A Letter from Kenya
by Richard Pitt
I recently returned from Kenya where I was working at the Kenya School for Integrated Medicine, the only homeopathic training program in most of Africa. South Africa is the only other country offering professional training. It offers a three year full time training program with a potential capacity of 150 students. The inspiration behind the school is a Dutch homeopath called Marie Magre, who has been living in Kenya for the last seven years and has two adopted Kenyan daughters. She began the school after working with Homeopathy without Borders on homeopathy projects and since then has been living and working full time on the project.
As one can imagine, starting and running a homeopathic training program is not easy in Kenya. Homeopathy and other alternative and complementary therapies are recognized in Kenya but the government has not established mechanisms to evaluate and regulate many of these therapies. They are struggling to regulate traditional healers, who practice forms of herbalism and the government is concerned with the safety issues of some herbs and the ways in which they are given and so an imported therapy like homeopathy has not been given much consideration. There are a lot of Indians in Kenya and some Indian homeopaths practice there and the government is OK with foreign trained doctors and other professional homeopaths practicing. But right now, they don’t feel they can fully license domestically trained homeopaths until the school and homeopathy is fully regulated. So there is a catch 22 situation in which our school is training people in both homeopathy and conventional medicine, including public health subjects, but graduates of this diploma program can’t get a license to practice as of now. However, the problem is more complicated as the new Kenyan constitution has devolved many powers from Nairobi and the Central Government to regional governments in the many counties who are now taking more political responsibilities, which includes medical policies and which may include the dispensing of licenses. However, as the government hasn’t really set up the appropriate boards to fully regulate homeopathy and other CAM practices, then graduates of the school and other homeopaths are unable to practice until this is established.
The health office told Marie that the four teachers she has currently doing most of the teaching at the school, and who were in the first year of graduates four years ago, should be sent abroad for one year to gain more supervision experience at international homeopathy schools with degree licensed homeopaths. However, they have been working independently and have had a lot of supervision over the last four years so asking all the teachers to leave to get more supervision cannot work for the school. The expense itself makes it impossible to achieve even if the option was there. So we are continuing as before until ideally they see that this won’t work and another solution arises. One can see how, in the guise of establishing and protecting standards, it makes life very difficult, with obstacles put in the way to make doing something new very hard. This is Africa!! Things aren’t easy.
One thing that is changing at the school and which I was working on with Marie is in changing the program from a three year full time program to a four year program. The first year will be a government certified program in Community Health and also a 90 hour introduction to homeopathy. Graduates at the end of that year can either leave with a community health certificate and work in government facilities and also have a basic knowledge of homeopathy to use as well or they continue to do another three years of professional homeopathy training. The next two years would be theoretical training in homeopathy and medical sciences, including some clinical experience and the fourth year given totally to clinical experience, the majority in homeopathy clinics and also doing internships in local hospitals. Right now, 3rd year students in the school are doing internship training in three local hospitals, gaining valuable experience of working in medical environments. This new four year program would more effectively train them to a level of professional competency and the extended clinical training will give them that much more experience in the field. Right now one of the issues has been giving students enough quality clinical training and an extra year of school will make them that much more mature and ready for practice. Also, in order for the Department of Higher Learning to fully register the school, we have to offer some programs that are already regulated and evaluated by the government, which is where the community health program comes in, as it is designed by the government. This is another challenge of starting a new school with a new system that is not currently recognized in the country.
As homeopathy is in its infancy in Kenya and most people don’t really know what it is, graduates of the school need support in helping to develop their practice and the reality is that most people will want to work in either government or private clinics, more than being able to go out on their own. Therefore, we are looking at ways in which we can help to establish homeopathy with existing medical practices.
One plan we have is to offer an introductory program in homeopathy to doctors, clinical officers and public health officers, nurses etc and during my time there recently, we visited seven different hospitals and medical training schools, doing introductory talks on homeopathy. We have designed a fifteen day program, spread over five 3 day weekends for the beginning of next year. This is based on a similar training offered to medical doctors in the U.K. through the Faculty of Homeopathy. If this is successful we are planning to extend this training for another nine months part time to train health professionals to a higher level of competency. Ideally we will work with government and other health bodies to gain accreditation for the program, helping to establish homeopathy within the existing health care system.
Another topic is the licensing of homeopathic medicines in Kenya. All “drugs” in the country, especially if imported have to go through trials to assess toxicity/safety or appropriate documentation produced to prove safety. It also costs a lot of money to license each medicine, making it only affordable to large companies. Homeopathic remedies are regulated differently, under herbal and alternative medicines, so they don’t have to go through the same licensing process. However, if homeopathic remedies are to be imported into Kenya to be sold commercially, then they do need to go through a registration process, which costs $1,000 for each medicine and $300 to maintain a license each year. Also, a surveillance plan has to be put in place to trace for side effects, complaints and any other response to the medicines. Evidence of manufacturing quality, toxicity issues etc have to be supplied for each medicine. So, even if there is nothing toxic in homeopathic medicines, this process still has to be applied.
I spoke to a person working in the Pharmacy and Poisons Board in the government office in Nairobi and he gave me all this information. I was as much interested though in how we can bring in homeopathic remedies for professional use, not commercial use and he told me that remedies don’t have to be licensed if they are simply to be dispensed by practitioners. But, if in the event of side effects being seen in practice then the board would be involved in evaluating possible issues of toxicity. Also, the individual practitioner’s license and the organization giving the license would be open to government enquiry. There would still need to be in place methods of evaluation of a remedy’s possible side effects.
However, I think it is important that the government understands the process that homeopathic manufacturers go through in Europe and the USA and so in the future we can establish a pharmacy in Kenya, making homeopathic remedies there, under internationally accepted standards of practice. Also, in educating the government into the action of homeopathic medicines, knowledge of the difference between side effects and aggravations would have to be made clear as well as understanding the mechanism of action of homeopathic medicines. Their concern of possible side effects of imported medicines is appropriate but one can see some of the challenges in establishing homeopathy in Kenya and also other African countries. If one imagines the government is not very involved in life in Kenya or other African countries, it is not true. It is highly regulated and the government wants to know exactly what is happening. Some people currently import and sell homeopathic remedies under the classification of being a food product, similar to vitamins etc and while that is legal right now, it is not following the exact letter of regulations regarding the classification of homeopathic remedies in Kenya.
There is currently a Kenyan Society of Homeopaths that was set up a few years ago and ideally it can evolve, become more professional and help to represent homeopathy to government organizations, especially as they seek to regulate CAM therapies and integrate them into the health care system in Kenya.
So, these are some of the challenges that Marie is currently facing and for those of us supporting her vision, we are all working hard to make it happen. A new website is currently being designed and various building projects are being initiated, along with some significant fundraising projects, that could involve serious research into homeopathy being carried out by the school. I recently put in a fundraising proposal to the Bill and Melinda Gates Foundation to help establish a Health Savings Account Insurance program in our County, to encourage poorer people to access ante and post natal health care and get appropriate preventative care, nutritional support etc. We are currently waiting to hear if we get this grant which could be a radical program to get many people to join the current Kenyan Hospital Insurance Fund and improve access to available health care.
Please consider helping the school out. It is run by a charity based in Holland and donations are tax deductible if you live in the USA or the E.U. Please go to www.4kenya.org. If in the UK. You can also find us at http://www.homeopathyactiontrust.org/kenya-school-for-integrated-medicine/. If in the USA and you want to donate, please contact me below and I can send you the appropriate information. Thank you.
Richard Pitt
