The impact of traditional treatments on wound care in sub-Saharan Africa Making a difference for patients and carers
At least 70% of all the patients who
took part in the study had used some kind of traditional remedy before visiting a wound care clinician. Animal fur, for example, was used as a first-line treatment in 20% of all the respondents who had received burn wounds. The application of cow dung to the umbilical stumps of new borne babies, which is believed to enhance healing, was also common despite having been recognised as a major cause of neonatal tetanus for a long time. The application of herbs to wounds, which can cause gangrene and result in amputation, was also reported. Because of the free availability of
these remedies, most patients will try native treatments for some time before seeking treatment and even open fractures are sometimes first managed by local bone setters before patients visit hospital. Even when patients do eventually
seek treatment, their problems can be compounded by an unwillingness to reveal details of traditional remedies to clinicians for fear of blame, stigma and segregation. It is, therefore, important for wound care clinicians to employ tact and sensitivity when attempting to elicit patient histories and design care plans. There is also a common belief
(observed in at least six of the study countries) that certain types of wounds are better treated by traditional methods and even made worse by Western medicine. These mainly include cellulitis, osteomyelitis and chronic leg ulcers and it is usually believed that these wounds are caused by charms or spirits and, therefore, require the attention of a native healer. In fact, some patients do not seek any care for chronic ulcers because they are convinced they will not heal. Others believe their wound is a curse. Delay in seeking treatment for these
conditions can lead to complications such as gangrene, septicaemia, thrombophlebitis and in some cases will require amputation. Attempting to address these problems, both at an individual and a community level, through education and early intervention, could help improve some of the outcomes for these patients where culture and traditional beliefs have a significant negative impact on
wound care. Whether in relation to the primary issue of autonomy, values, cultural practice or the use of traditional remedies, it is important to establish how patients themselves regard their wound in order for any proposed plan of care to be effective.
For more details of the findings of this study, please contact Ojok Francis at:
fmdejoks@yahoo.com
Author details Francis Ojok is a Doctor at the Department of Plastic and Reconstructive Surgery, CoRSU Hospital, Kampala Uganda; Doctor Bua Emmanuel is Head of the Accident and Emergency Unit, Mbale Regional Referral Hospital, Mbale, Uganda; Regina Akise, is a Medical Student, Faculty of Medicine, Kampala International University, Western Campus, Ishaka
The application of cow dung to the umbilical stumps of newborn babies is a major cause of neonatal tetanus.
www.woundsinternational.com
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Editorial and opinion
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