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Educating bonesetters.

To the Editor: We appreciate the noble work of Dr Onuminya in his community. (1) However, the attempt to bridge the gap between orthodox and traditional medicine is not new. Shah et al. (2) undertook training programmes for rural health practitioners in Nepal. At evaluation after 6 years they found significant improvements in the knowledge base and working skills of these practitioners after undergoing training programmes. In a 2-year prospective study, Eshete (3) found a reduction in amputation rates after a one-day instructional course offered to bonesetters in Ethiopia.

Because of local high patronage it seems that the traditional system of bone setting is here to stay. The above pilot reports (1-3) indicate that it is possible to educate bone setters and reduce morbidity. Because of widespread prevalence of bonesetters in developing countries (in India it is estimated that there are 70 000 traditional healers and bonesetters who treat 60% of all trauma patients), a national initiative is required to include them in the mainstream health care systems of developing countries. These bonesetters often work in remote places and villages where there are no trained doctors. With some basic education and training in the field of orthopaedic care they can become a most effective vehicle for patient care and referral.

(1.) Onuminya JE, Performance of a trained traditional bonesetter in primary fracture care. S Afr Med J 2006; 96: 315-322.

(2.) Shah RK, Thapa VK, Jones DHA, Owen R. Improving primary orthopaedic and trauma care in Nepal. Education for Health 2003; 16: 348-356.

(3.) Eshete M. The prevention of traditional bonesetter's gangrene. J Bone Joint Surg Br 2005; 87-B: 102-103.

(4.) Church J. Regional news. World Orthopaedic Concern Newsletter Jan 1998; issue No.74.

Anil Agarwal

Manoj Kumar Goyal

Department of Orthopaedics

UCMS and GTB Hospital



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Title Annotation:Briewe
Author:Agarwal, Anil; Goyal, Manoj Kumar
Publication:South African Medical Journal
Article Type:Brief article
Geographic Code:9INDI
Date:Jan 1, 2007
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