Traditional Health Systems in African Societies; The Link with Modern Medicine

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Hello Hivers!
In today's article, I'll explore Ancient Traditional Health Systems in Africa and their relationship with Modern Medicine. Some of these traditional health practices are still done in present day especially in rural parts of Africa. Let's go.


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Image created by @gamsam. Photo template source: Unsplash, Photographer: Pasha Chusovitin


What Causes Diseases?

The sick often would notice an abnormality in his body to believe that he is sick. He seeks for treatment when he is convinced that the sickness is severe enough to warrant treatment. The form of treatment sought is often determined by the cause to which the illness is attributed. A Community Physician would be more effective in helping the sick, if he knows what people in his community of practice believe could cause diseases.

The question of what causes disease, and why people fall sick have troubled man since time immemorial. The quest to find answers have led to various health systems and partly, the different religions.

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The Traditional African View of Disease

Most African traditional societies believe in one Supreme Being, the creator of all things, who had to take his residence to the sky because of the pestering of the human folk. It is believed that before God went to reside in heaven, He handed the affairs of men to the deities and the ancestors who kept him constantly informed about all that happen on earth. The deities and the ancestors handle the day-to-day administration of the affairs of man, according to the dictates of the customs and traditions, but God remained the final arbiter.

Though, the WHO defined health as a state of complete physical, social and mental well-being and not merely the absence of disease or infirmity, one is said to be healthy in most African society when his spiritual, physical, mental, social and moral well-being are properly blended, permitting him to carryout his day to day activities according to the customs and traditions of his community.

The moral and spiritual aspects of life are stressed, because each individual must lead his life in such a way that the deities and ancestors are pleased, as failure to do so might spell doom for not only the individual, but also to his family and all that he cherishes.

In African societies, disease can be:

  • supernatural,
  • natural or;
  • natural with supernatural undertone.

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Supernatural Diseases

Supernatural diseases could result:

  • If taboos are violated
  • If the ancestors are treated with disrespect
  • Injustice to follow human
  • When sorcerers and witches are hired or acted on personal reasons
  • In loss of the soul; or
  • In spirit possession or the intrusion of an object into the body.
The supernatural causes are very real to those that believe in African traditional religion; but nonbelievers might see no way they can cause diseases attributed to them.

Supernatural factors cause disease to those that believe by creating anxiety and serious feeling of guilt. Sustained anxiety can kill within hours through the over-stimulation of the Autonomic Nervous system. Slower deaths result through the over-stimulation of the hypothalamus. Under sustained anxiety, the hypothalamus is capable of releasing large quantities of corticosteriods that can cause immune depression, cancers and at times, autoimmune diseases such as the swell disease (Nephrotic Syndrome). It is therefore, not without reason that our ancestors bury these patients in the evil forest, perhaps to tell the deities that they have recognized the deities’ handiwork, and asking for leniency for those left behind.

When a patient believes that he is under attack from the supernatural, the most cost effective place to refer him to is to a native doctor or to a church or Malam depending on his religion.

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Natural Diseases

Diseases believed to be due to natural causes are often attributed to:

  • “Worms”
  • Poisoning
  • Loss of body equilibrium
  • Hereditary
  • Poor feeding
  • Dirty environment
These diseases are often those with obvious causes, and those whose cures are not only common, but also amenable to widely known remedies.

Those attributed to worms often have the semblance of migration as in rheumatism, and colicky abdominal pains.


Poisoning

PoisonBy Unknown author - EPS file skull.eps from UNECE web site converted with ImageMagick convert and with potrace, edited in inkscape, Public Domain, Link
PoisonSource: Pexels, Photographer: Davide Baraldi

Poisoning was a common cause of ill health in most African society in years past. Writing about life in African society in the 18th century, ***Oladuah Equiano*** - a liberated African slave narrated how poisoning was so rampant then that any edible purchases made at the market had to be kissed round by the seller to assure the buyer that it wasn’t poisoned.

Poisons were delivered through various ingenious methods.

  • Some were sprinkled upon thorns such that the poison is injected into the body once the thorns are stepped up on;
  • some are smeared on edible things; while
  • others are so concentrated that one just need to step on them for their action to begin.

Most of the legendary actions attributed to charms were actually crafty poisoning episodes disguised to make them look supernatural. The recent unmasking of the activities at the Okija shrine follows a long list of treacherous expert poisoners that include the long juju of Arochukwu.

Writing in 1941, Harvey George Way - a medical anthropologist wrote:

The use of magical medicines and fetishes in secret societies has been shown to work in one of three different ways: through direct violence perpetrated by members but blamed on animals, through poison, and through fear of some known spell with which the victims were threatened. Without the support of an organization, black magic depends either on poison, or fear of the supposed power of a fetish, sometimes on both


Loss of basic body equilibrium

Some popular but wrong beliefs associated with loss of basic body equilibrium included:
  1. A person exposed to the harmattan cold would have excess cold in the body, and would therefore develop “pneumonia”

  2. Prolonged work under the intense tropical sun is believed to cause “malaria”.

  3. Haemorrhage is considered a most life threatening condition because blood is regarded as the fluid of life. Lack of blood is believed to make one a walking corpse, hence any medicine or food believed to be a haematinic is taken often in overdose for the accruing abundant life. Donation of blood is considered a particularly frightening experience, akin to losing days out of one’s life span.

  4. Impurities can disrupt the basic equilibrium of the body. These impurities are believed can be washed off the body followed by the recovery of the patient.


    This explains the widespread use of:
    • emetics,
    • purgatives,
    • diuretics and;
    • special baths.
      Special baths involving steam inhalation have particularly been found to be effective in the treatment of common cold and other respiratory ailments.

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Natural disease with supernatural undertone

This was used to explain certain atypical situations. For example:
  • Why are some malaria mild, and others severe?
  • Why did mama Tonye die in childbirth when women give birth in the community almost everyday?

The concept of natural disease with supernatural undertone is being actively supported by the activities of the traditional medicine practitioners. For example, in the pneumonia patient with the characteristic sharp pain on deep breathing, the traditional medical practitioner might massage out bundles of needles said to be causing the pains, thereby selling the idea that the needles must have gotten there by supernatural action.

Atypical illness have been shown in modern medicine to be due to a variety of reasons including the different genetic composition of people that make for varied reactions to infections and infestations, nutritional deficiency, psychological trauma, and reactions to physical and chemical agents.

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Disease Prevention in Traditional African Societies

By Marco Schmidt [1] - Own work, CC BY-SA 3.0, Link


The positive acts and the avoidance that constitute preventive medicine in traditional African society are only different from those of scientific medicine, because of the difference in the concept of disease. When the concept of disease in traditional African societies is considered, it would be found that the various protective and preventive measures are rational and effective.

For the prevention of disease of supernatural origin, all taboos were kept, and customs and traditions obeyed. The oracles, which were the direct link with the sensate agents, were regularly consulted and their recommendations implemented.

Parents were well taken care of while they are alive, for they have a potent curse when angered, which might ruin the child’s health and aspirations. When they die, all mourning rites and annual remembrances are meticulously observed to give them a high status in the comity of ancestors, enough to favorably influence the stay of their living children on earth.

To repel bad spirits, charms are kept on doorpost and the native doctor is called regularly to drive away those that might have gotten in through the windows or cervices, very much in the same way as disinfectants are used in modern medicine.

Because of what the enemy could do, good neighborliness is encouraged, and children are advised not to scorn the toothless old woman who could retaliate by sucking the child’s blood at night.

When good neighborliness cannot be guaranteed, a resort is made to protective charms, amulets, medicated rings, waist leather bands, special necklaces, inoculations and even special protective deity.

These are generally believed to be very effective, though their mechanism of action might be difficult to explain by even the traditional medical practitioners. However, it seems that those that involve inoculations work in the same way vaccines work in modern medicine - boosting the body’s immunity against poisons.

Apart from the protective devices; dreams, body signs and incantations are also believed to be useful tools in preventing misfortunes and disease.

Dreams are either taken literally or considered symbols conveying future happenings, or the opinions of the sensate agents. Appropriate actions are usually taken to for stale those indicative of future calamity.

Body signs such as rhythmic contraction of the lower eyelid are considered to be indicative of shedding of tears, whereas comet often heralds the birth or death of an important person.

For the prevention of natural diseases, some foods and drinks were avoided. This could be the family’s way of avoiding food idiosyncrasies.


Traditional Medical Practitioners

Traditional medical practitioners are of four kinds namely;

  1. The herbalist
  2. The witch-doctor
  3. The diviner (diagnostician)
  4. The specialized practitioners.

These four types flow easily one into the other, and are sometimes combined in the same individual.


The Herbalist

A herb shop in the souk of Marrakesh, Morocco. By gildemax - Own work, CC BY-SA 2.5, Link
Leaves of Eucalyptus olida being packed into a steam distillation unit to gather its essential oil. By Zaareo - Own work, CC BY-SA 3.0, Link

An example of a herbal medicine resource: the bark of the cinchona tree contains quinine, which today is a widely prescribed treatment for malaria. The unpurified bark is still used by some who can not afford to purchase more expensive antimalarial drugs. By H. Zell - Own work, CC BY-SA 3.0, Link
A platter of herbal medicines at Goa, India. By Joegoauk Goa - https://www.flickr.com/photos/joegoauk73/35587680106/, CC BY-SA 2.0, Link

They work with herbs especially those herbs that are not known to the general public, that require greater expertise to find and collect. The knowledge is often transmitted from a male herbalist to his son and from a female herbalist to her daughter.

Some acquire their trade by serving years of apprenticeship, paying their teachers in service during the whole time, as well as paying fees for each step as they advance.

Sometimes capabilities are improved by buying other remedies from other practitioners.

The herbalists treat their herbs as though they have a personality of their own. The herbs cannot be used without a payment of a fee. Failure to do so would render the medicine inert.

Though, it was thought to be pure encumberment when the herbalist collects his herbs with certain rituals, now it has been revealed that some of these practices were necessary for the maximum efficacy of the herbs. For example, optimum yield of active ingredients is obtained:

  • When leaves are collected just as they begin to open,
  • Flowers just before they are fully expanded and
  • Underground plant parts like roots and rhizomes, as their aerial parts begin to wither and die.

Herbalists were, and are still very useful in the treatment of diseases of natural causes. But the modern herbalist who make so much noise in the mass media in most African climes are to be avoided because they are just fraudsters out to fleece the poor and dying of their money. In a bid to add modernity to their practice, they have formulated their herbs into capsules and tablets, which they claim can cure very divergent illnesses.

They hide under the anonymity offered by the urban centers to commit their crimes, unlike the older herbalists who practice in their own communities, known to all their patients up to their fore fathers.


The Witch-doctor

Two Lassa witch doctors. By Photo Credit:Content Providers(s): CDC - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #1322. Public Domain, Link
Shona traditional healer, or n'anga (Zimbabwe). By © Hans Hillewaert, CC BY-SA 3.0, Link

This traditional medical practitioner can be described as the traditional medicine equivalent of the Psychiatric Doctor. They are so called because they are mainly involved in rituals connected with the finding of a witch or exorcising an evil spirit.

They require credibility for the success of their therapy, so they often weave very fantastic stories of their calling to the profession. Some might say they were taken into the deepest recesses of the river while taking their bath or fishing, and taught the practice by the water spirits.

The modern age witch-doctors would often say they learnt their trade in India since Indian traditional medicine is highly respected in most rural communities in Nigeria.

The medical fees collected by these witch doctors are often very large, although they are usually adjusted to the patients’ ability to pay. There is an initial fee to call him/her, and additional fees for each important step in treatment, especially when it becomes necessary to dip into the secrets of the spirit world. There are also little presents occasionally demanded by the witch doctor himself just to keep him in a good humor and sustain his interest in the case.
Finally, if the patient recovers, a large fee must be paid, which is sometimes in the nature of a thanks offering to the witch doctor and his spirit helper.

Treatment is not a matter that rest between the witch doctor and his patient. He must treat the whole family, if not the entire community to be allowed to continue with his work. If things do not go right, a member of the family or almost anyone else will suggest a change of doctor or some other modification in the procedure. Consequently, the witch doctor must be a good psychologist, a good actor, and a leader in the community, where his integrity and power are beyond question. This is where the stories of their calling to the profession come in handy.

The success of the witch-doctor in the treatment of diseases considered to be of supernatural causes is not in doubt. However, they lack the power to harm or even cause the least misfortune to befall a person that doesn’t believe in their activities.


The Diviner (Diagnostician)

A Kapsiki crab sorcerer of Rhumsiki, Extreme North Province, Cameroon. By Amcaja - Own work with Kodak CX6200 digital camera, CC BY-SA 3.0, Link
The main duty of this group of practitioners is diagnosing the cause of the ailment. In finding the cause of the patient’s problem, the diviner unlike the modern doctor does not require any history of the illness from the patient, but uses a variety of divination methods to arrive at the diagnosis.

The use of a divination method removes the blame from the diviner, and ensures that he/she is not held responsible for any error.

As masters of their acts, the results of the work of diviners often appear very wonderful to even the doubting Thomas’s, but considering the amount of faith reposed in them by the generality of the people, many things were accepted without questions.


Many instances of collusion and artful dealings have been discovered, but shrewdness and sagacity, a wide knowledge of men and things must be place in their credit

wrote Dr Obadiah Johnson - one of Nigerian’s earliest Doctors in 1889.


The Specialized Practitioners

These include:

  • Traditional Birth Attendants,
  • Bone setters,
  • Phlebotomists,
  • Massage-rs,
  • Circumcise-rs and
  • others that specialize in the treatment of one medical condition or the other.
They are often occasional practitioners who are usually of other trades, but render therapeutic aid to relatives, friends and to others on payment of the prescribed fees.

The secrets required for these types of practice, were either handed down as heirloom or bought at exorbitant price from specialist in that field.

As masters of their trade, the specialist practitioners could be likened to the present day medical specialists. They act on the result of experiments, but the link between science and superstition is very soon crossed, and the medical art passed with the greatest ease into the domain of magic, all the more so as the difference between science and magic is not perceived.


Traditional birth attendant
A Traditional birth attendant (TBA), according to WHO is “a person who assists a mother during childbirth and who initially acquired her skills by delivering babies herself or through apprenticeship to other traditional birth attendants.”

They can be a stopgap practitioner where a modern trained person is not available to deliver the service. When they practice, they should be trained to recognize the dangerous signs of pregnancy and labour for prompt referral of patients to where help would be found.

They should also be advised to adopt clean delivery practices, which include clean hands, clean perineum and clean delivery surfaces, and encouraged to break their alliance with harmful traditional practices.


The bone setters
They are still cherished because their fees are very affordable and their therapy seen as effective by many people. However, most bone setters know that bones heal despite the degree of angulation, but only the very best amongst them try to master the art of orthopedics.

Simple fractures they can handle, but their attempts at treating compound fractures had always ended in poor and delayed healing, infection and serious deformation.
Compound fractures are far beyond the capability of even the best bone setter.


Massage-rs
They are common amongst the *Ijaws* and other ethnic groups where certain diseases are believed to be due to the mal-alignment of certain internal organs.

They might play the role of physiotherapists especially in rural communities, except that their practices are often drastic. Patients are treated more like a batch of dough such that rupture of internal organs might follow exuberant massaging.

Moderation might be what is needed if the massage-rs are to be incorporated into modern medical practice.


Phlebotomists and Circumcisers
They have no role to play in the current dispensation, and therefore should be encouraged to lay down their equipment and move on to other trades. This is particularly important because of their unholy connection with various harmful traditional practices including bloodletting, blood oath and female circumcision.

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Conclusion

African traditional herbal medicine may have a bright future which can be achieved through collaboration, partnership, and transparency in practice, especially with conventional health practitioners.

Research into traditional medicine will scale up local production of scientifically evaluated traditional medicines and improve access to medications for the rural population.

The scope of herbal medicines in Africa in the near future is very wide, but the issue of standardization is still very important.


Do you have any questions or concerns? Tell me what you think below.

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Resources




Written by @gamsam - a Medical Student
All images used are copyright free
Vancouver Style was used for References.





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5 comments
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Really appreciating this wonderfully informative post, traditional medicine is so important and it is the premises on which modern medicine was built upon. It is so important to maintain these practices and I hope that they continue to be used by all. Thank you for sharing this with us all, what a rich history of healing this wonderful planet has xxxx

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