Afghan Turkmen suspicious of modern medical treatment

Rozgeldi was 53 when he found out he had cancer. A visiting health specialist of a local NGO to his village [Marchak located in northwest of Afghanistan] told him that he had an incurable disease. This led him to knock on the door of a local tebib, a kind of alternative healer. Unfortunately for Rozgeldi, this was the beginning of the end of his life.
After examining him, the Tebib advised Rozgeldi to drink boiled airplane fuel mixed with a whole cup of salt. Shortly after taking this advice, Rozgeldi's condition took a violent turn for the worse. He started to vomit blood, and within a days he was dead.
A doctor [originally from this town] who recently visited Rozgeldi's village and gave this account of his death says Rozgeldi is not the only victim of such unorthodox treatment. Dr Karim says medical treatment by tebibs, ‘mostly old and uneducated women’, is widespread among rural areas of Afghanistan, especially among Turkmen community.
Dr. Karim, is one of the few Afghan Turkmens to qualify as a doctor, says many people prefer to see a tebib instead of seeking professional help in the bigger cities like Kabul and Mazar Sharif’.
The Turkmens perhaps suffered more than any other community during Afghanistan's civil wars. They live relatively isolated lives in rural areas of the country, where they rarely have access to proper health facilities.
This social isolation, combined with a lack of awareness and education, has led to the kind of self-reliance that sees many Turkmen turn to tebibes for medical help.
According to Dr. Karim, a tebib is usually someone who also has some knowledge of religious studies. Some even read from the Quran as a way to treat their patients, depending on the kind of illness requiring treatment. Dr. Karim says tebibs never refuse to treat anyone, and that this has led many patients to die of treatable illnesses such as appendicitis, or for many women to die in childbirth’.
It’s not just tebibs who dominate the health sector among Afghanistan's Turkmen community. There are also the men who mostly deal with areas such as bone fracture and circumcision of babies.
One such specialist was Mustafa, also known as Dr. Musdak, who lived until recently in the Qalai zal District of northern Afghanistan's Kunduz Province. He worked for long time as a doctor, even though he was unable to read or write. Some Turkmen elders say he was even unable to read the name of medicines, so he used to call for a medicine by describing what was painted on the bottle. Nobody knows how he joined the medical profession.
Another, Dr Abdul Sattar from Chardere district of Kunduz province, has an interesting tale of how he came to be an orthopedic specialist. Sattar was a professional farmer, but used to take part in the wrestling competitions that are a common feature of wedding celebrations. As a result, he frequently had broken bones, and so went to the local bone fracture specialist for help. He got his expertise from this experience alone, and today he is one of the most famous orthopedic specialists in the entire region. He now has so many patients he has given up his original profession of farming, and he has set up a clinic in his home.
Dr. Karim says many people brave the risks of being treated by such self-styled specialists simply because they have no choice.
But Abdul Rahim, a Turkmen social worker active in the Imam Sahib district of Kunduz Province, says this is not the only reason so-called local health specialists are so popular. He says patients could go to Mazar Sharif and Kunduz, where at least ordinary medical doctors have always been available, but villagers are poor and many can't afford or pay the fees. The second reason, he says, is religious belief and traditional values. If a patient is female, her husband or father won’t take her to the doctor, since she will have to unveil her face and possibly let a male doctor touch her -- something they cannot accept’.
Many believe that community pressures also play a part. If someone seeks modern medical help the whole community will likely talk about it for days. To avoid this, many people find themselves bound to act as others in the community.
But there are signs that this is all changing.
Afghanistan's civil wars forced many people to leave the country. This re-shaped their family culture, values and tradition, as they were influenced by the society and customs of their place of exile.
After the formation of a new government in Afghanistan the flow of returnees has increasingly had an impact on the old trends in the villages. The younger generation, in particular, seems unwilling to accept the un-written laws of their elders any more.
These young people -- and their parents -- who returned back after years in exile are paying more attention to sectors such as education and health, and they have also started to scrutinize more closely the decisions of their elders.
Dr. Karim says he was happy to be the witness of such changes. He says however there is a gap between returnees and settlers, but the active work of foreign NGOs is playing an important role in changing communities' attitudes toward education and health. Early days, perhaps, but for Afghanistan's tebibs and illiterate doctors, this could all add up to a very bleak diagnosis.

Published in: - The Journal of Turkish Weekly [Ankara-Turkey]