CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
by Alain Agboton, Senegal, September 1998
THEME = HEALTH
Is it possible or indeed relevant to clarify, formalise and
regulate traditional medicine?
The government has tabled a Bill to try to put some kind of legal backing
to the practise of traditional medicine and to regulate the activities of traditional
practitioners
There's a great deal of consultation going on over the Bill's text, so as to find out what people really think about it. The Ministry of Health, which is guiding and orchestrating this delicate operation, is well aware of the difficulties involved. The reality is - there's a great deal of opposition, secrecy and resistance.
Since the CFA franc's devaluation in 1994 increased the price of medicines, traditional remedies have regained ground. It's estimated that 80% of the population consult traditional practitioners. Besides the financial aspect, it must be admitted that generic drugs, promoted by international pharmaceutical companies, are far from dealing satisfactorily with medical problems. In Senegal, there is one doctor for every 16,000 inhabitants, five times less than is needed, according to international norms. On the other hand, since devaluation, sadly there has been an unregulated proliferation of pharmacies in Dakar, without due regard to an equal distribution from a geographic point of view. Senegal is trying to organise the kind of medical practice which is described as "alternative" medicine. In reality it's not so, in that it's part of the national patrimony, and accounts for the majority of consultations when people fall ill. Besides, in Senegal, is there anybody who does not use both modern and traditional medicine?
Many obstacles have to be overcome within the framework of the proposed legislation. The first step must be to make a census and eventually, a selection of traditional practitioners. A well known hospital for traditional medical treatment, the Malango Centre for Health Care, is situated in Patick Region (about 150 km South of Dakar). The Centre is managed by a doctor who has been trained in both modern and traditional medicine. Many Senegalese as well as foreigners flock to this Centre for medical help. 450 traditional practitioners have been counted within the same region. Also, there are 95 traditional practitioners in the Dakar area, and 87 in the Thies region.
The census has been carried out in six of Senegal's ten regions but it hasn't all been plain sailing. The traditional "healers",(and no pejorative connotation is intended), constitute very much a "floating population" among whom many charlatans proliferate and thrive.
Added to that, a kind of mysticism envelops traditional medicine. Those involved are jealous of their knowledge and know- how, and want it to stay that way. In fact, many traditional doctors exclude, or rather refuse to collaborate with modern medicine. The question of handing on their knowledge and know-how, (which usually is passed down from father to son), has never, and never will be, completely settled.
Added to this, is the whole question of medicinal plants used in the "trade", as well as the preservation of the natural environment in which the plants grow.
The government accuses many traditional practitioners of working illegally. One wonders what the government means by "illegal" in this sense?
The proposed Bill determines what exactly is a traditional practitioner and forbids the practice of traditional medicine or the sale of medicines without a licence from the Ministry. The traditional practitioner must be in possession of an occupational identity card. Before getting this card, there's a whole investigation into the practictioner's background and good standing with his peers. But who can say if he is truly competent? At any rate, the length of administrative procedures will not be relished by healers who labour under the handicap of illiteracy. Those in charge of registering traditional practitioners are extremely reticent to issue licences especially when they see how diseases are identified and treated. They are also concerned about the quantity of traditional medicine administered.
The problem of fees does nothing to help matters. There is a tariff worked out by the National Council of Traditional Practitioner but its application is, to say the least, a gamble and a matter of luck.
And what about the factor of "tradition" which is echoed in the proposed Bill? It's stipulated that the traditional healer can demand fees according to the modus operandi of traditional medicine. But does this really exist? Some commentators note that anything approaching a Hippocratic Oath for traditional practitioners, is conspicuous by its absence. A consensus needs to be arrived at and a code of conduct needs to be worked out. The proposed Bill also condemns the kind of publicity which extols the efficacy of the practice of traditional medicine and its remedies, without due approval by the competent national institutions. Is it possible to police this area of activity? In any case, what are the real aims of traditional medicine? In recent weeks, for example, there have been many advertisements in highly respected newspapers - advertisements which can best be described as "aggressive marketing" by traditional healers. One cannot help asking whether supply exceeds demand or the opposite?
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CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
PeaceLink 1998 - Reproduction authorised, with usual acknowledgement