Pa Kombrabai Kabbia is frank about Ebola’s disastrous impact on his profession and livelihood as a traditional healer in Sierra Leone.
“Traditional healers have many roles when dealing with mortal man,” said Pa Kombrabai. “But not at this Ebola time. During the time when Ebola was not there, people would say, ‘Let me go to the native doctor.’ They didn’t want to go to the government hospital. Now there are laws that we have to send any sick people that come to us to the hospital.”
Pa Kombrabai and the 330 traditional healers that he leads in Kafu Bullom Chiefdom, Port Loko District, have seen their much sought after services become criminal acts, punishable by jail terms.
Traditional healers have long held a prominent position in Sierra Leone, particularly in rural areas where the majority of the population live and where access to formal health care services is limited. Prior to the Ebola epidemic, the World Health Organization estimated there were less than 140 doctors for the population of 6 million. Sierra Leone has about 40 hospitals (both public and private) and 1,200 Peripheral Health Units (PHUs). However, these facilities are poorly staffed and mostly located in district capitals and small towns, creating challenges of access for the majority of the population.
“I inherited the skills and knowledge to be a traditional healer from my grandfather,” said Pa Kombrabai. “I studied the plants and I know which ones cure and I was very successful. People saw my abilities to cure things – especially when people came suffering from witch-gun (witchcraft). So, they made me chief traditional healer.”
While the real extent of their medicinal value is disputed, their attempt to treat people with Ebola in Sierra Leone is seen by medical experts as harmful and a means of Ebola transmission. After advice from experts, the Government introduced emergency regulations banning traditional healers from treating patients.
“I never treated anyone with Ebola,” said Pa Kombrabai. “One time, a man with Ebola came to me, and I was afraid. We don’t know the medicine for Ebola. I sent him to the treatment centre. In this section (sub-chiefdom), there were two traditional healers who attended to Ebola patients, and they also contracted the disease and died.”
Part of the work UNICEF is doing in the Ebola response is to engaging traditional healers so that they know about the dangers of Ebola, follow the government rules, and encourage sick people with Ebola symptoms to see care and use the 117 hotline.
“If people come now who are sick, we send them to the hospital,” said Pa Kombrabai. “They have to come with clearance documents that they have been seen by the hospital before we will attend to them – even for cases where they say they have been fired by witch-gun – they go to the hospital first.”
Given the prominent position traditional healers have in rural Sierra Leone, Pa Kombrabai and his fellow traditional healers have a potentially important role to play in combatting the disease. In Port Loko district that is what’s been happening. Traditional healers are now called upon to reinforce social mobilization efforts of the Ebola response teams: Pa Kombrabai even participates in daily radio talk show that broadcasts on Ebola issues in the district.
While some see them as part of the problem, they also have the potential to become effective social mobilizers and agents that can bring about the behaviour change that is critical for preventing Ebola and getting down to zero cases.
Indrias G. Kassaye is a Communications Specialist working with UNICEF Sierra Leone