Traditional Healers, HIV/AIDS Prevention
By W.A. Woldemichael (USA)
In response to my article "Using Traditional Healers - The Fight Against
HIV/AIDS," published in the July 21 issue of Addis Tribune, Getahun Tadesse from Norway wrote a letter referring to certain problems that may be associated with the practice of traditional medicine in Ethiopia (Addis Tribune, July 28, 2000). Although some of the issues raised by Getahun Tadesse are valid, it appears that the message emphasized in my article was taken out of context. What is more, some of the information in his letter is incorrect as it does not take consideration of the developments that occurred during the Derg rule in the area of traditional medicine. This article, therefore, addresses these issues.
Getahun Tadesse seems to imply that if the efficiency of Ethiopian traditional medicine is improved from the ethical or moral point of view, the practitioners can have a role in the fight against HIV/AIDS by offering treatment to patients. I am in disagreement with this proposal. It is my belief that the traditional healers should not be encouraged to treat HIV/AIDS patients as this would discourage the public from taking preventive measures by developing a false sense of confidence on treatment procedures that have not yet worked.
However, as clearly indicated in the last paragraph of my article, with proper training and incentives, the healers can play a significant role in the prevention of HIV/AIDS. For example, they can be trained to participate in HIV/AIDS prevention by (1) educating their clients about the disease, (2) advising their clients to abstain from random sex or use condoms whenever necessary, (3) encouraging their clients to be tested or "break the silence", and by (4) referring their clients suspected of having the disease to modern health facilities. Meanwhile, the traditional healers can be educated about the dangers of harmful practices. Also, if the healers happen to be in possession of remedies claimed to have effects against HIV/AIDS, such an interaction can provide the opportunity to test the "remedies" scientifically, as it is being done in many other countries.
To illustrate the applicability of the aforementioned proposal, it is worth mentioning that a similar training program for traditional healers adopted recently by CARE international in Ghana has demonstrated a great deal of success (CARE: Inf. Center, May 12, 2000). In this program, healers were given a one-week course on the detection and treatment of sexually transmitted diseases, encouraging them to refer more serious cases to hospitals. The healers were instructed about HIV/AIDS prevention, how to use condoms and how to teach others about what they were taught in the course. It has been reported that, overall, the training program resulted in an impressive number of referrals from traditional healers and a positive cooperation between traditional and modern medical communities. Patients with incurable ailments like AIDS have also benefited emotionally from consulting traditional healers.
Getahun Tadesse also perpetuates the impression that traditional healers in Ethiopia have not been organized in the form of associations. This needs a bit of explanation to prove that it is wrong. Subsequent to the establishment of the Office for
Coordination of Traditional Medicine in 1979, many healers in Ethiopia have been registered with the Ministry of Health. The reported number of registered healers in 1991 was above 6000 (no report is available to this writer since then). In many places in the country, the healers have also been organized in the form of associations.
However, to the best of my knowledge, the healers have not been approached to work in cooperation with the official health delivery system in any sort of health problem except for the training of traditional birth attendants and for research purposes on herbal remedies. It should be added that in exceptional cases, the healers demonstrated great cooperation and the outcome of this cooperation has been fruitful. Although the information provided here is inadequate, it can serve as a starting point for subsequent actions to be taken regarding the use of traditional healers.
On this basis, it can be implied that the traditional healers in Ethiopia can offer useful service in the fight against HIV/AIDS provided that appropriate training and incentives are given to them. Whether one likes it or not, they are in contact with at least 70 % of the population in need of health service, and such a huge potential needs to be tapped. Moreover, the healers are very influential in their communities, placing them in a potentially useful position to serve as effective public health agents. No useful purpose can be served by simply criticizing the healers in the absence of appropriate action. It is up to us - the educated and responsible people in the government and private sector - to initiate and follow through such kind of action.