2024年第2期，总第79期。作者：电子科技大学西非研究中心团队；执笔人：HIRA ANWAR（电子科技大学西非研究中心团队成员）；翻译：孙恬甜（电子科技大学公共管理学院研究生）；校对：罗爱玲（电子科技大学公共管理学院研究生）；整理：孟雅琪（电子科技大学公共管理学院研究生）供稿：电子科技大学西非研究中心团队。

Challenges and Opportunities

It is important to note that while traditional healing practices hold significant cultural value, they are not without challenges (Bodeker & Burford, 2017). Noller and Shia (2019) asserted that the lack of formal regulation and standardization poses concerns regarding quality control and safety. Additionally, there are also opportunities for greater collaboration and communication between traditional healers and modern healthcare providers to ensure holistic and comprehensive care for individuals (Burford & Grundy, 2020; Bodeker, 2023). The major challenges faced by traditional healing practices include:

Ø Westernization and/or Modernization

Amid rapid modernization and westernization in all fields of life including medicine, the traditional practices have been marginalized. Furthermore, the rapid influences of modern medicines have put traditional medicines at the back (Burford & Grundy, 2020).

Ø Lack of Recognition

Official recognition is necessary for traditional practitioners as to anything else for patients to trust and adopt a particular healing approach. However, Traditional healing practices have not been integrated into the main healthcare system which limits their acceptance and use (Bodeker, 2023). The patients do not have much trust in these practices which limits their usage.

Ø Lack of Empirical Support

Since traditional healing approaches are based on personal and cultural beliefs and lack the support of empirical evidence. Due to this, these practices are viewed as unsafe, unproven, and ineffective for those who believe in evidence-based treatments (Shia, 2019).

Ø Lack of Knowledge

The younger generations seem to be less interested in knowing, preserving and continuing the traditional treatments which may lead to the extinction of these practices over time. Moreover, current trends of migration and globalization cause people to move away from their host regions which causes erosion to traditional treatments.

Ø Discrimination based on superstition

Traditional practitioners face discrimination as their practices are believed to be based on superstition. These social biases may deter practitioners and their clients from seeking these approaches.

Ø Regulatory Challenges

Traditional practitioners practice in legally objectional areas and face licensing and certification challenges. Due to this fact, traditional practices lack professionalization and common-scale practicing (Bodeker, 2023).

Ø Conflict with Religious and Cultural Beliefs

Finally, traditional practices may contradict religious and societal beliefs which hinders their widespread acceptance and use. Commercialization of such practices may lead to the exploitation of common societal beliefs for economic gains.

Dealing with the above-mentioned challenges and promoting traditional healing approaches require a balanced strategy; recognizing the cultural importance of these practices, integrating these practices in the mainstream healthcare system, promoting empirical research in the said domain to provide evidence in support of their effectiveness, conducting awareness programs, providing legal and regulatory support to license these practices a key to promote traditional healing practices.

Challenge to reform the Mental Health

The words “Shrubbery Specialist” are written in white letters on the wall of the blue painted dirt hovel. What Conteh refers to as “absurdity” is the rest of the wall, which is decorated with compositions of ailments that the traditional healer cures, such as toothaches, infatuation, or emotional health problems. In a country where the public's collective memory has been scarred by the bloodiest Ebola flare-up in history, a protracted and bitter national conflict, and extreme necessity, the last option is understandable. 10% of Sierra Leone's 7,000,000 citizens, according to the World Wellbeing Association, suffer from emotional well-being problems. However, there is a mystery amount of unreported cases, so the scourge of anxiety, depression, or post-traumatic stress disorder (PTSD) is likely to be much worse. There was only one expert practicing for a long time in the nation (now there are two), and patients receiving care in the primary mental emergency clinic were restricted from using fastens up until this point due to the unavailability of psychotropic drugs. Consequently, almost all affected individuals receive no treatment. If all else is equal, individuals who are denied access to the nation's 45,000 traditional healers are drawn there by supernatural beliefs (James, 2020).

(Source: https://www.planstreetinc.com/)

Unauthorized old-fashioned Physicians

The public authority of anticipates that THPs will undergo licensed preparation and that the Intermittent Conventional Wellbeing Professionals Committee of will oversee their practices. However, this cycle has been going very slowly, to the point that even THPs are having trouble due to unregistered fake THPs who expose their work to scrutiny and expose people in general to deplorable practices like using human body parts for healing. This results in the deaths of innocent people. Additionally, pregnant women are not spared from such mentality because they fall victim to these unreported THPs.  Members gave evidence that using human body parts to treat ailments was not a standard practice for THPs (Olufemi et al., 2023).

Conclusion

Traditional healing practices and medicine in Sierra Leone are deeply ingrained in the fabric of society, reflecting the country's cultural heritage and indigenous knowledge (World Health Organization, 2020). These practices offer a unique approach to healthcare, combining herbal medicine, spiritual rituals, and holistic healing methods (Broom & Magin, 2019). Adams and Andrews (2021) described that while embracing traditional healing, it is crucial to address challenges and promote collaboration between traditional healers and modern healthcare systems. James and Wardle (2022) said that by recognizing and appreciating the role of traditional healing practices, Sierra Leone can achieve a more inclusive and culturally sensitive healthcare system that benefits its diverse population (Adams, 2023).

Some of the traditional medications used in the region include Herbal Medicine. This includes providing relief through the use of medicinal plants found in that specific region. Herbal medicines are further classified as Botanical Diversity and Herbal Practitioners. The second traditional treatment is known as Spiritual Medicine which includes interconnected beliefs and spiritual healers. The third therapy involves Physical Therapies encompassing Bone Setting and Massage and Manipulation.

The field of traditional medicine is acknowledged for its effectiveness; however, it is not without challenges. The major challenges faced by traditional healing practices include westernization and/or modernization, lack of recognition, lack of empirical support, lack of knowledge, discrimination based on superstition, regulatory challenges, and conflict with religious and cultural beliefs (Fitts, 2020).

Dealing with the above-mentioned challenges and promoting traditional healing approaches require a balanced strategy; recognizing the cultural importance of these practices, integrating these practices in the mainstream healthcare system, promoting empirical research in the said domain to provide evidence in support of their effectiveness, conducting awareness programs, providing legal and regulatory support to license these practices a key to promote traditional healing practices. This report highlights the importance and challenges posed to traditional healing practices in the region of Sierra Leone. It has implications for policymakers to take into abovementioned facts into consideration while devising an effective policy for promoting traditional treatments including, herbal, spiritual, and physical treatments.  

There is a need to introduce these treatments in the main line of treatments and integrate them with modern medicines. There is also a need to conduct awareness programs to highlight the effectiveness of these treatments along with other modern techniques. The policy-makers must promote research on traditional practices to create empirical evidence in support of these treatments. Overall, traditional treatments are effective promising approaches that need the attention of concerned communities and policymakers to promote and preserve them. The roots of these activities date back to the pre-pioneer period, when networks relied on information on natural vegetation and beliefs in otherworldly beings for support and healing. Conventional healers, sometimes referred to as “sowei” or “ngangas”, continue to play a crucial role in the nation’s medical system today by providing complementary approaches to modern clinical therapy. The intriguing blend of herbal medicine, deep traditions, and non-invasive therapies reflects an all-encompassing understanding of health, acknowledging the interdependence of material, mental, and spiritual well-being.  

However, in the modern environment, these priceless traditional recovery drills confront a number of challenges. Significant challenges are presented by the forces of modernization and westernization, as well as by the lack of genuine recognition and targeted assistance. The waning interest of younger generations in maintaining and advancing these traditions, combined with logistical challenges and conflicts with rigid societal norms, further jeopardizes the sustainability of these activities.

Eventually, among these challenges, there may be opportunities for cooperation and peacemaking. Fundamental steps include realizing the social value of traditional healing, integrating these methods within the context of mainstream medical services, increasing precise research, and addressing administrative roadblocks. Furthermore, fostering awareness and comprehension among the general public on the sufficiency and societal significance of these activities can surmount any obstacles between traditional and modern (Fitts, 2020).

References

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[9] James, P.B., Wardle, J., Steel, A. and Adams, J., 2020. Ebola survivors’ healthcare-seeking experiences and preferences of conventional, complementary and traditional medicine use: A qualitative exploratory study in Sierra Leone.Complementary therapies in clinical practice, 39, p.101127.

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[11] Fitts, J.J., Gegbe, F., Aber, M.S., Kaitibi, D. and Yokie, M.A., 2020. Strengthening mental health services in Sierra Leone: perspectives from within the health system.Health Policy and Planning, 35(6), 657-664.