foreigners who left the country, because most health professionals had in fact been
foreigners. The civil wars of 1971–1986 disrupted medical supplies and the numbers of
Western-trained doctors and pharmacists declined dramatically. Since 1986 much has
been done to improve the situation but it is still very imperfect in up-country areas.
Suttonet al. interviewed 147 individuals in 13 villages. Their study showed that in
many cases where a disease was labelled ‘malaria’ it might have been something else,
and the same was true for respiratory and intestinal diseases. Accurate diagnosis is
a serious problem in up-country districts outside the main clinics and hospitals.
Why does not everyone go to the nearest hospital? Because, again, of cost. If you go
to hospital at Masindi, you have to take your food with you or pay someone to get it for
you. You have to pay for your stay in hospital and for the drugs you are given. We in the
BFP pay for the healthcare needed by our staff and so we know it is expensive.
Sometimes outside Masindi Hospital there are people who have walked, sick as they are,
to the hospital and then found they are unable to pay for treatment.
Medical personnel
A local doctor encountered by Sutton et al. (1996) was ‘Dr X’ (name withheld) who lived
and worked not far from Budongo. Dr X was trained as a ‘dresser’ in a nearby hospital.
Other than that he had no medical training. He was popular in the area, villagers trusted his
treatments, considered them affordable and effective on the whole, and were prepared to
travel long distances past local drug stores and other clinics to reach him. When inter-
viewees were asked why they liked Dr X they replied that he always had a supply of
medicines, he allowed credit, he always gave treatment of some sort, and he used a micro-
scope to look at faecal and blood samples. In addition he was a local man. By contrast, they
complained that the government clinics were often short of medical supplies, demanded pay-
ment at the time of treatment, and the health workers were outsiders, not from the local area.
As Johnson (1993) showed, traditional doctors using skills that include forest herbs
can be expensive, charging a chicken or even a goat for their services. The charge
depends partly on the perceived status of the sick person and their ability to pay. The
advantage of traditional doctors is that they can treat complex diseases such as mental
disorders, which may be brought on by ‘charming’, a form of sorcery or witchcraft.
They can also concoct potions for people wishing to perform sorcery. I have myself
witnessed twice the effects of a belief in sorcery, once in a man and once in a woman.
The results can be devastating, including pains all over, shaking, and involuntary talking
and shouting. One respondent explained ‘charming’ to Johnson as follows:
Sorcery (when an enemy creates a concoction and places it along a path so the victim will walk over
it) can result in swelling of the limbs, usually legs. For a cure of sorcery (charming) mix leaves of lenga
(Crinum kirkii), kanja (Alstonia boonei) and munyama (Khaya anthotheca). Put half the mixture in tea
and drink. Put other half in a sieve to obtain tiny particles and apply to small cuts made in the skin.Why are we discussing these things in a book about chimpanzees? There are two
reasons. First, looking at the details of the local population gives us an insight into the
Medical personnel 199