Sunday, April 15, 2012

Place of traditional healers in our hospitals

Sunday Nation 15 April 2012

The ministries of Health have recently become involved in an initiative to regulate the practice of traditional or alternative medicine in Kenya. In the wake of this effort, there have been calls for traditional medicine practitioners to be allowed to work alongside other health workers in our public hospitals.

Before we discuss the merits or demerits of this idea, we need to appreciate the nature of healthcare that is practised in the two settings.

In a hospital setting, there are standardised procedures for assessing patients and planning for their care, often based on algorithms that are, in turn, products of a huge body of research evidence. Unfortunately, training for health workers in formal health care settings does not include training in traditional medicine.
Since these health workers do not know what traditional medicine is all about, it is practically impossible to incorporate the practitioners of traditional medicine within these standardised algorithms.

Traditional medicine, on the other hand, may fall into three main categories. There are diviners who purport to foretell the future and communicate with spirits in order to effect healing by supernatural means. Then there are the herbalists who use plants and their extracts to treat various afflictions. Finally, there are the witches and wizards who purportedly cast spells and claim to be able to reverse them for the right price. Other traditional healers use a combination of these methods to deal with the various problems afflicting a human being.

There is some evidence that at least some of the methods and concoctions administered by traditional healers may be effective under certain circumstances. However, most of this evidence falls in the lowest category of medical evidence known as anecdotal evidence, or word of mouth.

The problem with this type of evidence is that despite spectacular claims of efficacy in a few individuals, it takes very little evidence of harm to render it invalid. It is also difficult to sustain the claims of anecdotal evidence when arrayed against scientific evidence derived from studies with tens of thousands of participants.

Another problem with traditional medicine is that it is difficult to explain to anyone how these methods work.
This is in stark contrast to the so-called conventional medicine which, because of extensive research information, is able to demonstrate the expected effects and side-effects of any treatment that is prescribed.

Traditional medicine practitioners, therefore, have a hurdle that they must overcome before they can be incorporated into the regular framework of the public healthcare system. Firstly, they must open up their methods to scrutiny in a scientific manner. They must keep records of their clients and allow research to be conducted to demonstrate whether their treatments work as purported or not.

Second, they must allow their treatments to be described and standardised, and develop a training system that ensures that the treatments are used in an ethical manner. Finally, they must acquaint themselves with the functioning of the public health system, in order to determine at what level they will fit.

It is obvious that were they to follow the prescription above, they would end up being “modern doctors”, and their treatments would be indistinguishable from “modern medicine”. Perhaps this is the way to go.

As we have observed before, there is neither “traditional” nor “conventional” medicine. There is only medicine that works!

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and lecturer at Moi University’s school of medicine

1 comment:

  1. Dr. I appreciate your insight into this but i have a few concerns.later


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