Calling All Healers

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While Sekagya concedes that modern medicine is better at blood transfusions, rehydration and aligning compound fractures, he insists that traditional ways should not be dismissed simply because they are not understood. "A Western yardstick is the wrong yardstick to regulate traditional medicine," he says.

He is also worried that expensive modern medicines may be smothering local knowledge, leaving the country dependent on foreign drugs and funding. "ARVs are not curing AIDS. They are improving the quality of life," Sekagya says. "Some traditional practices are doing the same. What attention are we giving to that? And if we come with ARVS and flood the whole system, will we lose those traditions?"

Uganda's medical establishment recognizes that to produce more Okellos they need to listen to the Sekagyas. Thus, the Ministry of Health is drafting a policy to regulate healers, and the Makerere University Medical School in Kampala is teaching students to respect traditional medicine--if only to learn what potions their clients are taking. "They are not going to control the behavior of their patients," says Samuel Luboga, deputy dean of education. "But by being hostile, they can prevent themselves from finding out [what their patients are doing]."

In the Apac district hospital near Alenga, where THETA has encouraged the nurses to accept traditional approaches, it's not uncommon for patients to ask a healer for supplemental herbs or to check themselves out to seek traditional remedies. But even in Apac, the doctors are not so accommodating. Okello carefully fills out referral forms provided by THETA, but they often come back with no comments or diagnosis. "We don't get the feedback," says Okello, who takes it upon himself to make sure patients are following their regimens. "Maybe they feel it time wasting."

Resistance varies from country to country. Nigeria, Mali and Equatorial Guinea, like Uganda, are mainstreaming traditional practitioners. But in South Africa, legislation formalizing the role of healers has met stiff opposition from doctors. "Can you imagine the chaos that would take place in South Africa if traditional healers are allowed to authorize people to receive pensions and disability grants?" says Heinrich Botes of the nonprofit group Doctors for Life International.

The stakes couldn't be higher. With so many sick patients, so few doctors and the ever present risk that misused medicine will spawn resistant strains, promoters of ARVs in Africa can only hope that doctors and traditional healers will learn to get along. "There are so many who said, 'You're crazy to be giving ARVs in Africa,'" says Dr. Michael Rich, the Rwanda director of Partners in Health, an aid group that pioneered community health care. "If we're not successful right now, then in 10 years people are going to say, 'See I told you so, it doesn't work,'" says Rich. "And the money will be gone."