Summary of Cameroon report on traditional healers

Interviewees fell into three categories (herbalists, priests, and diviners) and were distinguished as major or minor healers (depending on the types of illnesses treated) and on the basis of whether they practiced in urban areas, where they work principally in the healing profession and are more sophisticated, or in rural areas where healing practices are more ritualized and considered ancillary to other activities. The TH"s interviewed categorized diarrheal diseases into two types, specific and general, depending on whether or not the diseases are perceived as having a particular cause. Examples of such "causes" include infidelity, fish, rotten eggs, etc. General diarrheas can be treated at home, whereas specific diarrheas are generally dealt with by TH"s. In treating diarrhea, a wide variety of therapeutic actions may be taken. Of the 43 healers who treat diarrhea, 65% give remedies to drink which may cause purging, while 26% first give something to drink and then may add something that is to be licked or used to bath the child. Healers might also use a variety of therapeutic actions at the same time. The perceived cause of the diarrhea would also dictate the choice of therapeutic action taken. Judgment of the chemical properties or actual therapeutic effects of the treatments used by the healers being impractical, remedies were classified according to whether their effect was obviously harmful, beneficial, or neutral. Treatments considered beneficial included those which encouraged drinking fluids. Harmful treatments included purges and those advising parents to limit or stop feeding. Neutral remedies included licking, bathing, munching, and wearing a talisman. The cost of treatment of a diarrheal episode by a TH was generally comparable to that of the treatment in the biomedical sector, seldom lower. In rural areas, payment might come in the form of in-kind contributions rather than currency. Of the 50 healers interviewed, only 13 had heard of SSS, and only 12% had tried the preparation and found it satisfactory. Of those who had tried the solution, none prepared it correctly nor administered it in quantities large enough to be effective. When presented with the ORS packet, some healers confused it with a packet of Eno (an antacid similar to Alka Seltzer). Only three healers recognized the packet as ORS, and only one of those had tried it. But when healers were given an explanation of the purpose of ORS, they expressed great interest in using it. It was felt that healers could easily accept SSS/ORS and could integrate ORT into their practice. It would be necessary to explain to them that ORT would not have to compete with their regular treatment but would in fact make it more effective because ORT helps prevent the child from tiring, which was one of the major negative consequences of diarrhea noted by healers. The exception would be purges, which would be discouraged because they "kill the force" of ORT. The majority of TH"s had favorable things to say about the biomedical profession, particularly about the area of surgery. They also feel that hospitals treat other diseases, like malaria, effectively. But once it is perceived that the cause of illness might be dues to sorcery or something else supernatural, TH"s feel that the biomedical sector is not qualified to provide the most appropriate treatment. Sometimes the patient is treated by both sectors. It is not unusual to find a TH sending a remedy to a patient who has been hospitalized. From the biomedical side, allopathic practitioners seem impressed by the conviction of both health workers and patients that traditional medicine is effective. Referrals are taking place between hospitals and healers, and between healers and other healers. Collaboration, however, is not all that systematic. TH"s are trying to come out of anonymity and feel that recognition by the biomedical sector will give them credibility. Finally, an interesting point is that when they themselves (or their family members) fall ill, Th"s commented that they take pharmaceutical products, even if in their private practice, they work with herbs. (Author abstract, modified)