Disease is the dreaded uninvited guest that interferes with the normal functioning of our bodies. Each society historically had a unique process to diagnose and treat with the intention to restore normal body function. How we treat disease is often a process characterized by adaptation and assimilation of knowledge proven to produce successful outcomes. Modern medicine has been a game changer surpassing most of the traditional forms of medicine. However, herbs, holistic and natural medicines continue to thrive and are still widely used across Africa and other corners of the globe.
A child’s first encounter with traditional herbs occurred immediately after birth in many African tribes. The new born was bathed in a natural herb extract from the macerated shrubs called “ekyogero” (in Luganda language) which is a combination of indigenous herbs (Egirikiti, omululuuza, ebbombo, olweza, namirembe, kayanana ) boiled together in water. It is believed that these ceremonial baths protect the newborn from skin rashes, infections, fever and bad luck in addition to “shaping body parts” particularly the “head of the baby.”
Africans use a combination of indigenous and modern evidence based medicine. Pharmacies are not always accessible except in small towns and urban areas. A patient in rural Uganda who exhibits a fever, headache, nausea, night sweats or body aches— is often diagnosed and first treated with the wealth of indigenous knowledge acquired by the elders in that family and community. The most commonly used herbal medicine for fever are the leaves of a shrub called “mululuuza” (Vernonia amygodaline). This herb is boiled in water to produce a very bitter extract which one drinks. Other commonly used herbal medicines include “mmumbwa” which is a combination of clay and herbs, “ekigajji”, “nyambala butonnya” (Callistemon citranatus) among others.
The choice between using herbal remedies and modern evidence based medicine is a complicated maze to navigate influenced by numerous factors in the age of ever flowing information and technology. Herbal medicines are often more affordable, accessible and a convenient healthcare sanctuary for Africa’s rural population. Likewise, the level of education, socioeconomic status, mistrust of western medicine, adverse drug reactions and severity of condition also influence the behavior of patients as they seek healthcare. Understanding the impact of these factors is critical to address the healthcare needs of communities ravaged by disease across Africa.
As a result of numerous medication related disasters around the world, comprehensive consumer protection standards have been instituted over the years. Medications were required to be safe for consumption in 1906 after a legally marketed toxic elixir claimed the lives of children. In 1962 drug manufacturers also had to prove that their products were both safe and effective. This new standard was inspired by another tragedy when thalidomide use in expecting mothers led to babies born with absent or shortened limbs. Such incidents highlight the significance of setting standards for efficacy and quality assurance of herbal medications. Contamination, misidentification of plant species, adulterated ingredients and potential toxins could be harmful to patients. There is a need for clinical research to guarantee that herbal products are safe and effective while strictly abiding by good manufacturing practices.
Healthcare providers often dismiss traditional and herbal forms of therapy in favor of conventional- evidence based medicine due to lack of clinical evidence, herb-drug interactions and unknown underlying mechanisms of action. However, it’s critical to recognize that over 80% of the population in Sub-Saharan Africa alone has used one or more forms of herbal remedies. With the rising cost of healthcare, many more will continue to turn to cheaper and convenient alternative medicines. Stigma and negative attitudes towards use of herbal supplements often lead to mistrust and nondisclosure. As a result of this sobering reality, providers should accommodate and guide patients through the complex web of evidence based and herbal medicines to promote safety and efficacy and as a result optimize healthcare outcomes.
“The competent physician, before he attempts to give medicine to the patient, makes himself acquainted not only with the disease, but also with the habits and constitution of the sick man.” -Cicero