Concern voiced over traditional healing methods.

Byline: Kamila Hyat, Correspondent

Lahore: With few people having access to conventional medicine due both to a shortage of health facilities and to the cost of care, the use of alternative medicine sold by 'hakims' or traditional healers is common in Pakistan.

But with no regulation of the medicines they sell, concern has been growing over the safety of these substances.

The possibility of causing harm is denied by most hakims. "I have treated many people over the last 25 years, and my medicines work. There is no question of harmful substances being found in them," said Abbas Mohammad Baig, a traditional healer based in a busy Lahore market.

"We suggest people with weak eyes, especially children, use 'surma' [a black liquid used traditionally to line eyes for both medicinal and cosmetic purposes] to restore proper vision".

But there are potential problems in this. Dr Masood Kadir, an Associate Professor with the Community Health Science Department of the Aga Khan University Hospital in Karachi, said: "We have not primarily researched on this topic. It is reported in some studies that lead is present in poor quality cosmetics and 'surma'."

At a time where traditional medicines are increasingly used and international travel is commonplace, concern about lead in traditional medicines from the Indian-subcontinent, with similar preparations used across the region has emerged in other countries too including France and the US. "The tradition of using special herbs and combining them with other substances, including metals, is age-old. Indian 'hakims' [traditional healers] and those of us here practice the art of preparing these medicines in exactly the same way," said Baig.

But not everyone benefits. Three years ago, Farzana Ali [not her real name] was taken to hospital complaining of severe stomach pain, vomiting, weakness and numbness in her hands and feet.

"The doctors were initially puzzled. They ran all kinds of tests but could not explain the symptoms, including those with my nervous system. Eventually, after many tests, they discovered the lead content in my blood was dangerously high," she said.

The source of the lead was believed to be a 'kushta' she had used, prescribed by a hakim to tackle infertility. 'Kushtas', commonly used by hakims, are made by mixing metallic compounds with herbs.

"It is quite possible that some lead contaminates the 'kushtas' during the manufacturing process," said Faiza Rao'uf, a pharmacist. She said the medicines were prepared over high heat, and lead could enter them from the utensils or fuel used during this process.

Although the use of 'surma' has been associated with elevated blood lead levels, according to the US Federal Drug Administration, many people remain unaware of the risks. "I have always used 'surma' to keep my children's eyes safe from infection," said Ambreen Anwar, the mother of three.

Acute lead poisoning frequently produces abdominal pain and cramps. Lead exposure can also cause headaches, muscular weakness, numbness and tingling, aggressive behaviour, memory loss, reduced energy and anaemia.

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