**5.4. South Africa**

Most people in Ghana fully accept modern science-based medicine, but traditional medicine is still held in high regard. They believe in the physical and spiritual aspects of healing. Herbal spiritualists collectively called "*bokomowo*" indulge in occult practices, divinations, and prayers and are common all over the country. Tribal vernacular names of traditional healers include "*gbedela*" (Ewe), "*kpeima"* (Dagomba), "*odunsini"* (Akan), and "*isofatse"* (Ga). In some Ghanaian communities, especially in the Akan communities, traditional healers and practitioners are of the opinion that disobeying taboos is one of the ways that could lead to severe illness to the person(s) or community involved [43]. Taboos form an important part of African traditional religion. They are things, or a way of life, that are forbidden by a community or a group of people. One could also become sick through invocation of curses in the

In today's Ghana, a traditional Medical Directorate has been established in the ministry of health to provide a comprehensive, recognizable, and standardized complementary system of health based on excellence in traditional and alternative medicine. Establishing centers for integrating scientific research into plant medicines and incorporating traditional medicine into university curricular are now the current status in Ghana [44]. Also, degree-awarding

The first principle is diagnosis followed by complex treatment procedures using plants from the bush, followed by many rituals, the ultimate aim being to cure disease. Serious or chronic illnesses require "chizimba," which means sealing a disease or illness away forever. This involves killing a lizard and burning the heart with roots of certain trees and grinding with charcoal. Tiny cuts are made on the ailing area and left breast and the mixture rubbed into the cuts.

Plants may be used singly or in combination with other plants. The plant parts are harvested fresh, pulverized, and left to dry first, then soaked in water or other solvents like local gin. Some plant materials are burnt as charcoal and used as powder. Six major types of treatment common to the 72 or more ethnic groups in Zambia include drinking, eating, drinking as porridge, making small cut on skin and applying, bathing with herbs, dancing to exorcize spirits, and steaming with boiling herbs. The Zambian traditional healer is called *Nga:nga* [45].

In Tanzania, traditional medicine has been practiced separately from allopathic medicine since colonial period but is threatened by lack of documentation, coupled with the decline of biodiversity in certain localities due to the discovery of natural resources and excessive mining, climate change, urbanization, and modernization of agriculture. Traditional medicine in Tanzania is used by people of all ages in both urban and rural areas for both simple and chronic diseases. The traditional healers are of four different types: diviners, herbalists, traditional birth attendants, and bone setters. Erosion of indigenous medical knowledge occurred as most of the traditional health practitioners were aging and dying, and the expected youths who would inherit the practice were shying away from it and those in the rural areas dying of

traditional medical schools now train and graduate traditional medical doctors.

name of the river deity, *Antoa*, upon the unknown offender.

**5.2. Zambia**

202 Herbal Medicine

**5.3. Tanzania**

Traditional medicine features in the lives of thousands of people in South Africa every day. In fact, it is estimated that 80% of the population uses traditional medicines that are collectively called muti. Muti is a word derived from medicinal plant and refers to traditionally sourced plant, mineral, and animal-based medicines.

In addition to herbs, traditional medicine may use animal parts and minerals. However, only plant muti is considered a sustainable source of medicines. South African traditional plant medicines are fascinating with so many colors, forms, and effects. It is an art to know these and to use them correctly to bring about health and harmony, which is the aim of all true traditional healers. The plant muti is commonly sold in specific sections of the open markets in South Africa, as shown in **Figure 3**.

**Figure 3.** *Muti* market in Johannesburg (Source—Ancient Origins).

**Figure 3** shows a muti market in Johannesburg.

The traditional healers known as the *Sangoma or Inyanga* are holders of healing power in the southern Bantu society. In a typical practice with a female traditional practitioner, the methods used depended on the nature of the complaint. For example, headaches are cured by snuffing or inhaling burning medicines, bitter tonics are used to increase appetite, sedative medicines for depression, vomiting medicines to clean the digestive system, and antibiotic or immune boosting medicines for weakness or infection. She often counseled patients before administering appropriate healing herbal medicines [48].

Consultancy and Research, Enugu, Nigeria, a medical laboratory technologist, both revealed that their knowledge and 'gift' of medical practice were handed down by aged relatives who were also in the practice by both tutelage and supernatural means. Knowledge was however improved by further training, interaction, and discussion with colleagues, consultation of books on herbal medicine, and the Internet. They claimed that the practice was very lucrative, especially since some ailments that defied orthodox medicine such as epilepsy and madness could be completely treated by traditional medicine. The two men divulged that the old concept of secrecy and divination is gradually fading away and being taken over by improved skills, understanding, and use of modern equipment where necessary. Both however agreed to the "mystic" or esoteric power of plants, which they sometimes employ in their diagnosis and treatment. An Enugu, Nigeria-based nonprofit organization, the Association for Scientific, Identification, Conservation and Utilization of Medicinal Plants of Nigeria (ASICUMPON), of which the writer is a member, is committed to "highlighting the usefulness of medicinal plant resources and scientific assessment, preparation and application of these for the betterment of humanity and as Africa's contribution to modern medical knowledge," under the chairmanship of Reverend Father Raymond Arazu. Another prominent member of the association, Professor J.C. Okafor, who is a renowned silviculturist and plant taxonomist, is helping members to identify and classify plants. The group also shares and documents evidence-based therapeutic knowledge. Such groups and training schools exist all over Nigeria. ASICUMPON has published a checklist of medicinal plants of Nigeria and their curative values [19]. Other books have likewise produced useful information [16, 21]. The greatest problem still facing herbal medicine in Nigeria is lack of adequate standardization and safety regulations [52]. However, the interest and involvement of educated and scientific-minded people in herbal medicine practice have to a great extent demystified and increased the acceptability of these medicines by a greater percentage of would-be skeptical populace. A photograph of Dr. Anselm Okonkwo is shown here in **Figure 4**, who is a veterinary doctor and a typical educated

Herbal Medicines in African Traditional Medicine http://dx.doi.org/10.5772/intechopen.80348 205

and knowledgeable herbal practitioner with the writer after interviewing him.

**Figure 4.** The writer with Dr. Okonkwo of St Rita's Ethnomedical Research Center, Enugu, after the interview.

#### **5.5. Kenya**

As in many countries in Sub-Saharan Africa, Kenya is experiencing a health worker shortage, particularly in rural areas. Anecdotal evidence suggests that globally, traditional medical practitioners (THMPs) are the only point of contact for at least 80% of the rural poor [10]. In Kenya, very little quantitative evidence or literature exists on indigenous medicine and the health practices of alternative healers or the demand for traditional medical practitioners or on the role that they play in providing particular health services for the rural poor. As a result, TMPs currently do not have sufficient formal government recognition and are often sidelined in Human Resources in Health (HRH) planning activities; further, their activities remain unregulated. Community-derived data show that hospitals are preferred if affordable and within reach. There is also significant self-care and use of pharmacies, although THMPs are preferred for worms, respiratory problems, and other conditions that are not as life threatening as infant diarrhea and tuberculosis [49].

Traditional Medicine Practitioners in Kenya generally known as "*laibon"* far outnumber conventional or allopathic providers. Their practices are no different from other African countries. In many cases, they combine both modern and herbal medicines, especially if they are afflicted by chronic ailments such as HIV/AIDS, hypertension, cancer, and diabetes [50].

#### **5.6. Nigeria**

The various ethnic groups in Nigeria have different health care practitioners aside their western counterparts, whose mode of practice is not unlike in other tribes. The Yorubas call them "babalawos," the Igbos call them "dibia," while the Northerners or Hausas call them "boka" [5]. Traditional/herbal medicines have impacted the lives of people, especially in the rural areas where access to orthodox medicare is limited [51]. Apart from the lack of adequate access and the fear of expired or fake drugs, the prohibitive cost of western medicine makes traditional medicine attractive. Various training schools exist for both herbal medicine and homeopathy, and as such, most modern traditional health practitioners have great knowledge of pharmaceutical properties of herbs and the shared cultural views of diseases in the society and they combine their knowledge with modern skills and techniques in processing and preserving herbal medicines, as well as in the management of diseases. In oral interviews with two modern traditional medicine practitioners, Dr. Anselm Okonkwo of Saint Rita's Ethnomedical Research Center, Enugu, Nigeria, a Veterinary doctor, and Mr. Uche Omengoli of CGP Herba-Medical Consultancy and Research, Enugu, Nigeria, a medical laboratory technologist, both revealed that their knowledge and 'gift' of medical practice were handed down by aged relatives who were also in the practice by both tutelage and supernatural means. Knowledge was however improved by further training, interaction, and discussion with colleagues, consultation of books on herbal medicine, and the Internet. They claimed that the practice was very lucrative, especially since some ailments that defied orthodox medicine such as epilepsy and madness could be completely treated by traditional medicine. The two men divulged that the old concept of secrecy and divination is gradually fading away and being taken over by improved skills, understanding, and use of modern equipment where necessary. Both however agreed to the "mystic" or esoteric power of plants, which they sometimes employ in their diagnosis and treatment. An Enugu, Nigeria-based nonprofit organization, the Association for Scientific, Identification, Conservation and Utilization of Medicinal Plants of Nigeria (ASICUMPON), of which the writer is a member, is committed to "highlighting the usefulness of medicinal plant resources and scientific assessment, preparation and application of these for the betterment of humanity and as Africa's contribution to modern medical knowledge," under the chairmanship of Reverend Father Raymond Arazu. Another prominent member of the association, Professor J.C. Okafor, who is a renowned silviculturist and plant taxonomist, is helping members to identify and classify plants. The group also shares and documents evidence-based therapeutic knowledge. Such groups and training schools exist all over Nigeria. ASICUMPON has published a checklist of medicinal plants of Nigeria and their curative values [19]. Other books have likewise produced useful information [16, 21]. The greatest problem still facing herbal medicine in Nigeria is lack of adequate standardization and safety regulations [52]. However, the interest and involvement of educated and scientific-minded people in herbal medicine practice have to a great extent demystified and increased the acceptability of these medicines by a greater percentage of would-be skeptical populace. A photograph of Dr. Anselm Okonkwo is shown here in **Figure 4**, who is a veterinary doctor and a typical educated and knowledgeable herbal practitioner with the writer after interviewing him.

**Figure 3** shows a muti market in Johannesburg.

ening as infant diarrhea and tuberculosis [49].

**5.5. Kenya**

204 Herbal Medicine

**5.6. Nigeria**

administering appropriate healing herbal medicines [48].

The traditional healers known as the *Sangoma or Inyanga* are holders of healing power in the southern Bantu society. In a typical practice with a female traditional practitioner, the methods used depended on the nature of the complaint. For example, headaches are cured by snuffing or inhaling burning medicines, bitter tonics are used to increase appetite, sedative medicines for depression, vomiting medicines to clean the digestive system, and antibiotic or immune boosting medicines for weakness or infection. She often counseled patients before

As in many countries in Sub-Saharan Africa, Kenya is experiencing a health worker shortage, particularly in rural areas. Anecdotal evidence suggests that globally, traditional medical practitioners (THMPs) are the only point of contact for at least 80% of the rural poor [10]. In Kenya, very little quantitative evidence or literature exists on indigenous medicine and the health practices of alternative healers or the demand for traditional medical practitioners or on the role that they play in providing particular health services for the rural poor. As a result, TMPs currently do not have sufficient formal government recognition and are often sidelined in Human Resources in Health (HRH) planning activities; further, their activities remain unregulated. Community-derived data show that hospitals are preferred if affordable and within reach. There is also significant self-care and use of pharmacies, although THMPs are preferred for worms, respiratory problems, and other conditions that are not as life threat-

Traditional Medicine Practitioners in Kenya generally known as "*laibon"* far outnumber conventional or allopathic providers. Their practices are no different from other African countries. In many cases, they combine both modern and herbal medicines, especially if they are afflicted by chronic ailments such as HIV/AIDS, hypertension, cancer, and diabetes [50].

The various ethnic groups in Nigeria have different health care practitioners aside their western counterparts, whose mode of practice is not unlike in other tribes. The Yorubas call them "babalawos," the Igbos call them "dibia," while the Northerners or Hausas call them "boka" [5]. Traditional/herbal medicines have impacted the lives of people, especially in the rural areas where access to orthodox medicare is limited [51]. Apart from the lack of adequate access and the fear of expired or fake drugs, the prohibitive cost of western medicine makes traditional medicine attractive. Various training schools exist for both herbal medicine and homeopathy, and as such, most modern traditional health practitioners have great knowledge of pharmaceutical properties of herbs and the shared cultural views of diseases in the society and they combine their knowledge with modern skills and techniques in processing and preserving herbal medicines, as well as in the management of diseases. In oral interviews with two modern traditional medicine practitioners, Dr. Anselm Okonkwo of Saint Rita's Ethnomedical Research Center, Enugu, Nigeria, a Veterinary doctor, and Mr. Uche Omengoli of CGP Herba-Medical

**Figure 4.** The writer with Dr. Okonkwo of St Rita's Ethnomedical Research Center, Enugu, after the interview.
