/2327-5162.1000111
• Fereday, J. & Muir‐Cochrane, E. (2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods, 5(1), 80-92. https://doi.org/10.1177/160940690600500107
• Francis, J. J., Johnston, M., Robertson, C., Glidewell, L., Entwistle, V., Eccles, M., … & Grimshaw, J. (2010). What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychology & Health, 25(10), 1229-1245.
• Ghods, R., Sayfouri, N., & Ayati, M. H. (2016). Anatomical features of the interscapular area where wet cupping therapy is done and its possible relation to acupuncture meridians. Journal of Acupuncture and Meridian Studies, 9(6), 290-296. https://doi.org/10.1016/j.jams.2016.06.004
• Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough?. Field Methods, 18(1), 59-82. https://doi.org/10.1177/1525822x05279903
• Gulland, A. (2016). Global life expectancy increases by five years. British Medical Journal, 353. https://doi.org/10.1136/bmj.i2883
• Gödekmerdan, A., Arusan, S., Bayar, B., & Sağlam, N. (2011). Tıbbi sülükler ve hirudoterapi. Turkish Journal of Parasitology, 35(4), 234-239. https://doi.org/10.5152/tpd.2011.60
• Hennink, M., Kaiser, B. N., & Marconi, V. C. (2016). Code saturation versus meaning saturation. Qualitative Health Research, 27(4), 591-608. https://doi.org/10.1177/1049732316665344
• Hyson, J. M. (2005). Leech therapy: A history. Journal of the History of Dentistry, 53(1), 25-27.
• Iqbal N., & Ansari A. A. (2013). Al-Hijamah (cupping): the natural holistic healing art-a review. International Journal of Advanced Ayurveda, Yoga, Unani, Siddha and Homeopathy. 2(1), 23–30.
• Jiang, Z., Wei, Y., & Dong, J. (2019). Multi-dimensional resource integration concept and development path of traditional medicine in the new era. Traditional Medicine and Modern Medicine, 02(03), 85-91. https://doi.org/10.1142/s2575900019100025
• Krstić, V., Đurađević, M., & Trišić, I. (2020). The impact of complementary medicine on sustainable tourism development through event and nature-based tourism. Ekonomika Poljoprivrede, 67(2), 377-390. https://doi.org/10.5937/ekopolj2002377k
• Krstić, V. & Živanović, S. (2020). Ethical principles of complementary medicine application in health tourism. Hotel and Tourism Management, 8(1), 111-122. https://doi.org/10.5937/menhottur2001111k
• Kulakoğlu, F. (2011). Kültepe-Kaneš: a second millennium B.C.E. trading center on the central plateau. In: McMahon, G., Steadman, S. (Eds), The Oxford handbook of Ancient Anatolia: (10,000-323 BCE) (pp. 1012-1030). Oxford University Press.
• Küçük, Ö. M., & Yaman, O. (2019). Tıbbi sülük terapisi (Hirudoterapi). Journal of Biotechnology and Strategic Health Research, 3, 29-46. https://doi.org/10.34084/bshr.576663
• Liang, Z., Hu, H., Li, J., Yao, D., Wang, Y., & Ung, C. O. L. (2021). Advancing the regulation of traditional and complementary medicine products: A comparison of five regulatory systems on traditional medicines with a long history of use. Evidence-Based Complementary and Alternative Medicine, 2021, 1-16. https://doi.org/10.1155/2021/5833945
• Majeed, S. & Kim, W. G. (2022). Emerging trends in wellness tourism: a scoping review. Journal of Hospitality and Tourism Insights, 6(2), 853-873. https://doi.org/10.1108/jhti-02-2022-0046
• Majeed, S., Lu, C., & Javed, T. (2017). The journey from an allopathic to natural treatment approach: A scoping review of medical tourism and health systems. European Journal of Integrative Medicine, 16 (2017), 22-32. https://doi.org/10.1016/j.eujim.2017.10.001
• Majeed, S., Majeed, M., & Ajike, M.A., (2019). Dry cupping therapy and the wellness management of health travelers. Traditional Medicine Research, 4(1), 12–24. https://doi.org/10.53388/tmr201915095
• Malterud, K., Siersma, V., & Guassora, A. D. (2016). Sample size in qualitative interview studies. Qualitative Health Research, 26(13), 1753-1760. https://doi.org/10.1177/1049732315617444
• Masoud, H., Mortazavi, M., & Farsani, N. T. (2019). A study on tourists' tendency towards intangible cultural heritage as an attraction (Case study: Isfahan, Iran). City, Culture and Society, 17, 54-60. https://doi.org/10.1016/j.ccs.2018.11.001
• Mollahaliloğlu, S., Uğurlu, F., Kalaycı, M., & Öztaş, D. (2015). Geleneksel ve tamamlayıcı tıp uygulamalarında yeni dönem. Ankara Medical Journal, 15(2), 102-105. https://doi.org/10.17098/amj.44789
• Munshi Y., Ara I., Rafique H., & Ahmad Z. (2008). Leeching in the history-A review. Pakistan Journal of Biological Sciences, 11(13), 1650–1653.
• Nayab, M., Tausif, M., Lari, J., & Alam, A. (2017). Therapeutic potentials of hijama-bila-shart (dry cupping therapy): A review. International Journal of Unani and Integrative Medicine, 1(1), 21-24.
• Naaz, F., & Khan, N. (2016). Medical tourism in India: Perspective of Unani medicine. Journal of AYUSH: Ayurveda, Yoga, Unani, Siddha and Homeopathy, 5(3), 52-60.
• Okumuş, M. (2016). Kupa tedavisi ve hacamat. Ankara Medical Journal, 16(4), 379-382. https://doi.org/10.17098/amj.68279
• Özcan, M. (2024). Türkiye Cumhuriyeti Sağlık Bakanlığı, Sağlık Hizmetleri Genel Müdürlüğü, Geleneksel, Tamamlayıcı ve Fonksiyonel Tıp Uygulamaları Dairesi Başkanlığı İstatistiki Bilgiler. Retrieved 15 August 2024, https://shgmgetatdb.saglik.gov.tr/TR-52962/daire-baskanligi-istatistikleri.html
• Pan, S. Y., Gao, S. H., Zhou, S. F., Tang, M. K., Yu, Z. L., & Ko, K. M. (2012). New perspectives on complementary and alternative medicine: An overview and alternative therapy. Alternative Therapies in Health and Medicine, 18(4), 20-36.
• Parlakpınar H., & Polat S. (2021). Hirudoterapi (tıbbi sülük uygulaması) tarihçesi. İçinde. Hakan Parlakpınar, (Ed). Hirudoterapi (Tıbbi Sülük Uygulaması). Ankara: Türkiye Klinikleri. 1-6.
• Parlakpınar, H., & Polat, S. (2020). Kupa tedavisine genel bir bakış. Journal of Traditional Medical Complementary Therapies, 3(2), 246-264. https://doi.org/10.5336/jtracom.2019-72649
• Paudyal, V., Cadogan, C., Fialová, D., Henman, M., Hazen, A., Okuyan, B., … & Stewart, D. (2021). Provision of clinical pharmacy services during the COVID-19 pandemic: Experiences of pharmacists from 16 European countries. Research in Social and Administrative Pharmacy, 17(8), 1507-1517. https://doi.org/10.1016/j.sapharm.2020.11.017
• Peng, J., Yang, X., Fu, S., & Huan, T. (2023). Exploring the influence of tourists’ happiness on revisit intention in the context of Traditional Chinese Medicine cultural tourism. Tourism Management, 94, 104647. https://doi.org/10.1016/j.tourman.2022.104647
• Portella, C. F. S., Ghelman, R., Abdala, C. V. M., & Schveitzer, M. C. (2020). Evidence map on the contributions of traditional, complementary, and integrative medicines for health care in times of COVID-19. Integrative Medicine Research, 9(3), 100473. https://doi.org/10.1016/j.imr.2020.100473
• Qureshi, N. A., Ali, G. I. M., Abushanab, T. S., El-Olemy, A. T., Alqaed, M. S., Elsubai, I., … & Al-Bedah, A. M. (2017). History of cupping (Hijama): A narrative review of literature. Journal of Integrative Medicine, 15(3), 172-181. https://doi.org/10.1016/s2095-4964(17)60339-x
• Saad, A., (2015). Reviving the cupping therapy “Al-hijama” through the framework of developing health care tourism in Egypt. Journal of Tourism and Hospitality, 04(05). https://doi.org/10.4172/2167-0269.1000178
• Schreier, M. (2018). Sampling and generalization. In U. Flick (Ed) The SAGE Handbook of Qualitative Data Collection (pp. 84–98), SAGE.
• Singh, A. P. (2010). Medicinal leech therapy (hirudotherapy): A brief overview. Complementary therapies in clinical practice, 16(4), 213-215.
• Suri, H. (2011). Purposeful sampling in qualitative research synthesis. Qualitative Research Journal, 11(2), 63-75. https://doi.org/10.3316/qrj1102063
• Talhaoğlu, D. (2021). Geleneksel ve tamamlayıcı tedavi uygulamaları. Bütünleyici ve Anadolu Tıbbı Dergisi, 3(1), 16-29. https://doi.org/10.53445/batd.945893
• Tosun, N., Demir, Y., & Sağlik, E. (2020). Traditional and complementary medicine from health tourism perspective. International Journal of Health Management and Tourism, 5(1), 32-43. https://doi.org/10.31201/ijhmt.694384
• Traditional and Complementary Medicine Practices Regulation (2014). Official Gazette of the Republic of Türkiye (29158, 27 October 2014).
• Tuna, H. (2021). Sağlık turizmi̇ kapsamında geleneksel, tamamlayıcı ve fonksi̇yonel tıp turi̇zmi̇. Bolu Abant İzzet Baysal Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 21(1). https://doi.org/10.11616/basbed.v21i60671.861856
• Ünal, K., & Erol, M. E. (2022). Tıbbi sülük tedavisinin bilimsel değeri. Anadolu Tıbbı Dergisi, 1(3), 37-45.
• Walters, T. (2016). Using thematic analysis in tourism research. Tourism Analysis, 21(1), 107-116. https://doi.org/10.3727/108354216x14537459509017
• World Health Organization. (2024). Traditional, Complementary and Integrative Medicine. Retrieved 3 August 2024, https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine#tab=tab_1
• World Health Organization. (2019). WHO global report on traditional and complementary medicine 2019. World Health Organization. ISBN: 9789241515436.
• Yükselir Alasırt, F., & Yalçın Balçık, P. (2022). Geleneksel ve tamamlayıcı tıbba yönelik görüşlerin değerlendirilmesi: Aile sağlığı merkezi örneği. Hacettepe Sağlık İdaresi Dergisi, 25(2), 409-428.
• Zararsız, F. (2022) Geleneksel ve tamamlayıcı tıp (GETAT) uygulamalarına yönelik tutum ve davranışların belirlenmesi ve sağlık turizmi açısından değerlendirilmesi: Alanya örneği. [Master's thesis, Alanya Alaaddin Keykubat University]. Alanya Alaaddin Keykubat University Repository http://acikerisim.alanya.edu.tr/xmlui/handle/20.500.12868/1493