Traditional Medicine Practice Q l in Contemporary Uganda Cu ZI T m T raditional medicine practice in- In Uganda, there is at least one tradi- ?I volves a complex combination of tional healer for nearly 290 people C j Yc activities, order of knowledge, compared to one Western-trained beliefs and customs to generate the de- medical practitioner for every 10,000 o sired effects for the diagnosis, preven- people in the urban areas and 50,000 tion or elimination of imbalances in people in the rural areas respectively. L i I physical, psychological or social wvell- The majority of the population in being. Uganda have greater access to tradi- Traditional medicine practice is tional than to western health care. Tra- based on the indigenous knowledge of ditional healers are an integral part of a given people, a given community, and the local culture and are appreciated as their experiences in the context of the key and sustainable sources of care and local culture and environment - it is knowledge on disease and illness. dynamic and changes with time de- About 80 percent of the population of pending on the prevailing situation. Uganda rely on traditional medicine Traditional medicine practitioners because western-trained medical per- (TMP) comprise herbalists, sonnel are limited or not really ac- No. 54 bonesetters, psychic healers, tradi- cepted by the community, and tradi- March 2003 tional birth attendants, faith healers, diviners, and spiritualists who use in- 1IK Notes reports periodically on digenous knowledge for developing Indigenous Knowledge (IK) initiatives materials and procedures. in Sub-Saharan Afnca and occasionally on such initiatives outside the Region. It is published by the Africa Region's Knowledge and Leaming Center as The health service situation part of an evolving IK partnership between the 'orld Bank, communi- tgOWAL oo The relative ratio of traditional practi- ties, NGOs, development institutions and multilateral organizations. The tioners and university-trained doctors views expressed in this article are in relation to the whole population in X those of the authors and should not be Uganda is revealing as is true for many attributed to the World Bank Group I or its partners in this initiative. A parts of the African continent. webpage on IK is available at // www.Nvorldbank.org/afr/ik/ 0 11 0 i P n fi55/ l ~~default.htm lilLL Ur 2 tional healers are easily consulted, living in the same com- and ensures that the wealth of the products remains in the munity (Bannerman, et al. 1993). country through using local knowledge, skills and materials. The country imports most of its drugs from abroad and of- The health system thus becomes less dependent on external ten experiences serious shortages. That points to the de- sources such as multinational companies. Developing conser- mand for TMPs for medicinal plants and the fact that the vation and propagation strategies of the currently-known majority of the people, rural and urban alike, depend largely medical plants is based on the communities' local knowledge on herbal medicines for treating a variety of diseases (Esegu, of the environment, and shared experiences of institutions J.F.O. 2002). This reliance is mainly due to the high cost of like the Entebbe Botanical Gardens, of the National Agricul- conventional medicine and inaccessibility of modern health ture Research Organisation, and the National Chemothera- care facilities in most areas. peutics Research Laboratory. Economical advantage of traditional medicine Governmental efforts in promoting traditional medicine The lack of foreign exchange and the high cost of western The Uganda Law, Reform Commission is developing a lawv manufactured drugs make modern health care inaccessible for the recognition, the protection and practice of tradi- to the majority of the population. This consequently requires tional medicine (Kakooza, J.M.N. 2002). This enables na- the conservation, domestication and growing of medicinal tional institutions and international organizations to pro- plants. mote and integrate herbal medicine into their development Propagation techniques are needed in some cases as propa- plans. gation will lead to the conservation of rare medicinal plants The National Agriculture Research Organisation is integrat- ing the modernization and commercialization of indigenous knowledge for wider economic and social benefits in areas such as food, cosmetics, pharmaceuticals, aromatics and handerafts. would be of interest to: The Ministry of Health Strategy and Policy has recognized traditional medicine and it is developing regulations for in- Na1ne tegrating it into the primary health care system. KingthutJoin The Ugandan National Councilfor Science and Technology (UNCST) is implementing a project on indigenous knowl- Address edge and institutional development. The National Chemotherapeutics Research Laboratory is the main research laboratorv appointed by the government and is internationally funded - it has done the followving: o Mass screening of herbal remedies; o Toxicological testing; - 0 X ° Formulation and preserving herbal medicine; and o Standardization of products. affft CO0w6 WM G o 1MNon-governmental organizations promoting traditional 1~~~ ~.& W~3w medicine Pronetra Uganda, an affiliate of Prometra International, is ._______________________.________________________ an Association for the Promotion of Traditional Medicine and 3 is promoting traditional medical knoxvledge and practices for IIACMi - the International Institute of Alternative and improved health through mutual co-operation amongst Complementary Medicine carries out the following activities: health systems. The headquarters of Prometra Uganda is in * Managing over 10.000 different medicinal plants from KaNvempe -Kampala, the capital city of Uganda. The symbol Uganda and abroad on the institute's farm. of the organisation is a clay pot wvith holes and these holes *Improving formulation of herbal medicine. are to be symbolically filled through collaborative effort of * Medicine processing and packaging. other professions. The summarized objectives of Prometra *Teaching various local and foreign traditional healing Uganda are: methods, including Chinese Herbal Medicine, Indian * To generate and disseminate knowledge on traditional Herbal Medicine, Acupuncture, Music Therapy and Yoga. medicine so as to increase its utilization. * To strengthen and advocate for the use of traditional medi- MLAKO H-lerbalist Association, wvhose activities include: cines across the entire rural and urban population. *Training herbal medicine users on the basis of clinical diag- * To identify and fight against harmful traditional health nosis and supporting their efforts to provide quality pa- care practices through educational programs, establish- tient handling and care. ment of cultural centers and centralized treating areas. * Generating information through documentation and re- * To strengthen collaboration betveen traditional and other search about herbal medicine and making information health practitioners so as to increase information sharing available to and co-operating wvith researchers on traditional medicine. -Complementing the activities of traditional birth atten- * To initiate, encourage and support community programs dants by using skill and knowledge in areas such as tradi- on the sustainable utilization of the environment, conser- tional family planning methods. vation and preservation of all species of medicinal value. *Bridging the gap between elders with indigenous knowl- edge and the young herbalists for better knowledge re- TII-ETA -Traditional anld Modern Health Practitioners lb- garding herbs, i.e., transfer of knowledge. gether against Aicds and other diseases, is a Ugandan organiza- *Interacting wvith partners who have an interest in promot- tion wvhere traditional and modern health practitioners (THs) ing herbal medicines. are working together. Its activities include: *Continuously identifying indigenous plants with medicinal * Training THs as community counselors and educators on value in order to benefit patients. sexually transmitted diseases (including HIV/AIDS), as *Emphasizing the need for medicinal plant / tree cultiva- well as training for other organizations targeting THs tion among the public. countrv-wide * Training THs in basic HIV/AIDS patient care and support- Various other institutions are also involved in promoting ing their efforts to provide quality health care. and integrating Traditional Medicine into the health care * Exchanging information through a Resource Centre cre- system: religious organizations, private companies, media, ated in 1995 for research documentation and dissemina- and individuals. However, there is no systematic national tion of information on traditional medicine and AIDS. program. * Hosting a library, publishing a newsletter, organizing a monthly speaker bureau and carrying out advocacy for tra- . . . ~~~~~~~~~~Future research ditional healing systems. * Comprehensive training of traditional healers as trainees Increased urbanization and change in societies make it nec- in THETA district outreach. essary to modernize and develop traditional medicine and * Herbal medicine processing and packaging as well as the practice to meet demand in the context of changes in habits, maintenance of a herbal garden. cultural values, the environment, and economic conditions. This will require a new legal framework to prevent the ex- ploitation of indigenous knowledge and resources. The pic- ture that emerges is that overall, Uganda has a supportive environment for promoting traditional medicine. References Bannerman, R.H. Burton J & Chien Wen-Chieh (1993) Tradi- tional Medicine and Health Care Coverage, World Health Organisation, Geneva. Esegu, J.F.O. (2002) Research in Medicinal Plants in Uganda, Internal Presentation, Forest Recources Research Insti- tute, Kampala, Uganda. Kakooza, J.M.N. (2002) Personal communication 12.07.2002, Uganda Law Reform Commission, PO.Box: 12149, Kampala, Uganda. jeannette marie Smith S&6540 1 MC C31i This report was written by Anke Weisheit, freelance consultant, based on a study visit to the Traditional Healers Associa- tions and Projects in Uganda 2002 in co-operation with Male Moses, IK Consultant. This study was supported jointly by the World Bank and the MAKO Herbalist Association. For more information Contact:, Anke Weisheit,, Springstiiler Str. 41, D- 98547 Viernau, Germany; e-mail: ankeweisheit@web.de, website: http://www.herbplant.org, or Male Moses, Director, hALKO Herbalist Association, PO. Box 8022, Kampala, Uganda, e-mail: makoherbal(3zahga.com