Traditional medicine in a modern world

“Black magic” and witchcraft?
They are ubiquitous to almost every bustling urban African city, little signs advertising the services of a powerful herbalist, healer, native doctor or astrologist. Sometimes these signs are hand painted, other times they are printed from a computer, yet all claim to verify the power of alternative medicine. The initial reaction of most middle and upperclass Africans is to denounce these signs and anything associated with them as backward or superstitious. A herbalist might be able to cure a headache, but can a healer really cure money woes? Nollywood movies, too, tend to portray traditional herbalists in a negative light; there are always babas and dibias using black magic to help people with spells and charms that always backfire but can be controlled with a vigorous bout of Christian prayer. Granted one should be suspicious of anyone who claims to guarantee wealth coming your way after performing certain rituals but there is more to traditional medicine than superstition.

A signboard showing services of a traditional healer in Malindi town. Wherever you are in almost any African city today, you’re never far from a signboard like this one. Photo: Robert Nyagah

The Yoruba example
Traditional medicine has always been linked to spirituality. Among the Yoruba, for example, traditional philosophy views illness and disease as something connected to spirits, witches, wizards or ancestors, and these spirits are present in every animate and inanimate object or being. Furthermore, the wind, stars, sun and moon are also capable of affecting ones health.

Medicines prepared by the traditional Yoruba herbalists involve the use of roots and herbs, along with the odd incantation and ritual. In the bygone era, many herbalists were also hunters. They believed that coming in contact with the spirit of the forest made them well versed in diverse flora and fauna, and indeed they were wells of knowledge of plants and trees. So in addition to their knowledge of spirits and deities, occult arts, charms and incantations, rituals and sacrifices, they knew a lot about the healing properties of plants.

Clearly this way of thinking is very different from what we know today from Western medicine. Yet, from what we know, these medicines worked for our ancestors (which shouldn’t be altogether surprising since many modern remedies are based on plant extracts) and are still used today. In Yoruba traditional medicine today you will find specialists in bone setting, paediatric care, general medicine, stroke, hypertension and more. Healing is done using herbs like bitter leaves and basil, as well as trees and plants such as the cinchona tree (it’s got quinine in its bark), the neem tree, and of course the miraculous aloe vera plant.

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Honey is also used in combination with different herbs. An example of a herbal remedy would be a mix of bitter leaf and basil to reduce high blood pressure. A prescription for diarrhea may be made from a sieved concoction of guava leaves to be taken four times daily, while Dutchman’s pipe, bitter kola seeds and peeled off grains of paradise are dried and ground together and taken with pap in order to ease abdominal pain. Yoruba traditional medicine also places importance on the use of water, either taken plain or mixed with herbs and tree barks.

The spiritual aspect comes in the form of incantations, usually spoken over the medicine before it is given to the sick person. Rituals and sacrifices are done to appease the supernatural entity that caused the sickness, while amulets such as engraved silver rings may also be administered for protection against these spirits. Some amulets are ground herbs to be eaten, but they can also be rubbed on the body as lotion or used to bathe as soap.

A traditional healer stand in Accra, Ghana

Traditional healing in a modern world
All this will sound strange to anyone who grew up with a familiarity of injections, tablets and pills only. Nonetheless to dismiss traditional medicine or this pre-colonial, indigenous African philosophy as mere superstition would be presumptuous.

Our ancestors were not stupid, and while it’s impossible now to know what percentage of their “patients” recovered from their illnesses due to the placebo effect and what as a result of the administered herbs, the herbalists would not have been in business for long if their remedies had been completely ineffective. Yoruba herbalists interviewed by Olugbenga Olagunju insist that in pre-colonial days, people lived long and healthy lives due to this knowledge of herbs and magic. Meanwhile in places like Uganda and Rwanda, colonial European explorers wrote of witnessing local “medicine men” performing caesarean sections with banana wine used as an intoxicant and a cleanser, and the wound sutured with needles and a paste made from roots.

It seems to me that somewhere along the line, the line separating the healing part from the spiritual part became blurred, as did the difference between herbalists and those who seem to offer only bad luck to your enemies and good fortune to you and believe none of this is possible without an incisor from an endangered species. As read above, traditional medicine in its purest form is concerned with disease and healing. While the herbalists and their clients might believe sickness is caused by spirits, herbal remedies were/are still administered to do the actual curing.

Just pray and God will take care of everything

Today, there are Nigerians who eschew any form of medicine while believing prayer is all they need to be rid of their illness. And these days many traditional herbalists claim to bring about wealth and riches, love and success as though the lack of any of these things is itself a genuine disease. This corruption of the practice of traditional medicine probably began following the PR damage done to the profession by colonialism (colonial “rulers” basically outlawed traditional healers/herbalists, and in the process started a process of prejudice that still exists today among the middle and upper classes), and was exacerbated by the fact that we now live in a capitalist world where money rules everything and everyone is looking to enrich themselves by whatever means. Thus it is no surprise to read of a so-called traditional herbalist defrauding desperate jobseekers of N510,000 ($3114).

Popular still, but risky business
Nonetheless, traditional medicine remains popular, especially among Africans who live in regions that are far removed from pharmacies and hospitals (although claims about the majority using traditional medicine should be taken with a pinch of salt). Herbs are seen as a healthier alternative to more expensive Western drugs. There is also the belief that Western trained doctors cannot detect certain sicknesses. For some Africans, traditional herbs are the only form of medicine they know from birth to death.

Hedranthera barteri (used to make abgo)

Speaking with some of my extended family members who routinely consume traditional herbal mixtures we call agbo, the general consensus is that herbal medicine can cleanse the system and that it really works. I remember my mother giving me agbo as a child, I threw up immediately. Talking to her about it recently, she told me that some parents believe giving their children agbo is necessary because of all the sweets and chocolates kids typically consume. She also confided that a family friend had given her agbo for her backache and that the herbal mixture did relieve her from that pain. But Western-trained doctors and healthcare providers tend to dismiss indigenous African forms of medicine due to lack of clinical evidence, and there have been warnings against drinking herbal mixtures due to the preponderance of fake ones. People have died from drinking fake herbal drinks.

Agbo without the liquid. And without a Nigerian food and drug agency label.

The need for regulation
We don’t need to throw the baby out with the bathwater. Clearly, with countless quack healers handing out fake herbal remedies that can blind or kill – and generating prejudice against all traditional herbalists in the process – the industry is in desperate need of regulation. But traditional medicine itself shouldn’t be discouraged. Health ministries across the continent should cooperate with the more trustworthy traditional healers to research traditional remedies to establish clinical-based evidence for their efficacy.  Some of this is being done already: there’s a journal of traditional, complementary and alternative medicines for anyone interested in keeping abreast of latest developments and a Medicinal Plants in Nigeria research project being run by Professor Tolu Odugbemi (check his plant gallery), but the bulk of the research into the efficacy and healing properties of plants and traditional remedies is being conducted by western researchers. This is hope though. I once caught a documentary about a student from Benin studying traditional medicine at a university in Japan, and I know there are other students from other African countries specialising in the same subjects at universities in China. So perhaps it’s only a matter of time.

In the meantime though, while drink and drugs in Nigeria must carry a registration number from the Nigerian food and drug agency (NAFDAC) on their label, I am yet to see a NAFDAC registration number on the bottles of agbo consumed by members of my family. The only African country I know of that has moved to regularise traditional medicine is Kenya where the Kilifi County Assembly is set to introduce a motion that, if passed, will see traditional healers vetted and issued with licenses. This is a step in the right direction – vetting traditional healers should reduce the number of quack doctors and the cheats, and removing the criminal element should help people of the popular image of traditional healers as evil witchdoctors.

The utilisation of traditional medicine across the world, according to Zak Show