Trade-off between herbal and allopathic treatments: An ethnopharmacological case study in Rema-kalenga wildlife sanctuary, Bangladesh

The Rema-Kalenga Wildlife Sanctuary (RKWS) is a protected forest in Bangladesh that houses a variety of rare flora and fauna and supports the sustenance of 13 ethnic communities. This forest's indigenous and other inhabitants traditionally have a strong cultural connection to the plants, particularly medicinal plants. Due to modern allopathic medicine's rapid growth and commercial tree species prioritization, many medicinal plants are now on the verge of endangerment. Under such circumstances, it is crucial to explore how the local community perceives the importance of herbal treatments in contrast to allopathy, the underlying reasons for their perceptions, and the specific ailments for which they use the plants. The main objectives are: 1) to evaluate the perceptions of the local community towards allopathy and herbal medicine using Nussbaum's central capabilities approach, 2) to identify medicinal plant diversity, therapeutic usages, and quantitative indices, 3) to determine the factors that influence the use of medicinal plants. Repeated interviews and field surveys were conducted at the RKWS, interviewing 145 people, including the indigenous community (72.42 %) and traditional healers (8.27 %) from the surrounding seven villages. The study identified 51 medicinal plant species belonging to 39 families for their potent medicinal properties in treating various ailments. The predominant parts of the plants used in the treatments were leaves and roots. The uses were classified into 12 categories according to Nussbaum's central capabilities. The findings identified Aloe vera, Phyllanthus emblica, and Azadirachta indica as highly culturally important species. In contrast, Terminalia arjuna, Swertia chirata, and Azadirachta indica were found to have the highest relative importance. The underlying determinants influencing the preferences of individual users towards herbal medicine were income from agroforestry, beliefs, knowledge, and ethnicity, as revealed by the analysis of the ordinal logit model. The respondents viewed their strong inclination toward herbal medicine with many positive attitudes. Herbal medicine users held a negative perception of allopathy except for affiliation and practical reasons being viewed as the positive outcomes. Conversely, allopathic medicine users expressed mixed perceptions towards the treatment, with both positive and negative aspects being identified. Promoting the sustainable use of medicinal plants and their conservation efforts is imperative for the benefit of present and future generations in this region.