In a small village in rural Bangladesh, Rahima, a middle-aged woman, clutches her aching chest with silent pain. She turns to an herbal healer, a “kabiraj,” hoping the leaves and roots will bring relief.
Like many, she believes in the power of traditional medicine -- remedies passed down through generations. Yet beneath the promise of healing lies a shadow: Unregulated herbal treatments that mask chronic diseases and delay real medical intervention, weaving a quiet tragedy across the nation.
Rahima’s story mirrors the lived realities of millions who, constrained by poverty or tradition, navigate a healthcare landscape marred by mistrust and misinformation. The reliance on unverified traditional medicines reflects deep social fractures -- a fragile healthcare system, economic disparity, and cultural beliefs intertwined in a complex web.
Traditional medicine holds a revered place in Bangladeshi society, celebrated for its cultural roots and accessibility. Yet the unregulated use of these herbal treatments is a double-edged sword.
The absence of strict oversight has allowed an unchecked proliferation of remedies lacking scientific validation. Patients frequently resort to herbal cures for ailments like hypertension, diabetes, or respiratory issues, often without medical consultation. This delay in seeking professional help leads to worsening conditions and, sometimes, irreversible damage. Such silent suffering becomes a formidable barrier to societal progress.
Emily Dickinson also captured the thin line between life and death, with physical health slipping away amid quiet, final moments in her poem named The Soul has Bandaged moments termed as Poem 512, where she dealt with mental health and psychological restraint and spoke of trauma, repression, and moments of emotional or psychological paralysis.
“The Soul has Bandaged moments--
When too appalled to stir--
She feels some ghastly Fright come up
And stop to look at her--”
When chronic diseases go untreated, productivity declines; families endure financial strain, and healthcare costs spiral, burdening a nation striving for development. The problem grows quietly, unnoticed in overcrowded clinics and whispered in village homes.
The emotional toll -- anxiety, loss of trust in formal healthcare, and preventable deaths -- adds layers to the crisis. Moreover, the dangerous interaction between unregulated herbal compounds and prescribed medicines often exacerbates patients’ health, creating complex clinical challenges. In essence, unregulated traditional medicine usage is not just a health issue but a social one, reflecting gaps in education, healthcare infrastructure, and governance.
If this silent epidemic remains unaddressed, its ripple effects will penetrate all layers of society. Rural workers, already vulnerable due to limited access to hospitals, may suffer permanent disability or premature death, trapping families in cycles of poverty. Urban professionals juggling demanding lives might lose precious years of productivity, further stalling national growth.
The healthcare will buckle under escalating complications from delayed treatments, pushing Bangladesh into a crisis of chronic illness management. Beyond individual health, the unregulated use of traditional medicine threatens public health integrity, risking the spread of misinformation and unsafe practices. The social fabric frays as faith in modern medicine diminishes, deepening divides between scientific knowledge and cultural traditions.
The consequence? A society held back by preventable suffering, struggling to realize its potential in a rapidly changing world.
The reliance on unregulated traditional medicine in Bangladesh is not just a cultural preference but a dire reflection of systemic failure, evidenced by alarming statistics and tragic incidents. As per the Bangladesh National Health Accounts (BNHA), a staggering 68.5% of total health expenditure is borne by citizens out-of-pocket (OOP), one of the highest rates globally, directly indicating the inaccessibility and cost barriers of formal care.
This forces an estimated 70% of the rural population to seek initial remedies from unqualified sources. Between 2019 and 2023, media reports and public health surveys consistently documented the devastating outcomes. From patients resorting to herbal cures for hypertension, leading to delayed diagnosis and preventable strokes to reliance on traditional healers for tuberculosis (TB) diagnosis, there is no shortage of examples.
The most tragic examples involve vulnerable groups: In 2022, a cluster of incidents showed children suffering from severe diarrhoea or pneumonia died after being given unregulated “holy water” or caustic herbal mixtures by local practitioners, instead of life-saving saline or antibiotics. Furthermore, the dark side of herbal remedies for diabetes and sexual dysfunction has resulted in increasing cases of acute kidney injury (AKI) and liver damage due to toxic compounds like heavy metals, which remain unchecked by the Directorate General of Drug Administration (DGDA).
These cases and data points underscore a persistent narrative: A fragile healthcare system and unregulated traditional practices create a deadly gap where poverty and misinformation thrive, turning curable ailments into terminal tragedies and represent the unbearable emotional and financial burden on millions of Bangladeshi families.
The staggering 68.5% OOP expenditure is a silent tax on the sick, driving families into poverty and fueling a deep-seated mistrust in modern, yet inaccessible, healthcare. To witness a child's preventable death or an adult’s kidney failure -- simply because they chose a cheap, traditional cure over an expensive, distant medical intervention -- is a profound failure for the nation.
This crisis demands an immediate, coordinated shift in policy and public engagement. Our primary directive must be the revolutionary expansion of a quality, affordable primary healthcare network (PHC), ensuring every citizen, regardless of location, can access evidence-based medicine and health education.
Simultaneously, the government must impose strict regulatory oversight on all traditional and herbal products, eliminating toxic compounds and false claims. The future of Bangladesh depends not on ignoring tradition, but on integrating proven, scientific knowledge with cultural practice, empowering citizens to make informed health choices.
Dr Tarnima Warda Andalib is working as an Assistant Professor in BRAC University, Dhaka as well as a Global Consultant Director at Oxford Impact group, UK. Dauwood Ibrahim Hassan, in addition to being a Research Assistant in the BBS Department of BRAC University, is also involved with UNDP Bangladesh.
