Authors:

Anil KC, MBBS
Rakesh Kumar Shah, MBBS
Valbona Biba, MD
Deepa Luitel, MBBS
Tanya Amal, MBBS
Shrinkhala Maharjan, MBBS
Ayfa Riaz Bajwa, MBBS
Lubna Mirza, MD (Norman Endocrinology Associates)

 

Introduction/Background

Traditional healing is based on health practices, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, and exercises to treat, diagnose and prevent illnesses or maintain well-being. The high cost of drugs, and the increase in drug resistance to infections, has led to alternative traditional medicine being seen as a viable option for treating ailments.

Across the world, traditional medicine either is the mainstay of healthcare delivery or it serves as a complement to it. The prevalence of traditional medicine practices is estimated at 40% to 70% and, in some ethnic groups, it is the only option for disease prevention and cure – mainly due to exclusion, extreme poverty and the lack of access to basic health services.

The increasing use of traditional medicine has created challenges in public health from the point of view of safety, efficacy, access and rational use. For this reason, the World Health Organization has been increasingly involved in developing international standards and guidelines for alternative medicine with improved communication and cooperation between countries.

Individual Experiences

Dr. Anil KC, Nepal

“I have been working as a rural health care physician in Nepal for the last four years. I have encountered many patients previously treated by traditional healers as traditional healers are readily available in the rural areas of Nepal. Most traditional healers form close ties with their clients because they are the frontline providers for patients in need where healthcare professionals may be unavailable. Traditional healers use a variety of treatment options such as herbal medication, traditional instruments and prayer. I have seen patients with mental health issues or somatoform illnesses that are benefited by the treatment from the traditional healers as they spend more time with the clients. The traditional healers are oftentimes from the client’s hometown with great cultural and social insights for appropriate counseling. On the other hand, there have been circumstances where traditional practices brought harm to patients by delaying the care that these patients needed. I saw a case of a young pregnant woman with severe eclampsia with disseminated intravascular coagulation (DIC) in shock, and who unfortunately didn’t survive due to a delay in seeking medical care. She was previously treated with mainly chants and prayers with herbal medicine unsuccessfully for almost three days before presenting to our medical center. I believe there is a need to bridge the gap between these two realms of patient care by providing basic education to the traditional healers for timely referrals.”

Dr. Rakesh Kumar Shah, Nepal

“I worked for two and half years as a Medical Officer in a government health center in rural Nepal. The primary health center was a first point of contact with the health-care providers for almost 40,000 people. Due to an unavailability of transportation related to harsh geographical locations, many of our patients had to walk for hours to be able to see us which forced them to contact the health service only as a last resort. In the meantime, they resorted to seeing trusted and accessible local traditional healers before visiting our medical center. To me, it seemed that the traditional healers were an important part of healthcare decisions made by our patients. The traditional healers were able to handle mild physical ailments along with some mental health issues with what we would call “non-scientific” or “unproven practices”. I want to mention one specific instance out of many that led to a negative outcome. A child with severe respiratory distress was taken to a traditional healer for advice which caused a delay in presentation at our health center. We could not save this child. I wish we had received the child a few hours earlier, as this could have improved his chances of survival. Although the contributions of traditional healers are well-intended and largely beneficial, the role of these providers should be well-regulated for improved patient outcomes.”

Lubna Mirza, MD, Norman Endocrinology Associates, Norman, Oklahoma

“The news that a nail was driven into a woman’s head to guarantee a baby boy by a faith healer in Pakistan made headlines in February of 2022. This woman already had three daughters and was expecting a fourth at the time of the incident. Her husband was unhappy with her because she would not bear a boy and he threatened to leave her. This is not an isolated case, but instead is just a tip of the iceberg. Without the protection of child support and alimony with legal polygamy in the country, many of these young and uneducated women fear homelessness and hunger for themselves and their children seeking care from the unregulated faith healers. There is a need for improvement in public health education and the emancipation of women in addition to amendments in the constitution in line with the United Nations Bill of Rights protecting the rights of all people.”

History of Traditional healing practices

Human beings have been practicing traditional healing for ages. While some traditional practitioners use herbal medicine, exercise, and spiritual practice, others may use insights and beliefs based on astronomy and manual techniques to treat people. We, as social beings, are affected by the surroundings we live in. Regardless of socioeconomic status, almost all human societies practice some form of traditional healing. Many rely on traditional healers due to the lack of accessibility to modern medicine when they feel sick, and some seek solace in alternative medicine after losing hope in allopathic treatment.

In some parts of the world such as rural South Asia or Africa, people rely on traditional healers as their primary source of treatment for minor health concerns. Some rely on traditional healers instead of going to a hospital for even serious health concerns such as snakebites, jaundice, childbirth, seizures or psychotic episodes with schizophrenia, mania, and depression that has led to complication, negatively impacting the health condition and overall morbidity and mortality in populations.

What can be done to prevent harm?

While traditional medicine has been tending to ailments across the world for centuries; it is not short of horrific disasters. Termination of pregnancy using hot rods is an obvious example that highlights this issue. As remarked in the movie “The Physician,” the pain incurred in the treatment procedure is often directly

proportional to patient satisfaction. To curtail this, allopathic doctors have been advising patients against the harmful aspects of such practices. However, negative feedback in this manner has not been beneficial. It is time we resort to positive reinforcement: Give them credit for sharing the burden of healthcare in underserved communities, while at the same time arming them with tools that would enable them to provide good quality of care. These tools could be in the form of educational sessions such as videos and printed material regarding safe injection techniques, safe delivery and abortion practices. This can be followed by an evaluation on dummies by a certified medical professional. While this method would not eradicate the harms associated with traditional healing; it would definitely carve the way for safer practices in future.

To bridge the gap in understanding for one another between traditional and modern healers is pivotal to improve care and eliminate harm. We propose the following suggestions for collaborative work maintaining respect and integrity of each other.

For traditional healers:

* Basic life support and first aid training to be able to address minor urgencies.

* Identifying the need for referral to medical centers in emergent situations would save lives.

* Improvement in basic sterilization techniques will help reduce infections caused by various surgical methods used in traditional healing.

* Traditional healers should have easy access to oral rehydration solutions, over the counter medicines and analgesics such as paracetamol for patient care.

* Building bridges for easy communication with modern health care centers will help create a collaborative environment.

For medical professionals:

* Teaching medical students about the importance of the role of traditional healers especially in indigenous groups of people in their respective communities.

* Find ways to improve relations with local communities.

* Identifying the psychosocial aspects of the healer-patient relationship to working together with a common goal will help utilize every available resource for patient care.

Conclusions

Traditional healers play a pivotal role in the health care system due to their availability in localities and their strong bond with the community that needs recognition by modern medicine. Any harmful practices by traditional healers should be discouraged. Traditional healers should be oriented on the basics of modern medicine that is incorporated in the healthcare system to improve patient outcomes.

 

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