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J R Soc Med. 2007 June; 100(6): 294–296.
PMCID: PMC1885391

AIDS: Cures? Crisis!

There is an eerie cloud hanging over The Gambia, as if the skies are holding back tears, waiting, waiting for a torrential storm of violent desperation. The people are also waiting. Waiting for tomorrow. Always tomorrow. Always hoping things will improve. Hoping the rains will be sufficient. Hoping the crops will be ample. Hoping the rats and insects will not eat the maize and groundnuts and sorghum before they are taken to market. Hoping their children will not get sick. Hoping they will not get sick.

The stories I hear echo despair. Always the silent mutterings of ‘I give up’, ‘Get me out of here’, ‘Take me with you’. Many of the faces I see are frozen in acceptance, stony frustration and boredom. Ennui, an exotic sounding word—it isn't. It is simply the human condition here. The dust clinging to every pore. The faces beaded with sweat. Frozen, dusty, sweaty faces.

It was exactly 29 years ago today I first came to The Gambia. The roads were better, the wildlife was more abundant, the people were not as despondent, the soil was more fertile, the crops were more plentiful. There was no army. There were no guns. And there was no AIDS.

At the present time only about 1-2% of the population is thought to be HIV positive. Compared to many other countries, this is quite low. In fact, according to the UN, The Gambia, Mauritania, Niger and Senegal have the lowest percentages of adults living with AIDS in sub-Saharan continental Africa. There are probably many reasons why the infection is not yet widespread: in The Gambia there are no major trunk routes or prostitute stops, the most common places for spreading the disease in east Africa; virginity is prized—in fact it is often demanded; women in the villages usually have only one partner, although the men may have up to four wives; and there are major campaigns afoot to raise AIDS awareness. Supposedly, around 50% of the population has seen village cinema presentations about AIDS. Population and Family Life Education courses are held in the schools, where girls and boys are taught that AIDS can be spread through the use of shared needles and razor blades and unprotected sex.

This country was once thought to have a rather enlightened and educated view of AIDS. Unfortunately, change is afoot. The number of people infected with HIV could soon escalate because those diagnosed with the disease rarely disclose their status to their partners, there appears to be a steady rise in the sexual abuse of minors, and ‘false hope’ is being perpetuated by the powers that be.

In January, the president, His Excellency Colonel (retired) Doctor (honorary degree) El Hajj Yahya Jammeh, proclaimed that he could personally cure those with AIDS in three to thirty days by using secret herbal formulas and reciting verses from the Qur'an. The president, backed by his health minister Dr Tamsir Mbowe, claimed that his cure is 100% effective and refuses to allow anyone to investigate the secret ingredients in his ‘wonder drug’. According to Mbowe, the secret ingredients are Jammeh's ‘family knowledge of traditional medicine’ and ‘the teachings of the holy Qur'an.’

This is a small country in crisis. Every year the wildlife shrinks and the water quality and the soil fertility decline. Every other month another politician or journalist or civil servant is arrested. Every week the mounds of litter grow larger and larger. And now, every Thursday young and old, female and male, wait for the president's touch, the president's prayers, the president's secret formula to cure them from AIDS. Giving up their anti-retroviral medicines and subjecting themselves to the president's cure, those with HIV or AIDS are probably being given false hope. And, if they believe themselves to be cured, they will innocently spread the disease further.

While the Internet is abuzz with stories, international newspapers are full of articles about Jammeh and his so-called 100% cure, and the western medical establishment is incredulous at this ‘hoax’, many Gambians find it easy to accept the possibility that their leader has found a ‘natural cure’ for AIDS. After all, this is a land where the leader is supreme and diseases are believed to be caused by supernatural forces and cured through the use of wild plant and animal products and prayer.

Certainly, the forest contains a full-to-overflowing natural pharmacy. Traditionally, the twigs from the sinjango tree are used as chewing sticks to clean the teeth, the leaves are pounded with sorghum and sugar into a paste and given to nursing mothers to make them produce lots of rich milk, and a tea made from the roots is used for curing stomach aches, getting rid of worms, easing aches and pains and as a general all-round pick-me-up. Chewing the bark from the netto tree is used to cure impotence and the fresh green fruits are crushed into water and drunk to regulate a woman's menstrual cycle. The leaves of the kembo tree are boiled and the water is drunk to keep the gums strong and healthy. The roots of the batio shrub are put in a bottle, steeped for a day or two in water and then drunk to get rid of worms or cure malaria. These are just the commonly used plants—there are hundreds upon hundreds of concoctions used every day to treat both common and not-so-common ailments. Do these traditional medicines work? Maybe. Have they been tested? I doubt it. And if they were tested by international pharmaceutical companies and found to be of value, who would reap the benefits? The local people? I don't think so. There are obviously some plants and soils worth investigating. They could provide something new, something potentially life-saving that benefits the international community, but will they benefit the Gambian population? Probably not. The profits would most likely be swallowed up by CEOs on enormous salaries sitting in their high-rise, high-tech offices in London and Zurich and Washington. This scenario is not so far-fetched. All over Africa, biopiracy is taking place. Multinationals claim naturally occurring plants as their own and take out patents on them. The multinationals get the kudos and the money—lots and lots of money—for ‘their invention’, and the local people who live in the land where the plant occurred often receive nothing. And so, it may make economic sense to keep formulas secret.

The forest here is potentially a goldmine of medicines. I don't have to go very far to see this. According to a report written by Jay McGown in 2006 for the Edmonds Institute, GlaxoSmithKline, a huge multinational pharmaceutical company, reputedly took some soil from a termite mound in Abuko, a Gambian nature reserve, tested it, found it contained a rapamycin compound called 29-desmethylrapamycin that is useful as a fungicide and an immunosuppressant. Interestingly enough, there does not seem to be any paperwork detailing a sharing arrangement between the company and The Gambia. Thus, if anything worthwhile and valuable ever happens with the find, The Gambia and her people will probably loose out. It doesn't really surprise me then that the president refuses to tell the western journalists what is in his so-called ‘cure’. Of course, his secrecy also helps enhance both the power and allure of his formula, and helps preserve and enhance his own personal power and status.

Nor does it surprise me that people are lining up, begging to be treated by the president. Faith healers abound. Marabouts, a combination of priest, sage, mystic, prophet and healer, with their specially prepared jujus (amulets), sometimes containing bits of wild animals and Qur'anic verses often written with a bone from a black cat in blood from the same cat, are consulted on a daily basis. The marabouts appear to be the holders and guardians of truth. I have rarely met someone who did not believe in the power of the marabout or in the power of jujus. Marabouts are not questioned: they are assumed to be experts, and their truth is THE truth. They are the scholars, teachers, healers and diviners. In ancient times they were the judges in the councils of the kings. In fact, one man tells me that the ‘marabout is The Gambian scientist’. And another man tells me that ‘Jammah is the best, the most powerful, marabout.’

For centuries wild plants or animal products and prayers have often been used when disease is prevalent. The women in the local village have often given me recipes for various ailments. When I have a fever the list of cures is unending. I could wear a red nightgown or I could drink a tea made from neem leaves and lime or I could feast on a dish of onions, red pepper, black pepper, salt, lime and fish. When I get old and infirm I might need to cook a red colobus monkey in a special clay pot and eat the soup. If I develop epilepsy I should go to a marabout in Senegal who will make a special body wash for me out of cowry shells and magic water and I will immediately ‘stop falling down and blowing soap bubbles out of my mouth.’ TB? No problem. All I have to do is kill an agama lizard, skin it, chop off its head, boil the skinless, headless agama in water with tomatoes, salt and pepper and eat the soup. Stroke? Gorging on Gambian pouched rat will reverse my paralysis and stammering.

Early this morning as I drive along the road I notice that my favourite billboard—the brightly coloured rusty tin sign sponsored by UNDP that declared ‘My Friend with AIDS is Also My Friend’ has been painted over. I wonder if this is connected to the fact that the UNDP representative who criticised the president's AIDS cure was evicted from the country.

Mid-morning as I stop to ask an old friend if he would go to President Jammeh for an AIDS cure if he was suffering from the disease, he easily replies, ‘Of course, it is free and he is giving it to his people and I am one of his people and soon Gambia will get lots of money for the cure and we will be a superpower and the television shows us that all the people he sees are 100 percent cured and even the king of Morocco and your hospitals and doctors know he can do it.’ His companion agrees with his assessment and immediately adds ‘Now The Gambia will be rich, a superpower like America. It will be the America of Africa. It will be the Saudi Arabia of Africa. The entire world is coming here now to be cured of AIDS. The president has been given the gift of healing from God and the whole world knows he can do it.’

In the afternoon as I walk along a forest path I meet a young man looking for Gambian medicine. He goes into the bush and brings back the rotten skeleton of a hooded vulture. He then strips off ten feathers and gives them to his friend who is suffering from back pain. His friend will take them home, place them on his back, and tie them around his waist.

‘Do you have to use a special part of the bird?’ I ask.

‘No, any bones or feathers from a chest or leg. It makes no difference.’

‘How do you know this?’

‘I'm a black doctor. My father taught me.’

‘Then why do you always ask me for paracetamol?’

‘Some things need black medicine, some things need white medicine.’

‘What is black medicine best for?’

‘Sometimes people go crazy in the head and they blah blah blah all day. Our medicine is good for making the blah blah blah stop.’

‘How?’

‘I read special verses from the Qur'an and think deep and they get calm.’

‘Does it work only because the people believe it works or does it work because it really works?’ I ask.

‘I don't know. It makes no difference. It works. That is all that is important. We black people know how to take things from the bush and use them. You white people don't know how to do that because you do not have the knowledge and you do not have the belief and the faith. Maybe you need both.’

Yes, this young man may be partially right. Unfortunately, however, sometimes belief and faith are dangerously misplaced.

Notes

Competing interests None declared.

References

1. McGown J (B Burrows, ed). Out of Africa: Mysteries of Access and Benefit Sharing. Washington DC: Edmonds Institute, 2006. Available at http://www.edmonds-institute.org/outofafrica.pdf

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press