Bridging Africa’s Healthcare Gaps with Ethnomedicine

A photo of mother and child from the
indigenous Himba Community in Namibia

Photo:William Matews 2011 

African ways of life are highly characterized by communities’ relationship with nature. Their mostly agricultural economies are also dependent on their natural environment for primary health care, in the form of Ethnomedicine.

Although healthcare is modernizing on a global scale, a significant number of African economies have limited resources to carry out decentralized responsibilities such as revenue collection, leading to limited funds for delivery of social services such as healthcare, particularly in rural areas.  Lack of resources also results in poor enforcement of health standards and codes, leading to limited compliance.

Statistics show that approximately 60-80% of people in Africa still rely on traditional remedies for primary health care, to treat themselves for various conditions. This is because of limited access to modern health care facilities due to distance and high costs.

As a Development Studies student at Makerere University, I researched how indigenous knowledge has contributed to socio-economic development in Uganda, and wrote a paper on a case study in Masaka District. I interviewed traditional herbalists who use indigenous medicine to treat people, as well as farm owners, who use it to treat animals, and also use indigenous knowledge to control pests using animal urine, among other things.
My maternal grandmother, with a herbal tea spice "omujaaja",
aka "African Basil," that helps with flatulence and constipation
"Omujaaja" Plant
Photo: Africa2U
Of course, we know that medicinal plants date back to the Stone Age, making them the oldest form of primary health care, and various ancient cultures discovered medicinal plant usage through a process we could now call “botanical research.”

It is important to note that 30%-40% of allopathic drugs used to treat or suppress symptoms are derived from plant-based compounds, and many are synthetic analogues built on prototype compounds similar to those from plant species.  Also, 11% of the World Health Organization’s essential medicines, 340 or more drugs considered as basic and essential to "satisfy the priority health care needs of the population," originate from flowering plants.

Unfortunately, indigenous remedies have been inconsistently documented, and this knowledge is transferred orally, thus creating a large possibility of error. Due to the nature of medicinal plants and herbal medicine, doses vary depending on the person administering them, and are usually given until symptoms disappear. However, that does not make a treatment itself ineffective unless it is wrongly administered, just as with any modern medicine.

Indeed, indigenous medicines contain more medicine and less packaging.  Wikipedia reports that only 5 to 10 percent of a tablet or pill is the active substance, with another 10 percent being compounds for easy digestion and 80 percent being inactive fillers, binders, et cetera.  So 90% of a pill is not even medicine, but packaging.

This takes me back to the primary health care practices of communities in Africa. 

Regardless of modern challenges of cost and access, one cannot ignore that African communities had specialists in various medical procedures and health care in general.  The question is, why have Africans lost these specialized indigenous skills?

One might argue the promotion of formal education and employment has drawn young people to urban areas, where they are less likely to perpetuate indigenous practices. Another factor is that many poor people are losing their land to commercial investors or government.  

These factors disrupt the socio-economic and political stability of African communities, and threaten the livelihood of practitioners in indigenous medicine.

In addition, human activity threatens the habitat of medicinal plants.  To produce indigenous medicine and offer treatment to the large populations that need it but cannot access or afford modern medicine, we must maintain ecosystems to sustain renewable natural resources for herbal medicine.

At a regional level, I know the African Union’s NEPAD Declaration is closely linked to the attainment of the Millennium Development Goals (MDGs), including human rights, combating HIV/AIDS, malaria and other diseases.  

It should be reiterated, though, that these Health-related goals are only feasible when attention is given to key socio-economic indicators such as improving health outcomes and sustainable management of the environment. And these are not tenable without affected communities meaningfully participating in decision-making at all levels.

The state of healthcare and health financing in many African countries is lacking. Healthcare budgets are often donor-funded, which makes them unreliable for creating and sustaining affordable modern healthcare systems.  There are also very long periods between censuses and other demographic or health surveys, which impacts the timeliness of information that could be used to improve healthcare.

Finally, in addition to high domestic birth rates and growing populations, some African Union member countries in sub-Saharan Africa have fulfilled their international obligations and taken in refugees from areas of conflict, who have few resources and require care from health care systems that are already spread thin.  

So, what should African countries do to bridge the health care gaps? This takes me back to our theme, “Preserving Ethnomedicine.” I recognize that there are challenges that come with the undocumented herbal medicines used in the past, but African leaders can and should place emphasis on anthropological and agro-research in the health sector, and include the indigenous communities who are already heavily relying on this type of health care.  This could help serve more people in a timely and cost-effective manner.

I will leave you with a thought exercise, to try to get a feel for the scope of accessibility and affordability of modern health care in sub-Saharan Africa.

1. Think of the average income of an individual in a rural African community.
2. How many people are in their household?
3. How many of these people are employed?
4. What is the number of children in this average household? 
5. What is the approximate household income?
6. How many suffer from at least one condition requiring medicine in a month?
7. How much does it cost for a single treatment with an essential drug?
8. What are the percentage odds this household can afford modern medicine?
9. How many will die without access to modern health care?
10. How will that affect the productivity of the community?
11. How will this affect the general human development index of the country?
12. How does this affect the future of the country?
13. After healthcare, what percentage of income is left for other necessities?
14. Can you propose points for health care intervention in this scenario, to avoid the loss of life?

This presents us with the reality of the state of health care in Africa, and why it is necessary to bridge the health care gap by recognizing existing indigenous ethnomedicine and promoting its incorporation into healthcare.

Watch the Episode:

Vernonia Amygdalina
Photo: Dailymotion. com

Local  East and West African names 
Source: www.doktorsea. com

“mululuza”  –  Luganda (Uganda)
 “ewuro”  – Yoruba (Nigeria)
“onugbu” – Igbo (Nigeria)
 “shiwaka”  or  Chusar-doki – Hausa (across central and west Africa)bitter leaf 2
“ndole” –  Douala (Cameroon)
“figatil” or “necroton”  – Brazil
“grawa” – Amharic (Ethiopia)
“etidot” –  Ibibios (Nigeria)
“ityuna” –  Tiv  (Cameroon and Nigeria)
“oriwo” –  Edo (Nigeria)
“labwori”  – Acholi (North Uganda and South Sudan)
“olusia”  – Luo (Kenya and Tanzania)

The herb/plant is popular in these African communities. It has, historically been used to treat fevers related to Malaria, and as an anti-inflammation home remedy, among other things.

Vivian Birchall

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