ACW: Traditional Medicine

Malawi seeks to oust fake AIDS healers

2008-03-06T10:11:00.001+07:00

By,AFP, March 5, 2008

Lawmakers began examining Tuesday draft legislation aimed to rid HIV/AIDS-plagued Malawi of quacks claiming to cure the virus through such remedies as sex with virgins, health authorities said.

"When it passes into law, all traditional healers claiming to cure AIDS will be dealt with," Mary Shaba, head of HIV/AIDS issues for Malawi's health ministry, told a parliamentary committee asked to provide input to the measure before it is submitted to the full 193-member parliament later this year.

"The Act will regulate and protect people from healers who prescribe sex with albinos, the disabled or virgins as a cure for HIV and AIDS," she said of the bill drafted in collaboration with traditional Malawi healers and the World Health Organisation.

Shaba did not specify possible sanctions against bogus healing claims for a virus that has devastated this southern African country, infecting more than one in 10 people.

But under the draft legislation, the country's 30,000 traditional healers -- many of whom operate in towns and villages where hospitals are few and far between -- would be required to register with a board set up by the health ministry.

Besides direct solicitation by healers, newspaper and radio advertisements for AIDS cures are also common in Malawi.

Last year, a United Nations-funded study found that about 60 percent of people aged between 15 and 49 lacked knowledge about HIV prevention.

About 14 percent of Malawi's population of 12 million is infected with HIV, which causes AIDS, according to official figures and there are about 78,000 AIDS-related deaths and 100,000 new infections every year.

Source: http://afp.google.com/article/ALeqM5gyfef6mZQ_ABFBXZTdzejGeUhSOw

Cameroon: Traditional healers drilled on HIV/AIDS

2008-01-10T15:42:00.000+07:00

By, Fred Vubem, Cameroon Tribune (Yaoundé), January 9, 2008

The training was offered by a traditional doctor from South Africa.

An expert in traditional medicine from South Africa was recently in Cameroon to train Cameroonian traditional healers on how to take care of HIV/AIDS patients. The secretary for the International Society of Traditional Healers, Mercy Manci, said traditional doctors need to have information on the prevention and symptoms of the disease so as to be able to know how to care for them and refer them to the hospital when necessary. However Mercy Manci who also heads the Nyangazeziwe organisation in South Africa was quick to reassure that traditional healers don't treat AIDS. "We treat the opportunistic diseases", she said.

She regretted the fact that traditional healers in Cameroon have not benefited from any training on the part of government as in South Africa and urged countries to tolerate traditional and work towards a harmonious relationship between traditional medicine and medical science. In south Africa, research in traditional medicine has yielded some positive results as some tablets have been developed from traditional medicine which are widely used today in that country. Over 85 per cent of the public consult traditional healers. People have a right to treatment and a treatment of their choice.

Mercy Manci who is on her third visit in Cameroon said the first time she came, was to attend the international AIDS conference in which she presented a paper on traditional medicine; the second time was to train Cameroonian traditional healers on the prevention and symptoms of HIV/AIDS. The present visit which took her to some parts of the North West like in Mbengwi, was to follow-up those she trained last time and equally train others. According to the head of traditional healers in Cameroon, Fai Fominyen, the training fall in line with building the capacities of Cameroonian traditional healers, exchange experiences as well as offer treatment to some of the ailing members of the Cameroon association of traditional healers.

Source: http://allafrica.com/stories/200801090651.html

How acupuncture is working wonders for people with HIV-Aids

2007-10-17T14:51:00.000+07:00

By, Jim Pollard, The Nation, October 14, 2007

A pilot project in Chiang Mai province to treat people who have HIV and Aids with acupuncture and traditional Chinese massage has yielded such positive results it will soon be replicated in Africa, India and elsewhere in Thailand.

The project - launched by Dr Laura Louie, a Canadian naturopathic doctor trained in the traditional Chinese medicine - has been running at the small Mae On hospital, 35 kilometres east of Chiang Mai, for more than three years.

Acupuncture has worked minor miracles for some patients, who have enjoyed a big boost in their mental, emotional and physical wellbeing.

"I noticed after two to four treatments patients were having a dramatic improvement in their symptoms. People who'd had headaches or chronic pain for years reported that they no longer felt any pain. It really balanced their body out," says Louie.

"I thought 'Wow!' It still amazes me how much it [acupuncture] can help people.

One man in his early 30s, who she prefers not to name, was stuck in a wheelchair and unable to walk because of severe numbness and pain in his legs. He had little appetite and needed someone to assist him. After treatment he gained weight and is now back walking and working.

A study from 2004 to 2005 on 27 patients showed that 96 per cent had an improvement in their physical wellbeing. The acupuncture and short massage sessions had either resolved or decreased the frequency or intensity of their symptoms.

And "86 per cent said they had improvement in their sense of wellness and emotional well-being, which is important - quality of life is a significant factor in why I did this.

"We know we've got the [anti-retroviral] drugs to help them live for a long time, but what's their quality of life?"

About half of the patients say acupuncture has cut their physical symptoms and allowed them to work more, thus reducing their financial worries and enabling them to participate more in community and social activities.

The beauty of the programme is that it's cheap. "Acupuncture has few serious side-effects if used correctly," says Louie. "And it's very cost effective. It costs just US$6 (Bt216) to treat a person for one month, which is one session a week.

"It also treats the side-effects of anti-retroviral drugs - digestive problems, loss of appetite, numbness in the extremities or headaches. They are good drugs; however, they don't come without several side-effects. Those cause people to stop taking the drugs, so acupuncture is a very good regime to use in parallel.

"There are also secondary benefits - many patients came back saying 'I have more energy, better appetite, less stress and better sleep'. They were not treated for these conditions but acupuncture is a holistic medicine that balances out the whole body."

Louie, 47, has been practising acupuncture for 12 years. Originally from Vancouver, she has been coming to Thailand about three times a year for periods of between six and 12 weeks to train and supervise the staff at Mae On, plus helping with any problems or concerns.

Highly positive results from trial treatments in early 2002 prompted her to propose a programme of acupuncture training and treatment to the hospital director to complement the anti-retroviral drug programme already in place. The idea was accepted and Louie went home and started raising money.

"The official training programme started in April 2004 with two nurses who volunteered to do a course in traditional Chinese medicine in their own time."

By August they had undertaken 110 hours of classroom training. "We then opened the acupuncture clinic. I think we raised C$35,000 (about Bt1 million at the time) - both from my friends and family. We are not a registered charity, so it was just people who believed in me."

The money was spent on training the nurses - specially chosen by the hospital - in the fundamentals of traditional Chinese medicine, acupuncture points and meridians.

It also paid for Louie's airfares plus the basic equipment and materials for a small clinic at Mae On Hospital.

"At the start, I taught them how to locate the acupuncture points and insert the needle. We'd interview patients and teach what questions to ask [to assess people's health]. Some patients had specific problems; others just said 'unwell'.

"Acupuncture is very individualised. You find imbalances and do acupuncture to help that. It's 3,000 years of knowledge that determine this system. That includes the depth the needle goes in, the angle and the function of the acupuncture point - points have particular functions associated with them - resolving dampness, or clearing heat, removing blood stagnation, etc."

As well as acupuncture, patients also get a 10-minute tui na massage -an ancient Chinese technique.

"It appears to help decrease the stigma of HIV because it's done without using gloves or a mask unless indicated," Louie explains.

"When I first volunteered, I'd be giving the tui na massage and many concerned individuals would ask why I wasn't using gloves. This gave me the opportunity to explain how one contracts HIV and this helped to decrease the stigma."

"The acupuncture clinic has also helped create a very nice support network. People can talk safely and there's laughing and telling jokes. Some even say the nice social atmosphere is why they come.

"I want to make sure the programme is a success and the nurses get good results. But now it's been running for three years, they know they can do it on their own."

Louie has spoken internationally about the Mae On Project, which she now plans to replicate in Tanzania and India. Early last year, she presented a talk on her findings from Mae On at the Global Summit on HIV/Aids, Traditional Medicine and Indigenous Knowledge held in Accra, Ghana. She met a doctor from Tanzania who asked her to set up a similar clinic in his country.

"People were very receptive. They like the fact that it's very easy to implement and also that's is so inexpensive.

"At home in Canada and in the US, lots of people with HIV use acupuncture and traditional medicine. I'd assume it's happening in China too."

American acupuncturists working for a US non-profit group treating Africans with HIV in Uganda have reported "the same dramatic results we get here in Thailand", she adds.

The only drawback for Thailand is that nurses are not allowed to undertake acupuncture unless supervised by a medical doctor.

"They're not allowed to sit exams to become licensed acupuncturists. Whereas in all Western countries that I know of - England, Canada and the US - nurses can go on and become licensed acupuncturists."

On the Net: LauraLouieHopeFoundation.org

Source: http://www.nationmultimedia.com/2007/10/14/lifestyle/lifestyle_30052248.php

South Africa's traditional healers help fight HIV

2007-06-05T10:01:00.000+07:00

By, Rebecca Harrison, Reuters, June 4, 2007

South Africa - Tryphina Ngwenya slides a pink condom over the magic wooden stick normally used to conjure up ancestral spirits, unleashing a ripple of laughter among her audience of traditional South African healers.

"You see it's easy -- there's nothing poisonous or dangerous about condoms," she told the group of some 80 sangomas -- as traditional healers are locally known -- draped in brightly colored wraps, animal hides and beads.

Ngwenya has recruited the sangomas -- sometimes called witchdoctors -- as foot soldiers in the fight against HIV, which has infected about one in three adults in this deeply traditional corner of rural South Africa.

She is teaching them basic AIDS awareness and prevention.

Many of the healers once believed HIV was a curse from the spirit world and patients had been bewitched. Some claimed they could cure AIDS -- and many who have not been trained continue to claim this.

But while they still prescribe roots and herbs for ailments and mutter incantations to dispel evil spirits, these sangomas now also issue condoms, refer patients to clinics for HIV tests and urge them to take life-prolonging anti-retroviral drugs.

"Before, I didn't even know what this HIV animal was, but the training has brought sophistication to my work," said Miriam Tembe, who has been consulting the spirits for tips on treating patients for 25 years.

The training helped her with the practice of scarring a patient then rubbing herbs or powder into the wound: "I used to use one razor for five people -- I used to kill people," she added. "Now I teach them how to protect themselves."

BEWITCHED

The project linking traditional parishioners with modern health systems is being run by African Medical and Research Foundation (AMREF), which says more than two-thirds of people in rural Africa consult sangomas before attending a clinic.

Sangomas are revered and trusted in rural communities and play multiple roles as spiritual guide, healer and counselor. Mostly but not always woman, they might offer tips to a young couple on their sex life, advise on proper burial rites, or concoct a treatment for toothache -- all in a day.

AMREF wants sangomas to keep providing spiritual succor and basic healthcare, and also to use their influence and authority to promote HIV-testing and modern medicine in areas where many people are distrustful of hospitals, clinics and ARV drugs.

"Traditional healers are so important in these communities. People trust them more than they trust us nurses," said Ivy Mdletshe, a nurse who works in AMREF's HIV testing centre.

Zandile Bukhosini has benefited from the system. When her feet swelled up and she developed a hacking cough she assumed she had been bewitched and went straight to see Tembe -- her local sangoma.

Fortunately, Tembe knew how to spot the symptoms of tuberculosis, which often accompanies HIV infection. She consulted the spirit world as usual, then sent Bukhosini for an HIV test. The results were positive.

"When Miriam sent me for a test I was skeptical, but her medicine had helped me before so I decided to trust her," said the 25-year-old, hunched inside a mud and straw hut, the bitter aroma of burning incense wafting from the corner.

Now, with Tembe's support, Bukhosini is taking anti-retroviral drugs and looks happy and healthy.

"Miriam encouraged me to take the medicine the doctors gave me," she said. "But she also gives me her own treatment and tells me if I need to slaughter a chicken to appease the ancestors."

TOXIC DRUGS

The AMREF project has particular resonance in South Africa, where Health Minister Manto Tshabalala-Msimang has angered AIDS activists by appearing to question accepted science and emphasizing treatments such as lemon, garlic and the African potato.

Ngwenya insists the two approaches are not mutually exclusive, and argues sangomas can help treat some of the side effects of HIV -- such as skin problems or coughs and colds -- and break down the stigma attached to it.

"Obviously there is not a traditional healer who can cure AIDS but they can help treat the symptoms and help support patients by giving them what they want to believe," she said.

But she also says much more must be done. An estimated 200,000 traditional healers are practicing in South Africa -- there are almost 900 in this small district of some 200,000 people -- and organizations like AMREF have trained just a handful.

Many healers still tell patients anti-retroviral drugs are toxic, condoms are infested with disease-carrying worms and killing a goat will appease ancestral spirits and cure the sick.

And while a few weeks of basic training can halt dangerous practices like razor-sharing, healers may continue to promote traditional methods over modern medicine.

But most sangomas see little conflict between the two approaches, and say learning about orthodox healthcare has helped improve their traditional practice.

"How can the ancestors be angry with me?" said sangoma Philile Gumbi when asked what the spirits thought when she encouraged patients to turn to modern medicine: "Both me and the hospitals are doing the same thing -- we are saving lives."

FEATURE-Believers seek AIDS cure at Ethiopian springs

2006-11-29T09:46:00.000+07:00

By Tsegaye Tadesse, Reuters AlertNet, November 29, 2006

ADDIS ABABA - Shivering under a tattered blanket, a young woman tries to sleep at the foot of the mist-shrouded Entoto Mountain, north of the Ethiopian capital, Addis Ababa.

Nearby, a mother and child huddle together in the early morning cold.

"I decided to come to Entoto to seek a cure from the holy water after a doctor told me that I am HIV-positive," Abebech Alemu, 35, said.

"I am a follower of the Orthodox faith. I strongly believe that I will be cured by drinking the holy water rather than drugs," she added.

Ethiopia is one of the countries hardest hit by the AIDS epidemic, with more than 1.5 million people, including 100,000 children, living with the HIV virus.

The World Health Organisation (WHO) says the epidemic was previously an urban problem, but the virus has started to spread to rural areas where an estimated 85 percent of the country's 75 million people live.

In Ethiopia's remotest corners, awareness of health and medical issues is very low, and many in isolated communities believe HIV infection is akin to a plague or curse from God.

Abebech is among thousands of Ethiopians who trek from far-flung parts of the Horn of Africa nation to what they believe are holy springs, searching for cures. Many hope to rid themselves of HIV/AIDS.

At the site of the holy spring on Entoto near St. Mary Church -- built by Emperor Menelik II at the end of the 19th century -- a priest holding a large wooden cross stands on high ground.

Below, partly naked and trembling patients line up to be immersed in the water and blessed by the priest. Each patient carries away about five litres of the water, which they drink every day believing it will cure their ailments.

Monks have built awnings made of sticks and straw around St. Mary Church to shelter the wealthier visitors, but most live in the open, surviving by begging.

"THE ALMIGHTY'S CURE"

"I know about the free distribution of HIV medicine, but I have decided not to take it. I am convinced I could be cured by the holy water," Abebech said.

Head priest Bahetawi Gebremedhin Demise said he came to Entoto 10 years ago after God told him in a dream to go to the deep ravine under the mountain where a holy spring would cure the sick.

"Once they feel better, I send them back to the hospital where they were declared HIV-positive. They come back with a negative certificate," he said.

Bahetawi Gebremedhin said 1,390 HIV-positive people had been cured in the past year alone, according to his records. He said the spring had healed more than 500,000 people, including many foreigners, suffering from different ailments.

"This is a place of God where all those who believe in the Almighty are being cured. People from all walks of life who seek God's mercy come to us and we try and help everyone irrespective of their creed, religion or nationality," he said.

But Dr. Solomon Zewdu, administrator of Johns Hopkins University HIV/AIDS Drugs Distribution Centre in Addis Ababa, said he had appealed to the Orthodox Patriarch to tell HIV-positive people that they can take anti-retroviral drugs (ARVs) along with the water.

"HIV drugs are life-saving. Those who are drinking the holy water can also take the drugs. I do not see any contradiction," he said, adding he had seen patients abandoning their hospital beds and the ARV regime, opting for holy water.

Only 33,000 people in Ethiopia are receiving ARV treatment, according to the WHO. In many developing countries, life-saving drugs are either unavailable or too expensive for millions living with the virus.

"Those possessed by the devil come in chains, others on a wheelchair or on the backs of men, still others, who lost their eyesight, are led here by friends," Bahetawi Gebremedhin said.

"After a few weeks of intense prayer and religious rites, they are baptized with the holy water and they get cured."

Source: http://www.alertnet.org/thenews/newsdesk/L13849437.htm

Medicinal plant "fights" Aids

2006-08-31T10:36:00.000+07:00

A South African indigenous medicinal plant may hold the key to the treatment of millions of poor people living with HIV and Aids, helping them relieve the symptoms of Aids.

For the first time in South Africa's medical history, the plant, Sutherlandia Frutescens, sub-species Microphylla, is to undergo clinical trials to assess its immune-boosting propertie

The Medical Research Council will conduct the trials early next year and results are expected within three to six months.

Anecdotal evidence is already mounting, suggesting that this plant can improve the quality of life of thousands of people both with HIV and full-blown Aids.

Sutherlandia Frutescens grows wild in the Western Cape and in the hills of Zululand.

Cancer bush

A particular variety of the plant has been used for centuries as a potent medicine by South Africa's indigenous San people who call it "Insisa" - the one that dispels darkness. They used it as an energy booster and a powerful anti-depressant.

Traditional healers have been using it for decades Zulu sangomas or traditional healers know it as "Unwele", the great medicine that was used to ward off the effects of the devastating 1918 influenza pandemic which claimed 20 million lives worldwide.

The Tswana people know it as "Mukakana" for its power in treating gonorrhoea and syphilis, while the Afrikaners call it the "Kankerbossie" or cancer bush, because of its properties in treating people suffering with internal cancers and wasting.

Molecular combination

A local company specialising in the development of indigenous plant medicines, Phyto Nova, first started researching the bio-chemical properties of Sutherlandia about three years ago.

A multi-disciplinary team headed by Dr Nigel Gericke, a botanist, medical doctor and indigenous plant specialist, found that Sutherlandia contained a powerful combination of molecules which have been identified and used in the treatment of patients with cancer tuberculosis, diabetes, schizophrenia and clinical depression and as an antiretroviral agent.

Phyto Nova were so convinced that Sutherlandia could be used as a tonic for people infected with HIV and Aids, that they contracted farmers to plant acres of the bush, to prevent wild supplies being over-harvested. They have been manufacturing high quality Sutherlandia tablets, gel and powder.

Having determined that the product was safe when administered with a balanced food diet, the company distributed Sutherlandia to Aids patients.

Quality of life

"Anecdotally we are accumulating evidence that wasted patients with Aids, TB and cancer pick up weight, regain energy and appetite," says Dr Gericke.

"The claim we are making on the basis of this, is that we can significantly and dramatically improve the quality of life of many ill Aids patients... We are certainly not making the absurd claim that Sutherlandia is a cure-all or a cure for Aids."

Whatever comes of the clinical trial, word of the plant's properties is already spreading among South Africa's traditional healers.

At the same time as Phyto Nova was conducting its research, one of the country's most venerated traditional healers, Dr Credo Mutwa, 80, was using Sutherlandia to treat Aids patients.

"My aunt Minah, who is 103 years old, told me that we should use the great medicine against Aids," said Dr Mutwa. "I said to her: 'But aunt, the white people tell us there is no cure for this disease'.

"And my aunt said: 'For every disease there is a treatment. Try this medicine'. And I tried it."

'Near-miraculous'

"I have treated people who were told by the doctors at the hospital to 'go home and die' and they are still alive today, three years after they should have died. This plant is near-miraculous, I can say that with certainty," he says.

Testimony to the efficacy of the plant continues to mount.

Anne Hutchings, an ethno-botanist and lecturer at the University of Zululand has been using Sutherlandia, together with a range of other indigenous plant medicines, to treat Aids patients who attend the weekly Aids clinic at Ngwelezane Hospital.

She has 176 patients who all testify that Sutherlandia has helped them to live a fuller, healthier and more productive life.

No response

In the Northern Cape town of Kuruman, nurse and sangoma, Virginia Rathele is using Sutherlandia at her clinic to treat more than 300 Aids patients.

She says an integral part of the treatment is to tell patients to eat healthily. "Sutherlandia does not work properly just on a diet of porridge. You have to have vegetables," she said.

One client, who weighed 26kg and was close to death in April this year, now weighs 45kg and is helping Ms Rathele run the clinic.

Patents cannot be taken out on plants which have well-documented folk use, which means that Sutherlandia should remain accessible to anyone.

At present, one month's supply of Phyto Nova tablets costs a little under $2.50 and two months' supply of the powder form of the medication can be bought for under 50 cents.

Phyto Nova has approached the South African Government in a bid to persuade them to grow the plant on a massive scale for use in public health treatment.

So far they have had no response.

Source: Carolyn Dempster, BBC News

Traditional medicine

2006-08-31T09:46:00.000+07:00

What is traditional medicine?

Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being.

Countries in Africa, Asia and Latin America use traditional medicine (TM) to help meet some of their primary health care needs. In Africa, up to 80% of the population uses traditional medicine for primary health care. In industralized countries, adaptations of traditional medicine are termed “Complementary“ or “Alternative” (CAM).

Increasing use and popularity

TM has maintained its popularity in all regions of the developing world and its use is rapidly spreading in industrialized countries.

In China, traditional herbal preparations account for 30%-50% of the total medicinal consumption.
In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicines at home.
WHO estimates that in several African countries traditional birth attendants assist in the majority of births.
In Europe, North America and other industrialized regions, over 50% of the population have used complementary or alternative medicine at least once.
In San Francisco, London and South Africa, 75% of people living with HIV/AIDS use TM/CAM.
70% of the population in Canada have used complementary medicine at least once.
In Germany, 90% of the population have used a natural remedy at some point in their life. Between 1995 and 2000, the number of doctors who had undergone special training in natural remedy medicine had almost doubled to 10 800.
In the United States, 158 million of the adult population use complementary medicines and according to the USA Commission for Alternative and Complementary medicines, US $17 billion was spent on traditional remedies in 2000.
In the United Kingdom, annual expenditure on alternative medicine is US$ 230 million.
The global market for herbal medicines currently stands at over US $ 60 billion annually and is growing steadily.

Safety and efficacy issues

Scientific evidence from randomized clinical trials is only strong for many uses of acupuncture, some herbal medicines and for some of the manual therapies. Further research is needed to ascertain the efficacy and safety of several other practices and medicinal plants.

Unregulated or inappropriate use of traditional medicines and practices can have negative or dangerous effects.

For instance, the herb “Ma Huang” (Ephedra) is traditionally used in China to treat respiratory congestion. In the United States, the herb was marketed as a dietary aid, whose over dosage led to at least a dozen deaths, heart attacks and strokes.

In Belgium, at least 70 people required renal transplant or dialysis for interstitial fibrosis of the kidney after taking a herbal preparation made from the wrong species of plant as slimming treatment.

Biodiversity and sustainability

In addition to patient safety issues, there is the risk that a growing herbal market and its great commercial benefit might pose a threat to biodiversity through the over harvesting of the raw material for herbal medicines and other natural health care products. These practices, if not controlled, may lead to the extinction of endangered species and the destruction of natural habitats and resources.

Another related issue is that at present, the requirements for protection provided under international standards for patent law and by most national conventional patent laws are inadequate to protect traditional knowledge and biodiversity.

Tried and tested methods and products

25% of modern medicines are made from plants first used traditionally.
Acupuncture has been proven effective in relieving postoperative pain, nausea during pregnancy, nausea and vomiting resulting from chemotherapy, and dental pain with extremely low side effects. It can also alleviate anxiety, panic disorders and insomnia.
Yoga can reduce asthma attacks while Tai Ji techniques can help the elderly reduce their fear of falls.
TM can also have impact on infectious diseases. For example, the Chinese herbal remedy Artemisia annua, used in China for almost 2000 years has been found to be effective against resistant malaria and could create a breakthrough in preventing almost one million deaths annually, most of them children, from severe malaria.
In South Africa, the Medical Research Council is conducting studies on the efficacy of the plant Sutherlandia Microphylla in treating AIDS patients. Traditionally used as a tonic, this plant may increase energy, appetite and body mass in people living with HIV.

WHO efforts in promoting safe, effective and affordable traditional medicine

The World Health Organization launched its first ever comprehensive traditional medicine strategy in 2002. The strategy is designed to assist countries to:

Develop national policies on the evaluation and regulation of TM/CAM practices;
Create a stronger evidence base on the safety, efficacy and quality of the TAM/CAM products and practices;
Ensure availability and affordability of TM/CAM including essential herbal medicines;
Promote therapeutically sound use of TM/CAM by providers and consumers;
Document traditional medicines and remedies.

At present, WHO is supporting clinical studies on antimalarials in three African countries; the studies are revealing good potential for herbal antimalarials.

Other collaboration is taking place with Burkina Faso, the Democratic Republic of the Congo, Ghana, Mali, Nigeria, Kenya, Uganda, and Zimbabwe in the research and evaluation of herbal treatments for HIV/ AIDS, malaria, sickle cell anaemia and Diabetes Mellitus.

In Tanzania, WHO, in collaboration with China, is providing technical support to the government for the production of antimalarials derived from the Chinese herb Artemisia annua. Local production of the medicine will bring the price of one dose down from US $6 or $7 to a more affordable $2.

In 2003, WHO support has so far facilitated the development and introduction of traditional and alternative health care curricula in seven tertiary education institutions in the Philippines.

Training workshops on the use of traditional medicines for selected diseases and disorders have also been organized in China, Mongolia and Vietnam.

Priorities for promoting the use of traditional medicines

Over one-third of the population in developing countries lack access to essential medicines. The provision of safe and effective TM/CAM therapies could become a critical tool to increase access to health care.

While China, the Democratic People’s Republic of Korea, the Republic of Korea and Vietnam have fully integrated traditional medicine into their health care systems, many countries are yet to collect and integrate standardized evidence on this type of health care.

70 countries have a national regulation on herbal medicines but the legislative control of medicinal plants has not evolved around a structured model. This is because medicinal products or herbs are defined differently in different countries and diverse approaches have been adopted with regard to licensing, dispensing, manufacturing and trading.

The limited scientific evidence about TM/CAM’s safety and efficacy as well as other considerations make it important for governments to:

Formulate national policy and regulation for the proper use of TM/CAM and its integration into national health care systems in line with the provisions of the WHO strategies on Traditional Medicines;
Establish regulatory mechanisms to control the safety and quality of products and of TM/CAM practice;
Create awareness about safe and effective TM/CAM therapies among the public and consumers;
Cultivate and conserve medicinal plants to ensure their sustainable use.

Source: WHO

http://www.who.int/mediacentre/factsheets/fs134/en/

Global Summit on Traditional Medicine, Indigenous knowledge and HIV/AIDS

2006-05-06T07:42:00.000+07:00

Accra, Ghana, March 14 -18 2006

HDN Key Correspondent Conference Report

This short report is in three sections: an overview of the conference, its aims and objectives; a consideration of the various interventions that were presented; and a broader discussion around how the approach to traditional medicines contrasts with the allopathic (orthodox medicine).

This paper does not claim to be a full report of the event, but rather aims to highlight the key issues and - more importantly - ensure that traditional medicines in HIV care receive due consideration.

1. WHAT WAS THE CONFERENCE HOPING TO ACHIEVE?
80% of Africans utilise traditional healers (TH) dispensing traditional medicines (TM). Stated by Dr Richard Fru of Cameroon during the opening presentation of this important conference, held in the Ghana Institute of Management and Public Administration, Accra, Ghana, this stark fact set the scene for the rest of the week.

Though allopathic medicine has achieved almost global hegemony; it is local, community-driven and culturally relevant interventions that are the primary source of treatment for millions of people - their first point of contact. The 'ancient', or indigenous knowledge that informs traditional medicine was often contrasted here in Ghana with the relatively recent, and therefore more youthful allopathic interventions.

The purpose of this summit - opened by an enthusiastic Health Minister of Ghana, the Hon Courage Quarshigah - was to remedy the imbalance between allopathic and traditional medicine, and at the same time promote a paradigm of care allowing the two approaches to co-exist. Presenters at the summit hailed from African nations, and beyond, including: Zambia, Tanzania, Ghana, Cameroon, Belgium, Malawi, Canada, Hong Kong, the United States and the United Kingdom.

In spite of the geographical variety, there did seem to be for the majority of delegates a united and unifying desire to emphasise alternative approaches to the care and treatment of PLWHA rooted in local knowledge, drawing on a long cultural heritage that in many instances predates modern interventions by centuries, perhaps millennia. Given most people attending the conference were from Africa, many of the topics focused on herbal and plant-based interventions.

Non-African interventions included traditional Chinese medicine (TCM), and the use of acupuncture for HIV/AIDS symptom relief in northern Thailand, by Dr Laura Louie - the Mae On Project. Promoting acupuncture as a cost-effective intervention which does not interact with ARVs, is cost effective and improves quality of life, Dr Louie's presentation confirmed that 'ancient' treatments still have a role to play in the management of 'modern' disease', a notion confirmed throughout this event.

2. TRADITIONAL MEDICINE AND ITS BENEFITS
So, what are the benefits of traditional medicines? Primarily, is the fact it uses a holistic approach, taking into account the physical, mental, emotional and spiritual aspects of an individual, which are invaluable for healing/health and often overlooked by allopathic medicine.

Treatments were not the only focus of the summit - many of the presentations and discussions also considered issues around equity, the need for mutual respect between TM and allopathic practitioners, and intellectual property rights. Some presentations described methods used by empirical science to evaluate the application of TM in HIV treatments - including a paper by Dr L Pieters of the University of Antwerp in Belgium, describing the development of research studies to evaluate the effectiveness of herbal remedies, and the specific modes of action of particular herbs.

Another paper, by Dr Mary Richardson of the National Foundation for Alternative Medicine, Washington, highlighted the continuing need to regulate traditional medicines, to maximise safety and efficacy - especially around contamination. The urgency in developing research paradigms and appropriate independent verification would, she suggested, lead to more effective low cost medication.

These and similar papers did reveal an especially difficult facet in the evaluation of TM - consistency of the product. If one herb being used for a treatment is to be evaluated for example, when in the lifecycle of the plant is the medication to be extracted? From where?

These and similar questions pose serious challenges for traditional African medicine, but one common feature reiterated throughout the week here in Ghana is the relative affordability, low toxicity, and ease of manufacture of TM. Their effectiveness against the 'monster' of HIV/AIDS - as suggested by one of the first speakers - is also a feature that many at the summit felt significant.

It is the strong cultural relevance of TM, derived from knowledge within the local community that is perhaps their most potent characteristic. They are - literally - owned by the populace. Indeed, Dr Rokia Sanago of the University of Mali suggests that because TH live in the 'same reality' as their community, their impact is especially powerful: subtly suggesting perhaps that practitioners of allopathic medicine are less adept at engaging with their clients.

Clearly, TM has resonance with the local community. However, issues of regulation of practitioners remain important, a fact highlighted by Dr Dabra VI during his description of a local project in which TH were provided with additional information about HIV in a bid to ensure that their practice was safe. The results of the project - a marked increase in knowledge and understanding of HIV/AIDS - demonstrated that TH could also play a vital part in the community for HIV prevention, because they are often the most trusted practitioners.

A similar project, in Mali, also suggested that, in the right circumstances, TH were willing to engage with education programmes designed to ensure that TM was practiced safely - in a way that would not diminish its uniqueness or relevance, but also to ensure risk of HIV transmission was minimised (e.g. during circumcision rituals). Dr Rokia Sanago of the University of Mali described a study in which 249 TH took part.

Following culturally sensitive education, 97% altered their practice to minimise HIV transmission. Other examples - for example, ensuring the TH are aware of interactions between anti-retroviral (ARV) medication and TM, suggest it is possible to integrate traditional and 'modern' knowledge in meaningful and beneficial ways, as has been often demonstrated in the context of western naturopathic medicine.

3. WHAT IS INDIGENOUS KNOWLEDGE?
TM is founded upon indigenous knowledge, and is therefore local and immediate. People seeking treatment are already part of the 'world' of the TH, whose approach is also shaped by the cultural history of the region, or predicated on the need for close and meaningful interactions between the healer and the patient.

However, defining this indigenous knowledge is difficult, for at best it is a nebulous concept - still not well-understood even by the 'custodians of this knowledge themselves', according to Dr Luis Sambo, Director of the regional office of the WHO in the Democratic Republic of Congo. As a result, it is imperative there is a legal framework, national plan and a need to protect the intellectual property rights (IPR) of TH: and this was a leitmotif of the event - the nature and ownership of knowledge.

Dr Esther Kibuka-Sebitosi of the University of South Africa discussed the meaning of indigenous knowledge, and - perhaps most significantly - the ways that the knowledge held by traditional healers can be protected from unscrupulous or excessively acquisitive organisations and companies.

Based on a survey carried out in the region, traditional healers, she suggested, are afraid of exploitation, and wary that they would not get fair recompense from the passing of knowledge to 'outside' organisations. She raised interesting additional points that resonated with others during the conference - the very nature of traditional healing and indigenous knowledge is that it is, by definition, local and rooted in the immediate culture.

From a legal and ethical perspective, therefore, trying to define what actually needs protecting is difficult - names of plants and interventions will vary between regions; taxonomies will inevitably be different. She therefore highlighted the urgent need to develop appropriate mechanisms to protect the interests of traditional healers, avoid bio-piracy and develop radical frameworks to preserve the intellectual property rights of those in possession of 'indigenous knowledge

4. A CLASH OF CULTURES?
Throughout the event, the unifying factor underpinning all activities was a firm belief in community, and the power derived from approaches to illness and treatment rooted within the local social and cultural system. A fear of losing this ancient knowledge was reiterated many times - Health Minister Courage Quarshigah suggested people had unfortunately 'decided to disconnect [themselves] from indigenous knowledge' - partly, he suggested, because scientists have 'no use' for it at all.

He declared his ardent support for TM - perhaps a sign that in Ghana at least, there will be additional prominence given to policies that protect and encourage traditional medicine.

The essential contrast between allopathic and traditional medicine was illustrated well by one particular presenter, a practising allopathic doctor - Wisconsin-based Dr Richard Nagler. He was incisive in his critique of the inflexibilities in western medicine, with its 'different goals and different approaches to the use of knowledge', and which often sees alternative approaches as competition.

Nagler's argument is clearly central to the whole question of validity and acceptability of TM, and close to the view of anthropologist Arthur Kleinman writing in the 1980s, who argues that all approaches to illness are essentially relative, and equally valid. What is perceived as the 'orthodox' approach is simply just another approach, and from the perspective of culture, no more or less valid than any other - it is simply a matter of point of view.

Nagler concluded with a call for all governments and organisations to have as their goal the 'support and respect' of TM. Dr Richard Atleo Hereditary Chief of the Ahousaht in British Columbia, Canada also confirmed the contrasts between knowledge generated by traditional science - through research; and that from traditional medicine - based on outcome.

To western ears, this may sound like heresy, and indeed, when evaluating the efficacy of TM, orthodox western driven research paradigms may not be the best approach.

Clearly, what is important is the need for a model of treatment and care drawing on the best of both paradigms - the scientific approach of western medicine (valuable for many medical emergencies) and traditional medicine rooted in indigenous knowledge and often best suited to chronic conditions unresponsive to western interventions.

As this conference confirmed, whilst this may seem a perfectly rational way of dealing with contrasting paradigms, in many instances the allopathic, 'scientific' approach usurps the traditional, with the result that interventions offered to patients received are founded entirely upon an alien paradigm.

On the final day of the conference, Dr. Godfrey Swai proposed a self-sustaining integrated medical clinic featuring allopathic medicine, traditional Africa medicine, acupuncture, nutrition and health maintenance programs, as an example of a useful model for development. He described how over the centuries, the rise and fall of colonialism and slavery was inversely related to the dominance of traditional medicines in African cultures, and he feels now is the time for truly holistic interventions in the relief of HIV/AIDS symptoms, especially as the provision of ARVs and associated treatments were falling short of expectations - and promises.

The summit here in Ghana was driven by a desire to encourage mutual trust and respect between traditional and allopathic medicine. Both have value, and the search for a holistic and integrated approach between these two types of medicine, was clearly the intention of this conference. Dr Rodwell Vongo, President of the Traditional Health Practitioners Association of Zambia perhaps provided the most revealing statement: 'do western doctors believe in demons or ghosts? Do TH believe in psychosocial issues?'

At other times this week, words not normally heard at events dealing with 'treatments' were heard: dreams; visions; myths; stories, and whilst Vongo was clearly encouraging the development of TH in mainstream treatments, he also went on to comment on the lack of progress on both sides for not expanding their understanding of other approaches and paradigms - but he was also clearly aware of the stigmatisation of TH, and proposed that allopathic and traditional healers 'join forces', and achieve a level of synergy that is currently lacking.

5. CONCLUDING POINTS
As HIV/AIDS continues to ravage many parts of the developing world, and the roll out of ARV lags far behind the targets set by international agencies, traditional medicine offers an accessible alternative, especially when allied with allopathic treatments that are already well established, such as treatments for TB. The campaign AIDS-Care Watch is one initiative that wishes to highlight the value of TM, especially in areas starved of ARV but with access to other allopathic treatment.

TM is not dependent on external and often culturally novel treatments that for many are too expensive or simply unavailable. They provide - in this case - a resolutely African solution for an African problem, and as argued throughout this summit, when grafted on to other forms of treatment, result in an overall package of care with an impact far beyond that of individual components.

Following the conference, the declaration included these words - summing up the spirit of the event and challenging governments and agencies to act:

'...We urge State parties, governments and multilateral organizations to respect the customary laws and practices that define access and availability of indigenous cultural knowledge, and to ensure adequate and mutually acceptable exchanges.'

The full declaration can be found here:
www.africa-first.com/gsaidstmik2006/declaration.htm

More information about AIDS-Care Watch can be found here:
www.aidscarewatch.org

Source: AF-AIDS eForum

Zimbabwe Herb Prolongs Lives Of HIV-Infected

2006-01-21T09:06:00.000+07:00

Scientists Anna Chibamu, 12 January 2006
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ZIMBABWEAN scientists yesterday claimed that they had made a major breakthrough in trying to find a solution to increasing even further the lifespan of people living with HIV and Aids, a puzzle bugging the medical fraternity for two decades.

Health and Child Welfare deputy minister Edwin Muguti said clinical tests done on a herbal medicine, locally called gundamiti, had so far proved that it possesses healing properties for people living with HIV

"The clinical trials started on December 1 in 2005. To date, 45 patients are on trial for the herbal medicine which we are confident will go a long way in helping patients who are HIV positive," Muguti said.

He said preliminary results so far were encouraging as the condition of patients on the herbal therapy had improved tremendously with some opportunistic infections disappearing "I can safely say their CD4 count had increased, while viral load decreased," the deputy minister said.

"This herbal combination is very safe with no deaths recorded and side effects detected so far."

Muguti said the new development was innovative and refreshing to HIV and Aids patients, as most could not afford the prohibitive anti-retrovirals. "Local products are less expensive and readily available and this makes gundamiti a promising herbal medicine for our country," he said.

Initially, Muguti said the ministry had intended to put 50 patients on trial, but ended up getting 45. "Those who are 18 years and above qualify for the trial and these should be HIV positive," he said. "And they should not have taken any anti-retroviral therapy before."

Last year, the ministry created the department of Traditional Medicine to focus primarily on safe and rational use of herbs and other natural medicines. Muguti stressed that this was very necessary as most countries were now relied on natural medicines due to high cost of conventional drugs

"Research and alternative treatment is vital for the development of Zimbabwe. For example, China and India have produced doctors from Traditional Schools of Medicine, so the same should also happen here," he said.

The Zimbabwe National Traditional Healers Association (Zinatha) president, Gordon Chavhunduka, also praised the dawn of the herb, he also said was very effective judging by research carried out since 2002.

"Zinatha has been trying this herb for the past 4 years and I can acknowledge its effectiveness in patients, who are HIV positive," he said A few years ago, Zinatha set up a training college for traditional healers, but the project had to be shelved due to financial constraints.

Source: Partners-Zimbabwe eForum

China, Thailand To Distribute Herbal Drug To Treat HIV-Positive People

2006-01-14T03:38:00.000+07:00

from Kaiser Family Foundation, January 11, 2006

Thailand and China plan to distribute an herbal drug that researchers say can boost the immune systems of HIV-positive people and help manage the virus, health officials said on Wednesday in Thailand, AFX/Forbes reports.

The drug, called SH Instant, combines three medicinal herbs from China and two from Thailand and was developed as part of a six-year, $2 million project, according to the Medical Science Department of Thailand's Ministry of Public Health (AFX/Forbes, 1/11).

China's Department of Medical Services Deputy Director Pongphan Wongmanee said that China and Thailand worked together to test the efficacy of the herbal drug (Thai News Service, 1/11).

In a study of 60 patients, the 40 people who took the drug "fared better in fighting the virus than the 20 who did not" take the drug, AFX/Forbes reports (AFX/Forbes, 1/11). SH Instant was shown to reduce the participants' viral load by 43% but does not eliminate the need for standard antiretroviral drugs, according to the Thai News Service.

In initial trials, patients experienced no adverse side effects to SH Instant. The drug currently is in the third phase of testing. China's Ministry of Public Health said it plans to distribute SH Instant within the next three months.

The drugs will be produced in China, but Thailand is negotiating an agreement to sell the drug in Thailand before it is available in other countries, Pongphan said (Thai News Service, 1/11).

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More Than 5,800 HIV-Positive People in China Using Traditional Medicine More than 5,800 HIV-positive people in China are using traditional forms of Chinese medicine, according to She Jing, director of the State Administration of Traditional Chinese Medicine, Xinhuanet reports.

She said 3,500 HIV-positive people in China are using traditional medicines through government funded programs in 11 provinces, and an additional 2,305 are using medicines provided by 15 health institutions in 19 provinces.

She added that the government hopes to widen traditional medicine treatment programs to 14 provinces this year and will continue monitoring the efficacy of the medicines in people living with HIV/AIDS.

According to She, traditional medicines have been proven effective in treating some infectious diseases that occur as a result of HIV and can help patients with some of the painful side effects of antiretroviral drugs (Xinhuanet, 1/11).

Source: Kaiser Family Foundation

Ugandan govt to recognize traditional healers

2005-09-14T09:39:00.000+07:00

10/9/2005, China View

KAMPALA, Sept. 10 (Xinhuanet) -- The Ugandan government is designing a policy to recognize traditional healers as regular medical service providers to boost the low doctor-patient ration of one doctor to 18,000 Ugandans, local media reported on Saturday.

Nelson Musoba, an official with the Ministry of Health, was quoted as saying that the healers made a significant contribution in the fight against AIDS and the government had given them a top priority.

The traditional healers are more than the professional doctors in Uganda, with a 1:400 healer-to-patient ration, according to the ministry.

Musoba said the public health law should empower authorities to provide a comprehensive ranges of services for prevention and treatment of HIV/AIDS.

"They are conceptually more appealing to the population and in term of counseling, they are superior," Musoba added.

Ugandan Health Minister Jim Muhwezi also said last week that the government was in the final stages of developing a national policy on traditional and complementary medicine which would be crucial in defining the role of traditional medicine in the national health care delivery systems.

In Uganda and Africa at large, up to 80 percent of the population use traditional medicine to help meet its health care needs. Traditional health practitioners are well integrated in the communities and they are major stakeholders in the health prevention.

Source: China View

ZIMBABWE: With ARVs beyond reach, rural folk resort to herbs

2005-09-14T08:26:00.000+07:00

Rural Zimbabweans battle to cope without access to ARVs

BULAWAYO, 25 Aug 2004 (IRIN) - Moketsi Nleya, a subsistence farmer in rural Madlambuzi, western Zimbabwe, painfully retrieves a bunch of thin brown roots from under his pillow, which he breaks into tiny fragments and chews, followed by a cupful of an analgesic herbal concoction that also acts as a sedative.

Nleya, 55, is among a growing number of HIV/AIDS patients in rural Zimbabwe who have to resort to traditional medicine because they have no direct access to antiretroviral (ARV) therapy.

"Ours is a delicate and desperate case. Some people tell us that our condition could improve only if we could get antiretroviral drugs. The pain is unbearable, but when you take some of these herbs you do get a decent sleep, at least for a night," Nleya said. His scrawny body showed the signs of fast-deteriorating health.

Some of Madlambuzi's residents said the Zimbabwe National Traditional Healers Association (ZINATHA), a body representing traditional healers and herbalists, encouraged them to seek herbal therapy while waiting for the government's announcement on rolling out ARVs in rural areas.

ZINATHA has called for the acceptance of traditional medicines at health institutions and is lobbying government to allow its members to work with doctors and nurses to tackle the AIDS pandemic.

Dr Gordon Chavhunduka, president of ZINATHA, told IRIN that in the fight against the virus, all medical practitioners should work together for the benefit of the patient."We have been lobbying the government for the past two decades to incorporate traditional healers' knowledge and practice into the country's health delivery system, without much success. It has always been the norm and custom among African communities to use traditional medicine in whatever circumstances, and indeed, people infected with HIV/AIDS are among those who use them," Chavhunduka said.

Official figures indicate that AIDS-related illnesses claim more than 2,500 lives every week. Faced with empty coffers, a fast-crumbling health delivery system, isolation from the international community and shortages of foreign currency to buy drugs, Zimbabwe is grappling with the epidemic that has reduced life expectancy to 35 years.

The population of children orphaned by AIDS is estimated to be hovering at above one million.Last month the Geneva-based Global Fund turned down Zimbabwe's request for US $218 million of assistance, the bulk of which was meant to support ARV rollout programmes in both rural and urban areas.

Estimates indicate that while almost 25 percent of Zimbabwe's 11 million population are HIV-positive, only 5,000 are on ARVs.The government set aside about Zim $15 billion (US $2.6 million) for the purchase of ARVs at the beginning of the year, but critics said the amount was completely inadequate.

Because of the desperate situation unfolding in rural areas, some NGOs have stepped in with medical assistance: Medecins Sans Frontieres (MSF) intends rolling out ARVs to rural people in Matabeleland in the southwest of the country."At the moment we are setting up an HIV/AIDS project in rural Tsholotsho. Basically, our intention is to start running opportunistic infection clinics, together with the staff from the Ministry of Health and Child Welfare. When that has been done, we will then provide ARVs just to those in need," said MSF spokesperson, Monique Van de Kar.

ARVs would initially be available at the Tsholotsho hospital, with three other health centers in the Matabeleland North province - Sipepa, Mkhunzi and Pumula - following suit. "AIDS has had a devastating effect on most parts of Africa and, in some instances, rural people have been the hardest hit. People in rural areas have difficulty traveling to urban centers for ARVs and this is the main reason why we have chosen this rural area," Van de Kar added.

MSF is already working with Mpilo Hospital in Zimbabwe's second city of Bulawayo in Matabeleland North to administer ARVs to patients.According to a government health specialist based in Matabeleland, the plight of people infected with the disease was further compounded by the shortage of simple suppressants that could play a major role in reducing some opportunistic infections.

"It is so painful to see people flocking to hospitals for treatment every day, only to be turned away because there are no drugs - [not even] simple painkillers ... The situation is so desperate," said Ostine Dube, a nurse at a government hospital in the province.

Source: IRIN News

China: Hunan province offers free herbal treatment for HIV/AIDS carriers

2005-07-31T11:50:00.000+07:00

ChinaView.com, 20 July 2005

CHANGSHA, July 29 (Xinhuanet) -- The central province of Hunan launched a program Friday to treat HIV/AIDS carriers with free traditional Chinese medicine, according to the provincial healthcare department.

About 450 AIDS patients and HIV/AIDS carriers, who volunteered to participate in the program, are expected to receive free treatment in five test clinic bases to be established soon in the province during the one-year program.

Compared with the Western-style drugs that have too many side-effects and are too expensive, the cost for traditional Chinese medicine in HIV/AIDS treatment is relatively low and results in less side-effects.

The program is part of China's ongoing campaign to help thousands of HIV/AIDS sufferers with the use of traditional Chinese medicine as a way to fight the fatal disease.

Since the national test program was launched in 2004, about 2,300 AIDS patients in the five provinces of Hebei, Anhui, Henan, Hubei and Guangdong, have got help.

The Ministry of Health will expand the free treatment program in 11 more provinces and municipalities including Hunan this year to prevent the spread of the disease and treat a total of 4,500 HIV/AIDS carriers.

The central government has earmarked 2.07 million yuan (over 255,000 US dollars) for Hunan's program, 80 percent of which will be the cost for the drugs and the rest will be used in the training and management of the medical staff.

The local government and the hospitals will keep the privacy ofthe volunteer patients and doctors will adopt different therapy topatients in accordance with their specific conditions.

It is also possible to use the combination of western-style anti-retroviral drugs with traditional Chinese medicine, doctors said.

Hunan had registered 1,249 HIV/AIDS carriers by the end of lastyear, 99 of which have passed away.

China reportedly has 840,000 HIV/AIDS carriers, including 80,000 AIDS patients

Source: ChinaView.com

Traditional healers being integrated into HIV care and treatment in Kwazulu-Natal

2005-06-14T07:28:00.000+07:00

by Theo Smart, Aidspan, June 13, 2005

Efforts to improve the care and treatment of South Africans with HIV/AIDS are often hampered by misunderstandings and poor relations between Western healthcare workers, and the community-based African traditional healers (or sangomas) that many people first turn to when they have a medical complaint. However, a new project launched in the Nelson R. Mandela School of Medicine/University of KwaZulu-Natal (UKZN) in Durban is trying to build bridges and improve collaboration with traditional healers caring for people with HIV/AIDS.

African health care Systems
It has been estimated that 80% of South Africans see traditional healers or `sangomas` on a regular basis and that there are around 200,000 sangomas in the country, but efforts to test and treat people with antiretroviral therapy often leave the community sangoma `out of the loop.`

This can have disastrous consequences, leading patients to disregard their doctor’s advice, or take `muthi` (herbal remedies) that sometime have dangerous interactions with pharmaceuticals they are taking. However, working closely with traditional healers could reduce workload, improve patient care, and give the treatment programme key stategic allies and counsellors who live within the patient’s own community.

Speaking at a satellite conference prior the 2nd South African AIDS Conference, Dr. James Hartzell, an adjunct lecturer at the school of medicine said: “The medical school has long had a strategy to develop a focus on complementary systems of medicine including African Health Care Systems (AHCS), Indian Systems of Medicine (such as Ayurvedic), Chinese Systems of Medicine (Traditional Chinese Medicine, Japanese, etc.), and other traditional, complementary and alternative systems.” The Department of Family Medicine has lectures on complementary systems of medicine for undergraduate and graduate medical students, and has a number of research initiatives under development.

One of the first to be approved by the faculty is the African Health Care Systems (AHCS) Research Network. In October 2003, a MOU was signed between the school and the KZN Traditional Healers' Council (including the Ethekwini (Durban) Traditional Healers' Council), Mwelela Kweliphesheya, and the Umgogodla Wesizwe Trust. An HIV/AIDS task team was established from KwaZulu Natal’s eleven health districts; and the US State Department funded two workshops to discuss future directions for collaboration.

These discussions generated the first major AHCS proposal: The Saving Lives: Biomedical and Traditional Healing Collaboration on HIV/AIDS, which received funding last year from the US Presidents Emergency Plan For AIDS Research (see link).

The Project is in the process of training 350 traditional healers (in five one-week long trainings) on HIV/AIDS awareness, voluntary counselling and testing, home-based care and antiretroviral therapy awareness.

“This is a select group, we don’t just take anybody from off the street. Each participant has to be registered with one of the councils,” said Dr Hartzell.

Project components

Guidelines development: The project is also working to develop joint HIV/AIDS clinical guidelines using Family Medicine guidelines (which Dr. Hartzell says has lots of similarities with the traditional healer approach), the Ethekwini health guidelines, KwaZulu Natal’s Department of Health guidelines as well as traditional healer guidelines that ACHS has been helping to formalize (based upon informal, unwritten guidelines that already exist).

Two-way referral system development: To an extent an informal system of referral already exists between sangomas and health care facilities. But, said Dr. Hartzell, “Traditional healers complain that it is largely in one-direction (from the sangomas to the clinics).”

Frequently, patients move back and forth from the sangoma to the clinic, especially when they want to hear an `alternative` diagnosis after testing positive for HIV, but the traditional healers don`t know what is happening at the clinic. “Traditional healers already send referral letters to clinics and are just asking for at least basic information back from the biomedical team (which is often hostile to them) such as what were patients given in terms of treatment”, said Dr. Hartzell.

Forming better two-way communication could be vital to a patient’s health. Dr. Hartzell suggests that “traditional healers can make big impact on patient compliance and OI management with good collaboration from the biomedical team."

However, confidentiality issues must be clarified before doctors will feel free to share patient information with the traditional healers. and the project is working with the Department of Health on these issues.

Medical kit supply: Most traditional healers work in resource-constrained settings, seeing an average of five HIV-positive patients a day, and yet most of them don’t even have rubber gloves. The project is working to supply them with a modified version of KZN DOH Home-based Care Kit.

Introduction of record keeping systems: “This underlines the success of the entire project”, said Dr. Hartzell, “but is a brand new concept to most traditional healers.” Even so, it has already been agreed to and advocated by the traditional healer councils.

However, this is one of the project’s greatest challenges because of the issue of illiteracy, which means systems have to use pictograms and check boxes. Dr Hartzell said they may experiment with tape recordings as well.

If succesful, these systems, according to Dr Hartzell, should deeply and broadly improve our understanding of traditional healer practices, and should dramatically improve the chances of success for the long-term collaboration between practitioners of the two systems.

Voluntary Counselling and Testing (VCT) strategy development: Traditional healers are expert counsellors, and are already involved in pre- and post-test counselling, but they are not currently allowed to legally test in South Africa. Many other African countries, though, allow healers to perform the test. Giving sangomas this right could greatly increase access and acceptance of HIV testing in the communities.

Development of more effective prevention messages and behavioural counselling: According to Dr Hartzell, “Patients listen well to what healers tell them. Healers affirm that they can work together with us to develop more effective behavior change strategies, and healers are available 24 hours a day like real old style family and community doctors."

Healers care for patients while they are on the waiting list for ART: Dr Hartzell noted that healers can advise patients on good nutrition and positive living, and encourage behavioural changes. There are many good herbal remedies for strengthening the immune system, increasing appetite, treating oral thrush, skin rashes, sexually-transmitted infections and diarrhoea. According to Dr. Hartzell: “Traditional healers are already doing a lot of these things, providing a lot of these services within the community. We’re just helping them formalise it.”

Source: Aidspan

Broadening Notions of AIDS Treatment, Care in Africa

2005-05-27T00:34:00.000+07:00

By: Trust for Indigenous Culture and Health (TICAH)

With Rockefeller Foundation support, TICAH hosted a meeting at the Rockefeller Conference Centre in Bellagio, Italy, to discuss strategies for broadening notions of AIDS treatment and care in Africa.

We invited policymakers and donors who shape treatment protocols and funding; program managers, care providers, and researchers involved in AIDS care in Africa; positive treatment activists from Africa; and Rockefeller Foundation staff responsible for the Foundation's HIV/AIDS programs.

Our goals were the following:
1) Ground recommendations for treatment and care in the realities of patients' lives, and in the context of Africa;

2) Identify opportunities for providing optimal AIDS treatment in Africa at all stages of HIV progression, including attention to herbal and traditional medicines;

3) Incorporate the treatment aspirations and choices that positive Africans are making into treatment protocols and funding;

4) Outline the fundamental tenets of comprehensive AIDS treatment in a clear and compelling public statement, and;

5) Determine next steps toward an alliance for action to bring about more inclusive and effective care in Africa.

Twenty-two of us actively participated in the Bellagio gathering. During three full days in this beautiful and protected setting, we shared stories about our own experiences as care seekers and we designed comprehensive prevention, mitigation, care and treatment packages for one African community in order to put our deliberations into their larger context. We discussed the role that traditional healers play in communities and that traditional medicines play in the health care of the majority of positive people in Africa.

We divided into two working groups, each focusing on one area of care which we felt was neglected in current treatment approaches. The first was on positive living, all of the health promotion activities which precede and can delay the need for medical care. The second was on two kinds of research: work to widen the available mix of tested and safe treatments to include traditional and herbal approaches; and research to better understand the ways in which traditional medicines are already being used by positive people and community organizations in Africa, often in tandem with biomedical therapies.

We collectively crafted and unanimously endorsed the following statement and invite others to join us in our next steps toward realizing our shared aim of improving AIDS care and treatment in Africa:

STATEMENT---ACCT-Africa

The Alliance For Comprehensive Care & Treatment of HIV/AIDS in Africa

We believe that the magnitude of the HIV/AIDS crisis in Africa requires that those who are infected with or affected by HIV/AIDS receive the most comprehensive and effective means of care and treatment, within the context of prevention, mitigation, care and treatment efforts worldwide.

All persons coping with HIV/AIDS and their supporters can be empowered to choose the optimal approach for themselves from among all the available methods of care and treatment.

We believe that it is the right of each person living with HIV/AIDS to be informed about the different modalities of care and treatment, including clear and up-to-date information about the strengths and weaknesses of various options. This is essential not only for empowering people for making the best possible choices for their health, but also for reducing the harmful impact of both traditional and allopathic practices.

The unique indigenous assets of each culture - herbal, medicinal, social and spiritual - must be recognized and mobilized in responding to the health challenges posed by HIV/AIDS. Traditional healers are an important part of African communities. Since the vast majority of Africans are already using traditional medicine, it is a public health imperative to increase research into this area to enable communities to know whether herbal therapies are safe and effective.

It is vital to accelerate the development of traditional medicines into the armament of treatment options available for HIV/AIDS in Africa. The health of Africans living with HIV and their access to care can be improved by promoting the integration of traditional and complementary medicine with Western medicine, including anti retroviral treatments, which are becoming more available. We will advance integration by:

a. Developing a compelling rationale for dramatically increasing percentages of HIV/AIDS research to quantify the clinical benefits of promising traditional medical approaches that can be widely replicated.

b. Developing and aggressively advocating adoption of holistic campaigns for healthy living that empower PLWHAs, caregivers, communities, and practitioners to seek and provide optimal care and treatment

c. Disseminating among all stakeholders, including donors, policy makers, implementers and users, current and accurate information about the benefits and limitations of available traditional and western/biomedical/allopathic treatment options.

Based on these core beliefs, ACCT-AFRICA advocates the following steps be taken to

(1) provide a continuum of HIV care and support that promotes healthy living and mitigates, delays or prevents the need for medical intervention; and provide comprehensive holistic treatment options when medical intervention is required;

(2) advance a research agenda to include a more comprehensive approach to the challenge of HIV/AIDS in Africa.

Promote a Holistic Approach to Healthy Living for Persons with HIV/AIDS and Empower PLWHA and Communities with Positive Health Skills and Knowledge.

Existing observational, field, and published evidence suggests that people living with HIV/AIDS who make optimal use of nutrition, psycho-social support systems, spiritual systems, family support, and prompt access to good services will experience a better quality of life and possibly delay the progression of the disease. Further research into existing local, traditional practices is required to improve, define, and disseminate the benefits of such an approach.

ACTIONS:
A) Health Literacy Campaigns:

Establish parameters for and promote implementation of health literacy campaigns that reach defined audiences with relevant information to increase access to food and nutrition and comprehensive AIDS care and treatment.

1. Identify all appropriate audiences (eg PLWHAs, caregivers, communities, practitioners etc) 2. Conduct literature reviews to identify available curricula and campaign strategies that can be disseminated or adopted for trial use 3. Secure resources for implementation of model campaigns by local partners and assessment of their effectiveness 4. Disseminate lessons learned and strategies for wider implementation to donors, governments, regional and local implementers etc.

B) Code of Practice: Promote development of codes of practice that improve collaboration between traditional and conventional medicine.

1. Convene specific meetings of traditional healers and biomedical practitioners separately and together that help to forge better collaborations and to build consensus for a common code of practice to benefit all patients.

2. This code of practice should be accompanied by specific training for effective implementation that includes:
- describing and defining referral systems protocols
- defining and implementing standards for quality control and appropriate use of traditional and conventional medicine

Advance a research agenda to include a more comprehensive approach to HIV/AIDS care and treatment.

A majority of Africans already use traditional medicine and therapies for many illnesses including HIV/AIDS, and there are some indications that traditional remedies contribute to improved health and/or delayed disease progression. In this context, it is important to draw from existing and expanded research funding (rather than funding from care and support) to better understand traditional health practices and products and to understand and promote collaboration between traditional health systems and biomedical approaches.

ACTIONS:
A) Research on practices and products
-- Strategically document existing practice and use of traditional medicine for AIDS care in Africa

-- Identify the most promising products to be further validated. Actions to be taken to move these products forward: criteria for choice - safety, evidence of efficacy with some understanding of type of use[1], replicability, ease of administration, ease of manufacturing, low cost.

-- Develop acceptable standard protocols to accelerate the research processes for development of traditional medicine in Africa for AIDS care. The protocols should be ethical, have statistical power, clearly identified and scientifically sound end points, match the type of product and use.
B) Research to understand and promote collaboration between two systems

-- Conduct research into optimizing and integrating care modalities (e.g. looking at role of traditional healing in supporting ARVs and other AIDS care efforts; testing effect of integrating traditional healing and bio-medical approaches)

-- Document and rapidly disseminate findings and lessons learnt on the contributions/collaborations between traditional healing and biomedical systems to improved HIV care and treatment in Africa.

For more information, visit our website: www.ticahealth.org

[1] Anti-viral, immuno-modulation effect, symptom alleviation, treatment and prophylaxis

Herbs Helping Fight HIV And Aids

2005-05-15T11:19:00.000+07:00

ZIMBABWE- Many rural communities in most parts of Zimbabwe are realising the importance of using natural remedies such as herbs to treat some HIV-related opportunistic infections because they have been let down by the ailing health system.

Zimbabwe's health sector has deteriorated over the years and rural communities have been the worst affected as shortages of drugs and other essential medicines continue to dog rural district hospitals and clinics.

The HIV and Aids pandemic has increased the demand for health care for many people in the country but health institutions are finding it increasingly difficult to cope, especially in light of the numerous problems in the health sector itself.

People living with HIV and Aids often seek treatment for opportunistic infections such as skin rashes, sores, coughs and colds, tuberculosis and chest pains. These are problems that public health institutions have to deal with on a day to day basis.

However, as StandardHealth recently found out, in spite of the hard times, some rural communities are using their ingenuity to survive.

Having realised that the problems in Zimbabwe's health sector will not be overcome soon, some rural communities have resorted to natural remedies to treat common ailments affecting PLWAs.

Florence Guzanga, vice chairperson of the Murereka Home Based Care (HBC) programme in Makonde, says her community has benefited immensely since they established a communally-owned herbal garden.

"The herbs are working wonders for most people here and as caregivers we notice changes in people who have used them for one reason or the other when we visit them," said Guzanga.

"There are various herbs. They treat many ailments from skin sores, rashes, headaches, nausea, stomach pains and so many other things."

Herbs that are being grown and used in Murereka include lemon grass, banana powder, yarrow, Black Jack, Marjoram and warm wood.

"Lemon grass is for energy, appetite, sore legs and it also helps blood flow well in the body. One takes dried lemon grass and puts it in boiled water for a while then takes it like tea," explains Guzanga.

Recommended forpeople who have ulcers is the banana powder, which is made from dry bananas. One dose consists of one teaspoon of powder to one cup of milk.

Black Jack (tsine) is used for stomach pains, oral thrush and is also an immune booster. The roots are taken and dried in a shade and pounded to a powder after drying. The powder is then used for making tea.

Spiwe Kuzvinzwa-Chingozha from Murereka says she tested positive in 1998 but has never since been admitted to hospital.

"We rely on this herbal garden for most of our illnesses. People here hardly go to the hospital or clinic unless it's extremely necessary and serious," said Kuzvinzwa-Chingozha.

"Even when I am well I use some of these herbs because they keep me healthy and boost my immune system. I have never been to hospital ever since I tested positive and I am not on any hospital."

In Mhondoro, members of the Tsungirai Home Based Care Programme have just started a herbal nursery which they are optimistic will assist them in meeting their treatment needs.

Through the National Aids Council (NAC) and another non-governmental organisation - COSV - the Mhondoro community has established herbal nurseries under drip irrigation.

"We have learnt from other communities here the benefits of a herbal garden and we are optimistic that we will help our community once it is fully operational," said Nestai Mathlatini, a caregiver who is living positively with HIV and Aids.

"Instead of everyone rushing to hospitals and clinics where they will be disappointed because there are no drugs, we hope to give them an alternative here."

Source: Zimbabwe Standard (Harare), April 25, 2005

Lacking drugs, HIV patients turn to herbs

2005-05-14T07:58:00.000+07:00

YANGON-- For three years Phyu Phyu Thin has volunteered to work with HIV patients in Myanmar, but like many charities, hers is unable to offer life-prolonging drugs.

That has prompted many patients to turn to traditional herbal medicines and Buddhist meditation, which offer some comfort if not a cure.

"Sometimes I feel very sorry for the patients. We can only provide counseling and education. We have no medicines like anti-retroviral drugs," Phyu Phyu Tin says.

"Our contribution is very limited and that makes me very sad," she says.

Charities like the one Phyu Phyu Thin volunteers full-time with, which is run by Aung San Suu Kyi's opposition National League for Democracy, can offer little more than aspirin and multi-vitamins to treat people with HIV.

An estimated 339,000 people were infected with HIV at the end of last year, according to statistics from the military government's National AIDS Program (NAP).

In the last three years, the ruling junta has opened up to about 30 international agencies working to fight the disease, but their activities are still limited and most volunteers would speak only on condition of anonymity.

A young vendor smiles while waiting for customers at his roadside condom shop in Yangon in this photo taken on April 6. Myanmar's National AIDS Program estimated that more than 338,000 people were infected with HIV by the end of last year.

Although Myanmar has one of the highest rates of HIV infection in Asia, estimated at 1.2 percent of the adult population, fears that aid money could be misdirected has left donors reluctant to contribute very heavily to anti-AIDS efforts.

International agencies working here are reluctant to speak about their activities, citing the military's restrictions on their work, but so far have only managed to secure financing and government approval for a few small treatment schemes.

That has sent many sufferers searching for alternative remedies, sometimes through traditional healers or Buddhist meditation, which volunteers say they know cannot cure the disease but may at least provide some comfort.

Last September, Buddhist monks and nuns in Yangon started their own outreach program, known as Yadana Myitta, that uses the teachings of Buddha to counsel patients and to educate volunteers.

In addition to trying to educate communities about how to avoid HIV, the program also trains volunteers to work at a free clinic and teaches patients how to meditate, which traditionally has been viewed as a means of pain relief by focussing on inner peace, one 21-year-old volunteer says.

"At first, I was nervous about dealing with HIV cases. But that changed after I received the training," he says.

Christian groups, who make up about 4 percent of Myanmar's population, have also started awareness programs.

"The most important thing is educating people ... because at first they might find it difficult to accept someone with HIV," an officer with the Myanmar Council of Churches says.

Some people have turned to traditional cures to try to treat the disease, especially in remote, rural areas, he adds.

Myanmar officially tries to discourage herbal remedies, banning traditional healers from advertising their services, which the military views as quackery.

But in rural areas, healers still search in the forest for plants that they grind or boil into remedies that sometimes are the only affordable medicines available.

But volunteers say the junta's attitude toward HIV prevention has improved in recent years, after the military spent most of the 1990s in denial about the disease's rapid spread.

The first AIDS case in Myanmar was reported in 1991. By the end of last year, Myanmar's National AIDS Program estimated that more than 338,000 people were infected -- a 91 percent rise from an estimated 177,279 cases at the end of March 2002.

"The main difficulties for HIV prevention here were the funding and the coordination of partner agencies," an NAP official says.

A special fund was created for HIV programs in Myanmar, meant to address donor concerns that the military would misuse the money. The Global Fund to Fight AIDS, Tuberculosis and Malaria has allocated about US$54 million.

That's nowhere near enough to provide treatment for everyone with HIV, and volunteers like Phyu Phyu Tin fear the epidemic will worsen unless anti-retroviral drugs are provided.

Clinics are also needed around the country for poor people who cannot afford to travel to cities for treatment, Phyu Phyu Tin says.

"Sometimes we also have to collect our own money to cremate the patients who died here with AIDS-related illness because their family members have no money," she says.

One volunteer says that compassion to comfort patients was all that could be offered to people in their dying days.

"Without medical supplies, this is the only way in this country," he said.

Associated Foreign Press, Taipei Times May 8, 2005