African Herbal medicine (For the Sudan Mirror)

A recent UN report warned that in ‘developing’ countries fake prescription drugs are now widespread. The International Narcotic Control Board warned that in some countries the figure for fake pharmaceuticals could be as much as fifty percent. This could have disastrous consequences for those using these drugs. Not only will they fail to treat the ailment but they could actually have adverse effects on the health of the people using them. Much of this could be as the result of the sale of ‘generic’ non-branded drugs on the market. There is also the problem of drugs which are available for sale on the internet which require no prescription. Many of these drugs are not traceable and carry no guarantees of their authenticity or safety.

Of course such issues are part of a series of broader concerns about the safety of many medicines. For example the use of antibiotics can cause many diseases to evolve and become more resistant to treatment making them more dangerous and meaning in turn that more and stronger medicines will be used to treat them adding further to the problem.

Examples of irresponsibility on the behalf of pharmaceutical giants can be seen when in the late nineties when an American company donated large quantities of medicine to NGOs and groups working in Sudan. However as it transpired these medicines were all expired and would have had to been destroyed otherwise. The company had reasoned that it would be cheaper to fly them to Sudan and offload them in this way than to destroy them in a proper manner which would have been costly. It is estimated that the company saved $42,000,000 us by doing this. Further to this when large companies donate to charity in the United States they are entitled to generous tax rebates. To make matters worse it transpired that a large number of these drugs were actually slimming pills. Something that certainly is useless in the middle of a war!

I learned the ruthlessness of multinational healthcare companies when I worked in a factory making medical devices. The pieces we made were used in procedures to unblock arteries and were designed to be used once as after this not only were they not sterile but they could actually cause a heart attack. However they were so overpriced that in many countries south of the hemisphere they were used three to four times as it was not affordable to operate in any other way. Western pharmaceutical companies make massive amounts of money from selling drugs to ‘developing’ countries. Very often however these drugs are based on traditional medicines that are being abandoned by the people who have practiced them for centuries.

Andrew Kuria is an herbalist practicing in the Kawangware district of Nairobi. He has been practicing for seventeen years having learned about herbs from his parents. He in turn is training his children in the same manner. Every family member learns this tradition but they also study pharmacology or nursing in order to allow them to diagnose their patients or to understand the medicinal qualities of the herbs.

Herbs that can have medicinal qualities are found throughout Africa in a variety of climatic and geographic conditions but the strongest herbs are found in the driest areas. This has meant that herbal practices vary from region to region. For example the treatment for malaria on the coast or in the higher regions use different herbs but to the same effect. Not only will the treatments vary but so to will the doses. Kamirithu herbs where Andrew Kuria works gather these different treatments and blend them into one strong drug that can be used by every tribe or in every region.

Kuria says herbal remedies are no longer as popular among many Kenyans due to the massive amount of money multinational pharmaceutical companies are able to spend on promoting their products. He also points to the failure of the Kenyan government to decolonise the health system. He tells me, ‘Currently we have nobody in the ministry of health who is responsible for herbal medicine. We are only covered by the Culture Ministry and this is more than culture. It is tackling health issues.’ This has meant that the herbal market is largely unregulated with no quality controls on products being sold. This has led to a situation whereby practitioners from outside of Kenya are able to import whatever they wish into Kenya and sell it there. Meanwhile the government will not even know if the clinic exists.

The other problem facing Herbalists is that ‘at the same time the multinationals have done a vigorous campaigning to promote their drugs. They have sophisticated ways, networks to reach their clients, to reach hospitals. Which is a definite advantage over us.’ The result is that Herbal medicine is lagging behind and the government has done nothing to promote it.

However many ‘conventional’ medicines are based on traditional formulas which can be duplicated and manufactured in large quantities at a cheaper price. ‘We have drugs for malaria, for syphilis, stomach ulcers. We have drugs for asthma, which can cure. So the only advantage I know is that herbal medicines have no side effect. They have no side effect because herbal medicines contain no chemical compound and therefore the issue of a dose does not arise. You can take as large a quantity as you want as long as you are able to. That’s why they are more effective. Herbal medicines are more effective in curing diseases that are chronic that are not easily treated with conventional medicines.’ A problem faced by herbalists though is that they don’t have access to the same means of publicity as the large pharmaceutical companies and so depend on word of mouth.

When I ask what it is that makes people choose herbal remedies he tells me, ‘What drives people to herbal medicine is when the disease becomes chronic. When they have been there in the hospital for five years and nothing is happening. That’s when they turn to alternative medicine. That’s why it is called alternative medicine. So when you come here you have developed a lot of complications and that is why it is not easy to treat you and furthermore it’ll cost you a lot of money. We are damn expensive.’ Here he hesitates as he decides on a price to tell me. ‘We can’t charge less than $50 us per month’s dose.’ With treatment possibly lasting a year or six months this can add up. This is of course expensive compared to mass manufactured medicines some of which are even given out for free by the government.

For the treatment of meningitis a course will last one month, malaria can be treated in two weeks. The medicine should be taken every day and it is important to eat a lot of food while undergoing the treatment. He feels that it is not the cost that is prohibitive but rather how people have been brought up. If somebody is raised to go to hospital for treatment they will do that but if they have been raised to see the benefits of herbal medicine they will prefer this treatment. However when hospital treatment fails people go for alternative treatment. Kuria however is quick to point out the limitations of herbal medicine. For example while he is able to treat a stomach ulcer if the patient has a perforated stomach he will refer them to a hospital to receive appropriate treatment. However this is a one way process ‘There is no Doctor who can refer somebody for herbal medicine.’ As they know so little, unless they come from a background in herbal medicine they generally will never refer a patient to a herbalist. This is because they fear herbal medicine as they do not how the drugs work and think that they are toxic. Some doctors will also tell their patients that they should not take both herbal and conventional medicines but according to Kuria there is no problem in mixing the two.

Another problem is the stigma attached to practicing herbal medicine. For a long time herbalists were portrayed as witchdoctors. This of course was discouraging to people who were Christian and did not want to be seen to associate with witchcraft and led to many to come from an environment were herbalism was looked down upon. ‘Now they are realizing that this is a tradition they have potentially lost. Now there are so many herbal products coming up. Why? Because people have started to appreciate herbal medicines.’ Kuria feels that many young people feel encouraged to return to herbal medicine and recover the traditions that their parents lost. He also feels that herbal medicine is of particular importance to young people as it provides an excellent treatment for STD’s such as syphilis and gonorrhea.

In order to become a herbalist takes quite a bit of time as there are many areas to learn and if Kuria is to believed will also cost you quite a bit of money but he is eager to point out that this can be retrieved quickly as the job of herbalist is quite a lucrative one.

Oscar Mutua is a Doctor in the clinic. He explains that honey is a large part of the treatment. Firstly it sweetens the taste of the herbs, which can be quite bitter but also it contains components such as fructose which help the treatment. Kamirithu herbs blends all its own herbs on the premises and creates the compounds necessary for treatment. Oscar trained in conventional medicine graduating just a year ago. When I ask him what made him turn away from conventional medicine he says ‘It’s not that bad, the only problem is that at the end of the day it leads you to create side-effects.’ The reason for this is that while conventional medicine may seek to duplicate the benefits of traditional medicine it involves the addition of chemical compounds to stabilize the drugs and to guarantee their effectiveness. This creates problems for the body as it puts pressure on the liver and on the kidneys. This means the body is weaker and therefore less capable of dealing with the disease. Oscar says herbal medicines are different as they leave the body easily and do not put the same sort of strain on the system.

He says that as many people come to an herbalist after undergoing conventional medical treatment it causes more complications due to the strain their body has been under and they then must carry out what he calls ‘damage limitation.’ When I ask how his family felt about him abandoning conventional medicine to pursue more traditional treatments he replies with a smile, ‘Believe me, they don’t even know I’m here. They have a dream of me being in the hospital and making money.’ He says that he feels it is a problem that many Doctors are more interested in their careers or in prestige and money and this was another incentive for him to abandon conventional medicine. He feels there is still a stigma attached to traditional medicine saying ‘It is mostly in the youth. Most people below the age of thirty years wouldn’t come here.’ His overall view of the situation is ‘The more people who can turn to herbal medicine the better.’ Emphasising ‘Good herbal medicine.’