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On a changing continent, traditional healing also changes

October 18, 1997

KAMPALA, Uganda (AP) _ Mutebi Moses Tokamalirawo doesn’t look like an African traditional healer, at least not the skin-clad, wild-eyed witch doctors of Western bias.

Trim and easy moving at 50, with muttonchop sideburns, an untucked shirt and green pants hanging over beach sandals, he gently tickles toddler Andrew Waliggo to elicit a giggle while examining the boy’s dark skin rash.

No animal bones or snake heads are in sight. Instead of chanting or burning incense, Tokamalirawo speaks softly to Andrew’s mother, her own skin spotted by skin lesions, about the AIDS virus causing such ominous blotches.

The scene replicates any neighborhood examining room and shows how, more and more, traditional healers in Africa are assuming conventional roles in countries struggling with growing populations and overburdened medical services.

Part doctor, pharmacist, psychologist and fortune teller, healers practice a centuries-old blend of mysticism and medicine to provide much of the continent’s health care.

Many Westerners view healers as voodoo practitioners or charlatans preying on the ignorant and superstitious. But the international medical community now acknowledges that African healers, particularly herbalists familiar with local diseases and conditions, provide significant primary health care across the underdeveloped continent.

The World Health Organization estimates up to 80 percent of Africans _ or more than a half billion people _ visit traditional healers for some or all of their medical care. Almost every city, town and village has a thriving market for the roots, herbs, dried chameleons and other tools of the healers’ trade.

As African nations shuck the vestiges of colonial rule, healers remain the strongest link to tribal cultures slowly being eroded by social evolution. Now, new realities and a global shift toward natural remedies are bringing increased attention and status for healers.

Governments seek to register them and regulate their medicines, and some health insurance plans in South Africa and other countries reimburse the costs of traditional treatments.

At the same time, healers have been forced to accept changes. Dwindling sources of medicinal plants and animals makes healers worry about preserving and replenishing them. While some healers stubbornly hold to superstition-rooted practices of old, others like Tokamalirawo have started adopting modern teaching and methods to deal with maladies like AIDS.

Tokamalirawo knew something was amiss during the AIDS scourge that hit Uganda in the 1980s. His herbal medicines could soothe symptoms such as rashes and diarrhea, but patients kept dying.

Then the private group THETA _ Traditional and Modern Health Practitioners Together Against AIDS _ offered training in AIDS counseling, and Tokamalirawo agreed to take part.

He was one of 400 healers to attend the first meeting in June 1993. Only 20 completed the program 15 months later, the rest having left out of intransigence or to keep making money.

``Before the training, I wouldn’t distinguish between AIDS patients and others. I treated people as bewitched by ancestral spirits,″ Tokamalirawo said in his Spartan, one-room office in a dusty Kampala neighborhood. ``Now I accept that it is a disease I cannot cure. AIDS has changed society and the healers have to change to deal with it.″

For Margaret Namatovu, the toddler’s mother, that change has been crucial. A tall, angular woman of 34, she was first diagnosed with the AIDS virus three years ago and her world fell apart.

She avoided government AIDS workers because of rumors they supplied pills to quickly kill off the sick. Banished by her sister, with three children and another on the way, she grew depressed.

``I felt I was no longer useful,″ she whispered, staring off into space. ``I felt like killing myself.″

Then she developed her rash and went to Tokamalirawo, who is renowned for treating skin ailments. He showed her another view.

``The doctor told me not to fear dying, that even today you could die of an accident, that even those who stigmatized me and point fingers could die before me,″ Namatovu said. ``I’ve seen that come true. I saw my sister, who was stigmatizing me, die in a car accident.″

Now she and Andrew show up once a week for checkups. Tokamalirawo taught her to be careful around the non-infected children, especially when she is cut, and to draw up a will and take other steps to prepare for her death. In short, he demystified the disease.

That’s what THETA wanted when it began the training, which has spread to five of Uganda’s 39 districts and about 150 healers, said Teo Nakyanzi, the group’s resource center manager. It felt enlisting healers _ often deeply grounded in daily life _ would spread the AIDS awareness message most effectively.

Some believe that kind of role best suits the healers.

``This is a massive work force for health,″ said Dr. Peter Folb, chairman of South Africa’s Medicines Control Council, similar to the Food and Drug Administration in the United States. ``We could achieve miracles if there was real cooperation between the two polarized sectors.″


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