My experience of homeopathy in South Africa
Bear with me, but I'm deviating from my normal blog format to write about something I feel incredibly strongly about. This is in no way an indictment of any of the clinics I have been working with. These thoughts are my own and not those of anyone I'm affiliated with in South Africa.
Whilst in clinic we were asked if we minded having some students sit with us and, of course, said yes. It transpired these were third year homeopathy students from a 6 year course at Durban University of Technology (DUT). Those of you who have ever had the pleasure of being on the receiving end of one of my sceptical rants will know how I feel about homeopathy, and I wanted to put down in writing why it has provoked such a response.
Homeopathy was thought up in the 1790s by Samuel Hahnemman, a German who constructed the concept of treating like with like, as opposed to conventional 'allopathic' medicine. There are good summaries of this system and how it purports to work here and here, but, in short, infinitesimally small quantities of compounds that would normally induce the symptoms you are trying to treat are given in sugar pills. Along the way there is some very important hitting of vials against special pieces of leather, which apparently aids the water in gaining the memory of the original substance.
There is absolutely no good evidence to suggest that homeopathy works in any way other than as a placebo. Contrary to what proponents will try and tell you, there have been plenty of randomised control trials and meta-analyses, all of which have failed to show any efficacy (see the House of Commons 2010 Select Committee report here and for those with less time www.howdoeshomeopathywork.com is very readable). Indeed, it is argued that carrying out any more research would not only be a waste of time and money but also unethical, as we already have plenty of robust evidence it doesn't work. This is hardly surprising given that homeopathy is based on nothing that even vaguely resembles modern science.
I'm illustrating my story with that much beloved device of the alternative practitioner, the anecdote. A lady came to the clinic and told us a few weeks before she had been treated for a fungal skin condition with a topical anti-fungal, anti-fungal tablets and a homeopathic preparation 'prescribed' by one of the students. Her rash had cleared up beautifully and she had returned to the clinic to get some more of the homeopathic remedy, believing this to be the one that had worked. She now thinks that homeopathy is an effective, safe way to treat medical conditions. This is a concerning development given she is on (rigorously tested and evidence-based) anti-retroviral therapy for HIV.
Those who say 'but what's the harm?' would do well to look at this website, which compiles cases where homeopathy, other alternative therapies and misinformation have been implicated in illness and even death. This question is even more important in a country desperately in need of qualified medical professionals and access to quality medications. South Africa (and KwaZulu Natal in particular) is still gripped by the HIV pandemic, and tuberculosis (TB) is widespread amongst the poorest members of the population. Defaulting on treatment is a huge problem, which contributed to the rise of Multi-drug resistant (MDR) TB and now Extensively drug resistant (XDR) TB. To suggest that one of the answers to these problems lies with homeopathy, a claim made by Durban University of Technology in their course brochure, is outrageous, and has the potential to make already serious problems very much worse.
I'm angry enough that there are still homeopathy services offered by the NHS (although encouragingly the NHS Choices website has recently been updated to state that there is no evidence it works). But to train young people to dispense sugar pills to a poor, desperate population with health problems of such a devastating nature makes me livid. The students I met were bright, friendly and compassionate and had been taught the basics of anatomy and physiology well. They just want to help those in need, but have been taken in by a very expensive lie (the course costs nearly R100000, about £6000). If these resources were put to use training them as nurses and doctors then you'd begin to solve one of the biggest problems facing South African healthcare.
I'm not deluded enough to think my blog post is going to change South African health policy or make a university rethink its course, but if a few people have learnt something about the myth of homeopathy and why it's not a benign force, then that's a good start.