Oriental therapies can help chronically ill people stay strong and reduce stress levels during epidemics, according to research.
Researchers have shown that people who practiced the Oriental art of Qigong - which combines gentle exercise with breathing techniques, meditation and visualisation - reaped considerable benefits during the SARS outbreak in Hong Kong.
It also helped them to cope with the stigmatisation and discrimination that developed against chronically ill people during the crisis, as they were seen as a high risk group with a much greater chance of being infected by, and dying from, the disease.
"We were already studying the health benefits of this very popular therapy when SARS - severe acute respiratory syndrome - hit Hong Kong" explains lead author Judy Yuen-man Siu, who carried out the research in the Department of Anthropology at The Chinese University of Hong Kong.
"Chronically ill people, like the ones in our study, were particularly at risk during the outbreak, which affected 1,755 people in Hong Kong and killed 299. Because our study had already been established, we were able to extend it to monitor how people harnessed Qigong, which was used by many Hong Kong people during the crisis."
The study looked at 98 people - mostly in their 40s to 50s - who had enrolled before the SARS outbreak and 70 who enrolled after the disease hit Hong Kong.
Three classes were observed for four months before the SARS crisis and for another four months during the outbreak.
All the participants - who were suffering from chronic health problems such as high blood pressure, diabetes, heart disease, musculo-skeletal problems, cancers and kidney disease - continued practising during the outbreak. None were infected.
As well as observing the study participants by immersing herself in the day-to-day life of the groups, Siu carried out in-depth interviews with 30 of them to discover their motivation and experience of Qigong during the SARS outbreak.
There were five key reasons why people chose to engage in Qigong:
· Participants saw Qigong as the most "legitimate" of the alternative therapies available to them.
· It provided gentle exercise at a time when they were getting older and their health was deteriorating.
· They felt Qigong was more effective than biomedicine, especially when they saw little improvement in their condition using conventional methods.
· Qigong provided a way of coping with the emotional burden of being discriminated against during the SARS crisis, when chronically ill people were seen as a high risk group
· The alternative therapy made them feel more in control of their health during SARS because they felt they were doing something positive.
"Because there was no definitive medical treatment available during the SARS crisis, people had to take whatever steps they could to protect themselves and many turned to the alternative therapies that are such a big part of Chinese culture" explains Siu, who is currently based in the School of Population Health at the University of Queensland.
"This resulted in a significant rise in the number of people joining our three observations groups just after the outbreak. They told us that they had considered practising Qigong because of their health problems and the SARS outbreak was the trigger that motivated them to do something about it."
As one new group member explained: "No remedies seem to have promising outcomes, so I think the best way is to rely on myself...At least I can do something actively for my health not just wait here and do nothing."
Another stressed that practising Qigong sent a message to others that he was being responsible, at a time when a chronically ill person was seen as a "super virus spreader" and heavily discriminated against.
Other comments included how peer support from other chronically ill people reduced isolation and feelings of discrimination and how Qigong, with its emphasis on breathing control, provided protection against SARS.
"As well as underlining the positive health and emotional benefits of Qigong, this study shows how chronically ill people can easily become scapegoats when there is a health crisis like SARS" concludes Siu.
"People turned to Qigong to improve their health and provide protection against SARS. But they also did it because they needed the social support of other chronically ill people and to find a way of coping with the emotional burdens of their illness at a very difficult time.
"We believe that this study provides a valuable insight into how chronically ill people cope in epidemic conditions and provides healthcare professionals with important pointers for dealing with the special needs of chronically ill people during future outbreaks."