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Table 3 Malaria symptoms and related local treatment options

From: Local constraints to access appropriate malaria treatment in the context of parasite resistance in Cambodia: a qualitative study

Condition

Treatment

Examples of local treatment options

Krun chan (malaria)

Tnam Khmer (herbal medication)

Take twigs of a sdaw tree, peel them, mix with three cups water and boil until one cup remains, resulting in a very bitter mixture. A variant is to soak the twigs in water instead of boiling, although the mixture is then believed to be less effective

Eat 10–20 chillies per day as prevention to krun chan

Take bon-dole-pek (a kind of winder), the bark of the sdaw tree and the bark of the kdol tree. Cut it into pieces and clean it with water. Then you can either boil it or soak it in water, before drinking. If you boil it, you take tree cups of water and boil it until one cup is left. Repeat this procedure for another two times, adding water each time. Then add rice flour (msaw) to the mixture, stir it, and when it is well mixed, make round pills of it to swallow. To make these pills, often a bamboo layer is used

Tnam Pet (biomedical medication)

Paracetamol (para)

Antibiotics such as amoxicillin and ampicillin

Antimalarials such as artesunate-mefloquine (malarine), quinine, chloroquine, tetracycline

Often sold in a ready-made mix (psom tnam)

Kjol (discomfort)

Manual therapy

Coin-rubbing (kos kjol): a very popular self-care technique among the Khmer, during which neck, chest, back shoulders and upper arms are vigorously rubbed with the edge of a coin, spoon or cover of a small tin box, lubricated with Tiger Balm or other types of heat rub, until the scraped areas turn red. The darker the red, the more effective the procedure is perceived to be

Cupping (chup kjol): another practice to relief internal pressure linked to kjol, which refers to placing heated small cups on the part of the body that is troubling the person. This can be the chest, the back, the upper arms or the forehead. Bad air (kjol) is perceived to be sucked out of the skin when the air inside the cup cools down and a vacuum is built. Red circular marks are left on the skin, which will remain for several days (see Fig. 2)

Pulling hair strand (dork sork), all around the head, by short twitches, causing a feeling of svaang (relief)

Chaab kjol, a specific type of massage which is considered as the most painful of all the techniques to relieve the bad air, as it produces bruising, by pinching and releasing skin folds repeatedly over the same site while applying Tiger Balm, thereby increasing the circulation of blood to the area

Kob sorsaai (blockage of meridian)

Tnam sorsaai (herbal medication)

Take the bark of the bom-pong chong-krom tree and boil it

Take the roots of the sdaw tree and ang kroang plant and boil these together with leaves of the sdoal tree in water

Manual therapy

Massage of the sorsaai (chaab sorsaai, kes kaay (i.e. “dig up”) or tver sorsaai)

Krun kdaw (fever that feels hot)

Manual therapy

Showering

Fanning (bork)

Wiping or covering the person with a krama soaked in water or with slices of traw-larch (winter melon)

Coin-rubbing (kos kjol)

Cupping (chup kjol)

Tnam trawjak (herbal medication reducing high body temperature)

Pile bitter melon leaves and sav mov leaves together, add sugar, and mix it with water, which results in a very better mixture

Mix the roots of three kinds of plants, sbaw plaeng, pkaah-yok and chkaeh sreng, together and boil it with water

Take the barks of the trees kagn-jes and roh-lork, and mix it with 3 cups of water. Boil it until only one cup is left. Add water and repeat this procedure for another two times

Tnam pet (biomedical medication)

Mostly paracetamol (para)

Krun njeak (fever with shivering)

Tnam Khmer (herbal mediciation)

Take the roots or bark of the trom kmoach and ampov kmao dai darch trees and boil them in water together with the skin of a ripe coconut for around half an hour. It is also a remedy against digestion related problems.

Cheu kbaal (headache)

Tnam Khmer (herbal mediciation)

Take the leaf traw-jeak chruk, grind it and put it in water.

Manual Therapy

Coin-rubbing (kos kjol)

Fatigue

Manual Therapy

Coin-rubbing (kos kjol)

Malaise

Manual Therapy

Coin-rubbing (kos kjol)