Emmanuel Mwendwa
15 October 2007
Nairobi — When nine-year-old Sharon Wanjiru developed a recurrent chest infection her parents took her to a private hospital in Nairobi's Eastlands estate.
"We did not have much money but we opted not to gamble with her health even if it meant making a sacrifice on our meagre resources," recounts John Njuguna, an accountant with a city manufacturing firm.
NJOROGE: "Use of herbal and other alternative medicines is on the rise as majority of Kenyans find themselves caught up in financial difficulties.
But even before the ailing child's condition could be reviewed, her parents had paid a consultation fee of Sh750 upfront. And after diagnosis, they were referred to the hospital's pharmacy to purchase prescribed medicine. "I had not expected the cost of medicine to be so high. We were required to buy syrups and tablets worth Sh4,750 bringing the entire medical bill to Sh5,500,"says Njuguna.
Since they could not raise the whole amount, the couple barely had enough money for two medicines. They explained to the pharmacist that they would collect the rest of the prescriptions later or the following day.
During the past decade, some low-income earners and a section of the middle class across the country have been experiencing difficulties in accessing and purchasing conventional medicine sold over the counter.
As a result, there has been a remarkable shift towards seeking alternative, herbal options, widely regarded as being more affordable for those with limited financial resources.
According to Dr James Njoroge, of Almed Health Products, use of herbal and other alternative medicines is on the rise as majority of Kenyans find themselves caught up in financial difficulties.
"Access to quality healthcare for the average citizen still remains a major challenge. But as proponents for herbal medicine we are striving ensure we provide affordable alternatives in tandem with rising demand for effective and pocket-friendly medicine for assorted ailments," he says.
While pointing out that herbal prescriptions are as much effective as most of the conventional drugs, Njoroge notes that cost-effectiveness is driving the shift towards use of alternative medicine, not only locally but globally as well.
Though there are official figures, it is estimated about 55 per cent of Kenyans in rural areas and urban centres rely on herbal medicines. The increase is partially attributed to growing public dissatisfaction with the rising cost of conventional medications.
"When we established the Institute of Herbal Medicine in 1988, it was in response to a flood of foreign herbal drugs, some of them brought into the country as food supplements. A variety of other products with natural ingredients got into the country through multi-level marketing distribution systems," notes Njoroge.
Most of these foreign herbal products would be sourced mainly from the Far East, Asia and USA. Some are still in circulation.
Since its inception, the herbal institute has achieved major strides by bringing together traditional healers and medicine men armed with vast knowledge on a virtually inexhaustible range of medicinal plants available especially in rural areas where conventional healthcare is beyond the reach of many.
But even as herbal treatment clinics mushroom mainly in urban centres, the use of conventional medicine is the preferred choice for many who can afford the costs in private and retail chemists.
GlaxoSmithKline's Commercial Director, Mr Davies Gichuhi, says the rigorous processing of conventional medicine is an expensive affair that often spans numerous years of research and trial tests for safety and effectiveness.
"There are a lot of overheads, which most patients may not be aware of as they purchase their prescriptions over the counter. The registration of a new drug could cost up to $2,000 (Sh134,000) prior to rigorous laboratory preparations and tests," says Gichuhi.
And before any drug is available in the market, clinical trials to establish safety and effectiveness are undertaken to earn certification, which has to be based on factual data.
"These stages are crucial to gauge possible side or withdrawal effects. In fact we have many products that remain in the laboratory for years. And after a particular drug is released for prescription, the manufacturing firm has to invest in post-marketing surveillance and consumer monitoring," he notes.
Yet in comparison, herbal treatment incurs lesser development costs more so in villages where traditional healers and medicine men have plied their trade for decades without any regulatory checks.
The preparation of concoctions, for instance, requires the healer to venture into the forests in search of tree barks, plants seeds, berries, roots, leaves, or flowers to extract specific properties for consumption purposes.
Gichuhi asserts that cost effectiveness of any form of medicine, whether conventional or herbal, ought to be weighed on the scale of the efficacy and effectiveness. "We have instances whereby despite taking the prescribed dosage, patients don't get well, resulting in follow up checks, hence additional costs."
Appeal for herbal treatment, though for centuries past practiced outside of the conventional circles, is fast edging into the mainstream as up-to-date analysis and new research approaches indicate inherent medicinal value in treatment and prevention of myriad diseases.
Specialist retail clinics or stores sell herbal products packaged in several different forms such as teas, syrups, oils, liquid and dry extracts in the form of pills or capsules.
"The tea products are simply used as dried herbs left to soak for a few minutes in boiling water before consumption. Syrups are made from concentrated extracts and are frequently used to treat sore throats and coughs. Oils are extracted from plants and often used as rubs for massage, either alone or as part of an ointment or cream," explains Njoroge.
In comparison to conventional treatment, access to herbal treatment is for many Kenyans significantly much more affordable. "Though rates are not standardised, one can spend between Sh300 to Sh2,000 for common ailments. Most herbal and traditional healers rarely charge consultancy fees, and instances where any such payments are required you can negotiate," says Beatrice Ngendo, a patient Shillings & Sense found at a city herbal clinic.
Whereas treatment of complex conditions like fibroids, common among women, costs between Sh20,000 to Sh30,000 depending on the hospital visited, Njoroge points out there is a herbal treatment prescribed for its management. "Our fibroid patients spend on average about Sh10,000."
"Herbalists' rates are often flexible and negotiable, unlike conventional hospitals whose fees are fixed and on instances have to be upfront prior to admission or treatment," Njoroge says.
Local herbalists have made inroads in preparing herbal products for varied sexual problems, which require natural therapy and not chemical prescriptions.
"We have the African Viagra product on the market and which is made from herbs that have been used for generations. A monthly dose costs Sh1,500 compared to Sh2,000 to Sh4,000 paid for several pills imported Viagra equivalents, used for a few days. A monthly dose would cost more than Sh10,000,"says Njoroge.
Also available are new herbal products being researched and others currently undergoing observation trials, aimed at addressing ailments such as penile size and breast enlargement.
The institute has developed the product Vira Kil, which under trial tests has managed to suppress the HIV virus.
And as the tide begins to turn against conventional medicine in favour of alternative treatment some prescriptions are labeled as products having herbal extracts - perhaps in an effort to counter the shifting trends.
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