Centre, orange: Didi Ananda Ruchira, homeopath and Yogic nun, posing with graduates from her Kenyan homeopathy school.
Martin Robbins is a writer and talker who blogs about weird and wonderful things for the Guardian and New Statesman. Here Be Dragons is a new column that explores denial, conflict and mystery at the wild fringes of science and human understanding. Find him on Twitter @mjrobbins, or email tips and feedback to email@example.com.
We were stood in front of a small bookcase filled with hundreds of little vials, each identical in shape but with myriad different labels, like "Arsenic" and "Belladonna". Each vial contained perhaps a thimbleful of tiny, white sugar pills, identical to those you’d find in the homeopathy section of Boots.
“It looks a bit like my mum’s spice rack,” I ventured.
“That’s pretty stupid,” Didi Ananda Ruchira, homeopath and Yogic nun, replied.
Homeopathy is a bogus system of medicine that relies on the assumption that “like cures like”. In the words of Britain’s Society of Homeopaths, “drinking too much coffee can cause sleeplessness and agitation, so when made into a homeopathic medicine, it could be used to treat people with these symptoms". It sounds a bit like the logic behind vaccines, if that logic had been concocted at a time when we knew nothing about germs or the immune system.
To get from the substance to the "cure", you have to go through a process of dilution and "succussion". A homeopath would take the coffee, dilute it to one part in a hundred of water, then hit the remedy against a firm object to shake it up. The exact technique here is unclear. One of Britain’s leading homeopaths, giving evidence to a House of Commons select committee investigating the subject, told MPs that succussion “has not been fully investigated. You have to shake it vigorously, but exactly how much you have to shake it – no [we don't know]. If you just gently stir it, it does not work."
After repeating this process 30 or so times, you end up with a bottle of thoroughly shaken water, which – in the words of the British Homeopathic Association – is “often diluted to the point where there may be no molecules of original substance left”. This water is poured over pills made of sugar that act as the delivery mechanism. The result? Your new insomnia cure is a tiny sugar pill, splashed with water that once contained traces of coffee. Weirdly, this performs no better in rigorous trials than a placebo.
In Britain, homeopathy seems eccentric and harmless, used by the kind of people who might also think they have a spirit guardian watching over them, or keep a counter-top zen garden on their desk at work. In countries like Kenya, where real medical help is often unavailable or too difficult to reach, these unproven alternatives are being used as frontline medicine. Whatever their situation, whether they live in carefully distressed boho townhouses in Holland Park, or iron-topped wooden shacks in the slums of Nairobi, homeopathy’s customers all share one common trait: they're putting their bodily ailments in the hands of something that's been repeatedly proved as ineffective. Though clearly the consequences have the potential to be far more dire if you're a refugee with a life-threatening illness than a bored hippie mum trying to inject some joie de vivre back into her life.
Didi, myself and filmmaker Michael Story were standing in a small outhouse on the edge of her homeopathic compound, a collection of dusty sheds and tall trees in the garden of a sprawling bungalow. Nestled in a leafy, well-heeled suburb in western Nairobi, the site serves as clinic, research station and college, teaching homeopathy to small classes of perhaps a dozen students at a time. It is also the HQ for her aid organisation, Abha Light, which is dedicated to spreading homeopathy across Kenya and the African continent.
At the time of my visit, Didi’s operation was in disarray as they prepared to move to new premises, pushed out by the rapid growth of Nairobi’s booming city centre. She seemed on edge. Dressed from head to toe in bright orange, she stalked from shed to shed like an angry satsuma, irritably dismissing my queries. “Try that again.” “That’s a stupid question.” “That’s also a bad question.”
My first interview with Didi was off to a poor start, but despite her impatience, she seemed eager to show off. I gestured again toward the bookcase and the scores of meticulously labelled vials that represented her entire stock.
Perched at the top, a small bust of Samuel Hahnemann, a German physician, surveyed the scene. Hahnemann invented homeopathy in the late 18th century as an alternative to mainstream medicine. Given that the medicine of the time – common practices included blood-letting – was about as likely to kill you as cure you, it was a pretty low bar to reach. “How many days’ supply do you have here?” I asked.
“That’s another stupid question. Ask me it again.”
I waved my arms around a bit, confused.
“Ask me it differently," she said. "Don’t say ‘days’.”
“Okay.” It was far too hot to argue. “How much supply do you have here?” I asked, gesturing at the shelves.
“With this, we can treat millions of people,” she declared. “For years.”
In for a penny...
- - -
Sometime in the late 90s, a middle-aged American woman named Barbara Lynn equipped herself with a diploma from the British Institute of Homeopathy, donned the bright orange robes of a Yogic nun, changed her name to Sister Didi Ananda Ruchira and moved to Nairobi to help the disadvantaged – for a fee.
“To me, it was quite providential in the cosmic flow to find myself here,” she told Rachael Mutinda – an Abha Light graduate – in an interview for the website hpathy.com. “My newly developed skills now had a focus – to popularise homeopathy and natural medicine as a solution to affordable health care in Kenya and, by extension, Africa.”
By the end of the 90s, Didi's work in the slums of Nairobi had become lucrative enough that she could establish a permanent clinic, renting office space in the Kariobangi district. Before long it became apparent that the impact one woman could have was limited, and in 2000 she started training others, like Mutinda. “If I could learn it, then others could too!”
The Abha Light Foundation spread quickly across Kenya. A second clinic opened across town, then a major treatment facility and laboratory in Kibwezi. By the time of my visit, the foundation claimed to have spawned 20 health centres, treating hundreds of patients each, while two dozen mobile clinics rattled their way across the dusty villages of rural Kenya distributing sugar pills to the masses.
Graduates from Didi's Abha Light Foundation receiving their diplomas.
Even more surprising was the source of Didi’s academic credibility. The Diploma in Homeopathy she hands out to graduates is issued by the Centre for Homeopathic Education, a British institution that works in partnership with the University of Middlesex. At around two thousand dollars, the courses cost roughly 18 months’ salary for the average Kenyan. The CHE have yet to respond to my request for comment, while Middlesex University told me that while they validate the CHE's BSc Homeopathy degree, they have no involvement in the Kenyan diploma or Abha Light's projects.
“This one little box represents 300 medicines.” Didi was showing me her field medical kit, more vials of pills packed into an A4 box folder. “In a kit like this, we could go out in a mobile clinic and treat many, many diseases at one time, which is why we promote it here.”
“What are the most common things you treat?” I asked.
She paused for a long time, as if deciding how much to tell me. “What are the most common diseases? Well, here in Africa, people come to us with a lot of infectious diseases… and, er, parasite diseases, like amoebic dysentery, rotavirus. Malaria. Typhoid.”
In the early days, Didi had limited her ambitions to a spot of homeopathic first aid, but the challenge of Africa’s biggest killers became an irresistible lure. That, combined with her near total denial of the idea that homeopathy might have limits, led to MalariX, a homeopathic treatment for malaria. It consisted of the same tiny pills as the rest – drop one in a bottle of water, bang the bottle ten times against your palm and you’re good to go.
Even leading homeopaths think this is crazy. It’s one thing to peddle quack remedies for little Xanthe’s sniffles in Islington, quite another to claim you can treat serious tropical diseases in Africa. Peter Fisher, director of the Royal London Homeopathic Hospital, was emphatic in telling the BBC: “There is absolutely no reason to think that homeopathy works to prevent malaria, and you won't find that in any textbook or journal of homeopathy.” According to Fisher, suggestions from homeopaths to the contrary could mean that “people will get malaria, people may even die of malaria”.
Every medicine needs its testing ground, and Abha Light found an ideal place to test MalariX. Joining forces with the ironically named Real Medicine Foundation, the medicine was dispensed in Kiryandongo, one of Uganda’s largest refugee settlements. Thousands of displaced people from Somalia, Southern Sudan, DR Congo and beyond had arrived at the site, only to be used as guinea pigs for a range of pseudo-remedies. According to the RMF’s video, even refugees with advanced cerebral malaria were treated with these sugar pills.
We arrived in Kiryandongo a week later, but found the MalariX project abandoned after an intervention by the Ugandan health minister, Dr Stephen Mallinga. Mallinga is a physician as well as a politician and had launched a major crackdown on the alternative medicine industry, shutting down bogus aid projects and driving reflexologists from the streets of Kampala. The refugee settlement’s "innovative" approach to healthcare had not escaped his attention. “We had 20 acupuncturists, too,” an RMF guide ruefully told me, “but we had to let them all go.”
The prospects for patients with typhoid and malaria who are given what is basically just "magic" water instead of real medicines would be grim in the West. In the slums of Nairobi, the consequences of Didi’s supreme belief in the mystical powers of homeopathy were beyond grim, yet her patients were so desperate, and so lacking in real medicine, they would try anything they could afford. “Africa is ripe for homeopathy,” she told Rachael Mutinda. On that last point at least, Didi was right.
Follow Martin on Twitter: @mjrobbins
More stories from Kenya: