THPs Census Report in Rwanda

REPORT OF TRADITIONAL
HEALTH PRACTICTIONERS
(THPS) CENSUS IN RWANDA.
REALIZED IN COLLABORATION WITH MINISTRY OF
HEALTH
COORDINATED AND PRSENTED BY AGA RWANDA
NETWORK
Website: www.agarwanda.com
Email: agarwanda@agarwanda.com

Introduction

• This project was initiated to identify all
Traditional Health Practitioners (THPs)
working on Rwandan ground and set up a
database of all those Practitioners wishing to
pursue the treatment and healing profession in
order to have a membership card issued by an
official National Forum called AGA RWANDA
NETWORK in collaboration with the MOH.

Introduction

• It was urgent to set up that database and create a
legal framework for traditional medicine to clean
up this sector, which increasingly becomes a
victim of charlatans who sully it by their business
practices harmful to public health.
• The project has been accomplished and
submitted to the Ministry of Health in order to be
sponsored yet, in the requested amount which
was over 28 million of Rwandan Francs, the
Ministry of Health has provided about 297
thousands for the national radio announcement.
This has been caused by the fact that the
requested sponsorship was not prepared in the
budget of MoH.

Introduction

• However, the direction board of AGA
RWANDA NETWORK has tried its best to
realize the projected census despite of lack of
that requested sponsorship. Leaders of the
Forum have been working in the place of
temporal employees that would be hired once
sponsored. They were only encouraged by the
fact that the projected census was to help in
the creation of professional and legal
framework through which TM would be
practiced in Rwanda.

Introduction

 This document provides the overview of AGA
RWANDA NETWORK, Census Project of all
THPs in Rwanda and the way it has been
conducted, results from collected data
analysis and it will end by recommendations
based on found results.

1.2. About AGA RWANDA
NETW ORK

• AGA RWANDA NETWORK is an abbreviation of
Kinyarwanda and English words which means
ABAVUZI GAKONDO RWANDA NETWOK. It is a
National Forum of Rwandan Traditional Health
Practitioners which aims at both sustaining and
improving Rwandan Traditional Medicine in line
with modern development. It has been created in
March 27th 2011 at Kigali by volunteer people, who
already had discovered the richness hidden in
Traditional Medicine and how it can enhance
health services in Rwanda hence the
development of the country.

NETW ORK
• Mission
• To sustain and improve Rwandan Traditional
medicine in line with modern development therefore
fully exploit the related wisdom in Rwandan culture.
• Vision
• To enhance the traditional medicine in Rwandan
culture improving knowledge and skills of traditional
medicine practitioners.
• Location
• The National office is now located in Kigali City,
Nyarugenge District, in Gitega Sector near the Gitega
Sector’s offices.

NETW ORK
• Achievements
• From the moment it has been initiated, AGA RWANDA
NETWORK has realized different achievements such as:
• Establishing the National Office, located at Gitega near of the
Sector.
• Making a garden of different medicinal plants
• Establishing provincial and District committees all over the
country.
• Conducting trainings for Traditional Health Practitioners in all
Provinces and Kigali City. The trainees have acquired
enriched knowledge and skills in different courses such as
human anatomy, physiology, pathology, how to prepare
natural medicine, nutrition, introduction to psychology, Asian
medicine, Rwandan traditional medicine, etc.

NETW ORK
 Production of AGA RWANDA NETWORK
documentary movie
 Preparation and production of a book of TM
that will continue to be produced in Volumes.
The first volume is called: “INDONGOZI
Y’UBUVUZI GAKONDO BWA
KINYARWANDA”
 Census of all THPs all over the country
 Preparation and celebration of the 09th African
Day of TM celebrated on 02nd Sept 2011.

1.3. The census project

• 1.3.1. Objectives and expected results of the census
project
•
Project goals
The objectives of this census were:
- To identify and record all activities on traditional
healers in the entire country;
- To produce a database of traditional healers at the
national level that will allow to know t heir location,
specialty, etc.
- To produce a membership card to be issued to
confirm the recognition of each Traditional Heath
Practitioner (THP) in the domain.

• Expected results
• This project would allow:
- AGA RWANDA NETWORK forum to make
actions plan to strengthen the capacity of
traditional healers in order to help the
government to professionalize traditional
medicine in Rwanda;
- To fight against quackery and enhance the
profession of traditional medicine.


• 1.3. 2. Beneficiaries
• The direct beneficiaries
• The direct beneficiaries of this project are in
particular, THPs forum members.
• Indirect beneficiaries
• The indirect beneficiaries are the entire
Rwandan population in general who may be in
one way or another, a victim of the unlawful
practices of charlatans who claim the true
healers.


• 1.3.3. The implementation of the project
•
1.3.3.1. Resources and ways to implement the
project.
a ) Re s o urc e s re q uire d
• M te ria l re s o urc e s :
a
• - It was supposed to use means of transport of the
mission team and beneficiaries: Since the action
of recording was to be on two or three sites, as
appropriate, in each province, the mission team
would need a vehicle for their travel and ticket
costs for THPs to motivate them.


 - Technical equipment to facilitate the creation
of the database: it was also necessary to avail
two laptops computers, one desktop
computers, a printer, a machine for printing
plastic cards, a photocopy machine, and two
digital cameras.


• Hum a n re s o urc e s :
• The mission team would consist of two
enumerators, two photographers and an
expert in the creation of databases. The
enumerators should be persons experienced
in the field of traditional medicine in order to
reap all the technical information necessary for
the data of traditional practitioners. It would
also be a census project coordinator.


• Fina nc ia l re s o urc e
• At the conception of the project, it was supposed that the
financial resources that would be used were to come entirely
from the grant that would be mainly allocated as follows:
• - Cost of technical equipment
• - Transportation costs of the mission team and tickets for the
movement of beneficiaries.
- Fees paid to consultants for this mission
• - Operating expenses for the coordination of this activity.
• It is very important to consider that when the project was
implemented all resources used were only from the
arrangement of AGA RWANDA NETWORK. That is why all
predetermined actions in this projected were not done
properly and/or entirely.

 Tim e re s o urc e s
 The realization of this mission was divided into
three main steps:
 - Data collection on field;
 - Data processing;
 - Publication of results and validation


• B) Wa y s to im p le m e nt.
• Da ta Co lle c tio n a nd the ir e ntry o n the fie ld a nd d e live ring c a rd s .
• Here is explained the process of the data collection and entry,
photographs identification, and cards delivering:
• The registration of all information relating to the identity of traditional
healers was done by using the method of interview. AGA RWANDA
NETWORK trained five persons of his educated and dedicated
members were used in order to help as skilled interviewers. A
questionnaire was prepared as an interview tool. Interviewers were
helping interviewees to answer this questionnaire and answers
were recorded immediately with software which would serve in data
analysis. After giving asked information according to the
questionnaire, there was a photographer to take the picture of THP,
which was used for his identification card. The cards were printed
and delivered hence registered in the book of AGA RWANDA
NETWOK immediately.

• The mission of census was done at different sites in each province as follows:
• Province/
City
• Site
• Dates
•
• KIGALI CITY
• Nyarugenge
• 07/08/11
• 08/08/11
•
•
• WEST
• Nyagatare
• 09/08/11
• Rwamagana
• 10/08/11
• Bugesera
• 11/08/11
•
• NORTH
• Gicumbi
• 12/08/11
• Musanze
• 14/08/11
•
•
• EAST
• Nyabihu
• 15/08/11
• Karongi
• 16/08/11


• Da ta p ro c e s s ing
• Data processing was being done by an expert in
creating basic data to arrive at a computerized
database that would be used each time for
consultation when necessary.

Public a tio n o f re s ults a nd va lid a tio n
• The results of the mission was supposed to be
published as a report and validated during a
validation session of all stakeholders: MoH, IRST,
WHO, UNESCO etc.

• 1.3.3.2 Uncounted problems
• The period all along the covered census for all
THPs working in Rwanda has been very
important for it had helped to contact many of
THPs, their names, their ages, where they are
located, their way of treating and/or healing
and diseases and/or illnesses that they find
solution to. All these collected information will
help to make a strategic plan for improving
health care delivered from Traditional
Medicine (TM).


 However, this action of National Census of all
THPs in Rwanda has encountered different
challenges as it was also done unexpectedly
without any other prior preparation. Therefore,
encountered challenges can be grouped in
following lines:

 a) Lack of financial means
 As it was proposed in submitted project to the
Minister of Health for the covered census, the
project contained a budget of 28,990,000Rwf
in which the Ministry of Health has only
provided 297,000Rwf for radio announcement.

• Where do you think other amount of money
has been found for implementing submitted
budget for realizing the projected action of
census? Could Leaders of AGA RWANDA
NETWORK let the action not done because of
that lack of financial sponsorship…..? If the
National Forum of THPs in Rwanda was
directed by leaders who did not get the idea to
initiate it, they would suspend the action, but it
has not been the case.

• The Leaders of the Forum are also initiators of its
creation. They were rushing with time in terms of
improving TM in Rwanda. That is the reason why
they could not let the opportunity pass without any
exploitation. The forum has taken loan for different
basic needed materials such as computers,
printers, machine for cards plastification, and
other amount, though it was still insufficient for
activities that were to be performed. This means
that though the action of census has been
realized all over the country, the executer, AGA
RWANDA NETWORK, is still facing the problem
of the used loan.

• b) Lack of enough human resources:
• It was proposed that the team in census project
should be composed of 10 persons: two
enumerators, two photographers, two persons for
cards making, one person for cards registration
and delivery, two officers of AGA RWANDA
NETWORK for coordinating activities, and one
consultant for data collection and analysis. The
used team lacked 3 persons: 1 photographer, 1
card maker, and 1 person for cards registration
and delivery. Some of census activities have been
done by AGA Leaders themselves. This lack of
enough human resources has been the cause of
following challenge:

• c) Unfinished census at some sites:
• Because of insufficient human resource, census was not
done for all THPs at some sites due to the big number of
them at these sites, which are: Bugesera, Musanze, Nyabihu,
and Muhanga. The team has returned at the Site of Bugesera
on 21st August 2011 where it has also been found out that
there still is a need to go at what was called Ngenda
Commune because there has been claimed to be many THPs
who are not yet registered because of misinformation. The
site of Musanze was composed by 3 Districts: Musanze,
Burera, Rulindo, and Gakenke. The census was done for only
one District, Musanze. The census team will be obliged to go
at each District of the remained for avoiding cost of journey to
people. Other people at Nyabihu and Muhanga Sites were
registered but not given membership cards because of
electrical problem.

CHAPTER II: THE OVERVIEW OF
TRADITIONAL MEDECINE AND
HEALTH IN RW ANDA.

2.1. Definitions
 With reference to WHO documents, this
document takes into account the following
definitions:

2.1. Definitions
 Tra d itio na l M d ic ine (TM) refers to the sum of
e
knowledge and practices, explicable or not,
transmitted from generation to generation,
orally or in writing, used within a human
community to diagnose, prevent or eliminate
disequilibrium of physical, mental, social or
spiritual wellbeing.

 He a lth tra d ip ra c titio ne r (HT) is a person who is
known by the community within which he lives
to be competent to provide health care, by
means of plant, animal or mineral substances,
and other methods, based on socio-cultural
and religious beliefs, as well as on knowledge,
behaviour and beliefs related to physical,
mental, social and spiritual wellbeing and
causes of illnesses and disabilities prevailing
within the community.

 Tra d itio na l Pha rm a c o p o e ia is the repertory of
a set of plant, animal or mineral substances
used within a human community in order to
diagnose, prevent or eliminate disequilibrium
of physical, mental, social or spiritual
wellbeing.

 Tra d itio na l m id wife (TMw) is a person who is
widely known within her neighborhood to be
able to help parturient women and whose
competence comes from a familial legacy or
from training with other traditional midwives.
They are at present known as Maternal Health
Assistants (MHA).

 I p ro ve d Tra d itio na l M d ic ine s (ITMs) are
m e
medicines made on the basis of local
traditional pharmacopoeia, with known toxicity
limits, with pharmacological effect confirmed
through scientific research, with quantifiable
dosage of which quality can be controlled
when put on the market.

 Tra d itio na l he rba lis t is a person who has
knowledge of medicinal plants and sells them
at a fixed place, preferably in a marketplace.
 M d ic ina l p la nts (MP) are plants used in
e
Traditional Medicine of which at least one part
has therapeutic properties.

2.2. History and current status of
Traditional Medicine
 2.2.1 History
 Traditional Medicine was practiced in Africa
long before the adoption of western medicine.
Its practice stood the test of colonialism,
despite measures taken at that time to
marginalize Traditional Medicine

 Being a huge pool of knowledge, philosophy
and cosmogony not yet exploited, Traditional
Medicine not only offers possibilities of
effective and accessible treatments for
pathologies prevailing in communities, but also
constitutes a cultural legacy and a means to
establish the relationship between populations
and their own history and culture.

 Until now, the WHO estimates that 80% of
rural population living in developing countries
relies on Traditional Medicine for their health
care (WHO, 2001).
 The Alma-Ata Declaration of 1978 and many
relevant declarations by the WHO and other
international organizations have emphasized
the importance of Traditional Medicine.

 In Rwanda, it is sure that a large majority of
the people still uses resources of Traditional
Medicine to solve health problems. Referring
to research works done in other countries of
our sub-region, we estimate that there is about
1 tradipractitioner per 500 inhabitants.

 The creation of Traditional Medicine Service in
the health care Division of the Ministry of
Health goes back to 1980. It was in charge of
establishing a National Policy on Traditional
Medicine, coordinating its implementation,
establishing Rwandese Traditional
Pharmacopoeia and preparing basic
documents aimed at integrating Traditional
Medicine and health tradipractitioners,
including traditional midwives, into the
framework of primary health care.

 Moreover, the utility and timeliness of
integrating Traditional Medicines which have
been proved innocuous, effective and of good
quality into the collection of therapeutic
products available to deal with pathologies
predominating in the community need not to
be demonstrated.

 In 1980, within the National University of
Rwanda, a ‘Ce ntre Unive rs ita ire d e Re c he rc he
e n Pha rm a c o p é e e t M d ic ine Tra d itio nne lle ’ –
é
CURPHAMETRA- (University Centre for
Research in Pharmacopoeia and Traditional
Medicine) was created. This was later on
transferred to the I titut d e Re c he rc he
ns
Sc ie ntifiq ue e t Te c hno lo g iq ue – IRST-
(Institute of Scientific and Technological
Research).

 It is nowadays known as the Ce ntre d e
Re c he rc he e n Phy to m é d ic a m e nts e t Sc ie nc e s
d e la vie (Centre for Research in
Phytomedicines and Life Sciences). This
centre has the mission, among others, to carry
out the study of medicinal plants and any other
products or methods used in Traditional
Medicine.

 Medicinal plants have always been the source
of new molecules used by pharmaceutical
industry. It is thus necessary to protect natural
sites of natural medicinal plants and take
specific measures designed to domesticating
and reintroducing endangered or extinct
medicinal plant species, as well as to grow
medicinal plants that are most widely used.

 According to the WHO, about 70% of the
world population uses Traditional (natural)
Medicine and indigenous knowledge to satisfy
health care needs. It is believed that this
number is higher in sub-Saharan Africa
because many people use TM instead of
conventional treatments

 . One of the reasons that account for this is
that sub-Saharan Africa is a region where
poverty levels are the highest and very few
people have financial means that allow them
to have access to expensive health services.
 In addition, doctors are not always available
and there are also customs and practices
which make them prefer TM

 Therefore, the majority largely depends on the
TM as far as health and health education are
concerned. Despite that the role of TM is
recognized, it is not yet, in sub-Saharan Africa,
a component of the formal health system as is
elsewhere in other regions.
 In Africa, Asia and Latin America, many
countries use TM to meet some primary health
needs. Here are some examples:

 In China, plant-based traditional preparations
represent between 30 and 50 % of the total
sum of medicines consumed.
 In the United Kingdom, annual total sum of
money spent on alternative medicine
represent US $ 230 millions. In industrialised
countries, “complementary” or “alternative”
medicine is an equivalent to TM.

 In Germany, 90% of people take a natural
medicine at a certain time in their life.
 In Ghana, Mali, Nigeria and Zambia, the first-
line treatment for 60% of children infected with
strong fever due to malaria resorts to
medicinal plants administered at home.
 70 % of Canadians use at least once
complementary medicine.

 In the USA, 258 million of adults use products
from complementary medicine.
 The world market of medicinal plants, which is
rapidly growing, represents at present more
than US$60 billion per year.
 According to the Commission for Alternative
and Complementary Medicine, a sum of
US$17 billion was allocated for Traditional
Medicines in 2000 in the USA.

 The African community will be celebrating the
African Traditional Medicine Day on 31 August
each year. The decision to institute this day is
a result of the adoption, in 2000, of a
resolution on the “Promotion of the role of
Traditional Medicine in health systems:
Strategy of African Region” by the health
ministers of the Region.

 The ministers, on that occasion, asked that
this day be instituted in Member States and
introduced in the calendar of days celebrated
by the WHO.
 The celebration of that day aims to highlight
the importance of that resource which helps to
improve health.

 The image and role of Traditional Medicine
have been reinforced in Africa when the
Heads of State of the continent declared in
Abuja in august 2001 that research in
Traditional Medicine must be a priority. This
declaration was followed by another, made in
Lusaka in July 2001, which made the 2001-
2010 period a “Decade of African Traditional
Medicine”.

3. Current situation of TM
 Nowadays, Rwanda’s policy on the
development and utilization of Traditional
Medicine resources is based on many strong
points:
 The existence of technical structure within the
Ministry of Health in charge of implementing
this policy;

 The support given to health cooperatives of
tradipractitioners in order to promote the
conservation of traditional knowledge and
protect health tradipractitioners’ profession
against money-mindedness and quackery that
are spreading because of urbanization and
traditional value crisis.

 The interests directed towards different
cultural aspects of Traditional Medicine by the
Rwandan and foreign education and research
institutions and the existence of “living
treasures” of Traditional Medicine’

 The existence of different levels of education
and research activities in the field of
Traditional Medicine in the framework of
national, sub-regional and international joint
collaboration.

 The availability of western medicine health
workers and health tradipractitioners so that
they can collaborate, in the framework of
doing operational research on the
complementarily between both health
systems, in order to really improve the health
status of the populations;

 The development of traditional pharmacopoeia
in order to make safe, effective and accessible
local medicinal plant-based medicines
available;
 Measures taken to protect biodiversity;

 However, a more detailed analysis of different
aspects is necessary in order to better define
strengths to be consolidated and weaknesses
to eliminate in the framework of implementing
the National Policy of Traditional Medicine.

 Strengths and weaknesses in the field of TM
 2.4.1. Law and regulation framework
 Strengths
 The Government of the Republic of Rwanda has
set up conditions to be fulfilled in order to practice
Traditional Medicine in Ministerial Instructions N°
20/18 of the 16th June/2006.

• The Law no. 95/004 0f 18/01/95 sets up conditions
for the management of forest resources in Rwanda.
(Paragraph discussing TM to be included). See
Official Gazette.

 W eaknesses:
 The existing laws and current procedures do
not really regulate everyone’s activities in this
field and do not defend true health
tradipractitioners: a review of laws involving
concerned people is therefore necessary.

 The blueprint law on health does not specify
the role of Traditional Medicine in the
improvement in the health status of the
populations and social and health
development programmes, even if it provides
for Traditional Medicines in the framework of
National Pharmaceutical Policy.

 The absence of a Code of practice and ethics
adapted to the reality of Traditional Medicine.
 2.4.2 Institutional framework
 Strengths
 The existence of the service in charge of TM
within the Ministry of Health. This service has
many missions, of which the most important are:
 Elaboration the policy on TM and following up
its implementation;

 Elaboration rules, norms, regulations of the
TM practices;
 Promotion of the rational use of traditional
medicines;
 Coordinating interventions in the field of TM

 the existence of Traditional Medicine
Department within the Institute of Scientific
and Technological Research;
 Some partners of the Government intervening
in the field of health collaborate or support
IRST in the development of Traditional
Medicine. We can mention, among many
others, the WHO, UNESCO, and others.

 W eaknesses
 The absence of national multidisciplinary and
intersectoral framework for consultation and
coordination between different institutions
concerned with the development of different
aspects of Traditional Medicine.
 Insufficient administrative and technical staff
(in the field of Traditional Medicine) in terms of
quantity and quality.

 The insufficiency of equipment and funds for
research does not allow full exploitation of the
Traditional Medicine services and the
achievement of objectives.
 The place and role of Traditional Medicine in
comparison with other decentralised structures
of the Ministry of Health are not clearly
defined.

 Apart from IRST, there does not exist any
other institutions in charge of developing
Traditional Medicine and coordinating
operational research and education activities
in this field.

 . Improved Traditional Medicines (ITMs)
 Strengths
 The level of achievements in the field of
research in Traditional Medicine in Rwanda is
indeed undisputable but not sufficient:
 The existence of sufficient raw materials
 A good collaboration between tradipractitioners
and IRST

 W eaknesses
 Despite the existence of a lot of reliable
information about medicinal plants used to
obtain local Traditional Medicine, new ITMs
are not quickly made.

 There are no funds for scientific evaluations of
the traditional remedies, the only way to get
evidences of their efficacy, safety and quality;
and to fully integrate TM in the national health
system.
 ITMs, since they are not recorded, are not
officially put on the market.

 CHAPTER III: CENSUS FIELD MISSION
RESULTS PRESENTATION AND ANALYSIS.
 3. 1. Introduction
 Before we present results from the census, it
is very crucial to remind the processes of this
mission on the field. Registration of all
information relating to the identity of traditional
healers. This was done by using the method of
interview.

 AGA RWANDA NETWORK trained five of his
educated and dedicated members in order to
help as interviewers. A questionnaire was
prepared as an interview tool. Interviewers
were helping interviewees to answer this
questionnaire and answers were recorded
immediately with software which would serve
in data analysis.

 After giving asked information according to the
questionnaire, there was a photographer to
take his picture which was used for his
identification cards. The cards were printed
immediately.

 . Census field mission results.

 Below are figures of people given the
complete service from the interview to the
stage of turning home with the cards. Those
figures are according to district and they are
showing how district participated in this action.

 According to these figures in the table above,
in Muhanga districts is where we have many
registered traditional healers registered; in
Nyaruguru is where we have the lowest
number. It can be thought that in Muhanga we
have many TPs registered because it has
been the last site during the time of this
census mission; so it was reached when a big
number was already informed.

Sex of questioned and
registered TPs:
SEX NUMBER %

Female 514 52.72

Male 461 47.28

Figure 1: Sex of questioned and
registered TPs

47%
Females
Males
53%

 It is clear in this table that we have many
females TPs than males. Normally Rwanda as
a country is inhabited by a big number of
females than males; this is due mainly to the
war and Genocide. So, it is not surprising to
see that even in the field of traditional
medicine the number of females is above the
number of males.

 But there is another aspect of gender which
must be considered in traditional medicine in
Rwanda.

 In Rwandan culture, there is no segregation as
far as traditional medicine heritage is
concerned. If we admit that culture is “the wa y
p e o p le live . Culture a ffe c ts e ve ry thing we think
a nd d o , fro m ho w we tre a t o ur e ld e rs , to who
we a llo w to be a he a le r, to wha t we d o whe n
o ur c hild re n d o no t fe e l we ll” ;

 Then we will conclude that even though
females were neglected in many aspects of
Rwanda traditional culture, they were
considered and very involved in this aspect of
culture which is traditional medicine.

Group of ages Number of TPS %

Under 35 257 24.65

36- 60 349 35.50

60 and above 369 39.85

350 Not attended
school at any level
300 304
274
264 Not finished
250
primary level
200
Finished primary
150 level
100 Vocational
59 training
50
3021 31,18
28,1
27,07
13 10 6,05 2,15 1,05
0 3,07 1,33 A' level
NUMBER OF TPS %

O' level

College

University

 The graphic shows that a big number of
traditional practitioners never attended the
school even at a primary level; they number
31.18%. Another big number never finished
the primary level 28.10%. Only 1.05 attended
university level of education. There is also
illiteracy problem.

 . Most of encountered THPs working in
Rwanda have neither informal nor formal
education. Most of them do not even have
skills of writing and reading. This is one of
handicaps for their collaboration with
conventional health practitioners.

 It has been found out however, that there are
some people among THPs who have
advanced levels of education, even
Universities’ that they should be promoted for
specializing in TM as one way of improving
TM related services
 Answers received from TPs concerning
different system diseases/illnesses
treatment/healing ability are clear in the table
below:


Diseases curing ability Number of THs with ability %

Circulation system diseases healing ability 462 47.38

Nervous system diseases healing ability 291 29.84

Muscle system diseases healing ability 217 22.25

Immune system diseases 104 10.66

spiritual and psychological illness healing ability 479 48.82

Digestive system diseases healing ability 535 54.87

Respiratory system diseases 169 17.33

Reproductive system diseases healing ability 467 47.89

Integumentary system diseases healing ability 584 59.89

 The table and the graphic above are showing
the diseases treatment ability of traditional
practitioners according to their testimonies. All
diseases were put in groups according to the
human body systems.
 A big number of TPs are those who deal with
integumentary system diseases (59.89%) and
the lowest percentage is for those with
immune system diseases (10.66).

Figure 3: Graphic of kinds of
therapy

700 639
600
500
400 336
Magical therapy
300
Natural therapy
200
34,46 65,54
100
0
Number of TPs %

 According to testimonies of TPs we realized
that there are two kinds of therapy used in
traditional medicine. One is magical therapy
another natural. What we have called magical
is that one that uses spiritual power in
treatment and the natural one is that uses
only, natural medicine from natural resources.

 We found that a big number of TPs is using
natural therapy (65.54%) but we must not
neglect 34.46% that uses magical therapy.
 Concerning where the TPs have got the
knowledge in traditional medicine, answers
are grouped in four following groups:

Table 10: Classification of THPs concerning
where they have got knowledge in TM

Where the knowledge is from Number of TPs %

From ancestors 320 35.39

From parents 280 28.71

From schools 80 8.20

From elsewhere 270 27.70

 Those who declared to have the knowledge
from ancestors (35.39%) are more than other
groups. When you consider in deep, you will
find that almost all magical traditional
practitioners are in this group. A small group
(8.20%) is that one of those who got the
knowledge from schools. All of those last
ones are natural therapists.

Figure 4: Concerning
collaboration with Health
centers:

Figure 4: Concerning
collaboration with Health
centers:

500

400

300
There is a collaboration
200 There is no collaboration
100

0
Number of TPs %

 In this mission it has also been found that
some of THPs do not work with Health
Centers. This is caused by two main facts.
The one is that some THPs were not informed
that they were to work with Conventional
Medicine Health Practitioners (CMHPs). The
second is that some of Health Centres still
ignore the role of THPs in health services, the
reason why they do not recognize them yet,
they are much needed.

Table 12: Concerning TPs affiliation in
cooperatives, the table below shows what
has been found:

Cooperative affiliation Number of TPs affiliated %

Affiliated in cooperatives 583 59.80

Not affiliated in cooperative 372 38.20

 As shown in the table above 59.80% of
tradipractitioners is affiliated in cooperative
and 38% not yet. Even though is big number
is affiliated in cooperatives; others are still
working in disorder because these
cooperatives are not established all over the
county.

 Activities to support/ give advice to
cooperatives of tradipractitioners are not
widespread.
 The Ministry was still having some
weaknesses with regard to organization,
services and logistics of TM. The coordination
of traditional therapists’ cooperatives is not
done. Through AGA RWANDA NETWORK all
those shortcomings can be resolved.


 CHAPTER IV: CONCLUSION AND
RECOMMENDATIONS.
 4.1. Conclusion
 The work which has been done according to
means which was available is worth of praise.
This project required both human and
financial resources beyond AGA RWANDA
NETWORK capacity.

 It is important to see that what were done will
serve as a stepping stone to many some
activities action plan. It is in this context that
the mobilization of resources and sensitization
must be planned for the future.

 Recommendations
 All above encountered situation and
challenges have led us to following
recommendations to the ministry of health:

 To provide budget for payment of taken loan in
realization of actions done in covered census
because it was very needed to be done
though there was no prepared budget for it.
The Ministry of Health should even look for
whoever can be sponsor so as to find financial
means to AGA RWANDA NETWORK as the
Forum is too new born to face financial
problems that it has to find solutions to.

 To allow AGA RWANDA NETWORK
additional time for returning to sites where
census was not finished and provide budget
for that action.
 To contribute in trainings of all THPs working
in Rwanda for increasing the efficiency of their
services to the people.

 To help in partnership extension between AGA
RWANDA NETWORK and other Forums of
THPs all over the world as a good way of
improving experiences for THPs working
under umbrella of Rwandan Forum.
 To establish a special program to affiliate all
recommend facilitation all THPs to Health
Centers near of them for collaborations

 To find scholarship for some skilled THPs in
order to help them specialize in TM
 To help in the creation of National College of
TM as a very efficient way of training skilled
THPs

 To reinforce the program of working in
cooperatives because Tradipractitioners’
cooperatives are not established all over the
county.
 To strengthen AGA RWANDA Network is
other to assume properly the function of
coordination of traditional therapists’
cooperatives.

 Establish the code of practices and ethics for
TMs in Rwanda: There does not exist a code
of practice and ethics adapted to the
organization of the health tradipractitioner’s
profession and fight against quackery.

 Enhance training programs for TPs:
Tradipractitioners’ needs for training/education
are not fully taken into account at different
levels of health system.
 Elaborate specialized module in traditional
medicine and insert them in curricula: There
do not exist in different curricula, modules of
specialized education, especially with regard
to the study of TM.

 Establish a laboratory of traditional medicine:
Existing laboratories in which lab work can be
done are not well equipped.
 Health tradipractitioners do not formally take
part in passing on knowledge at different
levels.

 Promotion of research and education in the
field of traditional medicine: The frameworks
for joint national, sub-regional and
international collaboration between different
structures involved in research and education
in different aspects of Traditional Medicine are
always formalized.

 To establish a library and data bank on
traditional medicine: There are difficulties in
accessing updated libraries and data banks in
the field of research on Traditional Medicine.
There do not exist any reference book on
Rwandese Traditional Pharmacopoeia and a
complete and accessible data base of
medicinal plants of the flora of Rwanda.

 To strengthen national institutional and
organizational capacities related to the
development of TM resources.
 To reinforce health tradipractitioners’
capacities in order to help them provide the
population with quality services.

 To strengthen national capacities in charge of
training/education and researches on different
aspects of Traditional Medicine.
 To reinforce the collaboration between
tradipractitioners and conventional medicine
practitioners in order to address priority health
problems.

 To increase the quantity of Traditional
Medicines available, within the framework of
National Pharmaceutical Policy

CONTACTS
 Tel: +250 (0) 784 18 65 85
 E-mail: rekerahoe@yahoo.in
 AGA RW ANDA NETW ORK E-mail adress: agarwan

 WEB: www.agarwanda.com

THPs Census Report in Rwanda

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