Ethiopia: Towards Integrating Traditional, Modern Health Care System

When I was only 12, my mother took me one day to Churkos Church here in Addis Ababa; because I was sick of hepatitis or commonly known as Yewof Beshita. Inside the church lived an old lay in a house near the cemetery. My mother had the comprehension to assert the syndrome; after she saw the change in color of my eyes, finger nails and the skin pigments. She bought a new handkerchief and seven lemons before we went to the woman in the church.

The old lady prepared a kind of hard baked traditional bread. I don't remember now why the lemons were for. Then she told me to eat that sour bread holding it with the new handkerchief. After I finished eating, she told me to stand up and wave the handkerchief over my head three times and throw it to the back. I did exactly as I was told to. 'Don't look back' she screamed when I was about to.

Then the ritual was over and my mother paid five birr for the service. The old lady prescribed what I had to eat for the whole month. I was strictly told not to eat meat throughout the month. Chopped garlic combined with green pepper was the most common food I had throughout the month. Inexplicably, I recovered and became well within a month. Later on, I learned that I could have died, had I not gone to that lady in time; as modern medical services were scant in the country. Besides, the number of health professionals was too small to accommodate the demands of the inordinately growing number of population at the time.

Ancient chronicles of Ethiopia, which were written primarily by religious scholars, depict that our forefathers were endowed with the wisdom to figure out the healing powers of plants. They are gifted with learning trails of symptoms of diseases and prepare medicines accordingly. Though some of diagnoses are mixed up with bizarre religious rituals; which tend to appear superstitious, the issue of healing will not be compromised in many cases.

In rural Ethiopia, the majority of people still rely on traditional medicines; where accesses to modern medical practices are unavailable. Even in the capital, many still have a robust conviction on traditional healers; in some cases even more than the modern medications. In other words, many people including those residing in big cities including the capital, where modern medicine is accessible, traditional healers have retained cultural acceptability and respect from the public. As a result, many continue to go to them until today.

It is important to differentiate traditional doctors from spiritual healers; as the former mainly rely on herbs to diagnose patients. Traditional doctors prescribe how and when to use the medicines the way modern medication works. Primarily written in Geez, many ancient parchments that are still available in Ethiopia and others looted from the country in different times denote how skillful our forefathers had been in terms of understanding symptoms and prescribing medicines.

Traditional medicines have attained formal recognition by the government since 1942. Since then, they were not denied of an encouragement from the government and they have been encouraged to flourish. Nonetheless, there were no as such any pragmatic efforts made to incorporate them in the modern health system of the country. Perhaps, traditional healers attained better attention during the Derg regime, when the country's health policy emphasized disease prevention and health service development in the rural areas. At the time, official attention was given to the promotion and development of traditional medicine, particularly after the adoption of the Primary Health Care Strategy in 1978, records testify.

Many scholars do believe that traditional healing practices would have become more efficient, had they been integrated with modern health care systems. One of the benefits of this collaboration would help decide dosage of intake of some traditional medicines. Besides, the side effects of some traditional medicines are not properly recognized by the healers and their future impacts on the patient are hardly recognized.

On top of that, some chronic illnesses like Tuberculosis demand urgent medical treatments and many tend to delay taking traditional medicines putting their lives at stake. After all, some traditional healers claim to have treatment for almost all kind of diseases; hence significant number of patients usually turns to modern health care systems when they become hopeless of the traditional healing. In other words, traditional healing practices are negatively affecting the public health delivery efforts.

On the other hand, an incorporation of the traditional knowledge of herbs would highly contribute as a datum point for medical researchers by pinpointing where and how to start their medical researches. In this regard, traditional healers do have rich knowledge and experience that is central to conduct medical research activities thereby enhancing scientific innovations in the country.

To clarify this, traditional healers have the knowledge to identify and prescribe herbal medicines to patients for a lot of sicknesses. Modern medicine can conduct various researched on the herb so that they may come up with well-tailored analysis on the side effects, dosage and timing of prescription, among others; so that modern medicine with the maximum level of healing and minimum side effects could have prepared in a scientific manner.

In my personal opinion, the effort of integrating traditional and modern health care system requires a consolidated effort of all stakeholders including development actors like NGOs. As almost all of the traditional medicines are herbal, the fauna or the habitat of the herbs should be properly preserved; which calls for an intervention of the environment protection authority. Environmental degradation in the country is significantly endangering many of the traditional plants that were previously used to cure various diseases.

Despite the dangers facing them, Ethiopia is also very diverse in its flora composition being characterized by a wide range of ecological, edaphic, and climatic condition. Contemporary researches indicate that the flora of Ethiopia is estimated to contain close to 7000 species including medicinal plants; of those, 12-19% are estimated to be endemic to the country. The medicinal plants have been used for various types of human and animal treatments in the country. This is a huge natural resource of the country; though little attention has so far been given to preserve them.

The bottom line, the integration of the traditional and modern medical systems would yield enormous benefits to enhance the country's health service provision in many ways. On top of this, Ethiopia can learn a lot from the experiences of Far East Asian countries like china, Japan and Korea. In Ethiopia, you see support and recognition to traditional healing and the policy tend to incline on coexistence instead of integration. A

n effective integration of traditional medicine into a modern health care system should begin at the grass roots level that is with the training of physicians and practitioners. Provision of successive trainings would help both modern and traditional health care practitioners to share experiences, develop common terms and languages to specific diseases and medicines. Traditional healers would also get solutions on problems facing them in their service provisions. The Ethiopian Traditional Medical Practitioners Association and Professional Medical Association could perform a great deal to visualize the anticipated integration of the two.

All in all, the benefits of integrating the two would yield enormous benefits that are vital to foster the progress of the country; as the improvement in the health care system is one of the most crucial development indicators that serve as a benchmark to measure the standard of living of any given population.

The writer can be reached at endaleasse@yahoo.com

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