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Herbal medicine and health care

In Africa, the role of herbal medicine in primary health care cannot be underestimated and its knowledge has been passed on through generations in a complex way.

Traditionally, such important knowledge is passed on to the first-born sons or to other trustworthy persons in the community. In the process, the person inheriting the knowledge will normally take an oath not to reveal its secrets to anybody else. These instructions are normally given in the field, where the son is shown the plant used in herbal medicine. The person is given the vernacular name of the plant and told how to prepare the drug from the plant part for that specific disease. The sequence of passing on the knowledge is oral and tedious and requires the recipient to have a good memory.

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It is truly remarkable that African elders are knowledgeable in herbal medicine and are able to identify useful herbal medicines and pass the knowledge down to the next generation. For centuries, herbal medicine use has hinged on ‘ancient wisdom’ theory. The theory argues that if the herbal medicine has been used for generations, then it must be both effective and safe. More often herbal medicine is more effective when it comes to prevention, chronic diseases, and in addressing the mental, emotional, and spiritual needs of an individual in Africa.

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Current estimate indicates that over 80% of people in developing countries take herbal medicine not as an alternative, but rather as a basis of their healthcare.
The knowledge of herbal medicine used across the different tribes in Africa may vary in the plants they use, the way they prepare and use medicines obtained from these plants, and the philosophy of their approaches to treatment. Different cultures may also use the same plants but may differ in how it is used, or the part they use. The most common methods of preparation of herbal medicines in Africa include: boiling the plant parts and the resulting decoction used either internally or externally; secondly, plant parts can be pounded and then soaked in cold water or warm water, and the infusion used either internally or externally; thirdly, the plant parts can be burnt and the patient inhales the fumes from the burning herbal medicine. In some cases, leaves, roots or barks are frequently chewed as a quick treatment for snake bites, mouth diseases, or stomach problems. Some herbal medicine like vegetables and fruits are consumed as part of the daily diet.

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It is important to note that Africa is endowed with diverse herbal trees and shrubs. Among the unique trees used as herbal medicines are: Prunus africana, Warbugea ugandensis, Kigelia africana and Vitellaria paradoxa. These medicinal plants have wide medicinal uses in Africa.  Prunus africana is highly effective in treatment for benign prostatic hyperplasia and prostate gland hypertrophy among the many other diseases. Warbugea ugandensis is widely used by the local communities to cure several ailments such as stomach ache, constipation, toothache, candidiasis, among others. Kigelia africana is used to treat a wide range of skin ailments from fungal infections, boils, acne, psoriasis and many other diseases. Vitellaria paradoxa is a superb moisturizer and has amazing skin healing properties.
The reason for the increased demand for herbal medicine has been attributed to their  effectiveness in the management of a wide range of diseases common to Africa like malaria, respiratory tract infections (like cough, colds, tuberculosis), gastrointestinal diseases (like worms), HIV/AIDS and opportunistic infections associated with HIV/AIDS (e.g. tuberculosis). An other factor that escalated the use of herbal medicine in Africa is the limited accessibility to modern medicines and drugs, particularly among middle and low income countries.

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Most national health care facilities are few and far from peoples’ homes. Even the road network to health facilities is not in a good state. Also, there are more traditional health workers than conventional health works in African countries. For instance, in sub Saharan Africa, the World Health Organization (WHO) estimated that the ratio of traditional healers to the population is 1:500 compared to 1:40,000 for conventional doctors. The majority of these conventional medical doctors available in Africa tend to concentrate in urban areas and cities at the expense of rural areas. Therefore, for millions of people in rural areas, the only health care is provided for by traditional health practitioners that are easily accessible and provide an affordable source of health care. For example, malaria which is the largest killer in Africa is in most communities managed by herbal medicine, because it is considerably cheaper and may sometimes even be paid for in kind or according to the ‘wealth’ of the patient, compared to its treatment by using conventional medicines from a pharmacy which costs a person an average of US $3.0, an amount which is far too expensive for most African households who live below US$ 2.0 a day. The other factor that has led to wide use of herbal medicine is its acceptance by communities as part of their cultural heritage passed on from generation to generation.

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While herbal medicine makes an enormous health care contribution to health care in Africa, the sector faces a number of challenges that sometimes put its use into disrepute. The introduction of western culture in Africa made some people consider herbal medicine as primitive, particularly in urban areas. The conventional health care education curriculum has no component of herbal medicine, thus making its integration into the national health care delivery system challenging.  Herbal medicine sectors in most African countries are not fully regulated by government and as a result some people who are not real traditional health practitioners have infiltrated the sector for financial gains.
Nevertheless, there is increasing evidence that the use of herbal medicine in Africa is on the rise both in rural and urban areas despite the existence of health care facilities.

Komakech Richard & Omujal Francis
Natural Chemotherapeutics Research institute.
Kampala (Uganda)

 

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