On-line version ISSN 2078-5135
Print version ISSN 0256-9574
SAMJ, S. Afr. med. j. vol.99 n.4 Cape Town Apr. 2009
African traditional medicine
To the Editor: The Draft National Policy on African Traditional Medicine (ATM) for South Africa was published as Notice 906 in Government Gazette No. 31271 of 25 July 2008. Subsequently, the South African Medical Association (SAMA) issued a Position Paper setting out their stance on the matter.
The SAMA Position Paper states inter alia: 'It is also impossible to quantify African Traditional Medicine by using "Western" scientific methods. The approach of African Traditional Medicine is holistic and is not, and never will be, quantifiable by empirical scientific methods."
And further: 'There is risk involved in attempting to regulate traditional medicine by means of principles which are applicable to allopathic medicine. The use of the criteria "evidence based medicine" cannot be applied to traditional medicine as the holistic nature of African Traditional Medicine incorporates aspects which are not quantifiable by scientific means.
'It is known that in some cases there are allegations that African Traditional Medicine has resulted in harm to the patients using it. As with any allopathic treatment regime there is always a risk of harm to the patient.'
The Branch Council of the KZN Midlands Branch of SAMA wishes to differ from these positions. The primary goal of any therapeutic contract between a health care provider and a client must be the welfare of the client. This is striven for in 'allopathic' or 'Western' medicine by the rigorous testing of therapeutic interventions by means of clinical trials. It is untrue to say that ATM is somehow special because it espouses a 'holistic' approach to patient care. This is what we should all be doing, whether we are African traditional practitioners or 'allopathic' practitioners; Western medicine also strives to be holistic. The effect and effectiveness of holistic medicine can be studied scientifically - by using methodologies appropriate for the question, such as phenomenology.
The correct method of studying the effect and effectiveness of therapeutic medicinal regimens, however, should be strictly scientific and should not differ according to whether the therapeutic agent is derived from 'allopathic' medical practice or 'traditional African medical practice'. If the remedies and practices applied by ATM are efficacious, they should be codified and their use should be supported and extended to other fields of practice. If they are ineffective or harmful, their use should be prevented. The only way to establish whether they are effective or not is to conduct proper, controlled clinical trials, such as that being conducted at Edendale Hospital at the moment on the traditional remedy, Sutherlandia.
There may be risk of harm to patients in 'allopathic' medicine, but the degree of risk relative to the expected benefit is quantified and taken into account in embarking on a particular therapeutic course. The same standard must be applied to ATM.
The welfare of the patient is paramount and must be protected by all means at our disposal.
KZN Midlands Branch Council, SAMA
PO Box 285, Pietermaritzburg 3200