BOSTON

The world of relationships is seeing a new medical marriage — one between traditional healers (once called shamans and witch doctors) and those from university hospitals. For example, physicians treating epilepsy, an illness affecting 50 million people worldwide, are partnering with village healers to bring treatments to patients in developing countries. The new alliance is emerging as doctors grapple with huge unmet medical needs and search for culturally sensitive solutions.

Last month, at the American Epilepsy Society’s 63rd annual meeting, Steven C. Schachter, M.D., a Harvard neurologist and AES’s president last year, brought together leading physicians for the President’s Symposium, “It Takes A Village,” to talk about strategies for eliminating the treatment gap. It was emphasized by John P. Howe III, M.D., who heads Project HOPE (Health Opportunities for People Everywhere), that gaps in care still include tuberculosis, HIV/AIDS, and diabetes as well as epilepsy. His group operates SS Hope, a hospital ship that provides humanitarian assistance during crises, in addition to fighting disease and disorders.

With epilepsy, more than half of the people affected develop the condition in childhood. And astonishingly, two-thirds receive no medical treatment. A neurological disorder characterized by unprovoked seizures, epilepsy affects 3 million people in the United States, of whom about 80 percent achieve some relief with effective treatment. Nonetheless, in industrialized countries, despite treatment, epilepsy can interfere with education, driving, recreation, parenting, pregnancy and work. In some developing countries, where the disorder is misunderstood, it is grounds for a man to divorce his wife or the rationale for depriving a child of food.

Dr. Schachter pointed out that epilepsy is “misunderstood, feared, hidden and stigmatized” in developing countries. “While these are but some of the underlying causes of the treatment gap, they can be addressed; for example, by education to reduce stigma, utilization of sustainable health care, collaboration with village leaders and sensitivity to cultural beliefs,” he said. “Given the relative rarity of physicians in developing countries, people turn to village healers, who frequently recommend botanicals.”

He added, “Botanicals are often culturally acceptable; however, to become a viable therapy, botanicals must be shown to be safe and effective. Also, they should be locally available, sustainable, low-cost and better tolerated than drugs more typically available in developing countries, such as phenobarbital.”

Dr. Schachter is currently working with huperzine, a Chinese club moss sold as a dietary supplement and sometimes used to enhance memory. Huperzine A is among the most potent compounds ever tested in laboratory models of epilepsy. His work has been funded by the Epilepsy Research Foundation, and he hopes that testing for its effectiveness will soon begin.

Dr. Schachter has a long interest in less traditional therapies, and edited “Complementary and Alternative Therapies for Epilepsy” with doctors Orrin Devinsky and Steven Pacia, and is also the editor of “Epilepsy in Our World: Stories of Living with Seizures from Around the World.” He serves on the task force for the Global Campaign Against Epilepsy, which is a joint undertaking of the World Health Organization, the International League Against Epilepsy and the International Bureau for Epilepsy.

“Our nation’s health is strongly connected to global health,” says Dr. Schachter. “We need more sensitivity with cross-cultural issues, particularly today as an increasing number of patients in the U.S. come from developing countries.” Similarly, notes Gretchen Birbeck, M.D., Ph.D., “What is happening in Zambia can be translated to many places in the U.S.” Dr. Birbeck is director of the International Neurological and Psychiatric Epidemiology Program at Michigan State University.

According to Citizens United for Research in Epilepsy (CURE), founded by Susan Axelrod and her husband, David Axelrod, special adviser to President Obama, of the major neurological conditions, Alzheimer’s, Parkinson’s and autism, epilepsy receives less total funding per patient. And yet, with epilepsy, research is vital to seeking a cure.

Now a new model might be on the horizon. Translational research is the process of bringing discoveries made in the laboratory to clinical treatments for patients — a “bench-to-bedside” process that involves connecting basic scientists to physicians. If Dr. Schachter and his colleagues are right, solving the treatment gap could involve a new approach via “tradition-to-bench-to-bedside.” By connecting basic scientists and physicians with their new partners — traditional healers — help for people with epilepsy around the world may become a reality.

Rita Watson, a monthly contributor, is an associate fellow at Yale’s Ezra Stiles College, and the executive editor of www.GreenLegals.com.