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M.D. or Herbal Remedy?
The Effectiveness of Traditional Medicine in Africa
September 24, 2007
A traditional healer treating a patient in Uganda.
Throughout history, Sub-Saharan Africa has been plagued by various illnesses, including malaria, cancer, skin diseases, and most notably HIV/AIDS. Due to cultural beliefs and the scarcity and cost of physicians, many Africans prefer to use traditional medicine.
What is traditional medicine?
Traditional medicine is defined as “health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being” (http://www.who.int/mediacentre/factsheets/2003/fs134/en/). The World Health Organization estimates that 80% of the African population uses traditional medicine as primary healthcare (http://www.who.int/mediacentre/factsheets/2003/fs134/en/). It incorporates religion, spirituality, community, and cultural traditions in a holistic approach to healthcare and well-being. Healers use herbs, plants, animal products, and other natural remedies in order to treat illness. They work in the same way as a pharmacist would, mixing different ingredients and detailing the dosage, depending on the severity of the illness. The mixtures are taken orally, topically, or in a manner that the healer sees fit. Patients are treated either in their homes or in traditional therapy clinics. Most traditional medical techniques are passed down orally through generations, and many are based on religious beliefs.
Ingredients and tools used to prepare a traditional remedy.
Why do people use it?
One reason that people use traditional medicine is because of its availability. Traditional healers are abundant in African countries. A New York Times article reported that South Africa, one of the most Westernized African countries, has approximately 23,000 physicians, while they have 322,000 traditional healers (http://query.nytimes.com/gst/fullpage.html?sec=health&res=9F00E0D7103FF93BA2575BC0A9629C8B63). Another reason that the people of Africa prefer traditional medicine is because of its longevity. Before modern medicines were available, traditional medicines were the only effective option. When modern medicines were more widely available, people were reluctant to change their ideas about treatment. In addition, traditional medicines are more inexpensive and widely available than modern medicines. Most traditional techniques are not well researched, and therefore many Western healthcare authorities are skeptical about their effectiveness. However, traditional techniques carry cultural importance, and therefore continue to be commonly used.
Does it really work?
Few studies have been done on the effectiveness of traditional medical techniques. However, the following studies give an idea about its effectiveness. Study one tests the effectiveness of a holistic traditional approach, while studies three, four, and five test the effectiveness of specific herbal treatments.
Study 1: South Africa, 2004
A group of 33 HIV+ men and women were treated individually at a traditional therapy clinic in South Africa. Their CD4+ T-cell counts and viral loads were monitored at the beginning of treatment, after four months, after 8 months, and after 12 months at a public hospital. Patients were given modern drugs for opportunistic infections that resulted from their AIDS, but the AIDS virus itself was treated only with traditional techniques. At the end of 12 months, at least sixty percent of patients (and sometimes up to eighty percent) experienced better physical appearance, increased appetite, increased feeling of well-being, disappearance of skin marks and urogenital lesions, resumption of workplace duties, weight gain, significant reduction in viral loads, and significant increase in CD4+ T-cell counts. It was concluded that the traditional techniques were effective in improving the overall health of people suffering from AIDS. It was also concluded that a larger study should be done in order to gain more information (Tshibangu, et al, 2004).
Although Study 1 concluded that herbal medicine was effective, the study was not carried out in a reliable manner. The study size was too small to give conclusive results, and there was no control group. In addition, all study participants were not given a uniform treatment, and patients’ compliance was not monitored. This study does, however, give a general insight into the effectiveness of traditional therapy.
Study 2: Uganda, 1998
An herbal drug, known as “AM” (in order to protect the rights of the traditional healers involved), was tested. Nineteen patients with sufficiently high parasite counts were involved in the study. Patients were given explicit instructions on taking AM. They took the herb for an average of 8.4 days, and had follow up appointments after 2, 7, 14, and 28 days. At follow up appointments patients were asked about symptoms and side effects and blood films were made in order to measure parasite counts. The study concluded that AM is safe, as all side effects were minor, and no patient experienced life-threatening adverse reactions. In addition, during the first week of treatment there was a reduction in symptoms, and parasite counts declined in all patients. Furthermore, one patient experienced total parasite clearance. The study shows that AM is effective in treating malaria (Willcox, 1999).
Study 2 clearly shows that more research is warranted in this area. However, the study would have been more effective had there been a control group, or a group treated with modern medical techniques. It does, nevertheless, contribute positively to traditional medicine’s efficacy.
Study 3: Nigeria, 2003
The leaves from the plant Aspilia Africana are widely used by traditional healers throughout Africa. They are used to stop bleeding, clean surfaces of sores, and treat bee stings and other skin problems. This study tested the effectiveness of this technique. The plants were taken from Nigeria, cut up, and ground into a powder. Methanol extract and hexane and methanol fractions were taken from the powder. These extracts were then used on rats, mice, guinea pigs, and humans to test toxicity, clotting time, coagulation time, microbial activity, and rate of wound healing. In each experiment, the constituents of Aspilia Africana were not toxic and were effective in treating wounds, as compared to the control groups. Therefore, experimenters concluded that the leaves of Aspilia Africana as used in traditional medicine are effective, and their use is warranted (Okoli, et al, 2007).
Although many of the tests in this experiment were performed on animals, the results are still accurate. This traditional medical technique is valuable in treating wounds.
Study 4: 2004
Two plants, Hypoxis and Sutherlandia, are often used by traditional healers to treat AIDS. This was a review paper on the two aforementioned drugs. Hypoxis is traditionally used as an immunostimulant to treat AIDS. It has also been used to treat urinary infections, heart weakness, internal tumors, nervous disorders, and cancer. Most patients take a daily dose of 2400 mg of the raw plant. There is some indirect evidence that sterols and sterolins, which are found in Hypoxis, have a positive effect on immunity. There is also evidence, however, that Hypoxis’s interactions with certain enzymes can interfere with anti-retroviral (ARV) treatments. Sutherlandia is used in the treatment of many illnesses including cancer, tuberculosis, diabetes, influenza, arthritis, peptic ulcers, clinical depression, and HIV infection, among others. There have been claims that Sutherlandia was effective in destroying HIV lymphocytes, but these claims have not been thoroughly tested. Like Hypoxis there have also been claims that Sutherlania can interfere with ARV treatments. Both of these treatments, however, are supported by the South African Ministry of Health. This review paper also highlights several pitfalls of traditional treatments, including hygiene and toxicity. One big problem with traditional medicine is that healers may use unsanitary equipment, therefore contributing to the spread of blood borne diseases, including HIV/AIDS. Traditional healers and modern medics should work together to find the best treatments for AIDS patients. The review concluded that much more research is needed before determining the safety and efficacy of traditional medicines (Mills, et al , 2005).
Study 4 gives an idea about the complexities of traditional medicine, and it agrees with the other studies in that traditional medicine is usually effective in treating illness.
It is clear to see that traditional medicine is effective in treating a plethora of illnesses that affect the people of Africa. This conclusion is limited though because very little research has been done in the area. Although some treatments are of use, problems arise when plants and herbs have a negative interaction with other drugs, or are used in an unsanitary environment.
So now what?
With more research, it is possible that traditional treatments may become more accepted and be incorporated into modern medical techniques (http://www.answers.com/topic/traditional-african-medicine?cat=health). Until then, the World Health Organization believes that it is important to formulate policies and regulations for the proper use of traditional medicine, create guidelines and raise awareness about their safety and quality, and conserve medicinal plants to ensure their sustainable use (http://www.who.int/mediacentre/factsheets/2003/fs134/en/). Traditional medicine is very important in African culture. In areas where primary care physicians are not readily available, its importance is magnified. Though little research has been done, it is evident that traditional medicine is an effective option for treating various illnesses in Africa.
The official logo of traditional African medicine.
"By this symbolic action (of unveiling the logo), we are affirming our commitment to the development of traditional medicine in the African Region which has always been -- and will always be -- with us. It is our culture, and our future." - Regional Director of the World Health Organization African Region, Dr Ebrahim Malick Samba (http://www.afro.who.int/note_press/2003/pr20031009.html)
Okoli, C.O., Akah, P.A., & Okoli, A.S. (2007). Potentials of leaves of Aspilia africana (Compositae) in wound care: an experimental evaluation. BMC Complementary and Alternative Medicine, 7, 24.
Tshibangu, K.C., Worku, Z.B., De Jongh, M.A., A.E. Van Wyk, Mokwena S.O., & Peranovic, V. (2004). Assessment of effectiveness of traditional herbal medicine in managing HIV/AIDS patients in South Africa. East African Medical Journal, 81, 499-504.
Willcox, M.L. (1999). A clinical trial of ‘AM’, a Ugandan herbal remedy for malaria. Journal of Public Health Medicine, 21(3), 318-324.
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