"If the shoe does not fit, must we change the foot?" an American feminist and political activist once quipped sarcastically.

And talking about the foot, most of us normally take our feet for granted.

But not everyone thinks like American Film Director Samuel Fuller who advises us, "When you're at the end of the rope, all you have to do is make one foot move out in front of the other, and just take the next step. That's all there is to it."

Yes, the journey of a thousand miles begins with one small step, on foot, that is.

In an age of astronomical medical costs and drugs, health conscious Malaysians are brave enough and taking this small step.

Looking at every possible avenue, Malaysians are beginning to learn more about alternative medicines and preventive measures in an attempt to stay healthy.

One path could well be the ancient art of reflexology.

In fact, the practice of Chinese reflexology has been around in the country for a long time, confined to few "sin seh" practitioners (Chinese herbalists) among the Chinese community and very few know about the health benefits of foot massage.

Yet the sudden surge in popularity is curious in many ways.

Only 3 years ago, reflexology centres sprouted everywhere like mushrooms particularly within the Klang Valley and elsewhere in major towns and cities.

Local operators provided the necessary capital on a profit-sharing basis with reflexology experts from mainland China, saw businesses booming.

Evidenced by dozens of new branches being opened in populated residential areas, the reflexology business seemed to be promising and had a probable bright future.

Liberal working permits were then easily made available for mainland Chinese male or female practitioners in reflexology and demand readily met with the supply side in the recruitment exercise.

Despite the high levy fees and other related costs of between RM8,000 to RM10,000 per worker, and allowing a 3-5 year period subject to renewal, the bubbling business at reflexology centres was a raging success.

Extra service in uncertain future

Not anymore. The economic downturn, the uncertainty in worker recruitment policy for reflexology centres and the illegal sexual misconduct condoned by a few operators have precipitated an uncertainty for the business venture.

Charging between RM38-45 per hour for foot massages, some reflexology centres located mainly in shop-lots and hotels, also provide other services like ear-waxing, traditional body massages and acupuncture.

But the gloom of uncertainty has returned in less than 5 years although the popularity has caught on the customer side.

The application for reflexology workers from China has been frozen despite an earlier hike of the levy charges and other fees amounted to RM15,000.

The fresh supply of workers has stopped even as work permits expired for existing workers.

Reflexology centres are caught in a plight facing a shortage of foreign and local foot massage therapists.

To aggravate matters, some "black sheep" operators were left with no choice but to employ workers on social visit passes.

The predicament faced by operators also provide an opportunity for unscrupulous well-organised syndicates to cash in by providing lesser qualified female workers who in turn preferred to make a fast buck by offering 'extra sexual" services to customers.

It is a pity that distrust and scepticism have set in officialdom due to the malpractice and indiscipline of a few black sheep operators as the majority of them are adhering to strict regulations and rules in their business operations, specifically the conduct of their workers within their premises.

But the issue of regulating the spa-health centres and reflexology enterprises should not be allowed to destroy whatever health benefits that could be derived from this ancient treatment.

An ancient art

The ancient art of Chinese reflexology is a sub-division of the Chinese traditional medicine dating back thousands of years since the Sui and Tang dynasty 581-682 BC.

Reflexology is widely practiced in modern China by doctors in clinics and hospitals with great success for many conditions as reflected in published research.

Thousands of young people are being trained by the China Reflexology Association.

Increasing circulation of energy within the human body is fundamental principle in Chinese reflexology.

The concept of energy channels is the central point around which reflexology and acupuncture are based.

Basically, the Chinese discovered that "ch'I" is a life energy and is supposed to circulate in the body along what is called meridians (yin and yang) similar to blood, nerve and lymphatic circuits.

In Malaysia, the encouragement of combining western medicine and science with traditional Chinese medicine should be a continuing effort.

The effective use of reflexology in fact, is cost-effective, especially for the middle-income group, particularly reducing the cost and side-effects of drugs and medical intervention.

Reflexology is particularly developing in China and such centres are playing their part in the health and wellbeing of the people, the economy and clinics and centres have become meeting places (social events) as well as therapeutic centres.

The earliest evidence of of reflexology was found in Egypt with treating hands and feet in 2500 BC.

The term, "reflex" was first named by German physiologist Johann August Unzer with reference to motor reactions in 1771.

In 1833, the concept and term "reflex" action was introduced by Marshall Hall, an English physiologist.

Into the modern era

The scientific basis of reflexology, in fact, has its roots in early neurological studies conducted in 1880s by Sir Henry Head of England.

Sir Henry established "head zones" and conclusively proved the neurological relationship existing between the skin and internal organs.

But it was an American doctor William Fitzegerald, who is credited for being the founder of modern reflexology.

Another American doctor, Joe Shelby Riley was responsible for creating a chart for foot reflex zones as well as ear reflexes.

In 1990, the International Council of Reflexologists (IRC) was inaugurated at a conference held in Toronto.

The ICR Charter was formulated using the United Nations Charter as a guideline.

It has taken centuries for mankind to realize that the foot is just as important as the head.

"The human foot is a masterpiece of engineering and a work of art," said 17th century scientist and inventor Leonardo da Vinci.

British Poet Dramatist John Dryden once described dancing being the poetry of the foot and American celebrity actress Goldie Hawn got a heart tattooed on her foot, a reflexion of the foot being a miracle that moves your whole body weight.