While it is commonplace to have global policy wonks of all sorts allude to the data point that some 80% of Africans use some form of traditional medicine for a part of their primary care, it is rare yet to see conventional medical agencies working directly with traditional healers. A recent article in Al Jazeera offers a welcome account of the value that can come when these silos are broken. The article is entitled Sierra Leone: How Traditional Healers Helped Defeat Ebola.
The story, authored by Dariusz Dziewanski, takes place in the nation that suffered the most Ebola deaths, including a disproportionately high number of healthcare personnel deaths: Sierra Leone. Roughly 4,000 are estimated to have died from the virus. Early on, many locals mistrusted Western ways toward the disease and turned ahead to the nation’s approximately 45,000 traditional healers. Results went quite poorly: a traditional healer who eventually succumbed to the disease was linked to more than 300 deaths. Traditional practices for Ebola were banned for a time. However, “as authorities struggled to contain the epidemic, healers were brought back to help fight the virus.” The reason: “They played an important role in educating people about how to properly avoid and treat Ebola, helping to stop its spread.”
In fact, researchers studying Sierra Leone’s health system say that “the failure to include healers at an earlier stage may have prolonged the outbreak and increased its death toll.” Richard Mallett of the Overseas Development Institute’s Secure Livelihoods Research Consortium (SLRC) states that “traditional healers were largely ignored by the state and the international community throughout the early to mid-stages of the Ebola response.”
The article concludes with a quote from Mallett’s colleague Lisa Denney: “Understandings of illness in Sierra Leone are often not solely biomedical, but also connected to the spiritual realm. The Ebola experience has shown the importance of engaging with actors like traditional healers so that they are playing a positive role in the wider health system and don’t become spoilers. Unless healers are asked to motivate and educate people to go to hospitals, she said, they will provide their services ‘underground in a manner that will make it harder to regulate.’” (Photo from the 2012 founding of the Sierra Leone Indigenous Traditional Healers’ Union.)
Comment: The article highlights the value of traditional healers in spreading the word about public health steps and the role traditional healers can have in educating their constituencies to the potential value in imported medicine. When those from the West need help, if they have relationships with traditional practitioners, they can collaborate with them to quickly reach their networks. They are often among the most influential and connected in their towns and communities. What took place in Sierra Leone, as portrayed in Dziewanski’s article, is a good example of that value. A similar story of collaboration on infectious diseases, from South Africa, is shared in South Africa Summit Models Inclusion of Traditional Healers in HIV, Tuberculosis Campaign.
Yet this relationship, while a starting place, falls well short of interprofessional respect. Reading this article brings to mind research with which former US Ambassador to the United Nations Andrew Young has been associated. A group working with Morehouse University and the CDC discovered 4 herbs with researched in vitro impact on Ebola. The ultimate benefit from breaking the silos will come when industrial medicine comes seeking to understand the value traditional practices might bring, as first-line or complementary practices, not just for disaster, but in meeting WHO’s goal of primary care for all. (Thanks to colleague and Andrew Young Foundation board member Virginia Floyd, MD, MPH, for the heads-up on the Sierra Leone article.)