Public Attitudes Towards Traditional Medicine in Dermatological Care Within Blantyre, Malawi: Insights From Subject Matter Experts

This is an 8-week study through which is intended to conduct a review of the use of traditional medicine in dermatologic care through interviews with patients and traditional healers. The findings would allow equitable knowledge exchange about presentations of skin conditions on black skin and treatment approaches that center African knowledge systems.

Within Western medical education, in lectures and medical textbooks, there is a lack of teaching and images depicting the presentation of skin conditions on darker skin. This is a problem because diagnosis is dependent on the pattern recognition skills of the clinician, therefore, a lack of exposure to images of darker skin increases the chance of misdiagnosis. In various countries in sub-Saharan Africa, there are few dermatologists in the region and healthcare workers in the primary sector are not sufficiently trained to manage common skin conditions. The knowledge generated in Western countries informs practices in sub-Saharan Africa with little adaptation to suit the local needs of the population. This also holds true for the medical training in these countries, which upholds medical racism because the curricula are not decolonised. Apart from the direct practice of dermatology, healthcare workers are also responsible for improving the health literacy of their population. The chief investigator spoke to a doctor currently practising in Malawi, who mentioned that black skin is mostly depicted in books focusing on tropical medicine, while other medical books depict white skin. The intention of this study is to conduct interviews exploring this topic and create drawings that depict skin conditions on darker skin.

It is important to understand the approaches that local cultures use to manage common skin conditions, which range from recognition to treatment strategies. This includes the use of traditional medicine - ethnobotanical practices and healers - that are more easily accessible than the local dermatologists, whose access tends to be limited to the private sector. This study will have a particular focus on how laypeople/the public engage with dermatology.

There is a need for the development of programs and resources that incorporate Western biomedical knowledge with local indigenous ways of knowing. This research is important to bring visibility, as a lack of prioritisation of black skin health in Western countries directly translates to the experience of people dealing with skin conditions in African countries.