International Federation of Red Cross and Red Crescent Societies

Liberia: Traditional healers can play a critical role in post Ebola recovery

In many villages in Liberia, it has long been part of the culture for people to routinely search out the services of witch doctors or traditional healers when they are not feeling well. Patients believe they can get better and more affordable treatment, and with access to a basic health care system limited, a traditional healer is the first stop for most when sick. Traditional procedures can include magic, fasting or dieting, bathing, massage, and surgery. Some traditional healers apply blood to the patient’s skin to cure them of their illness.

Zwana L. Dunnah, a traditional healer living in Garmaymu Village, Kpaye Town, in Margibi County, Liberia with his son son Alhasana

It is a practice which proved fatal to many traditional healers when Ebola first came to Liberia at the end of March 2014. It was the first time this country had seen Ebola. No one knew what they were dealing with. When people fell sick, many opted for traditional treatments as they did not believe that the disease could be tackled through modern medicine, or because they denied that Ebola was real. As a result, traditional healers, who were treating their patients with potions, herbs, and other sacrifices, died, as did the ones for whom they were caring.

“Some traditional healers died because they believed they could cure everything. But Ebola was completely different from the other diseases we treated before,” says Zwana L. Dunnah, a well-known traditional healer living in the village of Garmaymu, in Lower Margibi county, 50 kilometres from Monrovia, the capital.

The Ebola epidemic was a disaster in Liberia. After killing nearly 4,000 people, the outbreak is now over following more than 18 months of tremendous efforts made by the government with support from partners including the Red Cross.

Learning from past mistakes

For Dunnah, 56, lessons should be drawn from the past to ensure things are done differently in the future. Married with six children, Dunnah recently re-started his practice, now taking extra precautions in treating patients. He says that working as a traditional healer is the only thing he knows to feed his family but he wants to stay safe. “I don’t touch any patient and respect a distance. If I notice that they have a fever, I recommend they go to the health post,” says Dunnah who is currently seeing an average of eight patients per week.

Ma Juah, a female herbalist living in Fendull community in the suburb of Monrovia, echoes Dunnah’s sentiments, adding it is not just a matter of keeping herself safe, but also her patients. “I postponed my activity as the risk to contract the Ebola virus was high. It was the only option to protect myself and my communities, and it forced my patients to go to health facilities as their usual recourse.”

Today, she is happy the Ebola outbreak is over but still asks every sick person who comes to see her to provide a paper from the hospital proving what they are suffering from. “You have to go first to the hospital. I don’t want to take any risk even if Ebola is over. You never know.”

Traditional healers, amongst other groups including women, youth, and community leaders, were part of the Red Cross efforts to disseminate Ebola information in Liberia during the emergency phase of the outbreak, through training and community engagement. As trusted members of their communities, they played a critical role in educating people about how to avoid the disease, helping to stop its spread.

Zwana Dunnah and Ma Juah are adjusting their ways of working by providing their services while also encouraging people to go to hospitals. This way, they too are participating in community surveillance and can act as early warning systems to alert the authorities if they suspect an outbreak of any kind.

Community event-based surveillance is a key component of recovery activities for the Liberia National Red Cross Society, and involving community members who are held in high regard by other villagers is an important strategy which the Red Cross will continue to use in the months ahead.

“Cultural barriers, cultural practices, and complacency are the big challenges, and emphasis should be put on community engagement and community surveillance,” says Boweh Barduae, acting Secretary General, Liberia National Red Cross Society. “Community engagement is key. This is the only way to stay at zero.”

The International Federation of Red Cross and Red Crescent Societies’ (IFRC) recovery plan of 22 million Swiss francs includes conducting community event-based surveillance training for upwards of 18,000 key community members including leaders, teachers, health workers, traditional healers, and religious leaders. Once trained in how to identify symptoms of illness, the proper authorities can be alerted quickly, and a rapid response system activated, if necessary, with the goal of preventing a disease outbreak. There is currently no funding to support the recovery plan. Due to the current funding status, activities are being planned up until the end of June 2016.

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Liberia: Traditional healers can play a critical role in post Ebola recovery