Traditional Medicine Endangers Afghan Lives

Abdul Latif Sahak

IWPR-trained reporter

Wednesday, 22 December, 2010

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Painda weeps as he sits beside his son’s hospital bed, where the small boy lies recovering from an operation to amputate his arm.

His father explains that three weeks before, the boy had broken the limb while playing with friends in their village in Samangan province. Pianda said he had taken his son to a traditional bonesetter, who told him that the child would continue to suffer pain for some days after he fixed his arm.

“After a week, my son’s condition worsened and I brought him to Mazar-e-Sharif [in Balkh province],” Pianda said. “The doctors decided to amputate his arm after they examined him, because they said that his bone had turned black.”

“It is all because of our stupidity,” he added, sobbing, “and government negligence towards ordinary people.”

Traditional medicine has an ancient history in Afghanistan and is still the main form of treatment in remote areas that lack transportation routes and health clinics. The likes of bonesetters and herbalists possess skills handed down through families, but they rarely have any kind of professional training.

Consequently, their treatments often result in serious injury, further illness or even death, especially among pregnant women, and doctors warn that the government should take action against such unregulated practices.

Ghausodin Anwari, director of Balkh hospital, said that he had so far reported five bonesetters to the police after children they had treated had lost arms or legs.

His colleague Rahimullah Hamid, head of the hospital’s orthopedic ward, said that over the last three years he had amputated limbs from around 60 children and young people, who could have been spared amputation had they been brought for hospital treatment rather than taken to a bonesetter.

“The bonesetters bind the broken parts of the arms or legs so tightly that they block blood circulation in those places, which causes them to turn dark or black in a few days,” he said, adding that although he was aware of the problems faced by amputees, they would likely die without an amputation.

“The other problem is that the people are poor and cannot afford to come to the city and pay for treatment,” he went on. “They mainly go to bonesetters who charge between four and ten US dollars. But they are unaware of the consequences.”

In the market, just 50 metres from the hospital, is the practice of well-known bonesetter Gholam Mohammad.

The 60-year-old said that he had learnt his trade from his father and grandfather. He said that between five to ten people come to him every day with broken limbs or complaining about back or muscle pain, and he charges between five to ten dollars for each patient, treating them with manipulation and ointments.

Rejecting the doctor’s claims that such treatment led to amputations, he said, “Why do people come to us if they do not get better?”

Dr Sakhi Nuroghli, spokesman for the ministry of public health, said that they were concerned about the situation but recognised that people sought traditional treatment because they simply did not know any better.

“The ministry is working on a law under which the bonesetters will be trained so that they will continue their work after education and not hurt their patients anymore,” he said.

Afghanistan has one of the highest rates of maternal death in the world, with women dying in childbirth because of a lack of access to medical facilities or an unwillingness to seek conventional medical help. Many rely on untrained village midwives, while experts note that some men are reluctant to take their wives to hospital for fear they will be treated by a male doctor.

Golbodin, a resident of Zareh district in Balkh province, has brought his heavily-pregnant wife to Balkh hospital because his first wife died while giving birth, despite the presence of village midwives.

“So I brought my second wife to the hospital this time because I do not want to go through the bitter experience again,” he said.

Nasira, an official in the maternity section of the hospital, said many maternal deaths in the region were avoidable.

“In most areas, people avoid taking women to the doctor at the time of delivery which causes the death of dozens of women annually,” she said.

Nasira pointed out that there were clinics and trained midwives in much of the province, yet people preferred traditional midwives.

“The midwives in villages have no knowledge, they cannot provide any help to the pregnant mother during the delivery and that is why the mothers die,” she said.

Doctors say that herbalist practices are also potentially dangerous, relieving pain but not treating the root cause of an illness.

The Janan pharmacy in Mazar-e-Sharif sells natural medicines for ailments ranging from backache, fever to headaches and liver disease.

Nazifa has come to the shop to get something for her weight problem. She said that her sister took a herbal remedy and lost a lot of weight. “The [herbalists] give good medicine. It is a lie that they know nothing in this regard. They have acquired their skills over generations,” she said.

Janan, who treats around ten patients daily, said he had no formal education in herbal treatments, learning what he knows as an apprentice.

“I worked with a [traditional medicine] doctor for three years as a student. I learned all his skills. Now, I work independently and the people are happy with my treatment,” he said.

However, mainstream doctors say that natural medicine can be harmful, focusing on relieving pain while not treating the root cause of the illness.

“The [herbal] doctors use drugs in their medicine which are good for pain relief and the patients imagine their illness is gone, but other diseases emerge in the patients’ bodies,” Balkh hospital director Anwari said.

“More than 20 cases have been registered during the past six months in which patients have either suffered serious harm or died by using [traditional] medicine.”

While sometimes effective, it is clear that traditional treatment does not always work.

Naqibullah says that his brother went to a bonesetter when he broke his leg last year and is now fully recovered.

“If you go to the doctor in this condition, your treatment might include x-rays, or an operation, which will raise your treatment cost to 50 dollars,” he explained. “However, the bonesetter treats you for four dollars.”

But when Naqibullah recently hurt his arm, he sought help from the same bonesetter. It now hangs from his shoulder, useless and paralysed.

Abdul Latif Sahak is an IWPR-trained journalist.