Liberia: Indigenous Health Practitioners as Community-based Allies.
By: Jimmy Shilue and Fatu Fotouma
Building a resilient health sector remains a huge challenge facing post-war Liberia as evident by the recent outbreak of Ebola which killed at least 4800 persons. A small West African state recovering from 14 years of brutal civil war, Liberia is working fervently to improve its service delivery to the population.
The years of war took a huge toll on the country’s infrastructures, especially its health system, rendering it less functional and practically incapable of meeting the health needs of the people. As a result, many Liberians, especially those at the lowest echelon of society, have minimal options when it comes to their health needs, as revealed by an ongoing study undertaken by a local nonprofit, Platform for Dialogue and Peace (P4DP). Funded by U.K Aid, Welcome Trust, and managed by R2HC and Save the Children, P4DP is exploring the role of traditional hearler since these “traditional scientists” continue to provide alternative health services to majority of Liberians.
The P4DP examines Liberians’ perception of the role of traditional healers in the country’s public health system. It explores the population’s understanding of the types of ailments they believe traditional healers can effectively handle, while probing locals’ understanding of how compelling healers are when it comes to handling illnesses. These key areas of focus enabled research teams to document a sense of uncontested belief in the healing power of indigenous medicines among Liberians.
Participants identified asthma, stroke, erectile dysfunction, pneumonia, typhoid, ‘open mole (Sante´ Humanitaire), among many other illnesses, they believe can be successfully taken on by healers with assured results. Respondents based in Lofa and Nimba counties were particularly vocal about the innate ability of locally-based traditional healers to successfully cure mental illness and leprosy.
“I had a stomach problem which made it difficult for me to conceive. I went to C.B. Dumba and Pala Hospitals [in Bong County]. My condition did not improve until I met Stephen Fully, a traditional healer, who boiled a [herb] that healed me. In 2013, I gave birth to a beautiful baby girl,” recalled a female participant.
Such a display of relentless faith in the mental and spiritual prowess of local healers attests to the fact that though biomedicine is generally accepted and used by locals throughout Liberia, it has not replaced indigenous health approaches. Biomedicine has rather augmented bush medicines. It also reveals that the accessibility and affordability of traditional medicine, coupled with such an ingrained faith in traditional healers among the population, make indigenous medicines the first and last line of defense against diseases.
Yet, traditional healers’ recognition remains a problem. They operate outside of the country’s formal health system. A classic example of this was the government’s reaction during the March 2014 Ebola hemorrhagic fever outbreak in Liberia. During that period, healers were strictly prohibited from interfering with communities. As though that wasn’t enough, they were threatened with arrest and withdrawal of license, as documented by research teams.
“The government attached too much fear to Ebola by giving us a strong [warning]. It distributed phones for people to use to hunt both the sick and herbalists. That made the herbalists afraid,” a traditional healer told research teams.
Such an act by government was seen as a reinforcement of the notion that conventional health practitioners are working against their indigenous counterparts, respondents said. This, they noted, confirmed that traditional healers are being sidelined, undermined and suppressed simply because doctors “do not want our (healers) impact to be felt by the population”.
“We were overlooked by doctors [during the Ebola outbreak]. They didn’t take us seriously. They kept suppressing us and are still doing so,” recalled another healer in Bong County.
Beneficiaries of traditional medicine consulted during the study advocated for formal recognition of traditional health practitioners by the Liberian government, stressing the need to integrate indigenous medicines in the national health system. They believe a collaboration between traditional and conventional health practitioners is needed for a more integrative and responsive health system in post-war Liberia. Such partnership, according to respondents, would remove the mistrust between the two sectors.
The bottom line is that traditional healers cannot be left on the sideline, and discrediting their work really has no impact on communities’ belief in the power of herbs. The fact remains that whether or not they can afford medical services, communities still consult traditional healers because they have entrenched faith in them. A patient with ingrained belief in the spiritual expertise of a herbalist may disregard a doctor’s advice and settle for herbs or even continue to eat bush mea, even if the latter is suspiciously the source of major health crisis. The Ebola crisis has shown what entrenched cultural practices can do and therefore should b a wakeup call. Traditional healers should therefore be considered as allies, of medical doctors, not only because they reside in impoverished communities but have long history of addressing the health needs of their folks. As such, there is a need for indigenous medicines and biomedicines to complement each other in Liberia’s health system because a collaborative effort between both health options will go a long way in saving lives, building trust and solving many health problems.
 For more on this sickness, see Abramowitz 2010.
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