Deprived of qualified doctors, rural Afghans are turning to herbal healers to cure serious illnesses.
By Abdurrahman Omar in Kabul
Suffering from stomach ache? Try pouring oil on a piece of cotton, burning it, and then spreading the ashes on the affected area. If epilepsy is the ailment, simply grind dried camel bone marrow and get the patient to inhale the dust.
In a country where conventional health facilities scarcely exist, and many of the men wearing white coats and stethoscopes are unqualified, millions of rural Afghans are turning to the only practitioners they can find - self-appointed traditional healers.
This can cause problems when serious illness strikes. Three months ago in the Andar district of Ghazni province, Zarho Zarlakhta's five-month-old son Ahmed fell ill, apparently suffering from stomach pains. While the child's mother has had 12 years of education, her husband is illiterate and is under the sway of his mother, a traditional rural woman, who said the boy was possessed by spirits.
"First we took him to some local spiritual men and mullahs and then to nearby doctors. But there is only one pediatrician in the whole district and he cannot possibly see all the patients," Zarlakhta told IWPR in Kabul's Sahat Tifl hospital, where she eventually brought her baby.
The Andar pediatrician, Mujtaba, has a number of trained assistants who stand in on cases he cannot attend to personally. They examined Ahmed five times, giving different diagnoses on each occasion. "Sometimes they said it was ameobiasis, or they said my milk was affecting him," Zarlakhta said.
At that point, she decided to bring her son to Kabul for treatment. However, this is such an expensive and momentous decision for a poor Afghan villager to make that her mother-in-law intervened once more, this time suggesting another traditional healer woman in western Ghazni province.
The healer poured oil onto some cotton and set it alight. Then, while the ashes were still glowing, she spread them over the baby's stomach, repeating this process for half an hour. Both mother and son were in tears by the end of the "treatment", and Zarlakhta said Ahmed became restless immediately afterwards.
Having persuaded her mother-in-law to relent, Zarlakhta took Ahmed on the eight-hour journey to Kabul, where he was examined by pediatrician Abdel Qahar Sarwari. Laboratory tests were ordered, and an intestinal infection was swiftly diagnosed. The baby was prescribed antibiotics for six days and was soon fit and well.
Zarlakhta reckons she has spent over 200 US dollars on treatment for her son - a year's income for many villagers - but worth every cent to get the expert care that is so lacking elsewhere in Afghanistan.
"I had a private clinic in Ghazni a few years ago," Sarwari told IWPR. "I knew many so-called doctors who had not completed their studies. A lot of their cures would make the patient worse, and that is why people turn to local remedies."
Conventional western-style medical treatment has never been widely available in Afghanistan, and herbal medicine was the most popular system before war broke out in 1979. However, the conflict wiped out the bulk of knowledge about such cures and for every genuine practitioner, there have always been a dozen charlatans prescribing whatever comes into their heads.
"Unfortunately, because of ignorance, many people have been using practices which are without foundation," said Minhajuddin Marij, director of the general medicine department in the public health ministry. "Sadly, these kinds of treatments are usually carried out in the home, and so we cannot investigate them."
The list of remedies is as long as it is fanciful. For example, one Wardak cure for jaundice is to tie an onion around the patient's neck. In the Qara Bagh district of Kabul province, warts are treated by putting snails on the skin - the theory is that the snail attracts blood out of the warts. And if you suffer from bone problems in Khost, you can expect to be treated by being wrapped up in goats' skins.
Abdurrahman Omar is a freelance journalist in Kabul