New tradition for African healthcare

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.