By Dr. Mark D. Anthony
It is estimated that over 70% of West Africans rely on traditional medicine for treatment of both communicable and non-communicable diseases. There has been debate in recent years over the belief that traditional medicine should be given a more legitimate place within the structure of West African healthcare.
Traditional medicine offers many positive aspects to healthcare. Despite the criticism of some traditional methods, many techniques used, especially those involving the use of herbs and roots, have scientific support and proven clinical success. The problem with traditional medicine lies in the belief of many that it should be the primary source of medical care. This belief that traditional healers are the first and the last line of defense against an illness can lead to potential life threatening medical emergencies.
A study conducted in three ECOWAS [Economic community of West African states] nations found that 60 of children suffering from malaria related fever were first treated with herbal medicines. This can be a dangerous situation. Heavy reliance on traditional means can bring about damaging results when a life is in danger. This also holds true in regards to women’s healthcare. For instance, treatments for miscarriages are often performed by traditional healers when procedures of this nature should only be performed by properly trained medical personnel.
Despite the issues, there is room for traditional and modern methods to work together. Most ECOWAS nations are in the process of developing policies and regulations for traditional medical care. Instead of working against traditional methods, many healthcare systems are looking to work with traditional healers. Given the lack of access of many West Africans to quality hospitals, it is important to take advantage of the medical solutions already in place. Nigeria healthcare system today houses both traditional and western medical systems. This non-cordial relationship depicts traditional medicine as fetish, primitive and therefore not ‘modern.’ This accounts for its relegation to the background in favour of western medicine. This is consequent upon the labelling of traditional medicine as “non-rational” and therefore deprived of recognition and funding from government like its western counterpart. This contrasts with the situation in most South East Asian countries like China, South Korea and Taiwan where traditional medicine is already fully integrated into the healthcare system. In Nigeria, a dichotomy still exists between traditional and orthodox medical practices even though there are now moves towards policies of some tolerance and recognition Herbal medicine.
Traditional herbal medicines are naturally occurring; plant-derived substances with minimal or no industrial processing that have been used to treat illness within local or regional healing practices. Traditional herbal medicines are getting significant attention in global health debates. Traditional medicine (also known as indigenous or folk medicine) comprises knowledge systems that developed over generations within various societies before the era of modern medicine. The World Health Organization (WHO) defines traditional medicine as “the sum total of the knowledge, skills and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.”
In some Asian and African countries, up to 80% of the population relies on traditional medicine for their primary health care needs. When adopted outside of its traditional culture, traditional medicine is often called alternative medicine. Practices known as traditional medicines Ayurveda, Siddha medicine, Unani, ancient Iranian medicine, Iran, Islamic medicine, traditional Chinese medicine, traditional Korean medicine, acupuncture, Muti, Ifa, and traditional African medicine. Core disciplines which study traditional medicine include herbalism, ethno-botany, and medical anthropology.
The WHO notes however that “inappropriate use of traditional medicines or practices can have negative or dangerous effects” and that “further research is needed to ascertain the efficacy and safety” of several of the practices and medicinal plants used by traditional medicine used by traditional medicine systems. The line between alternative medicine and quackery is a contentious subject.
Traditional medicine may include formalized aspects of folk medicine, that is to say longstanding remedies passed on and practiced by lay people. Folk medicine consists of the healing practices and ideas of body physiology and health preservation known to some in a culture, transmitted informally as general knowledge, and practiced or applied by anyone in the culture having prior experience. Folk medicine may also be referred to as traditional medicine, alternative medicine, indigenous medicine, or natural medicine. These terms are often considered interchangeable, even though some authors may prefer one or the other because of certain overtones they may be willing to highlight. In fact, out of these terms perhaps only indigenous medicine and traditional medicine have the same meaning folk medicine, while the others should be understood rather in a modern or modernized context.
Similarly, a home remedy is a treatment to cure a disease or ailment that employs certain species, vegetables, or other common items. Home remedies may or may not have medicinal properties that treat or cure the disease or ailment in question, as they are typically passed along by layperson (which has been facilitated in recent years by the internet.
At the turn of the century, folk medicine was viewed as a practice used by poverty-stricken communities and quacks. However the rejection of synthetic or biomedical products has become a growing trend in Western society and allowed for a rise in the demand for natural medicines. When less developed countries are taken into account it is estimated that over 50% of the world’s population relies on folk medicine practices. The prevalence of folk medicine in certain areas of the world will vary based on cultural norms. Much of today’s modern medicine though is previously based on plants that had been long used in folk medicine. Some researchers point out a significant factor, however, that many of the alternative treatments that they test are “statistically indistinguishable from placebo treatments.”
Although over 100 countries have regulations on folk medicines there are still some risks associated with the use of them, especially when they are used without supervision. It is often assumed that because the medicines are herbal or natural, that they are completely safe, but one type of folk medicine commonly used with Ayurvedic medicine is Rasa Shastra which involves the use of dangerously toxic heavy metals in herbal remedies.
The various societies that make up the Nigerian State have for long relied on the indigenous health system which was developed as a response to their environment and it involves the use of locally available resources of prevent and cure diseases. It is a natural health care system which many generations of Nigerians have used. The practice transcends the maintenance of good health of the people as it also protects them from the menace of wild animals, evil spirits, accidents, provide bountiful harvest, good luck and other human activities. Nigerians therefore, have a deep belief and reliance on traditional medicine, hence about 80% of the population uses it almost exclusively while about 95% use it concurrently with western medicine. This is because, to the Nigerian, traditional medicine treats the entire individual rather than one aspect of him or just his disease. At the centre of this practice are health professionals variously called Babalawo (Yoruba), Dibia (Igbo), Boka (Hausa), and among whom different expertise in healing has emerged. These include herbalists, bone-setters, traditional birth attendants, and psychiatrists among several others. They usually rely on vegetables, mineral substances, animal parts and certain other methods such as prayers, divinations, and incantations.
They typical medicine-man devotes much time and personal attention to the patient and this enables him to penetrate deep into the psychological state of the patient. Traditional health practitioners symbolize the hopes of society, hopes of good health, protection and security from evil forces, prosperity and good fortune, and ritual cleansing when harm or impurities have been contracted. Traditional medicine has endeared itself to the people especially in the rural areas who lack access to western medical practice. Furthermore the prohibitive cost of western medications present another attraction for traditional medicine. Throughout Nigeria, traditional medicine is very popular because the practice takes full account of the socio-cultural background of the people. This is viewed against its western counterpart who engages its patients in a “distant’ and “disconnected’ way from the spiritual elements of the human body. Moreover the efficacy of western drugs has been questioned. The Voice of America recently reported that 60 per cent of drugs circulated in Africa are fake just as ‘orthodox medical practitioners look forward to only between 30 and 35 per cent success rate for the efficacy of their drugs.
However, in spite of the popularity of traditional medicine worldwide, it has been challenged on several grounds, one of which is that its popularity is based on the anecdotal experience of the patients. The practitioners inflate the claims attached to advertisement and its products as well as not having scientific basis about its effectiveness, there in making it difficult to ascertain legitimate and affective therapy and therapists. Other arguments against the practice of traditional medicine include:
That traditional medical practitioners lack the skills required for correct diagnosis of serious disorders;
That they are always unwilling to accept the limitations of their knowledge, skills and medicine particularly in complicated organic disorders;
That traditional medicine lack standard dosage and have not been subjected to scientific verifications;
That even though the educated are convinced that the healers have supernatural knowledge and that this knowledge is medically useful, they have found them to be unscrupulous and dubious; and
That healer’s lack equipment required to conduct physical examinations.
Regulatory agencies have also noted their frustration in regulating traditional medicine due to ‘lack of documentation, inadequate coordination of the practitioners’ activities, poor communication between the practitioners and their patients, secrecy of actual contents and/or difficulty in determining actual ingredients.’
To be continued…