By Jennifer Gampell

Rosana Tositrakul, secretary general of the Thai Holistic Health Foundation, sits with three fellow members of her non-governmental organization on one side of a practically empty conference room at the Thai Ministry of Public Health. Dr. Narong Chayakul, the newly appointed secretary general of the Food and Drug Administration of Thailand, sits at the head of the table, flanked by a handful of F.D.A. officials.

For the past 15 minutes, the bureaucrats have been intoning the official position on a draft amendment to the 1967 Drug Act that is wending its arduous way through the multi-channeled Thai legislative system. The men speak in condescending tones, rarely making eye contact with their small audience of health activists. One official keeps nodding off.

Tositrakul switches on her microphone and addresses her nominal counterpart. "We have been working for nearly 20 years to revive the use of traditional herbal medicine in Thailand," she says, speaking forcefully and gesticulating for emphasis, "and I don't want all our efforts to come to nothing."

Point by point, she addresses problems in the proposed amendment. Soon everyone in the room is sitting up and leaning forward to listen.

The draft amendment has already been approved by the Cabinet but Dr. Narong, who has been at his post just over a month, has the authority to recommend revisions before it moves on from the Council of State to Parliament and the Senate. Tositrakul called this meeting in November 1999 to see whether the current secretary general would stick to his predecessors' promise to reconsider certain portions of the draft law.

Under the guise of upgrading standards of pharmaceutical production, the amendment would apply a single criteria – Good Manufacturing Practice – to the manufacture of both traditional and conventional medicines. Tositrakul believes that combining the two branches of treatment will effectively wipe out traditional medicine manufacturers by forcing them to implement expensive production techniques.

Tositrakul cites the experience of Germany, which enacted strict regulations for the production of herbal medicines. Within 12 years, 85 percent of small manufacturers had disappeared. She has been speaking out against the bill since it was first presented in 1997 and is spearheading lobbying to make the F.D.A. create a separate, clearly defined manufacturing practices for traditional medicine.

Traditional Medicine: A Victim of Modernization

Thai consumers will spend an estimated $60 million on imported medicines in 2000. Tositrakul insists that if the proposed law goes through and the role of traditional medicine is vastly curtailed, the Thai public will be forced to rely even more on Western remedies.

"You should not cut your foot to fit the shoe," is how the 46-year-old social activist describes Thailand's approach to regulating its pharmaceutical industry. "The shoe may be beautiful, but if it hurts your foot you cannot walk. You should cut the shoe to fit your foot."

After Thailand embarked on modernization in the early 1900s, hundreds of years' worth of traditional healing practices began falling into disuse and ultimately disrepute. University-trained physicians told villagers that their herbal remedies were unscientific and therefore unsafe.

Government slogans, like "Don't treat yourself, go to the doctor" and "If you want medicine, visit the pharmacist," further reinforced these notions. Although by the late 1970s, only about 30 percent of the people had access to the care provided by the Ministry of Public Health, reliance on Western medicine had become synonymous with "development."

Tositrakul didn't accept the government model. "Around 80 percent of illnesses are common and can be treated by people themselves," she maintains. She is a firm believer in humans focusing on creating right livelihoods for themselves and in being in control of the four basic necessities: food, clothing, shelter and medicines.

In 1980, as a recent graduate from Thammasat University in Bangkok, Tositrakul teamed up with a friend to form Traditional Medicine for Self Reliance, an NGO dedicated to reviving the knowledge of Thai traditional medicine as a means of empowering local communities. In 1990, the name was changed to Thai Holistic Health Foundation, ThaiHof, to reflect the expanded scope of the organization's efforts.

"The farmers and village people had the knowledge about herbal remedies, but at that time they felt inferior and lacked the confidence to trust in their own local wisdom," she explains in her office at ThaiHof headquarters, a modest wooden house in a Bangkok suburb. Dressed in a simple patchwork skirt and blouse made from scraps of traditional Thai silk, she sits behind a desk half buried under piles of file folders.

Tositrakul went from village to village in the Kudchum district, in the central region of Thailand, collecting data on medicinal plants and learning about centuries-old herbal recipes. Initially she disseminated the information on photocopied pages.

As the document grew from four to 16 pages, she switched to a magazine format and finally to publishing small booklets. Today the 40-title library has gone through more than 10 printings.

Ironically, it was Western intervention that shifted the government's position on conventional medicine: In 1984 the World Health Organization began to promote traditional medicine as one element of primary health care. Around that time, UNICEF funded a project in Thailand to collect and disseminate data on herbal medicine. As head of the only NGO working in this field, Tositrakul was invited to join the committee.

Meanwhile, in Thalaad, a village in Kudchum, she had joined forces with the abbot of the village temple ("wat" in Thai), a group of traditional healers, and a doctor and nurse from the local hospital. Like Tositrakul, Abbot Phra Supajarawat believed that by alleviating their poverty and thus their low status, the rural poor's battered self-esteem would see an upswing. To his mind, environmental ecology was a tangible route for effecting this change, echoing as it did, the popular saying: "the forest is a supermarket for the villagers."

The group set up a health center and herb garden in the temple compound in 1983. The villagers began visiting Wat Thalaad for herbal medicines and, empowered by their new sense of community, were soon were planting their own herb gardens. By 1986, Kudchum villagers were spending 75 percent less a year on conventional medicines, down from approximately 12,000 baht per family to 3,000 baht.

Learning Lessons in Japan

In 1989 Tositrakul spent a year in Japan working with Masanobu Fukuoka, a visionary philosopher-cum-agriculturist who believes natural farming embodies the interrelationship between body and soul. Inspired by Fukuoka's holistic approach to farming, she translated his seminal book "The One-Straw Revolution" from English into Thai. The book has been reprinted 10 times in the past 12 years.

In 1990, Tositrakul invited Fukuoka to Thailand to visit farmers in Kudchum and in other parts of the country. She also organized informational field trips and seminars between farmers in Kudchum and other provinces. Fukuoka's visit inspired the farmers to follow his natural farming methods and was the genesis of the pesticide-free rice farming movement in Thailand.

1990 was a year of change for Tositrakul and ThaiHof. "When we assessed our progress after the first 10 years, we discovered our activities were only partly successful," she explains. For example, despite the reduction in the cost of their medicines, the Kudchum farmers had ultimately abandoned growing herbs for their own consumption. They found the activity too time-consuming and discovered that no other economic benefits accrued to them save for the reduction in medical bills.

Instead, they preferred wage employment, which would allow them purchasing power for ready-made herbs, among other things. To sustain an activity then, Tositrakul realized her methodology must expand to include an economic incentive.

Tositrakul also determined that like the villages it helped, ThaiHof needed to become self reliant and generate its own income. With no assistance at first from the government, the NGO was entirely dependent on grants from foreign donors.

With the rise in health consciousness among Thais brought about by the concomitant increase in non-communicable diseases – cancer, diabetes and heart disease – Tositrakul felt the need for a more holistic approach. Thus, after a decade of working solely with farmers and villagers, Tositrakul decided it was time to establish links between the rural sector and the increasingly health conscious urban consumer.

Building the Commercial Underpinnings

These self-assessments led to Friends of Nature, the income-generating offshoot of ThaiHof. The idea of separating business activities from social/community development originated with an outspoken Thai social critic, Prawes Wasi. Making money by providing useful products and services was not inherently evil, he told her, as long as all the profits went to support the social activity.

Friends of Nature handles all the consumer-related and commercial aspects of ThaiHof activities. Part retailer, part wholesaler, part producer, it has grown from a tiny health food store attached to the ThaiHof offices to a successful and entirely self-sufficient small company.

Started in 1992 with $80,000 seed money, Friends of Nature generated nearly $290,000 worth of sales in 1998. Of the 200 items offered for sale in the store, 40 carry the Friends of Nature brand name (retail sales accounted for only 30 percent of the total). The $52,000 profit earned in 1998 paid the salaries of its 15 employees and contributed 10 percent toward ThaiHof's $52,000 annual budget.

By the summer of 2000, the country's first traditional health institute should be up and running on the outskirts of Bangkok. Built with an $84,000 grant from the Japanese Embassy, it will provide a multidisciplinary approach to holistic healing.

The early 1990s were also a seminal time for the small farmers of Kudchum. For years rice cultivation had trapped them in a pernicious cycle. To increase production, they had to rely on expensive fertilizers, which damaged the soil and kept them indebted to banks and the unscrupulous mill operators who often cheated them on the weight of their crop.

Fukuoka's visit had introduced them to the concept of non-chemical farming and reaffirmed the viability of the integrated farming methods they had abandoned in favor of rice monoculture. Encouraged by a string of small but crucial successes with the herb gardens and the health center, the farmers decided to take control over the mainstay of their livelihood: rice milling.

With about $16,000 as advance payment for milled rice from Friends of Nature and another $60,000 raised through share offerings, in Sok Khumpoon village the farmers formed the "ruk thammachat" group – nature care and conservation group – which ran its own rice mill. When the mill started operations in August 1991, the member-farmers received an average of $6.70 per metric ton for their pesticide-free rice above the market rate for normally produced rice.

The mill also set up a "rice savings system," in which farmers keep their rice at the mill and sell it when the price rises. And instead of cutting costs by using machines for processing and packaging, the process of hiring locals was continued. In addition to annual dividends based on the number of shares held, beginning in 1996 members also received a bonus for every ton sold.

Reaching the Critical Mass of Businessgs

Business-savvy friends of ThaiHof taught the farmers accounting and marketing skills. In an industry renowned for fiduciary fog, the mill's accounts are a paragon of transparency.

From 302 households in 1992, the farmer-run cooperative grew to nearly 1,100 families in 1999. (A second mill was recently built to cope with the increased volume of rice.) Now, instead of looking for work in Bangkok, several university graduates have come back to their village to manage the business side of the mill.

Tositrakul is not overly concerned with a temporary financial downturn, due in part to the devaluation of the Thai currency. As she points out: "Money is not a measure of success. If you think development is only about money, you have a very narrow idea."

The Kudchum rice mill was the first in the country to produce brown rice (initially sold through Friends of Nature but now available at throughout Bangkok). From the outset, a few farmers also focused on using fewer chemicals, motivated partly because of increased consumer awareness, but also to reduce their expenses. (In Thailand, the sales-price difference between organic and conventional rice is small.) Unfortunately the definitions of chemical-free, pesticide-free and organic are only now becoming standardized, so early production levels are hard to quantify.

By 1999, 61 Kudchum households were producing 100 percent organic rice along with other chemical-free crops. Fifty-five of these same households are also members of the newly-formed Raw Materials Center, which produces organic herbs and sells them to Friends of Nature. The mill was the first to export organic jasmine rice to Europe.

Tositrakul laughs. "We have to force him to keep his promise. If you don't keep sticking to the point, they will forget you. They want to forget you." For Rosana Tositrakul, every facet of human existence comprises holistic health, even politics.