Traditional Medicine: A Panacea to Botswana Health Care Challenges

Botswana is one of the few African countries that have made great strides in providing accessible, affordable and quality primary health care to its constituents. This is largely due to the prudent management of its economy and political commitment by its leadership. Despite reliance on a single resource, diamonds, Botswana has not experienced the Dutch Disease that normally accompanies such dependence as witnessed in other economies.
 
However the Global financial crisis and great recession of 2008 adversely affected the Botswana economy. The main impact has come through the international trade effects, with Botswana’s major exports – diamonds, copper/nickel and tourism – badly affected by the recession in major developed economies. As a result of problems in the international diamond market, mining of diamonds was cut back in 2009, which pushed the economy into recession in that year, with GDP growth of around minus 4 percent. Reduced export earnings have caused the balance of payments to deteriorate and require a drawdown of the foreign exchange reserves in order to finance imports. Reduced government revenues from the mineral sector have led to large budget deficits, financed by a combination of borrowing and drawdown of savings. To couple these events Botswana has seen a reduction in the amount of revenue shared by the Southern African Customs Union (SACU) which is also a huge contributor to the GDP of Botswana.
 
The combination of recession and twin deficits – on the balance of payments and the government budget – made 2009 the most challenging year for the Botswana economy for three decades. The savings and foreign exchange reserves accumulated from years of prudent policies have enabled Botswana to withstand these challenges reasonably well. Continued government spending during the crisis has provided a fiscal stimulus that boosted the domestic market. The crisis highlighted some of the challenges facing policymakers. Diamond exports are not expected to return to the peak levels of 2007 for several years, and substantial investments are required to extend the life of the main diamond mines. This has been made worse by the fact that, the effect of double dip recessions and austerity measures imposed on various government in the Euro Zone have also seen a decline in diamond sales to these markets. They have also experienced negative growth and decline in consumer spending which does not bode well for Botswana’s diamond industry.
 
The long-term fiscal impact on Botswana will be reduced government spending and a renewed focus on policy reform in order to boost economic growth: although the crisis was devastating, it acted as a snapshot of the future, should the economy continue being driven by the mining sector and we fail to diversify. Many years of successful development have been slowed by the economic crisis. It is thought that the unemployment rate has increased in 2009 given the closure of textile industry firms and retrenchments by some private companies, especially those that are export based.
 
With an anticipated decline in diamond production from 2020 onwards as existing reserves become exhausted, it is clear that the Botswana government can no longer afford to sustain the remarkable socio-economic trends as the economic system appears to be under enormous strain.  Emerging diseases, shortage of professional personnel, specialized equipment for specialized procedures and high cost of drugs challenge the sustainability of the current set up and renders it ineffective. Already Government has indicated that due to sluggish economic growth and the decline in revenues, funding for major services such as health services need to be scaled down.
 
This picture, therefore calls for government’s intervention and proposes for an assessment of the current system with a view to either effect cost sharing measures or consider embracing traditional medicines as an alternative, to augment the current practice for its sustainability. Countries like China have for ages continued to utilize their natural herbal endowments, whilst Ghana has legislated for the inclusion of traditional medicines into its health care system, and other regions in Africa are in partnerships with other non-profit organizations to develop traditional medicines and reduce costs.┬á
 
The use of traditional medicines is as ancient as the origins of man.  From time immemorial societies throughout the world have relied on traditional medicines and herbs for their health care. With the advent of western medicines some countries abandoned their use, opting for the more refined and modern medicine at their expense. The toxicity and in particular the sky rocketing costs have compelled nations to relook at their health care policies in a bid to address these emerging challenges.  Governments of China, Ghana, Madagascar and Brazil use traditional medicines and other associated practices alongside modern health care systems. On the other hand organizations such as the African Union (AU) and the World Health Organization (WHO), International Development and Research Centre (IDRC) and Africa First LCC have endeavored to promote research and commercialize traditional medicines and herbs for the benefit of Africans and the world at large.
 
Societies have for decades survived diseases and ailments through the use of indigenous plants and herbs in their environs.  New age developments have further improved and better addressed some of the medical problems that would have otherwise not have been attended to sufficiently leading to suffering and eventually death for some patients.  The same is true for traditional medicine.  Certain ailments continue to elude western medicine (allopath) but are easily addressed in the traditional set up.
 
As argued above, Botswana has put a remarkable health care system in place which is both accessible and affordable. However its long term sustainability given the ever increasing cost of essential drugs, shortages of qualified personnel, essential equipment, specialized procedures and the brain drain of medical professionals remains questionable. To this end, this impending distressing perspective calls on government to look elsewhere, particularly at traditional medicine to address these challenges. The increase in drug prices puts huge strains on the government of Botswana, but this strain is also felt in developed economies such as the United States of America where there is resistance to President Barack Obama’s Medi-Care government funded scheme which is seen as costly.
 
Traditional medicine refers to medical knowledge and application systems developed over past generations and passed through to each generation by word of mouth and deed. The World Health Organization (WHO) defines traditional medicine as health practices, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well being. The quality and efficacy of traditional medicines and herbs have never been questioned because they served their purpose very well up until the advent of western medicine which maligned its practice and use. An interesting development in developed countries is their uptake of alternative treatments and use of herbs for treating aliments, an example is the use of the African potato (Hoodia) to help in staving off hunger pangs for people who want to reduce their weight due to health concerns.
 
The first contact point of Africans with western medicine was through missionaries whose primary objective was to convert Africans whom they considered heathens, barbaric and uncivilized to Christianity. Their advent was by design, subsequently followed by the scramble of Africa by European powers in the 1800s. Once entrenched in the African soil, they persuaded Africans to forego their traditional beliefs and use of traditional medicines and herbs and instead turn to more refined and modern western medicine.  They criticized African practices and this gave way to stigmatization to take root.
 
As a result a new form of health care system was born. Hospitals managed by missionaries and funded by churches abroad were built in areas where they settled.  This further relegated traditional medicine practice to the back and western medicine as such took the centre stage and entrenched itself. Similarly, subsequent governments that came to power following their independence from colonizers unfortunately continued the status quo unlike in China and other East Asian countries where people and the leadership held steadfastly to their traditional beliefs and practices, leaving these unadulterated.
 
Fortunately and to the chagrin of western medicine sponsors, malignment of traditional medicine did not completely deter Africans from clandestinely visiting traditional healers for medical assistance to address conditions which western medicine was seen to be failing to cure.
 
In the next article I intend to explore, examine and interrogate existing traditional practices in light of the challenges that the modern health care system in particular, Botswana seems to be inundated with, to an extent that its sustainability is now in question. I also hope, through my articles, influence a shift from maligning traditional medicine and incorporating it into the mainstream modern health care system and thus address the hurdles faced thereof.