New tradition for African healthcare

http://www.csmonitor.com/2004/1013/p06s02-woaf.html


By Federica Bianchi | Contributor to The Christian Science Monitor

KAMPALA, UGANDA – Inside this one-room clinic a few steps off the
main road, Sister Mbaagatuzinda Narwoba, a member of the Good
Samaritans order, is all business: One minute she helps a crying
young woman who has come seeking medicines for her sick father; the
next she plays spiritual guide to a man who has just been told by
the local hospital that he is HIV positive. Father Anatori Wasswa,
her boss and one of the best-known traditional healers in town, is
not around. But that doesn't stop the influx of patients seeking
herbal remedies.
"People come here very much because they are afraid to use
chemicals," explains Ms. Narwoba.

Her patients are not just simple villagers from the remote reaches
of the jungle. They are also educated, urban Ugandans who, like 80
percent of sub-Saharan Africans, use traditional healing methods.

In September, the Ugandan government brought traditional medicine -
herbs, animal parts, and minerals, with a dash of prayer - out of
the bush and began to integrate it into its health system. The East
African nation became among the first on the continent to add
traditional healing studies to its university curriculum. The moves
underscore the important role that traditional methods play in
African healthcare, reflecting their effectiveness, affordability,
and the skepticism that many people here have toward modern
medicine. Critics warn that the government may be sanctioning some
practices that do more harm than good, like blood-letting; and
witchcraft is often confused with traditional healing. But
professors and government officials also concede that traditional
medicine greatly influences the lives of most Africans.

"We don't want students to learn traditional medicine but to
understand how it fits in the picture," says Luboga Samuel, deputy
dean of the faculty of medicine at the University of Makerere, which
introduced an eight-week program last year to familiarize new
students with Uganda's medical traditions. "We are teaching them
that traditional healers have a role, and that role needs to be
understood."

According to the World Health Organization, traditional medicine
refers to such systems as traditional Chinese medicine, Indian
ayurveda, and Arabic unani medicine, and to various forms of
indigenous medicine in Africa. Therapies can include acupuncture and
spiritual exercises.

Uganda has established a commission to develop standards and
determine which practices should be sanctioned. Once traditional
healing is fully integrated into the national health plan, licensed
healers will work side by side with regular doctors. Patients will
be able to receive free care for some traditional services.

Uganda is not the first African country to institutionalize
traditional healing. All over the continent, governments have given
official status to traditions that were pushed underground when
white colonists imported their own medicine. Last month, South
Africa's parliament passed a bill recognizing traditional healers as
healthcare professionals. Equatorial Guinea, Nigeria, and Mali have
already mainstreamed traditional health practitioners.

In some cases, officials say that traditional methods may fill gaps
or yield better results than Western medicine. Take malaria, for
instance, Uganda's main cause of death. "People have been using
quinine, which is very cheap, but it no longer works" because
malaria parasites have developed resistance to it, says Paul Waako,
chair of the department of pharmacology at Makarere University.
Herbs such as Artimisea Anua, a plant used in traditional Chinese
medicine, have clinically proved to be effective in the treatment of
malaria. In 2000 a declaration called Roll Back Malaria, signed by
53 African countries, officially recognized the contribution of
traditional medicine in fighting malaria.

Cost and availability are also factors that favor traditional
healing. In Uganda there is one doctor for every 18,000 people, but
there is one traditional healer for every 150. Some people live too
far from the closest conventional clinic; others simply can't afford
chemical drugs. There is also a comfort level that Ugandans have
with traditional healers, who are members of the community and live
next door to the people they treat.

"Patients rely on them because they can relate to them better, since
they share the same culture and they feel warmly welcomed," explains
Ramullah Kasuzi, a second-year student at Makarere.

Traditional healers often dispense remedies with spiritual
counsel. "This medicine goes with prayer," says Sister
Mbaagatuzinda, looking down at the long strip of rosaries for sale
on her desk. "God is the biggest pharmacy."

But treatments used by the country's estimated 150,000 healers are
not always helpful. Some practices, such as making incisions to draw
out bad blood, are dangerous, and the government needs to regulate
their practices the same way they do with Western medicine, explains
Grace Nambatya, director of research at the Natural
Chemotherapeutics Research Laboratory, the arm of the health
ministry that is advising the government on drafting a legal
framework for traditional medicine.