|Traditional Medicinal Plants (Dar Es Salaam University Press - Ministry of Health - Tanzania, 1991, 391 p.)|
|PART I: USE AND PROMOTION OF TRADITIONAL MEDICINAL PLANTS IN THE AFRICAN REGION|
Ministry of Labour, Culture and
Social Welfare, Dar es Salaam
In nature, man lived within a forest environment; through time man has continued to tame and interfere with nature; and now, man lives in a built-in environment, devoid of plants, except very few plant he domesticates (mostly fruits), e.g. pawpaws, oranges, peppers, etc. However, both in the wilderness and now, man has continued to exploit the forest environment, not only as a source of food, game, honey and other resources, but also as a source of curative herbs. In doing this, he has selectively used these resources for his betterment. Where successful, this knowledge has been transmitted from one generation to another in a variety of ways. This knowledge of the potential use of plants, ethnobotany, constitutes a major part of man's cultural knowledge, particularly in times of stress, e.g. hunger and disease.
The medical and pharmaceutical sectors, through history, have continued to exploit plants as sources of medicines, but have continually failed to realise, that what they are exploiting is knowledge, knowledge which is not only cultural, but also power. Given this fact, it is important that a certain level of cooperation, communication, and at times inclusions, of the cultural dimension are essential to the adoption and use of medicinal plants in modern medicinal and pharmaceutical practice.
The anticipated increased use of traditional medicinal plants must necessarily involve the 'tapping' or transference of the knowledge of their use and potentiality from the traditional to the modern sector. It is this change in the context in which such medicines will be used, that this paper wished to address itself to: the change from a Cultural to a Hospital context, for these are the respective operational spheres of traditional and modern medicines. The concept of culture has been defined in a number of ways, but the simplest definition offered here is that Culture is a way of life that is characteristic of a people, which identifies and distinguishes them from other people. Culture as defined here is the inevitable product of the interaction and interrelationship between man and environment. It includes, among other things, the material culture, social organization, organization and use of space, environment and things therein, belief systems (others will call this religion), and the general world view. All these aspects will be characteristic of a certain people and will differ from one people to another.
Viewed this way, what this conference is exploring may be seen as an examination of how man in the South wants to maximise the use of the products of his environment and share his knowledge on the curative properties of plants in the region. This is an attempt to share our cultural experiences and practices with the world.
Man and his environment
Present scientific knowledge, from archaeological evidence, places the origin of man to between 3.2 -3.5 million years ago. This evidence comes from the Rift Valley regions of Eastern Africa, from Omo in Ethiopia, through Lake Turkana in Kenya, and Olduvai and Laeotoli in Tanzania. Other corroborative evidence in the South, comes also from China, Southeast Asia and Southern Africa. In this long historical (archeological) span, the rise of modern civilizations in the Near East, the Mediterranean and other centres on the African, Asian and Latin American continents, is a comparatively recent phenomenon. This means that for a greater part of the history of humanity on this earth, man has lived in and with the wilderness. Put crudely, human beings have been part and parcel of the wilderness, and despite man's present level of technological developments, he is part of that wilderness or nature.
Man's operational spheres include: (a) the household, (b) the home range, and (c) the wilderness.
Figure 1: Diagrammatic sketch of man's operational spheres
With respect to the household cluster, one of the major technological advances that human beings have made, through time has been in architecture. From the rockshelters, branch shelters and other open air occupation sites/areas, man has developed permanent and semipermanent architectural structures, houses. These structures have become man's basic operational base from where he retires to at night, in times of danger or stress, and wakes up in order to tame his environment in his attempts and endeavours to satisfy his basic needs of food, shelter and clothing.
The houses may be built of plants or materials of plant origin and within them there may be stores for medicinal herbs, roots, barks, twigs, powders, mixtures and of course, other items of material culture. But these plants are mostly 'dead' and in usable or near usable form.
The home range operational sphere may differ from a few meters to several kilometers, depending on the type of social organization of the people, their subsistence pattern, the environment, ecology and climate. Hunters and gatherers will normally have a larger home range than agriculturalists. Women and children in foraging communities, will have a smaller home range than men and adults. Shifting agriculturalists and pure pastoralists will have a larger home range than intensive agriculturalists and mixed farmers. And, by extrapolation, people of the North will have a smaller home range than those of the South. The home range in a way, is more of an extension of the household and it is the main source of man's requirements of not only food and game, but also medicinal plants.
With regard to the wilderness sphere, this is more of the area beyond where man treads carefully. It is the area where few people venture to go. It is the region of the hunter, the brave, and I will dare to suggest, the man.
Man exploits this territory for medicinal plants, but the range of exploitable plants here is more limited than in the preceding two ranges. And, probably this is the area where most of the medicines stored in the household originate from, because this area is not easily accessible compared to the home range.
The acquisition of traditional medicine knowledge
Modern doctors, pharmacists, nurses and other medical personnel, acquire their basic skills through an intensive and selective education, specialising in the related medical disciplines. These skills are perfected with experience through years of practice. In contrast, the relevant skills in traditional medical practice, are acquired primarily through observation and a long and tedious apprenticeship. Others acquire it through normal cultural media of oral literature, oral traditions, folklore, rites de passage, borrowing, exchange, purchase and at times even divination. Given these differences of knowledge and use of traditional medicine, medicinal plants are peculiar and at times culture specific, compared to the universal modern medicine and medical practice. Particularisms of traditional medicine may also be greatly affected by belief systems, religion, and to a greater extent, ecology. Man will exploit most those plants and medicines that are within the immediate environment. Also, the cures that will be discovered or invented, will be in most cases those that are relevant to the diseases that are common to that particular society and the contiguous areas. Thus, this knowledge may not be easily transferrable to or easily accepted in other societies. Put differently, the knowledge and use of traditional medicinal plants is largely grounded in the ethnobotany of a particular people and can be strongly and negatively ethnocentric.
The processing of plants used in Traditional medicine
Modern medicine, the medicine which is preferred and openly acknowledged by most of the participants of this conference, is normally processed in sophisticated modern laboratories after a careful scientific analysis of the constituents and chemical combinations of the raw materials. The processing and manufacturing process is therefore standardized, and more often involves mass production and worldwide use and marketing of the end product. This process is normally preceeded and accompanied by careful studies of the after effects of these medicines on animals and human beings, in order to minimise short-term and long-term adverse effects. Also, according to modern commercial practice, the resultant medicines are produced under registered trade marks and are patented. Thus, replication of the medicines is not easy, though it is common to read of medicines that are marketed under false trade marks or those with the same general properties, ingredients and after effects. Traditional medicine, in contrast, is not easy to replicate, and the dosages administered are not easy to quantify. Thus, its use necessarily involves not only trust in the healer, but also belief in the ability of the medicine to cure and the capability of the medicineman to administer the right dose or doses. Its effectiveness is assumed and only demonstrable by seeing or hearing of people who had associated symptoms of a disease cured. This fact, at times, limits the universal applicability and acceptability of such medicine in other areas and hence makes such medicines cultural specific.
The processing of traditional medicine is normally considered unhygienic and unscientific, not because this is necessarily so, but largely because people are biased against the various methods of grinding, pounding, chewing, boiling, etc., that are used. Often these methods are just as hygienic as any in the modern industrial manufacturing process of medicine. The use of such 'crude' methods of processing may be dictated more by the scale of operation, the amount of raw materials, the market situation, and other physical or chemical characteristics of the plant itself.
Probably more than in any other areas, modern medicine diners from traditional medicine in its administration. All of us are familiar with the picture of the nurse, the doctor, and the hospital white uniform: a colour that is culturally associated with purity, hygiene, and probably modern science and technology. The administration of modern medicine is effected orally, by injections, or by topical applications etc. These methods are generally the same as the traditional methods, which also use incisions and excisions in addition to those mentioned above. But, instead of the colour of uniforms of the modern medicine, black is the typical colour of most traditional medicine practices. This is due to the processing and manufacturing process more than anything else, a process which is equally, clean, hygienic and definitely scientific.
Hospitals, modern medical practice and the doctor-patient relationship, are very objective and impersonal. The modern doctor and nurse, though belonging to the society, is generally detached from it in the execution of his or her duties. In most cases, one patient is taken to be just the same as any other patient. Individual or personal interest is only aroused when the patient or the manifestation of the diseases is peculiar, abnormal, and therefore of scientific interest. Even here, the patient becomes a case.
In comparison, the local healer and medicineman is part of the culture. He or she operates within a known cultural environment, with its own definite known cultural norms, values and beliefs. He is in most cases the next door person, an uncle, brother, grandmother, grandfather or any other relative. After all, the range of social relationships in any community is limited and prescribed. Therefore, the medicineman has a personal interest and stake in the patient. He is not a mere dot in a chain of people Stringing through the doctor's consultation office. There is a necessary cultural bond between the two. In fact, there are known instances of a healer taking the medicine on behalf of the patient, or even other people within the community doing the same for the patient. Normally when traditional medicine is removed from its cultural context and used in modern clinics, it loses this community touch and subjectivity and becomes impersonal and objective. This factor is very significant in considering how to use traditional medicine in modern contexts.
Research on traditional medicinal plants
To the author, the primary objective of research in traditional medicines, is to expand modern medical practice and medicines to cut down the bill for modern medicines and, as other people in this conference have said, to promote the return to nature. In short, to supplement and complement modern medicine. This brief review suggests that for this research to be meaningful, it is important to incorporate several cultural dimensions.
It has been mentioned here that traditional medicine is, first and foremost, culture-specific, and exploits and responds to the local environment and at times, beliefs. Traditional medicine researchers should therefore, start with or ground themselves in social and cultural research methods, and use these methods in their research. Results of such research may necessitate, first, the need to be accepted and trusted in the research area, to understand the local cultural norms and values, the nutritional methods and taboos, and other similar cultural premises.
The initial social and cultural research may prove to be cost cutting in the long run. It is for example a fact that diseases common in low-lying, forest costal areas, may not be present in high altitude areas, and vice versa. Thus, a researcher can benefit more by researching only in those areas where certain diseases are known to be typical. Thus, by using modern hospital clinic dispensary records, it should be possible to produce a map of the diseases that are characteristic of certain areas. The maps could then be used for identifying traditional medicines that are used to treat them and their effectiveness and thereafter, chart out a research programme for not only recording and testing these, but also for research in other possible medicines that may be in use in similar areas elsewhere.
Cooperation with local traditional medicinemen
If one acknowledges the fact that, culturally, people believe in the old, while looking forward to the modern, then it is only logical that we shall incorporate the use of traditional medicine in modern medical practice, and vice versa. Programmes should be worked out between modern and traditional clinics, whereby problematic cases may be treated collectively. This should not be very difficult At least in Benin, this method is successfully being used at the local level)
Earlier it was mentioned that man operates in three spheres, the household, the home range and the wilderness. Generally, and culturally, the household is the sphere of the women and the children while that of the wilderness is the territory of the man. This means that cures for diseases which are associated with the household, for example, prenatal, natal, post natal children's diseases, are in many cases known to the women, especially the mature and elderly women in the society, while cures for such things as snake bites are known to men. Thus, when planning for and undertaking research in traditional medicine, it is important to take cognizance of this very critical factor. It is not easy for a male to get access to medicines associated with child birth and maternity care. This concept can also be extended to age groups or groupings.
Recently, the Government of Tanzania restructured its salary structure. In the new structure, medical doctors and pharmacists have been categorised as being in rare professions. This is, in a way, a recognition of their special role and position in the Tanzania Society. It is an acceptance and an ascription of special status. This status is based on the special knowledge they have, the rigorous programme they had to go through in acquiring this knowledge, and their special relation to the process of life and living. However, in assessing the place of the traditional healers in this and previous societies, we tend to forget the fact that in their case too, our societies gave them similar or even more consideration. Therefore when undertaking our various researches in traditional medicine, we should be aware of the fact that by getting this pool of knowledge from our villagemen, a process which to them appears to be unidirectional, we are in fact stripping them of their special place in the society and hence their status. It is largely because of this fact that the author advocates for cooperation and collaboration in both research and use of traditional medicine by both parties.
Most countries of the South recognise the special role and the need for aggressive research in and use of traditional medicinal plants. Most of them have established special programmes of research in this sphere, usually at the University level. However, few of our governments have established clear-cut policies on traditional medicine, policies which define the role of the institutions and personalities involved in using traditional medicine. Such policies are needed to give due respect to the good traditional medicine practitioners. It is the author's hope that the holding of this conference is one step in the right direction towards the realization of definite policies on the use of traditional medicines, including traditional medicinal plants.
In this paper, the author has attempted to show that man's total social and natural environment constitutes his or her operational cultural context, and that the use of traditional medicinal plants, and other traditional medicines is not only logical, but is also natural. Realizing that research in traditional medicines is;
...the will of people prepared to innovate and bring new responses to new circumstance while bringing in a keen practical sense and social responsibility informed by ingenuity and creative inauguration (Winston, 1975:509).
The author has argued for the need for modern and traditional medicine to cooperate and collaborate in all their endeavours and to establish a dialogue between them. In short, he emphasises the need for traditional medicine to incorporate in their practices, the modern dimensions while modern medicine should also include the cultural dimension, for the betterment of their practices, and for the benefit of the community.
In this regard this paper gives credit to the process so far, with the same attitude as Narakobi's in the 'Malenisian way': "Every nation needs an ideology or a philosophy. What I say wrongly to-day, let the learned of tomorrow, or even this very day, set right. But if I do not say something today, those of tomorrow will have nothing to go from, or even to correct" (Narokobi, 1980:40).
Banton, M. (1966). Anthropological Approaches to the study of Religion. Tavistock Publications, London.
Gluckman, M. (1966).Custom and Conflict in Africa. Basil Blackwell, Oxford.
Malinowski, B. (1960). A Scientific Theory of Culture and other Essays. Oxford University Press, New York.
Middleton, J. and Winter, E. H. (1963). Witchcraft and Socery in East Africa. Rout-ledge, London.
Narokobi, B. (1980). The Malenisian way. Institute of Papua New Guinea Studies.
Rodcliff, B. (1964). Structure and Function in Primitive Society. Cohen and West Ltd, London.
Steiner, F. (1956). Taboo. A Pelican Book
Swats, M.L. (1966). Religious and Magical Rites of Bantu Women in Tanzania. Dar es Salaam, Tanzania
Van Pelt, P. (1971). Bantu Customs in Mainland Tanzania. T.M.P. Tabora, Tanzania.
Winston, J. (1975). The Malenisian Environment. Proceedings of the 9th Waigani Seminar.