Module 4 – Part 2 – Self-medication and medical pluralism

It is very common that people apply alternative remedies in addition to seeking advice from a medical doctor/ physician/ health care worker. In countries with less developed health systems, as is the case in Afghanistan and recently also in Syria, health services might not be accessible and biomedical drugs not readily available. Therefore, people try to assure their cure otherwise and thus often treat illnesses with traditional strategies, such as herbal medicine or particular forms of diet. In this way, they want to assure the best and often only possible treatment for the ill person that has – in their experience – proven to be successful. Similarly, many patients in Europe seek additional advice when they are ill and apply for instance Traditional Chinese Medicine (TCM) or Ayurveda and/or treat their conditions with herbal remedies they know from their childhood. The destination countries of the refugees in most cases have better health systems than their home countries, and medicinal habits that were the only available curative option in the home country, might not be the only option anymore.

Sometimes, a traditional curative strategy counteracts the health care efforts/ the treatment prescribed by you as a family physician/ primary health care provider/X . If for example a diabetic patient (secretly) receives food containing a lot of sugar and fat that is traditionally applied to strengthen the sick and to ease the healing process, it counteracts the necessary dietary strategies you want the patient to follow (cf. Wunn and Klein 2011). For you as a family physician/ primary health care provider/X  it is recommended to sensitively probe about such additional remedies. In case these remedies interfere with your treatment plan, it can be helpful to offer a clear explanation why the traditional remedies may have to be avoided in this case.