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Wednesday, December 1, 2010

Use of herbal remedies in HIV treatment still causes stigma

By Esther Nakkazi

When the cock crows and birds fly out of their nests early morning, the African herbalists rise with the sun to go to the forests.

There, they pick fresh leaves, peel new bark off trees and dig plant roots from the soft ground before the sun hardens it. They then apply the knowledge most of them acquired from their ancestors.

Traditional herbalists are custodians of knowledge on herbal concoctions that are used by millions of Africans to survive. In Uganda, they are big contributors to HIV treatment as high costs and shortages of modern drugs remains imminent.

The World Health Organization estimates that up to 80 percent of people in the developing world still rely on herbal remedies for their health care.  It has thus adopted a deliberate policy of encouraging the development and utilization of traditional medicine in HIV treatment and care.

In Uganda, it is estimated that 70 percent of Ugandans infected with HIV go back to nature and consult traditional herbalists for treatment as various symptoms present. But herbalists feel there is still stigma with the use of herbs in HIV/Aids although it remains a sustainable way in HIV treatment.

“When a client goes for HIV treatment they do not mention their use of traditional medicine. Yet the drug interaction between herbs and anti-retroviral drugs could be dangerous,” said Ms. Primrose Kyeyune, a technical advisor, Traditional and Modern Health Practitioners Together against AIDS (THETA)

Experts say the attitude towards traditional medicine use is bad because people do not want to be associated with it.

Stigma Still High Among Users of  Herbal Remedies for HIV

“People stigmatize herbal medicine but they buy it everyday and prefer herbal products to modern medicines,” said Kyeyune.

According to THETA officials stigma can only be reduced through training and counseling of both the herbalists and the HIV patients. Started in 1992, THETA is a Uganda non government organisation that has been working with traditional healers in Uganda especially in HIV/AIDS prevention and care.

With THETA trainings most herbalists have changed their ways of administering herbs in HIV treatment and care. Many now can identify the dangerous HIV symptoms and refer patients to health facilities to test for HIV. They have also been trained to do record keeping, maintain minimum standards of hygiene and offer counseling.

“Originally herbalists used to claim that they heal HIV but with our training they now have knowledge that it is not curable,” said Grace Nanyonga, the information officer at THETA.

THETA has trained the herbalists to understand the HIV cycle, which has ensured that most of them know that they can only treat symptoms but cannot heal HIV.

Working as a team the herbalists have now come up with herbs for HIV that can boost the immune system, relieve Herpes Zoster, diarrhea, skin diseases and oral thrush, all opportunistic infections of Aids.

Some of the herbs have been investigated at the research Laboratory in Wandegeya, a Kampala suburb and found to have active substances that are therapeutically useful.

Training for Herbalists

Ssenga Bernadette Nabatanzi a herbalist says since she joined THETA and trained under the Regional Aids Training Network (RATN) her way of treating patients has changed.

“I am now able to keep records of my clients- like the date, age, physical and telephone contacts, next of kin, type of disease-or symptoms, and the medicine, which I have administered.”

“In practice, I cannot cut patients with the same razor blade anymore and the patients do not accept because they know their rights. They no more can take herbs which we spit on,” said Nabatanzi a reproductive health specialist.

Nabatanzi says with limited time and long lines of patients, most doctors using modern medicines do not have the time to counsel patients and gain their trust. However, herbalists who are usually permanent residents of the community, are always available and have a lot of time to administer in-depth counseling.

THETA has integrated HIV/Aids information into counselling relating HIV to culture, which enables the patients to feel better. In counseling HIV patients, the herbalists are encouraged to prepare, persuade, and request those who have symptoms to go and check for HIV.

“Usually when they test and find that they are HIV positive they come back and consult me. They confide in me because most herbalists become their confidants and counselors,” said Nabatanzi who also advises on a good diet.

For their services, the herbalists or counselors accept cash payments in installments or in kind - beans, goats, chicken. The herbalists have also been taught about minimum standards of hygiene- toilets, clean drinking water, well lit and ventilated clinics to not get infected with tuberculosis.

“I am well respected in the society; and the community prefers coming to my clinic,” said Suleiman Nkuutu a herbalist.

But as the communities continue to seek herbalists’ services and trust them, these continue to charge exorbitant fees and with no law to regulate them some administer fake herbs. THETA's problem is that when most of them eventually get extremely rich and become untrainable, rigid, secretive- they fear that their concoctions will be stolen- so they work at night.

But medics still treat herbalists with a lot of suspicion and disregard. However, THETA official say that with continued training the gap is getting closed as they start appreciating each other’s role. THETA officials say they can work with all those that fall in the WHO definition of traditional herbalists including those who sacrifice children.

“We would wish to have the witches who sacrifice children on board so that we educate them to stop the practice. If the government can support us we can come together and train all of them using our trainers,” said Ms. Kyeyune.

Ends-

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