African Traditional and Complementary Therapies

*Josephine Ozioma Ezekwesili-Ofili and Anthony Okechukwu Ogbonna*

### **Abstract**

Complementary therapies describe a wide range of healthcare practices that can be used alongside conventional treatments to deal with chronic health problems, treat symptoms, or simply to stay healthy. Examples include herbalism, bloodletting, purgation, prayers and incantations, hydrotherapy, diet, exercise, massage, etc. The basis for these practices stems from core beliefs: imbalance of body functions causes illness, the body can self-heal under the right conditions, and treatment should be of the whole body and not just symptoms; religion, spirituality, and culture are very strong underlying factors. The reasons for using complementary therapies are primarily to maintain good health, dissatisfaction with conventional medicines, taking charge of one's own health, ready availability, and notions of safety. In rural Africa, complementary therapies have been used solely as alternative therapies due to inadequate healthcare. This chapter deals with the African traditional complementary therapies that coexist with conventional medical practices and their advantages and disadvantages.

**Keywords:** traditional, complementary, alternative integrative, therapies, medicine, African

#### **1. Introduction**

The term "complementary therapies or medicine" refers to a broad spectrum of therapeutic and diagnostic practices that exist largely outside conventional medicine and are not fully integrated into the dominant healthcare system [1]. It is often used interchangeable with both alternative medicine and traditional medicine in some countries [2] or collectively called traditional, complementary, and alternative medicine (TCAM). Stricter definitions describe "indigenous traditional medicine" also known as ethno-medicine as the sum total of knowledge and practices, whether explicable or not, used in diagnosing, preventing, or eliminating physical, mental, and social diseases, administered by a trained practitioner or as self-care [3]. This knowledge or practice may rely exclusively on past experience and observation handed down orally or in writing from generation to generation. These practices are native to the country in which they are practiced. The majority of indigenous traditional medicine has been practiced at the primary healthcare level [4]. Complementary medicine (CM), on the other hand, is defined as a broad set of healthcare practices that are neither part of a country's own tradition nor part of conventional medicine and are not fully integrated into the dominant healthcare system. CM practices are used interchangeably with TCAM practices in some

countries [5], while alternative medicine refers to practices used in place of conventional practice. Integrative medicine refers to conventional medicine combined with TCAM that are safe and show evidence of efficacy. TCAM is a focus on biological, psychological, social, and spiritual influences to pathology. It is characterized by a belief in the supernatural cause of illness, divination being a diagnostic tool, and the use of a wide variety of agents and techniques in its treatment [6, 7]. In the modern African setting, it may encompass local herbal medicines or products, indigenous healthcare practices [6, 8], and imported complementary and alternative medicine products and practices (e.g., acupuncture or chiropractic, etc.). Sub-Saharan Africa (SSA) is one region of the world in which TCAM has long been held to be widespread, with a considerable number of its population relying on it to maintain their health or prevent and treat communicable and noncommunicable diseases [9, 10]. However, some peculiar practices of TCAM, which include voodooism, incantations, chants and mysticism, etc., generate controversies and reduce the scientific credibility. The traditional healers'/attendants' rituals/incantations and other peculiar practices appear to be more important than the pharmacological effects of herbs and other practices. The traditional medical practitioner is usually a well-known and trusted person in his community, with competence to provide healthcare by using plant, animal, and mineral substances and other methods based on and religious practices. He makes use of indigenous social, cultural, and knowledge, beliefs, and/or experiences to treat disease and promote health. Healing power is passed down through generations via oral transmission and apprenticeship or through knowledge imbued by the "gods." Its powers and skills are generally reserved for the members of certain families by inheritance or the members of regional or cultural communities [8, 11].

TCAM is an important and often underestimated health resource with many applications, especially in the prevention and management of lifestyle-related chronic diseases and in meeting the health needs of indigenous populations, especially in Sub-Saharan Africa, where conventional healthcare systems are largely inadequate. Other terminologies that have been used include natural medicine, nonconventional medicine, or holistic medicine [2]. Common to most TCAM systems is a focus on individualizing treatment [1]. TCAM encompasses products, practices, and practitioners. TCAM has evolved over millennia by drawing on the religious beliefs and social structures of indigenous people and by exploiting natural products in their environment and more recently by developing and validating therapeutic and preventive approaches through scientific methods [12]. Despite the promise of contemporary medical practice, large segments of humanity either cannot access its benefits or cannot afford; rather, people opt for practices based on their culture, proof of efficacy, and accessibility. TCAM use is indeed very common in Africa but varies among different populations based on their beliefs and sociocultural practices [13, 14]. At least 4 out of 10 adults have used some form of TCAM.

In Africa, TCAM is interwoven with religious practices involving body and soul, hence the name holistic. This spiritual aspect of healing encompasses belief and worship to God and reverence and acknowledgement of ancestors. Ancestors are compassionate spirits of departed blood relatives of an individual and may involve a whole lineage spanning generations. They are revered but not worshipped as one would pray to God but serve to mediate between the living and God to bring healing and luck to them. They are regarded as custodians of the lives of future generations and, therefore, occupy a position of dignity and respect among their descendants [15]. According to [9], a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary, and alternative medicine (TCAM) to meet their primary healthcare needs; yet, there remains a dearth of research

evidence on the overall picture of TCAM utilization in the region. There have been reports of varied prevalence of the use of TCAM in Africa. In comparison, the use of TCAM products was found to be higher than that of practitioner services, especially for self-care and over-the-counter use among the general population. TCAM may be used alone or in combination with orthodox medicine, in both general population and specific health conditions.
