Monday, January 26, 2009

WHITHER CAMEROON TRADITIONAL DOCTORS

I have perennially been bothered by a lot of issues that bear allegiance to the civil and moral man and those paradigms that guide men generally as members of societies of the one hand and as stakeholders of the blueprint of civility of the other.

As a common rule, every community around the world accounts for a dichotomy of people, variously represented who lead or not a life, in tandem with the most legit and acceptable of mores wanting of their economic, social or moral statuses. The exception to the latter seems more commonplace, yet being the kind of community I should have yearned to fashion in a profoundly detailed exposition. But owing to the very implicit nature of man to exist in discretional liberty and freewill, I shall nevertheless chafe under the purpose of form and partiality.

It will be legitimate to circumscribe this intriguing debate to the utility of tradition and ethics including all that is involved as role and currency of the subject matter by those who perform and those who appraise the stockholdings. However, though these tags may seem over-drafted if connected to the following story, it certainly will gain to parallel the enlightenment of some civilians as much as checking the ingenuity of others.

Whilst in an express commercial bus travelling from YaoundĂ© to LimbĂ© recently and in sheer eagerness to beat a deadline, a drisly event occurred that defied even the least conceivable characteristic of social mores. This happened somewhere in the environment of an hour subsequent to our departure, when some finely dressed gentleman who had swapped his seat for the sake of using the aisle started delivering what seemingly appeared to be a hackneyed proforma oratory (only ‘second fouls’ wouldn’t seem to commend). The marvelous luxury of a solemn journey everyone was starting to enjoy petering out in tacit responsion. He claimed to the 70+ passengers aboard to be a traditional doctor and one competent enough to have researched into malignant human pathologies and consequently came up with amazing remedies that ‘cure’ legions of maladies and infections in very short periods of time. Photostats showing among other things his branded syrups and ground spices made from root vegetables, barks of plants etc were given to each passenger to pore and acknowledge. He spoke impressively in French and English, interspersing with the lingua franca (pidgin), informing everyone (some already made guilty by the remarkable revelation of common infections in currency) of the necessity to benefit from these relatively more efficient and affordable drugs he was so vivacious to have forfeited other serious businesses in order to deliver to us (lucky benefactors). He exhibited some of the drugs successively while proffering along with the prescriptions and modes of application. Such included the following do-it-yourself- off-the-shelf medications for their corresponding ailments:

Common resources like ear wax for the treatment and cure of snakebites, the liquid of washed rice to be administered orally to those who are seized with the inability to stifle urination, the paste of roaches and millipede to treat dermatitis like warts and wicklow respectively, potato leaf to chew, gargle and be left in the mouth for a while for the treatment of repugnant mouth odour and breath, some branded syrups and powders to act as a medical panacea treating tons of diseases ranging from sexually transmitted infections to even renal and disease of the bone and peritonea, even plants he demonstrated which would protect someone from poisoning during a drinking spree.

Before this gentleman had finished a quarter of his allotted timescale of his short journey with us, he had sold all the available stocks he had. The bus that was once appealing to the luxury of sobriety had suddenly become a busy place of a market; passenger bargaining here and there and some appealing to have the last piece of his branded drugs.

In practice, this kind of activity is gaining currency in many parts of the country where you will find gentlemen properly dressed, scamming these traditional medicines in township buses. Some of them do call themselves doctors of traditional medicines while others would tag themselves members of some research organization. They are more competent in marketing and oratory than anything else. They represent nowadays, the apprentices of erstwhile legends who themselves were architects of contemporary medicine that was characterized by a lot of falsities and unacceptable tentative methodology and black magic in treating patients especially in those communities as they were generally, wherein members had little or no choice mindful of impecuniosities and native belief. Their entire fates were totally dependent upon these ridiculous hypotheses that bear no allegiance to the actual problem or to the underlying causes.

These independent architects of yesterday are today, in spite of the abridged versions of the methodology to mix the granulated herbs, paralleling such bids to treat civility with added inconceivable approaches and techniques that unfortunately baffle the intelligence and discretion of even the most educated and civilized members of our communities today. Because these members are so conservative, they still compromise on these forms of treatment irrespective of their financial situation.

A study in Canada by examining the acculturation of Ghanaian immigrants in Greater Toronto Area (Canada) and focusing particularly on attitudes towards and usage of Ghanaian traditional medicine (TRM) revealed that 73% of the Ghanaian immigrants in Canada still have a positive attitude toward Ghanaian Traditional Medicine (TRM). This is in comparison with less than 30% who have changed their attitude for various reasons. Some of the attraction of TRM lies in its holistic origin. Ghanaians in the GTA have been pursuing 'integration' and 'assimilation' in their acculturation in Canada. Some have given up or modified some of their attitudes and opinions toward TRM to embrace the 'modern' or 'civilized' way of living. (link).

Inferring from our local instances, before the coming of the white man civilization to Cameroon and yonder henceforth, thousands of communities have lost members during crisis periods of epidemics such as malaria, cholera, polio, abdominal masses etc, - these diseases commonplace as now fathomed – amidst the prevalence of traditional doctors who we are told and have experienced first hand, had been benefitting from the honour to remain the mainstay of health mending and providence in these communities.

Brainwashed benefactors of some of these doctors unfortunately still believe in the limitlessness of these practitioners who have caused many natives to be oblivious of the distinction between ‘treatment’ and ‘cure’. They have always based their proceedings following symptomatic manifestations of diseases ignorant of the availability of ambiguity in the nature of many diseases. Because treatment which these traditional medicines offer but rather without curing their patients is apparently cheaper than cure, (and cure being the result of a chain process of laboratory investigation, topical prescription with appropriate dosage, control and re-laboratory investigation for ascertainment), our hospitals are often inundated with tons of patients, majority of whom are transferred as terminal cases from the care of some of these tradi-practitioners.

More than 150 years on, scores of unfortunate occasions in hospitals regarding deaths and terminal diseases are still being promoted by our traditional doctors. Below, I’ll provide just a couple of abstracts written by Africans who are also as concerned as anyone would under the circumstance in order to ascertain the incumbency in questioning our allegiance.

Dr. Osifo O.D, regarding abdominal masses (tropical splenomegaly due to malaria fever, frequently seen in children) noted on the Pakistan Journal of Medical Science website (link) that “Abdominal masses are very common in Nigeria.

These have been managed by traditional doctors even before the advent of orthodox medications. Traditional doctors are however, not able to distinguish between the various causes of abdominal swellings, hence all are diagnosed and managed as splenomegaly (ude). Their modes of treatment are scarification, tattooing and concoction application in different combinations. We retrospectively studied twenty two patients who were mismanaged by traditional doctors before presenting to us at the University of Benin Teaching Hospital, Benin City – Nigeria. They all presented very late with life threatening complications and advanced diseases. Treatment offered on presentation included wound dressing, resuscitation, blood transfusion, antibiotics and laparotomy with resection of the masses, depending on diagnoses. These could only salvage 13(59.1%) of the patients while a high mortality of 9(40.9%) was recorded. The need to improve on our health care delivery system is stressed.”

He continued to note that “The high mortality rate recorded in this study is in keeping with other forms of treatment by traditional doctors. Osime et al2 reported the high morbidity and mortality associated with management of gunshot injuries by traditional doctors. Omololu et al3 and Onuminya et al4 from the western part of the country drew attention to the high complications and avoidable amputations resulting from traditional bonesetters treatment. Reports from the northern part of the country by Yakubu et al, 5 also revealed the high rate of avoidable limb amputations due to treatment by traditional doctors”

“Apart from complications resulting from poor management, all the patients presented very late and at times in terminal stage of the disease. Many of them got the assurance that the ailment can only be handled by traditional methods. This is in consonance with the work of other researchers who reported that superstitious beliefs still play a major role in delaying and at times prevent seeking orthodox medication in many African countries.11-13 Poor responses to treatment were blamed on some spiritual forces which cannot be handled by orthodox medications except sacrifice, incantations, tattoos scarification and application of concoction. These made even the enlightened people to have faith in them, only to seek orthodox help when the case was terminal” he concluded.

The Mnegi website posted an article depicting a situation in Botswana where Chandapiwa Baputaki revealed that the Gaborone City Council has raised concerns on the number of traditional doctors that continued to flock into the country promising their clients miracles. One councillor Keitumile Gabonewe asserted that the doctors have made it their business to even parade the traditional medicines in the streets.

"A traditional doctor that helps you must know your totem and you wonder how these doctors can claim to cure people if they cannot even tell what your totem is," Gabonewe said. As a follow-up question a young lady asked on the website (copied verbatim) “Dear Sir, I am Tumelo Mofokng From South Africa Free State I went to a doctor few day ago and told that I am HIV positive. so my uncle took to tradition healer but my uncle doesn’t about my status. and traditional healer told me that I have been witched The HIV that I have it is a fake. What I want to know is that if traditional healer what he say it is true. thus this fake Hiv can affect the person maybe I can sleep with” (link) the post concluded.

However, these instances might be scores but on the other side of the coin, we may not refuse to acknowledge the great role which Traditional Medicine has played in Cameroon in treating people. Traditional medicine is the oldest most tried and tested form of medicine.

Geocities.com revealed an article where it states that “Traditional medicine has been used by all cultures for centuries and is still the main form of medical treatment among 80% of the world's population. It is sad to hear some doctors describing traditional medicine as quackery since many of today's drugs (e.g. quinine, reserpine, ephedrine, ipecac) come directly from plants while most synthetic drugs are based on chemicals extracted from herbs." the article continues.

"It was Chinese traditional medicine that educated the western world on the art of inoculation, from which the practice of vaccination was born. We owe the eradication of smallpox directly to Chinese traditional medicine practices. Without its practice of inoculating the young, the world would have been a very different place today.” the post concluded (link)

To conclude, it will be fair to say that Traditional doctors have come a long way in harnessing their role they played in societies. These roles were erstwhile primary due to the limitations of sophistication both in mental and material values. During this time and before the coming of the mainstream western form of medicine, deaths , preventable as well as relief were plenty in different proportions of course. Beyond the introduction of western medicine which proved legitimate and mainstream, traditional medicine has been forced to assume the role of alternate medicine, thus limiting its currency especially in cities and towns though it remained competitive in rural communities. But its shortcomings basically due to the inadequacy in competence both formally and conventionally for most traditional doctors to comprehend the ever changing complexities of diseases, their strands et al, have been alarming, although made oblivious by the patronizers of this service. Amid this, modern marketers who have indulged in scamming, proceed to advertise these drugs to people with added embellishment which are faulty in nature.

Government regulation is crucial in authorizing only those who shall meet some of the standards to be set up as blueprints for the business and a strict clause to include the incumbency of these Tradi-practitioners to work in close collaboration with Medical Doctors as subsidiaries only and not as peers of course.

In South Africa, the government is organizing South African traditional healers to mount sexually explicit AIDS prevention initiatives because recent local studies confirm 80+% of South Africa's black population see traditional healers. It is essential to recruit them into AIDS prevention in their practices, as well as into the training of other healers. Each healer now carries a dildo for condom demonstration, along with traditional instruments and herbal remedies. They are incorporating HIV/AIDS prevention into their practices and will account for 27,000 healers trained by December.

Fai Fominyen Ngu Edward and George Esunge Fominyen wrote on GEF’s Outlook (link) that to improve Collaboration Between MDs and THs:
• Traditional medicine should be officially legalized and made part of the official health care system in Cameroon
• Intellectual property rights protection should be extended to traditional medicine
• Government should openly and effectively support scientific research into traditional medicine therapies

Karlz JBilz

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