Integrating modern medical knowledge into traditional medical practice (5) Training traditional healers in eye health (2)

10 July, 2018

Dear Noela Prasad and all, (apologies Noela, I accidentally forwarded your message in my name)

Thank you for informing us about this interesting paper.

For the benefit of those without immediate web access, here are the citation and abstract:

Br J Ophthalmol. 1996 Aug;80(8):694-7.

Changing patterns of corneal disease and associated vision loss at a rural African hospital following a training programme for traditional healers.

Courtright P1, Lewallen S, Kanjaloti S.

https://www.ncbi.nlm.nih.gov/pubmed/8949711

Abstract

AIMS/BACKGROUND: Use of African traditional eye medicines (TEM) is associated with the presence of corneal disease, delay in presentation, and vision loss. An interactive training programme was conducted with traditional healers in Chikwawa District, Malawi and changes in the pattern of corneal disease assessed in patients presenting to the district hospital after the training.

METHODS: All patients presenting to the district hospital with corneal disease for a 15 month period before intervention and a 12 month period after intervention were enrolled in the study. Interviews and examinations were carried out by the same person using a standardised, pretested form.

RESULTS: Among the 175 pre-intervention and 97 post-intervention patients, delay in presentation improved only slightly. Blindness among patients reporting the use of TEM decreased from 44% to 21%; bilateral corneal disease in patients using TEM decreased from 31% to 10%. Multivariate analysis demonstrates that poor vision in corneal disease patients continues to be associated with TEM use and distance from the district hospital.

CONCLUSION: As there were no other relevant eye health programmes in the district it is believed that this collaborative eye care programme with the traditional healers was likely to have been responsible for many of the changes in the pattern of corneal disease in the district. Although the changing patterns are encouraging and are likely to improve with additional collaboration, distance to a district hospital will continue to be a barrier to timely use of Western eye care services.

The training to which this paper refers is described here: Courtright P. Eye care knowledge and practices among Malawian traditional healers and the development of collaborative blindness prevention programmes. Soc Sci Med 1995;41:1569-75.

Comments:

1. The full text of the Social Science and Medicine paper is restricted access - why do journals continue to restrict access to research more than 20 years after publication? How much income do they continue to make from the paper so long after it is published? Does the ethical case for making research freely available not outweigh the financial case for continuing to restrict it? After how long - 2 years, 5 years, 10 years, 20 years?]

2. Do HIFA members knnow of any other examples where traditional healers change their practice as a result of learning from 'nodern medicine'? This could be as simple as washing their hands or recognising that a particular traditional treatment can be harmful and therefore should avoided.

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (www.dgroups.info), which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org