Marita Black

Traditional African medicine needs to be evaluated in the context of the cultures in which it is practised and not on the basis of a modern understanding of Western medicine, said a recent Visiting Fellow to the ANU. 

The principles of modern pharmacology advise that the course of illness involves an invasion by a parasite, bacterium or cancer, or a biochemical process gone wrong. Under traditional African beliefs, however, illness is understood to arise as a result of some kind of antisocial behaviour or spiritual imbalance. 

"Illness is understood to be caused by an infringement of the moral laws of the community, which are determined by ancestral spirits," said pharmacologist Dr David Okpako from the University of lbadam in Nigeria. Dr Okpako visited the ANU's humanities Research Centre HRC last month. He started research into how the traditional medical system in Nigeria worked after a number of his curious students asked him questions about traditional remedies. 

As African medicine is based on an oral, rather than written, tradition, Dr Okpako conducted interviews and first-hand research into how plant remedies are prepared and applied. He focused on a single community in Nigeria, the Ughievwen Clan, where traditional healers or ‘diviners’ arc consulted for serious or life threatening illness. 

Diviners may inherit the position in the community from an elder, serving a sort of apprenticeship while learning how to practise the medicine. Others may feel themselves to be called to the position by an experience or dream which they interpret to be an indication of their future role. Diviners are not unique to African societies, but are found in many countries around the world. 

For minor illness such as headache and fever, most members of the Ughievwen community would have knowledge of commonly used plant remedies and use them when necessary. Many of the plants used do contain pharmacological products and some have been ‘discovered’ and used in Western medicine. Aspirin and quinine, both found in the bark of certain species of tree, were used in traditional medicine to treat fever before mass production in the West. If the patient is not cured by the plant remedy or the illness is of a more serious nature, as with tuberculosis, pneumonia, stroke or cancer, the healer is visited by interested members of the patient’s family and the community. The healer commonly throws bones, sticks or shells on the ground and then interprets the pattern made by the objects, making a vague pronouncement of the problem and cure. 

"The healer will usually evoke supernatural causes without saying exactly what the problem is," said Dr Okpako. 

"The patient is thought to be ill as they have gone against the moral laws of the community, offending the ancestral spirits in some way. When important people in the community die, normally male, they become spirits who provide moral guidance for those still on earth. Relatives usually discuss the healer's prognosis, work out between themselves what the patient has done and then carry out the advice of the healer," he said. 

The cure may include plant remedies, prayer, libation or feasting on sacrificed animals, again involving the whole community as the sickness represents a threat to their whole structural order. Even if the person dies, the community would have been treated as a whole to ensure that the spirits are appeased. 

"Philosophically we can ask, why arc most humans law abiding? The 'conscience' has a physiological basis. During upbringing, people are taught not to behave in an anti-social way, and this is rein-forced until this behaviour becomes a conditioned reflex action. Traditional societies are fragile with no formal laws. To ensure the survival of the community, moral laws have to be rigidly observed and their understanding of illness is an important aspect of the moral code," he said. 

Dr Okpako argues that the role of plant remedies in the treatment of serious illness is not primarily pharmacological. If plant remedies are prescribed by the healer, they may not even come in contact with the patient's body. They may be wrapped in a bundle and put under the patient’s pillow or on a windowsill. Otherwise, the remedy may be worn around the waist, neck or ankle. Food spices, valued for their aroma, arc common components of the remedy. 

"The effect of the divining process is to reinforce the patient's immune system by exposing the sin that the patient has committed, which can give a surge of relief and well being. The plant remedy may also contain compounds called immunostimulants which act in the same way," he said 

Plant remedies can have a powerful effect through their action as a placebo. The placebo effect has been well documented, accounting for between 35 and 60 per cent of the benefit of every therapeutic drug, said Dr Okpako. 

"There is a link between the physical and emotional components of illness which is recognised by traditional medicine, without the technology to describe it. Pain come from the mind as well as the body, and the belief that you're going to recover from an illness, can make a huge difference. 

As African cultures do no have the technology to measure weigh, volume and time in absolute units, dosage of plant material is not a feature of traditional medicine, Accordingly, overtime, plants having toxic effects have been removed from use its medicines to avoid poisoning. Conversely, Western medicine, is based upon the theory of selective poisoning, with the aim of killing the infecting bacterium, virus or cancer. this only becomes possible if dosage can be strictly controlled. 

"When looking for new pharmacological products, Western re-searchers should be asking traditional communities not just what plants or animals they use to treat disease, but also what they always avoid." 

While at the ANU, Dr Okpako compared the written pharmacopoeia of traditional remedies from China, India and Pakistan, which often have a philosophical basis. Chinese traditional medicine draws heavily on the teachings of the philosopher Confucius and Indian medicine likewise on ancient Sanskrit writings. He found similarities between the practices and beliefs in many parts of the world. "Most traditional medicines recognise that the human being is part of nature and that being well necessarily involves a state of harmony." 

ANU Reporter October 1996