- The unavailability of pharmaceutical drugs is forcing Swazis to rely on traditional medicines to alleviate their ailments.
The government, which created the shortages by its failure to issue drug tenders to companies supplying clinics and hospitals, is publicising traditional and herbal treatments as a remedy for its negligence.
"The inability of people to purchase even the simplest drugs, like over-the-counter painkillers, has made us examine the traditional ways," said Nellie Dlamini, a health worker in the central commercial town, Manzini.
Unlike neighbouring South Africa, where traditional medicines and pharmaceutical drugs have become a highly politicised issue, Swaziland's approach to using both has no political baggage.
Gogo Shongwe, an inyanga or traditional healer who has been prescribing indigenous roots and garden herbs for two decades, is encouraged by the official approval of traditional remedies to augment treatments available at clinics and government hospitals, although she has no objection to "Western" medicine and is herself dependent on pharmaceutical drugs for a bladder infection.
"There is nothing new about the use of garlic or eucalyptus to treat ailments, except that they are now written down on the flyers the health motivators are giving to the people," she said.
Most of Swaziland's one million people have mainly relied on traditional healers as primary health providers because of poor public health facilities, but the drug shortages now mean that there is little other choice.
"This is not about old being better than new, or the opposite. It is about taking advantage of all resources available to us during the current emergencies," said Dr John Kunene, a former principal secretary of the health ministry.
According to UNAIDS, 33 percent of the sexually active adult population is infected with HIV/AIDS - the world's highest rate - and two-thirds of its people, ruled by sub-Saharan Africa's last executive monarch, live on US$2 or less per day.
Poverty and a limited but growing distribution of free anti-AIDS medicines have reduced the demand for commercial drugs, but the use of traditional remedies is also encouraged in treating HIV/AIDS-related disorders.
To combat anemia, one of the conditions suffered by HIV-positive people, the health ministry is distributing flyers that prescribe an iron-rich diet featuring the widely available indigenous spinach called 'umbhidvo'. The endemic plant, which government recommends should be fortified with groundnuts, grows as easily in vacant city lots as in rural areas and is a fixture in many Swazi gardens.
Ginger, another widely cultivated plant, is being touted as a nausea cure for HIV-positive people, with the recommendation that the root be crushed and boiled in water. Other treatments for the same ailment are lemon juice in hot water, or herbal tea brewed from local herbs.
The silver lining to the drug crisis is greater openness between western and traditional practices. "There is a new reciprocal relationship, brought on by the AIDS crisis to be sure, but a good thing that brings both worlds of medicine together," said Dlamini.
Shongwe agrees: "Since time immemorial, we traditional healers have told our patients who suffer from thrush that they must eat fermented milk ['emasi'], with some herbs to make the nourishment more potent. It is well that the Western doctors are now saying this."
The government flyer, 'Medicinal Herbs', which Shongwe showed IRIN, affirms traditional remedies and prescribes garlic as "an antibacterial and expectorant, and to treat hypertension, arteriosclerosis, dysentery, common cold, typhoid and bronchial catarrh."
"We use garlic for this, and also as a way to chase stomach worms away; we use it to treat fevers and blood disorders, asthma, arthritis and rheumatism," she said.
Traditional healers have also used aloe to treat stomach worms. The white juice of the spiky plant, which grows abundantly in Swaziland, is drunk to improve digestion. The health ministry suggests it as a medication for AIDS patients, as well as dandelion and mint, brewed as a tea or chewed.
"Have you ever had a headache that won't go away? Mint mixed with almond oil and rubbed on your temples brings relief," Shongwe said.
These home remedies, once well known by Swazis, have been forgotten as a result of urbanisation and the loss of a middle generation to the AIDS pandemic, leaving young children in the care of grandparents who may be too frail to take their grandchildren to the forests for tutorials on natural remedies.
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