Traditional Medicine; Practise and Utilization in an Urban Setting.

Abstract

INTRODUCTION Whereas WHO recommends collaboration with traditional practitioners(TPs) in the provision of health care, in Uganda however there is little documentation on the practice and use of TM. This study examined the practice and use of traditional medicine in an urban setting. Kawempe Division of Kampala city was purposively selected, because Mulago Hospital, Makerere University and the Ministry of Health headquarters are all found in this geographical location. OBJECTIVES The purpose of the study was to investigate the extent and patterns of TM practice and use with a view to draw lessons for possible collaboration in public health practice. Specifically the study, carried out a census of all TPs, described their characteristics and that of their clients. It assessed and described a few procedures used by TPs. It also identified reasons/ factors that lead people to seek care from TPs. METHODOLOGY The study was descriptive cross sectional, deploying both qualitative and quantitative methods. It included a census of all TPs, interviewing all those available at the time of study and a sample of their clients. Observation of procedures used / places of practice, review of available records of practice and focus group discussions for selected members of the community was carried out. RESULTS In this one division of Kampala City 278 TPs were found and were actually being consulted. Four categories of TPs were found, majority (82%) were spiritual herbalists. Others included herbalists (8%), TBAs (6%) and faith healers (4%). Majority of the (70%) were males, 43% Muslims. Their mean age was 42 years (median 38 years) and 56% of them had practiced TM for >10 years. A large number 75% of TPs had no or very low education. Hence in spite of 55% receiving some training meant to improve their performance, only 32% for example kept records. Most TPs (>80%) mainly dealt with non medical conditions. The sample of clients of TM was easily obtained; majority of them were women. They were all from social strata had better education than the TPs they consulted. The reasons for seeking care from TPS were two- fold; cultural belief about disease causation and difficulties in obtaining care from and dissatisfaction with modern medicine (mm). Most (80%) of the observed procedures could not be explained significantly, hygiene was lacking in >50% of them and some procedures were harmful to health e.g. prolonged smoking of pipes with inhalation of herbal fumes. However TPs admitted to have benefitted from their practice materially and in status. CONCLUSION There are many TPs in Kawempe Division. Clients (majority of them women) actually seek care from them mainly for social /psychological problems, because of their belief in spiritual causes of illnesses. TPs therefore mainly dealt with non-medical problems. Some of the treatment procedures used were unhygienic and harmful to the health of clients. Recommendations Government through the MOH should legislate to regulate the practice of tm. IPH should initiate and coordinate more research on tm. Mulago hospital should clearly label the critical pathways, which direct patients to obtain health care services.