From hospitals to herbalists: Rx herbal medicines

Michelle Hibler 

CIDA photo: Peter Bennett, Uganda. A woman and her tree seedling. This tree is grown for its properties in the treatment of certain types of malaria.In Uganda, the rural population is as likely to consult a herbalist as a medical practitioner for common complaints, including diarrhoea, cough, blood disorders, headaches, malaria, and abdominal pains. 

The popularity of traditional healers in this country of 22 million people is easy to explain. Accessibility is key. In Uganda, there is one healer for every 200-400 people. Trained medical personnel are far fewer – only one for every 20,000 people. "And since healers live in the communities they serve, they’re easy to consult", says Mr Corn Alele Amai, Senior Research Officer at the Natural Chemotherapeutics Research Laboratory (NCRL) in Kampala. "Equally important, their services are inexpensive – in fact, herbal medicines are often free", he says, "or can be paid for in kind". There’s also a strong cultural attachment to this form of health care. Some plants are believed to have magical powers. Some rural people even believe that particular ailments – epilepsy, for instance – can only be treated by traditional healers.

With IDRC support, Mr Amai and a multidisciplinary team of researchers from the NCRL, Makerere University, and the Kawanda Agricultural Research Institute have been studying how one type of traditional healers – the herbalists – manage common diseases. "Up to 80 percent of Uganda’s traditional healers are herbalists", says Mr Amai. 

In 1999 and 2000, the team assessed the extent to which medicinal plants were used to treat common ailments in four districts of Uganda. They found that, with the exception of a few regional particularities, people in all districts consulted herbalists for roughly the same complaints. Many of the same diseases were also brought to the outpatient department of local health centres. In fact, as 70 percent of diseases were being treated by both hospitals and healers, the researchers concluded that "herbalists and other traditional healers play a great role in improving the quality of life and maintaining health in rural areas," says Mr
Amai.

Ensuring the plants’ survival

The researchers also found that the preparation of herbal medicines was crude and wasteful, however, even threatening the survival of some plant species. To help healers prepare better, safer, and cheaper remedies, the team has been working closely with healers to identify the common medicinal plants used to treat ailments, and learn about their preparation and administration. The herbal remedies’ safety is being studied. Researchers are also carrying out literature searches to document and validate traditional uses – and find others. All this information is fed back to the healers. The goal, says Amai, "is to help them prepare cheap, efficacious, but safe drugs."

Also needed is to find ways of ensuring that these medicinal plants continue to be available. "Many plant species are endangered or threatened because of pressure to cultivate land, a high demand for the plants, and destructive methods of harvesting", explains Mr Amai. "Herbalists should be encouraged and assisted to sustainably use medicinal plants," he says. To do so, the project is training healers and communities in improved collection and preparation techniques, as well as packaging.

Above all, however, "decision makers should recognize the significance, permanence, and magnitude of traditional medicine and products in health care delivery and the socioeconomic
well-being of local populations." Mr Amai recommends that the use and conservation of medicinal plants be put on the school curriculum in Uganda, from primary to medical schools. 

Local populations should be actively involved in all aspects of conserving and propagating medicinal plants. That includes setting aside land for medicinal plant gardens, an activity that is gaining in popularity. "People and associations of traditional healers now have home gardens of medicinal plants," Mr Amai told fellow researchers at a symposium on natural plant products organized by IDRC and the Université du Québec à Chicoutimi in Québec City in early August 2001. "They come to us to ask for some species and we provide the seedlings." Increasing these efforts should help ensure the future of this vital resource.