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As Africa changes, so does traditional healing
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KAMPALA, Uganda (October 18, 1997 12:05 p.m. EDT http://www.nando.net) --
Mutebi Moses Tokamalirawo doesn't look like an African traditional healer,
at least not the skin-clad, wild-eyed witch doctors of Western bias.

Trim and easy moving at 50, with muttonchop sideburns, an untucked shirt
and green pants hanging over beach sandals, he gently tickles toddler
Andrew Waliggo to elicit a giggle while examining the boy's dark skin rash.

No animal bones or snake heads are in sight. Instead of chanting or burning
incense, Tokamalirawo speaks softly to Andrew's mother, her own skin
spotted by skin lesions, about the AIDS virus causing such ominous blotches.

The scene replicates any neighborhood examining room and shows how, more
and more, traditional healers in Africa are assuming conventional roles in
countries struggling with growing populations and overburdened medical
services.

Part doctor, pharmacist, psychologist and fortune teller, healers practice
a centuries-old blend of mysticism and medicine to provide much of the
continent's health care.

Many Westerners view healers as voodoo practitioners or charlatans preying
on the ignorant and superstitious.

But the international medical community now acknowledges that African
healers, particularly herbalists familiar with local diseases and
conditions, provide significant primary health care across the
underdeveloped continent.

The World Health Organization estimates up to 80 percent of Africans -- or
more than a half billion people -- visit traditional healers for some or
all of their medical care.
Almost every city, town and village has a thriving market for the roots,
herbs, dried chameleons and other tools of the healers' trade.

As African nations shuck the vestiges of colonial rule, healers remain the
strongest link to tribal cultures slowly being eroded by social evolution.

Now, new realities and a global shift toward natural remedies are bringing
increased attention and status for healers.

Governments seek to register them and regulate their medicines, and some
health insurance plans in South Africa and other countries reimburse the
costs of traditional treatments.

At the same time, healers have been forced to accept changes. Dwindling
sources of medicinal plants and animals makes healers worry about
preserving and replenishing them.
While some healers stubbornly hold to superstition-rooted practices of old,
others like Tokamalirawo have started adopting modern teaching and methods
to deal with maladies like AIDS.

Tokamalirawo knew something was amiss during the AIDS scourge that hit
Uganda in the 1980s. His herbal medicines could soothe symptoms such as
rashes and diarrhea, but patients kept dying.

Then the private group THETA -- Traditional and Modern Health Practitioners
Together Against AIDS -- offered training in AIDS counseling, and
Tokamalirawo agreed to take part.

He was one of 400 healers to attend the first meeting in June 1993. Only 20
completed the program 15 months later, the rest having left out of
intransigence or to keep making money.

"Before the training, I wouldn't distinguish between AIDS patients and
others. I treated people as bewitched by ancestral spirits," Tokamalirawo
said in his Spartan, one-room office in a dusty Kampala neighborhood.

"Now I accept that it is a disease I cannot cure. AIDS has changed society
and the healers have to change to deal with it."

For Margaret Namatovu, the toddler's mother, that change has been crucial.
A tall, angular woman of 34, she was first diagnosed with the AIDS virus
three years ago and her world fell apart.

She avoided government AIDS workers because of rumors they supplied pills
to quickly kill off the sick. Banished by her sister, with three children
and another on the way, she grew depressed.

"I felt I was no longer useful," she whispered, staring off into space. "I
felt like killing myself."

Then she developed her rash and went to Tokamalirawo, who is renowned for
treating skin ailments. He showed her another view.

"The doctor told me not to fear dying, that even today you could die of an
accident, that even those who stigmatized me and point fingers could die
before me," Namatovu said. "I've seen that come true. I saw my sister, who
was stigmatizing me, die in a car accident."

Now she and Andrew show up once a week for checkups. Tokamalirawo taught
her to be careful around the non-infected children, especially when she is
cut, and to draw up a will and take other steps to prepare for her death.
In short, he demystified the disease.

That's what THETA wanted when it began the training, which has spread to
five of Uganda's 39 districts and about 150 healers, said Teo Nakyanzi, the
group's resource center manager.

It felt enlisting healers -- often deeply grounded in daily life -- would
spread the AIDS awareness message most effectively.

Some believe that kind of role best suits the healers.

"This is a massive work force for health," said Dr. Peter Folb, chairman of
South Africa's Medicines Control Council, similar to the Food and Drug
Administration in the United States.

"We could achieve miracles if there was real cooperation between the two
polarized sectors."

In South Africa, the first black-led government is studying how to register
the estimated 250,000 healers in an effort to establish ethical and
procedural standards and weed out charlatans.

Testing herbal remedies for regulation also has begun.

But centuries of mistrust and secrecy hinder full integration.

"All those words for (healers) are wrong -- control, regulation, proscribed
behavior," said Folb, who expects about 100 traditional medicines to
eventually gain government approval.

African healers come in all shapes and sizes, with dozens of labels as
distinctive as the tribes and regions that produce them -- "sangoma" and
"okomfo" for a diviner or prognosticator, "inyanga" and "dunseni" for
herbalists who blend medicines from the forests and fields.

Using knowledge passed down for generations, they diagnose common ailments
-- from malarial fevers and skin rashes to depression and hypertension --
and treat them with natural remedies often mixed with superstition.

Sometimes the "cure" is worse than the ailment. Throughout Africa, health
officials and healers cite accidental poisoning as the biggest problem with
traditional remedies.

Methods range from herbal teas, enemas, poultices rubbed in cuts in the
skin and inhaling fumes to bizarre rituals and potions made from animals
and even human body parts intended to rid superstitious patients of evil or
unhappy ancestral spirits. Chameleons are prized for potions that bring
change -- such as winning back a wayward lover -- because the reptiles can
change color.

Like all things linked to superstition, healing can descend into chicanery
and voodoo. In Zimbabwe, two men were sentenced to death this year after
admitting they killed someone to mix his brains with herbs for a potion to
help a businessman.

But simply dismissing the superstition can be a mistake.

Ancestors play a central role in daily life in most African cultures, and
healers use that as a way to intervene in problems and behavior, said Dr.
Nigel Gericke, a South African who studied with a rural healer for a year.

In most countries, people too poor for treatment at modern hospitals can
afford the small amount of cash, or perhaps a chicken, for the local healer.

At the same time, healers relieve the burden on already swamped clinics and
hospitals. In Ghana, there is on average of one healer for every 400
people, compared to one conventional doctor for every 12,000.

Christian missionaries, some of the first white settlers in Africa,
targeted healers as heathens and Satanists, entrenching the Western bias of
barbaric witch doctors.

A formal shift in status came in 1978, when a United Nations-sponsored
health conference called for governments to look at incorporating
traditional healers and medicines into national health plans to provide
more formal care for the poor.

Almost two decades later, growing awareness of benefits from traditional
knowledge has affected the global pharmaceutical industry.

The British company McAlpine, Thorpe and Warrier Ltd. estimates worldwide
sales of herbal medicines will reach $14.4 billion this year, more than 20
percent greater than in 1996.

While healers lack the training and equipment for major surgery or treating
catastrophic disease, they handle most common ailments.

Dr. Gottlieb Noamesi makes his dozens of herbal potions and medicines --
for everything from baldness and weak vision to jaundice and diabetes -- in
heavy iron pots over open fires in rural Hohoe town of Ghana's Volta region.

He proudly mentions his medical degree from Lakeland College in Wisconsin
and shows off a 1988 Organization of African Unity report that cited
Noamesi for successfully treating sexually transmitted diseases "which defy
treatment with orthodox drugs."

His vision restoring powder, taken twice a day, caused Reinhard Jakoby of
Karlsruhe, Germany, to put away his bifocals. Jakoby, 48, said in a
telephone interview that the compound he learned about from a television
documentary changed his life.

"I could only see blurred things without my glasses," said Jakoby, a nurse.
Now, "I can go without my glasses. I can read without my glasses. ... The
vision was restored and it didn't fail."

Noamesi and others want their expertise validated and rewarded. But
obstacles abound in getting herbal remedies out of the African bush. A
history of failed deals and unkept promises make African healers wary of
foreigners promising big money for their secrets.

Robert McCaleb, founder of the Herb Research Foundation in Boulder, Colo.,
said both sides lack understanding.

African healers want to market new medicines without the money, training
and equipment needed. Meanwhile, Western pharmaceutical companies seek to
test every known healing plant -- what McCaleb calls "chemical prospecting"
-- instead of working with healers.

"Generations of use by humans is better safety data than testing on
thousands on rodents," he said.

Advocates of herbal healing say the answer is partnerships between the
traditional practitioners and Western companies to quantify the healers'
knowledge and spawn significant local industries -- such as farms to grow
medicinal plants and factories to make the medicine.

"It will show the scientists that our people are not just a bunch of
superstitious savages," said Credo Mutwa, 76, a celebrated Zulu healer.

"If the world accepts many of our herbal medicines, this will help to
ensure the survival of our traditional healers."


By TOM COHEN, The Associated Press
Copyright 1997 Nando.net
Copyright 1997 The Associated Press
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