The Bare foot doctors

by ndubuisi edeoga

A physician in Nigeria gets about twenty years of education and training , in the United States it’s about the same, and so in most other countries. In the end you are given a license to practice medicine.

Many years ago in china barefoot doctors were the rave. These barefoot doctors usually received about half a year, but sometimes as short as a few months, and as a long as one and a half years of training that was very focused on preventive medicine and curing simple ailments that were common in the specific area. They also got more training in the form of apprenticeships under qualified medical doctors, who live within the area they cover. These Barefoot doctors acted as a primary health-care provider at the grass-roots level. Infact the system of barefoot doctors was among the most important inspirations for the Alma Ata Declaration in 1978. Interestingly, about a fifth of the barefoot doctors later entered medical school.

In India, Ayurvedic medicine is one of the most ancient medical systems using the alternative medicine schema. Some time in the early forties, the Central Council of Indian Medicine (CCIM) recommended and implemented policies for the research and development of the Ayurvedic system. In India, practitioners in Ayurveda undergo five and a half years of training including a year of internship in select Ayurveda medical schools wherein they earn the professional doctorate degree of Bachelor of Ayurvedic Medicine and Surgery (BAMS). Some go on to get doctorates and postgraduate training such as MD (Ayurveda) which includes a three-year residency and a dissertation similar to the MD or MS degrees in modern systems of western medicine.

What is the common thread running through all these: Training…Training…More training…accreditation….standardization…..oversight…….control….and more control. This training can be formal or informal.
Since approximately 80% of the world population uses traditional medicine as their primary health care, and most of these live in Africa. This formalization and accreditation of training becomes even more important.

Growing up my grandmother believed in the power of “dogonyaro”,(Neem tree) as the ultimate cure for malaria, I know a lot of pharmaceuticals come from plants like dogonyaro, but after rigorous, studies, standardization of dose and quality controls.

Now is the time to really do something about allowing all comers contribute to providing heath care for the most people with the caveat….that you must be trained, accredited, standardized, effectively under some form of control and more.

In India today the ASHA ( accredited social health activists), which is a refined version of an earlier community health worker scheme is doing great things in providing health care to the people with the least access to health care. The weaknesses and failure encountered in earlier projects have been seriously considered in formulating the current scheme.

This in line with what the Millennium Village Project of the Columbia University earth Institute is doing in many African, Asian and Latin American countries.Now most of these workers have bikes, cell phones but the basic concept still remains the same.

I will end by saying that the Nigerian Government, Nigerian Medical and Dental council, Nigerian Medical Association and all other established health bodies or other bodies delegated to enabling and monitoring the health of our people have failed us.

Yes….I called names.

If you don’t point fingers (four points at me and you of course) the buck will always get passed.

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

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