Why Urban Citizens in Developing Countries Use Traditional Medicines: The Case of Suriname

Abstract

The use of traditional medicines (TMs) among urban populations in developing countries and factors underlying people's decision to use TMs are poorly documented. We interviewed 270 adults in Paramaribo, Suriname, using a stratified random household sample, semistructured questionnaires, and multivariate analysis. Respondents mentioned 144 medicinal plant species, most frequently Gossypium barbadense, Phyllanthus amarus, and Quassia amara. 66% had used TMs in the previous year, especially people who suffered from cold, fever, hypertension, headache, uterus, and urinary tract problems. At least 22% combined herbs with prescription medicine. The strongest explanatory variables were health status, (transfer of) plant knowledge, and health status combined with plant knowledge. Other predictive variables included religion, marital status, attitude of medical personnel, religious opinion on TMs, and number of children per household. Age, gender, nationality, rural background, education, employment, income, insurance, and opinion of government or doctors had no influence. People's main motivation to use TMs was their familiarity with herbs. Given the frequent use of self-collected, home-prepared herbal medicine and the fact that illness and traditional knowledge predict plant use rather than poverty or a limited access to modern health care, the potential risks and benefits of TMs should be put prominently on the national public health agenda.

Preparation of Drugs in the Developing World

“…The manufacturing, preparation and use of these methods may be passed down and taught to individuals who then take over as on-site care givers for the current generation. This involves a knowledge of both the diseases, disease treatments and the processes for making the drug used [1,2]. The remedies have a higher than expected success rate and are relatively inexpensive to produce, even with the use of more expensive organic solvents.…”

“…The remedies have a higher than expected success rate and are relatively inexpensive to produce, even with the use of more expensive organic solvents. What is somewhat new is the combination of traditional and non-traditional therapy to treat diseases [2]. Despite the efforts of dedicated individuals to sort out the effects of the synthetic extraction reagent as compared to the actual plant API, little work has been done to define this.…”

“…The "extract" was often allowed to concentrate either by continued boiling or by boiling followed by simple (air) evaporation [2,3]. This basic process is used in various parts of the developing world to make human use products to treat patients especially with skin and intestinal disorders [3,6].…”

“…Access to native, or non-traditional medicines are essential for the treatment of patients in developing countries where health clinics are not readily available [1][2][3]. Often in the more remote areas medicines are produced by individuals who have no formal training, but are mentored and essentially field trained to not only provide patient treatment, but to manufacture the drugs that are proscribed [4,5].…”

“…These people are essential for the health of local populations who may be too far from an urban area, or who may wish to go to local providers for other reasons than location. However, use in the urban areas is increasing [2]. These practitioners provide treatments using procedures that may have been passed down from parent to offspring.…”