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Monday, August 24, 2020

Is Traditional Medicine Africa's Secret Weapon Against COVID-19?

 Covid-19 infections across Africa are on the rise. Although the confirmed number of infected people on the continent is still about 5 per cent of the global total, and the rate of increase seems to be slowing, hopes that Africa would escape the pandemic relatively unscathed are fading.

In many countries, especially those south of the Sahara, already creaking public health systems will struggle to cope with an influx of critically ill patients needing intensive care. This region hosts just 3 per cent of the world’s conventionally trained medics, who face one-quarter of the global disease burden armed with just 1 per cent of its financial resources for healthcare.

Even so, the continent does have resources that can help it cope. Not only has it had extensive experience battling epidemics of infectious disease, such as the Ebola outbreak in 2014 and the Aids and cholera pandemics, it also has a wealth of traditional medical expertise that it has barely begun to exploit.

Talk of indigenous medicine is often greeted with condescending colonial stereotypes of witch-doctors peddling snake oil. This is not helped by the ridicule inspired by leaders like former Gambian strongman, Yahya Jammeh, who claimed to be able to cure Aids using massages and a herbal concoction, or by the attempts by the regime in Madagascar to market an unproven and similarly ineffective cure for Covid-19. Back in 1969, Kenya’s first president, Jomo Kenyatta, condemned traditional healers as “lazy cheats who want to live on the sweat of others”.

Yet while quacks and fraudsters doubtless exist, there is compelling evidence that the majority of practitioners are skilled and experienced, and that their herbal prescriptions can be effective. As one recent study notes, scientific research “continues to validate therapeutic claims on medicinal plants made by traditional practitioners”. The Kenya Medical Research Institute also rejects the notion that they are inferior to conventional remedies.

Recognising this, the World Health Organization and the Africa Centre for Disease Control are collaborating in the use of traditional medicine as a basis for potential remedies for Covid-19. Indigenous medicine can also help offset manpower shortages where there are very few conventionally trained healthcare workers. Across Africa, there is one doctor for every 40,000, but one traditional healer for every 500.

By integrating their expertise and knowledge into the existing national health system, with appropriate safeguards, countries can bolster the deficit in medical personnel. This eases the burden on the public health system, freeing up resources to be employed in dealing with emergencies like Covid-19.

Three years ago, Kenya’s parliament adopted a new health law requiring the government to do just this. To date the law remains unimplemented. Apart from depriving the country of a valuable asset in the war against Covid-19, the lack of official recognition leads to continued stigmatisation of traditional medicine and makes it difficult for the public to distinguish between fraudsters and genuine practitioners. It starves the sector of the investment needed to translate indigenous knowledge into cheap, standardised and accessible medical services and products.

The problem exists across the continent. While most countries had by 2018 developed national or state level laws and regulations to govern traditional medicine, only three African states, Benin, Ghana and Mali, reported having an existing national plan for integrating it into their national health services. Such plans should be an urgent priority.

To tackle Covid-19 effectively, and ensure that it is able to provide affordable and sustainable medical services in the long term, Africa will need to mobilise all its resources. It would be a tragedy if, in this fight, the continent failed to use its most effective weapon: its people and their knowledge.

 

Wednesday, May 13, 2020

Our Worst Foe Is Civilization

In November of 1871, the then Prince of Wales, the future King Edward VII, contracted typhoid fever, a deadly disease which at the time was blamed on sewer gas, a noxious vapor which arose out of the modern conveniences that were a feature of middle- and upper-class homes. Water closets had been heralded by sanitary science as the safest and most efficient means for disposal and, despite the foul smell they were associated with, having one was still considered a privilege. “The pestilence that walketh in darkness” the Times called it, declaring that “our worst foe is Civilization”.

Today the world is stalked by another pestilence, one that does not spare the wealthy and has already afflicted the current Prince of Wales. In the words of the Times 150 years ago, "it is a more terrible, more constant, and far more insidious danger which now occupies the foreground in public anxiety”. Much of the concern is driven by the fact that Covid-19 is not just a disease of the poor. As Prof Alex Broadbent of the University of Johannesburg asks: “Would we care about the increased risk of fatal pneumonia that Covid-19 might cause in Africa, if it did not also greatly increase the risk of fatal pneumonia for prime ministers, business people and university professors, including those in countries where infectious disease and its terrors are supposed to be of historical interest only”? As sewer gas did, coronavirus has “shifted the focus away from the fever dens of the poor to the bedchambers of princes and, more frequently, "ordinary middle-class houses" as sites of disease and death”.

The pandemic is devastating more than just health systems. It is also shattering the illusion of safety engendered by systems which for centuries have concentrated global resources in a few societies, families and individuals while leaving many across the globe without access to basic life-sustaining necessities. And once again, the blame is being laid at the door of “Civilization”, this time in the form of globalization. "It's globalization that has allowed covid 19 to spread around the world at such incredible speed" declares Deutsche Welle, decrying how reliant the West has become on cheap medicines and products from China and India. illustrating just how dependent the world has become on just one economy, China. declares John Gray.

The coronavirus has hugely increased, at least in the short term, the costs of global inequality and exploitation. The question is whether “civilization” will win out as it eventually did in London, where following the Prince's recovery, sanitary reform became a national priority. Will the global pandemic pave the way for reform of the global system to make it more equitable or is John Gray right when he declares in the New Statesman that “the era of peak globalisation is over”?

Undoubtedly, continuing along the same path would entail the powerful accepting vulnerability as the price of inequality. After all, while the poor are paying a steep price for a disease that the wealthy are primarily responsible for spreading, Max Fisher and Emma Bubola note in their piece for the New York Times, that “in an epidemic, poverty and inequality can exacerbate rates of transmission and mortality for everyone”. Therefore in the absence of a vaccine (and a viable one is reckoned to be 12-18 months away), as long as the poor continue to get sick, so will the rich and powerful. How those at the top of the global food chain, be they the citizens of the global North or elites in the global South, act to reduce that vulnerability will depend on the extent to which they are willing to share the wealth along with the diseases.

On the other hand, while it is true that economic globalization has been taking a pummeling of late, a significant retreat as Gray prophesies seems unlikely. Already, there is talk of reopening economies and resuming normal life. Yet without globalization and the accompanying “worldwide production and long supply chains”, the new normal would be an expensive one. It is questionable whether countries like the US and Germany could afford to produce goods and medicines at the cost that they import them from countries like China and India. Or whether their citizens would be willing to forgo access to cheap iPhones to protect the one-percenters.

The other option open to the rich and powerful to reduce their vulnerability is to reform the global systems rather than retreat from them. That will require recognition that their privileged lifestyles are underwritten, as Umair Haque, the London-based consultant and author, notes, by “centuries … of colonialism, capitalism, supremacy, patriarchy”. That has created a world where Europe, which grows no coffee, can make 5 times more from coffee exports than sub-Saharan Africa which does. The global vulnerability to diseases like covid 19 rests on such distortions and inequalities.

Changing this will be impossible if the mold is not broken. And building a world that works for everyone will require more than just tinkering at the edges. As Haque puts it, “without building global systems, nothing much will change”.

At the close of the 19th Century, the scourge of sewer gas was not resolved by reducing the number of flush toilets within individual homes and retreating back into a world of cesspools and outhouses. It was ended through improvements in the unseen plumbing and infrastructure that ensured the sewer system worked for everyone. Not only did London get a new sewer system but in the 1870s and 1880s, hundreds of patents for sewer trap designs as well as water closets and flushing devices.

Similarly, the coronavirus pandemic can provide an impetus for a flood of ideas on how to construct a better global order, rather than for retreating from it. Doing so will not be easy or cheap. But it can be done if the West is willing to invest the resources that it has taken from the rest of the world. And to stop taking a dump on them.

Sunday, June 23, 2019

Press Freedoms Under Threat In Kenya


The arrest and detention of two Kenyan bloggers, Robert Alai and Patrick Safari over pictures of dead Kenyan security officers that shared on their Twitter timelines has once again shone the spotlight on government threats to media freedom in the East African country.

The pictures posted by the two showed some of the bodies of 12 police officers killed when their vehicle ran over a landmine suspected to have been planted by members of the Somalia-based Al Shabaab terror group. The bodies had been piled in the back of a government pick-up in a disrespectful manner.

The government, perhaps predictably, took a dim view of his actions, with the National Police Service and the National Cohesion and Integration Commission both urging the photos to be taken down the pictures. The police declared in a statement that the bloggers had chosen to “callously disregard common decency of showing respect to the departed and their families”. The NCIC chimed in claiming that the pictures would cause despondency among the country's armed forces and could be construed as “propaganda for war which is not protected under the constitution”.

Both institutions seem apparently oblivious to the irony of claiming that it is not the actual treatment accorded to the officers’ bodies that showed disrespect but rather the reporting of it that was the problem. It is however not surprising. Such attempts at shaming Kenyans into silence are always employed whenever the government wishes to hush up criticism of its apparent lack of regard for officers and troops.

In January 2016, after nearly 200 Kenyan soldiers were killed in an Al Shabaab attack on their base near the Somali town of El Adde, the government also attempted to suppress any images that would highlight the scale of the failure, even going as far as to arrest and question a number of bloggers and journalists who posted pictures of the attack (though not necessarily of the dead) on his Twitter timeline. The government-sponsored hashtag #HonourOurHeroes was deployed to suggest that those demanding the truth about how many people died and for senior officers to held to account were somehow the ones dishonouring the troops, not the clumsy attempt at a cover up.

Earlier this year, on the third anniversary of that massacre, Al Shabaab militants attacked the DusitD2 hotel complex in Nairobi, killing at least 21 people. The New York Times published pictures which showed bodies of some of the dead, sparking a wave of online outrage from Kenyans on Twitter, calls for the deportation of their incoming bureau chief and threats of deregistration by the Media Council of Kenya – a state-funded body which regulates media in Kenya. At the time, while agreeing with the general consensus that the NYT was wrong to publish the pictures, some, including me, warned that allowing, and even encouraging, the government to get involved would establish dangerous precedents.

Today, those chickens are coming home to roost. The legitimization of the use of state power to intimidate and threaten the media has further emboldened those who are wont to shut down dissent. It is worth remembering that the Kenya government has had a long-standing ambition to censor the publication of pictures from terrorist attack. One attempt in 2014 sought to amend security laws to criminalize the publication of photographs of the bodies of terrorism victims without the consent of the police. It was fortunately declared unconstitutional for violating the guarantees of freedom of expression and of the media.

The government is well aware that the High Court in that judgment clearly disagreed with the idea that “images of dead or injured persons” even those “likely to cause fear and alarm to the general public or disturb public peace” amounted to propaganda for war. Though it is yet to state what laws the two bloggers are supposed to have broken, following a court appearance, they will however be jailed without charge or trial for at least two weeks while the police apparently investigate “claims they might have received the photos from an Al Shabaab sympathizer”. This despite the fact that a police officer has reportedly been arrested on suspicion of being the source of the images. The point of all this seems less to secure convictions than to harass and intimidate citizens and journalists into silence. It is little more than an abuse of both police powers of arrest and of the court process. In addition, the whole saga may also be a ruse to distract from uncomfortable questions regarding the whereabouts and quality of armored and mine-resistant vehicles that the government procured for the police three years ago to protect officers form exactly this sort of attack.

The media in Kenya should be very afraid. In essence, the government is looking to punish reporting that paints it in a bad light. If this sort of harassment is allowed to stand, it will not be long before regular journalists find themselves similarly treated when their stories rub the government the wrong way.