There I was, minding my own business? well, technically I was minding the health of others but hey, if they decide to walk into my hospital to see a doctor, their health is my business. So there I was minding my own business when a lady I had discharged about a month back walked into the examination room. I’m always curious to know how the patients I’ve worked on fair after they go back to their daily lives, but not so curious that I’d call them up to see what’s going on. This isn’t a private business, after all. That, plus patients here seem to be practically addicted to lying to health professionals.
Anyway, this lady walks in and it becomes abysmally clear during our discussion that the corneal ulcer we’d been treating had gotten markedly worse. My heart sank just a little, in disappointment, and I set about examining her only to find that her eye had deteriorated much more than I could have even imagined. You see, it’s one thing for the medicine to not be working and the disease to continue along its natural course. Heck, it’s even one thing for the medicine to cause some complications. Some of these situations are expected and are dealt with accordingly. However, it’s a completely different thing for the disease to hulk out and do crazy things because someone fed it steroids. That’s what it looked like to me anyway, and the more I thought about the lady’s story, the less it made sense. There was no way the ulcer could have hulked out like that if she was using the medicine the way she?d claimed she had been.
I poked a few holes in her story and finally, she told the truth. I’d like to think that it was my heavy air of disappointment that had implored her to come clean, but I think she was just tired of my grilling and decided to give me what I wanted so I could shut up. Anyway, as it turned out, she’d stopped using the medicine we’d prescribed her and had gone out to get her some herbal drugs to put in her eye instead. That made me quite angry because I always take extra care to inform my patients that traditional eye medicine could only make their eye conditions worse. It contains some bacteria/fungi that cause some serious problems. I took it as a personal insult that she’d decided to ignore my warnings and decided to listen to a traditional healer’s advice.
As bad luck would have it, the ulcer had eaten away almost all of her cornea, including the parts that would help with healing and regeneration were the eye given enough care and time to heal. On top of that, the ulcer had become so deep that it had straight up perforated her eye and in short, nothing could be done to salvage that eye. We had to remove it. All the while, I was quite angry because corneal ulcers are hard enough to treat themselves, without people making that process even more complicated with their stubbornness. I work in a resource-limited setting where procedures like corneal grafts or even intra-corneal injections are like magic so we manage some of these diseases aggressively.
That wasn’t the first time a patient had gone on to use traditional healers instead of coming to the hospital. You’d think that I’d get some sort of sick satisfaction from the terrible consequences of their decisions. Schadenfreude was named so for a reason, after all, but I just get inexplicably extremely angry at them. From the women who get complications during birth because they’d decided to go to traditional birth attendants yet they’d been attending antenatal care at the hospital, to the lower income population that keeps traditional none-setters in business. Not to mention all the money they waste in the end. It all just frustrates me to the core.
The truth though, is that traditional healers have us medics beat when it comes to customer care. Granted, their methods are less than savoury and they do act like leeches but they guarantee 100% recovery and how many medics can beat those numbers? Whenever people are in need, assurance of better days is essential to keep them going and so diabetics decide to throw away their insulin in favour of some shady-looking jerrycans filled with a magical cure. I am close friends with that frustration that can overwhelm whenever all the hard-earned improvement a patient had been making is rendered null. Like when parents decide that their unconscious child would be much better off being checked out of the hospital and taken to some guy who guarantees that the cuts he’s made on the kid’s head will heal him.
No matter how much I’ve scoffed at these traditionalists, the general population seems to actually believe in these healers and gets quite defensive every time a medic says something to the contrary. On the other hand, we never seem to know the genuine benefits of these herbal remedies because we’re too indignant to even consider what those “hacks” are up to. I happen to be one of those people who would never consider going for herbal anything but I understand that my patients don’t share my sentiments.
A few of my colleagues come from countries where the government has decided to work with traditional healers so as to reduce mortality rates and I am wondering why that hasn’t happened yet in Uganda. We are the country where some of our prominent leaders think it wise to pray to the ancestral spirits. Where you can jump into any bus taking at least a 4 hour journey and be sure that some random guy will jump on and try to sell some herbal magical cure-all gotten from the poop of unicorns, or something of the sort. You can rest assured that most of his stock will be gone by the time he is through. People really are desperate concoctions that cure teeth cavities, diabetes, inflammatory bowel disease, acne, hypertension and cataracts all in one fell swoop.
We could attempt to give people what they want and partner with our traditional healers, teaching them how to recognise medical emergencies so that they can refer patients in a timely fashion. Give them rom and space to practice their craft with minimal stigmatisation and in exchange, expect them to know their limits.
Woman with fibroids wants to try herbal treatments? Go ahead, take her in, but leave that child with meningitis alone and refer him to the hospital. Woman wants you to attend to her birth using your ancient spirit magic? Errr…sure but do it from the hospital or know when it’s a complicated birth so you can send her to modern medicine. Dude wants you to cure his erectile dysfunction? Go ahead but if you find any abnormal lumps, send him far away from you. This might even encourage research to be done in those areas so we could eventually find out the active properties in some of these herbal infusions. That being said, should someone suffer or die following refusal to refer, the traditionalist ought to be investigated and legal ramifications should follow.
You knew that last part was coming, I don’t wield single edged swords, after all.
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