Traditional medicine has long been a part of Ethiopian culture, with many endorsing its benefits. Until now, however, there has been no official research or data to evidence the suitability of the substances used. Instead, personal testimonies have been used to register practitioners. Many experts working within modern medicine claim that traditional healers use dangerous plants, with a high risk of infection and even death now however, NARDOS YOSEPH, FORTUNE STAFF WRITER , finds out that steps are being tentatively taken to standardise the sector and officially register suitable medicines.
Afework Getahun, Meri Geta, has been a traditional medicine practitioner for a decade now.
Back when he was a novice to the business, he used to have an average of 30 visitors a day, willing to pay him up to 150Br. He thinks that it is his title, Meri Geta, that initially earned him his clients’ trust, and later his skills and capabilities.
He got his title, which indicates a rank a little higher than an ordinary priest, due to his deeper knowledge of the Ethiopian Orthodox Church’s sacraments and encoding. Nurtured under the church system since he was seven, his mentor and caretaker, a monk, passed all of his knowledge and skills of traditional medicine orally and through practical training.
“Those were the golden ages,” he said, nostalgically. “There were lines and lines of people every day waiting to see me.”
Now, he claims business has died out, directing us to look down at his empty, old, torn leather sofa. He used to have five employees, running around, trying to keep on top of the work. This included a transporter to deliver the medicine to five different regions at a time. Now, it’s all silent. He has only one helper to dispense the medication prescribed by him.
Such practice is not only recognised and valued by the clients, but also by government agencies too.
The Nifas Silk Lafto District Trade Office registered Afework’s Kokeb Birhan Clinic three years after the business had first become operational.
As a prerequisite, and equivalent to other certifications, all he had to produce was a practitioner’s license – a licence for herbal medicine practice – from the city’s the Food, Medicine and Healthcare Administration and Control (FMHACA).
“All I had to do to secure the professional licence was to present three witnesses able to testify to my ability,” Afework said, recalling the process.
What was also required as a formality in the Bureau was a permanent address for the service and the aforementioned three oral testimonies, attested by social court in the District.
Once an applicant completes the paperwork, an inspector will go down to the premises to assess the room layout, as well as the medication dispensary and displays.
“We are just confirming that all the individuals we certify are registered as a Traditional Medicine Practitioner,” said Getachew Wereti, director of the Addis Abeba FMHACA.
Kokeb Birhan, is located in the area commonly known as Hannamariam, in walking distance from the taxi station. Guided by two big signboards, close to half a kilometre away, it can be found right next to a private elementary School.
The clinic’s compound is old and unkempt. Pieces of rusted iron lie here and there and the uncut grass at times blocks one’s progress.
A grey Toyota Hatchback was parked in the compound.
“This was a gift from one of my clients, who was overjoyed by my service,” Afework said proudly, touching his car, while showing the premises to Fortune.
It was during the same visit that two friends were sitting together, arguing strongly on whether they should proceed to the service or leave immediately.
One was strongly opposed to the idea, since she had a prior experience that hadn’t worked out, and her hopes and promises from the healer to give her a child had remained unfulfilled. But her friend, who is suffering from serious pain from herpes zoster wounds on her back, was determined to take a chance with this one too.
“I have been to different places, but none have worked for me,” the angry friend said, sharing her thoughts with some of the others waiting in line. “I am now suffering from an ulcer caused by the different medicinal plants I swallowed.”
Despite opposing the idea, she was there besides her friend to offer support.
Regardless of how many clients can stand at any court to testify, there is no system yet in place to formally endorse the efficiency and non-toxicity of the medicines.
“We have no mandate over medications so far,” Getachew said. “But, they can apply for patents if they are registered as a practitioner in our institution.”
Traditional medicine in Ethiopia is rooted in a wide range of arenas, including plant, animal and mineral substances, spiritual healing and traditional midwifery, as well as surgery and bone setting. This is stipulated in both the Essential Medicines and Health Products Information Portal of the WHO and the nation’s Food, Medicine and Healthcare Administration and Control Proclamation No. 661/2009.
The description and categorisation of these traditional medicines are, however, never given by the same, but addressed in the preamble only.
The Addis Abeba Trade Bureau has so far registered 17 operational traditional healers, varying in kind due to the lack of clarity in categorisation.
But the number is much higher, as those looking to be licensed in the industry are very few.
All these formal, yet not thorough, procedures have never been a concern for a lady traditional healer at Qirqos Church, who opted to withhold her name.
She believes that there is a sacred element to its efficiency, being a fourth generation in this service, with her knowledge too being acquired through oral tradition.
The source of the medicinal plant she uses is top secret in her business, where she specialises in Jaundice in adults and kids.
“Modern medicine calls it liver disease, we call it wef beshita,” she said sarcastically, without even bothering to explain the naming and its connection to birds.
Both the nun and Afeworq source the plants for their medicine from Gojjam and Gonder, but refuse to say what it is.
Despite coming from a single source, a plant Afework produces provides medicine for more than five diseases, categorised into three groups. All, however, are displayed in bottles, and shampoo, conditioner and lotion tubes.
The green medications are all for erectile dysfunction, skin diseases and dandruff, as well as for pimple like illness and skin irritation. He has his registration and licence on the wall, in order to put across the message that the place is secure. Next to these is the display of his 32 medications – a hand written paper sign reads. While only three of these have been tested and approved as non-toxic by the FMHACA.
The price oscillates depending on demand.
“The most expensive medication I provide, and people know me for it, is for erectile dysfunction,” he said. “This costs up to 5000 Br, while the minimum for any kind of disease is as low as 400 Br.”
The Qirqos Church healer sounds modest when talking about price.
“People give what they like, but 30Br a service can give us something to live on,” she said.
She also, however, admitted that clients usually give more than asked and required – which is noted on the walls of her room.
She does not sound very enthusiastic about modern medicine, as her prescription is in complete contrast to what modern medicine prescribes for, particularly in the case of child jaundice.
“Most of the time, the difference lies in the dosage and manner of usage,” a physician working at the Black Lion Hospital explained.” Usually in the traditional setting, due to the matter of cleanliness, infections are common.”
High recommendation of carbohydrates and sweets is automatically rejected by the nun’s service, which prescribes as a follow-up to treatment that the patient limits her intake exclusively to the cultural alcoholic drink, Tela, and Injera, with a lentil sauce heavily seasoned with garlic.
It prohibits taking a shower or having any form of contact with water.
Bridging this gap of documentation and official studies is one of the mandates of the Ethiopian Public Health Institute (EPHI). A dedicated unit, the Traditional Medicine Research Directorate, was established a decade ago, though not much benefit has yet reached the end users. This has left many uncertain about which medical option to take.
Sentunaye Mebratu, a young man in this early twenties, is waiting for treatment at one of these traditional facilities, where he gets constant help. He prefers their approach to modern services.
“I have malaria,” he informs us. “I have been to several modern clinics and hospitals, since last July, but none could find me a cure that lasts more than one day – it always come back.”
His friend, who motivated him to come to the clinic, told Fortune, beaming with pride, that he had a pimple like sickness, and after many failed trips to modern hospitals, came to the practitioner who cured him completely.
For the green label bottle mix of medicine, Sentunaye, he had paid 70Br.
“At the centre of the difference is a matter of dosage,” Ashenefe Tadelle, director of the Traditional Medicine Study Unit at the Institute, explained.
He went on to elaborate that one of the main reasons for the Traditional Medicine Practitioners’ Association to be closed is the issue of dosage. They also use highly toxic indigenous plants, like Qulqual and Astenager, which have the power to end lives in less than half day. But the trigger point that highlighted the danger of these practices was the use of modern medicine in a mix with these traditional remedies.
Currently, the Directorate is working with 10 traditional apothecaries, while referencing various old Geez language prescription books. There are nine medicines for humans being researched and four waiting for clinical trials. Among the 12 examined traditional medicines for animals, the research for two has been completed and they are now awaiting the market feasibility study result from the Adamitulu Anti-Pesticide Manufacturer company.
“Pharmaceutical manufacturing factories are scared of taking the risk of producing small amounts of the drugs for pilot trials,” Ashenefe said. “They want government support – a luxury we ask for repeatedly, but never got an answer to.”
All the eight operational pharmaceutical factories EPHI approached, including the Ethiopian Pharmaceuticals Manufacturing Factory (EPHARM), declined the proposals to manufacture. Ashenefe points to joint ventures as a possible reason for losing the bravery to be involved in this business.
“Soon, the extreme attitudes will change,” he said. “After this, we hope to reach an integration and move the research on to an international level.”
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