Traditional Medicine in Malawi

In Africa, western medicine often has to compete with it’s indigenous counterpart. Traditional herbalists have long offered medical services to the ill, treating a variety of physical ailments and offering help to the injured and sick. Some merely offer herbal services, but others offer assist in the treatment of spiritual illnesses. Diagnosis of disease however, is a holistic matter, where practitioners look into the spiritual nature of the patient to discover answers to the type of ailment and the strategy of treatment. If ones looks hard enough, one can find herbalists on the outskirts of public markets. Often though, they wait by the entrance to standard hospitals, offering there products to anyone who passes by. Where western medicine fails, herbalists readily provide.

Many readily discredit herbalists and traditional medicine, but its my view that the characterization of fraudsters and hacks are undeserved. Herbalists often come from a long blood line of traditional doctors, and recipes are handed down and modified from father to son. Both of the herbalists I spoke with indicated that they first learned their trades from their parents or relatives.

Herbalists in Malawi are licensed to practice by the Malawian government and their legitimacy formally preserved. The Malawi Medical Practitioners and Dentists Act of 1987 protects the rights of traditional healers and herbalists to practice their trades in Malawi, assuming that life is not threatened:

“Nothing contained in this act will be construed to prohibit or prevent the practice of any African system of therapeutics by such persons in Malawi, provided that nothing in this section shall be construed to authorize performance by a person practising any African system of therapeutics of any act which is dangerous to life.”

Medications are intended for a variety of conditions, a few of which I list here. These were the medications which appeared in the short video I shot below:

1. Kuthenta Mapadzi – Medication for aching joints and feet

2. Mauka – for pain in urination, likely due to urinary tract infections or sexually transmitted infections

3. Konjzela Mphamvu – an aphrodisiac and sexual enhancement medication

4. High blood pressure medication

5. Back pain

6. Burns on the hands or body

7. Any type of problems at all, it appears to be an aspirin like medication

8. Chibayo – for kidney problems

9. Kudya Kanzanza – medication for diarrhea

10. Eye problems

11. Njohka – for cases of intestinal worms

Not surprisingly, most of these medications are for chronic conditions associated with aging. Medical service in Malawi, being as rudimentary as it is, likely cannot accommodate more serious chronic diseases. Thus, herbalists provide some level of relief for desperate patients. I asked the gentleman if he treats malaria, a disease readily treatable with western pharmaceuticals. He readily said no, that when patients come to him with malaria, he sends them to the local health facility. With the exception of basic pain killers and some anti-helminthic meds, none of his treatments were for commonly treatable conditions.

This is not to say that herbalist medications do not work. In fact, I am positive that at least some of them do. In contrast to more ambiguous forms of care, such as spiritual healing, traditional medicines cannot be completley ineffective. The ingredients in at least some of the medications are likely the same ingredients of more expensive factory produced meds. Studies of traditional medicines have been performed in the past, but it has only been recently that western practitioners have begun to take them seriously. The anit-helminthic and anti-diarrheal meds likely work to some level. I know that marijuana is commonly used throughout Malawi as a means of controlling nasuea during malaria episodes in adults. By probably no coincidence at all, traditional herbal meds to treat malaria in Tanzania contain cannabis.

My conversations with both of these men revealed immensely proud and professional medical practitioners. Both of them readily and openly discussed their craft with me as clinicians and not as charlatans. Neither one attempted to sell me any type of medication. Perhaps if I had gone to one complaining of some physical ailment, one might have. As with western doctors, there is no sense in treating those who are not ill.

Interesting to me was the method of packaging and sales, which follows a western paradigm. Medications are packed at pills, given at particular dosages from clearly marked containers. While the methods of pharmaceautical creation and diagnostic strategies may be as they were before Colonialization, the practice has clearly been absorbed into a standard western paradigm of licenses and packaging. In my experience, most things in Africa, from medicine to music to religion, are a fascinating reinvented mix of indigenous and western, producing something new and old at the same time in contrast to merely adapting new ideas to sell to a local population. Malawians, while in some ways very conservative, are in other ways a very curious and inquisitive people, eager to explore and integrate new ideas into everyday life.

Below is a short video I made while conversing with an herbalist in the Limbe Market last month.