By Taiyee N. Quenneh, PhD
It is common practice from time in the past in Liberia for people to turn to traditional medicinal practice as a second or last option when Western medicines fail them. The choice now appears to be reversed where sick bushes, with a method of traditional medicinal practice characterized by supernaturalism and witchcraft, take precedence over the local hospitals. It is understandable to seek sick bush treatments or seek healing in prayer houses in parts of the country where access to hospitals or western medical services is limited. The practice of opting for sick bushes and prayer houses in large urban areas like Monrovia, Buchanan, Gbarnga and Ganta, where the hospital system is accessible, should be alarming to health authorities.
Many Liberians, including people close to us, have reportedly died prematurely as a result of using sick bushes and prayer houses as options for care. I will mention three cases using fictional names to protect the deceased and their families.
Tia James was a beautiful young girl who had just graduated from Stella Maris Polytechnic University. Like most young people coming out of undergraduate studies, she had a bright future awaiting her. Tia suddenly fell ill a few months after her graduation and without the benefit of a medical diagnosis from JFK Medical Center or one of the several hospitals in Monrovia, she was taken to a sick bush for treatment. Tia died in a couple of weeks while at the sick bush. No post mortem was conducted to determine cause of death.
The most famous of those that have fallen to the hopeless allure of the sick bush was Thomas Kamara. Thomas was a shrewd political operator who was among the cadre of young intellectuals that propelled Ellen Johnson-Sirleaf to the Liberia presidency. He served in her government as a Deputy Minister at the Ministry of Finance and later as a Minister of State without Portfolio. Thomas was no stranger to western medical practice. In fact, he held residence with his family in the United States. Thomas Kamara died while in treatment at a sick bush. Again, no post mortem was conducted to determine cause of death.
Recently a prominent Liberian lecturer at several US and Liberian universities passed away after his condition elevated or turned dire while seeking treatment at a sick bush. The esteemed college lecturer had a preexisting condition of diabetes mellitus. He was flown to the United States where he later died following surgery.
The prayer houses have gotten in on the act as well. Pastors and preachers are touting healing powers that are luring the sick and vulnerable into prayer houses. These pastors are not alone in this scheme. They have a willing partner – the sick. It may be daunting to convince the sick who hold to the believe that the source of their illnesses is not a bacteria, a virus or lifestyle, but rather a demonic spirit inflicted on them by their enemies. Such illnesses, they harbor, can only be cured by the healing powers of the pastors and preachers of the prayer houses. While the healing powers of God are unquestionable, the dispensation of such powers by men and women of God on one hand, and medical practitioners on the other hand, is not mutually exclusive. It is God’s healing powers that are dispensed through the hands of medical practitioners. The pastors and preachers can exercise their healing powers at the patient’s bedside in a hospital instead of the patient going to the prayer house.
There are three factors that instantly emerge as drivers of this phenomenon. A robust argument can be made that our penchant for the supernormal and witchcraft, practices that are grounded in our cultural space, is a key driving factor. One can also easily speculate that perhaps modern medical practice in Liberia has failed to deliver on its promise. Lastly, the unaffordability of hospital care cannot be understated.
The former is a psychological manipulation that both the provider and the recipient must believe. It is characterized by rituals such as dancing in the nude mainly at nights; chanting, bathing in boiled herbs, chalk rubbing, and drinking liquids spiced with strange herbs. These rituals are exercised with no consideration for whether the recipient has a pre-existing condition or not. The acidity levels and chemical composition of the cocktails ingested by patients are not established nor measured by the providers. Additionally, the efficacies of the treatments and the outcomes are difficult to measure. Authorities seldom go through the burdens of understanding whether deaths in sick bushes are caused by the underlying illnesses of the patients or the iatrogenic outcomes of the sick bush treatments.
Though the practice is culturally entrenched, the community or society must be weaned off the idea that there is a better health outcome from a sick bush or a prayer house than from the local hospital. To date, there is no scientific body of knowledge that supports the efficacy of sick bush treatment. Sick bushes cannot treat diabetes; sick bushes cannot treat hypertension; sick bushes cannot treat renal problems; sick bushes cannot treat HIV/Aids; and sick bushes cannot treat the most common infectious and chronic diseases that afflict our population. Yet, purveyors of sick bushes provide no caveat when aggressively peddling the prowess of their treatments. Let it be noted, however, that the argument against sick bush treatment does in no way diminish or devalue herbal treatments as administered by trained/recognized herbalists.
How do we then address the threats these alternative sources of treatments pose to community health? The threats can be addressed just as we would address any treatment concern with adverse consequences:
- Health authorities must initiate a massive education campaign that will enlighten the public on the value of hospital medicinal therapy over witchcraft therapy. The values of first collecting vital signs, then performing medical diagnosis using MRI, CAT Scan, X-Ray or fluid (blood, urine, etc) testing, before the administration of treatment must be stressed.
- Health authorities must mandate licensure and certification to legitimate traditional herbalists so as to weed out those that practice witchcraft or voodoo medicine.
- The hospital system must adjust its fee-for-service model, which is costly for most Liberians, to a patient-centered model that emphasizes quality outcomes. In order words, the hospital system must ensure an affordable and quality care outcome such that potential patients will be dissuaded from seeking care at sick bushes.
Perhaps a much more practical measure that is aligned with the Liberian government’s pro-poor agenda would be the enactment of an Emergency Medical Treatment legislation that will require that anyone coming to a hospital emergency room should be stabilized and treated regardless of their ability to pay. This will ensure that during health emergencies, patients are not driven away from the hospital system with the desperate hope that their afflictions can be cured by the purveyors of sick bushes and prayer houses.