CHAPTER SIX

REVITALIZING AFRICA’S HEALTH HERITAGE: THE FUTURE OF TRADITIONAL

MEDICINE THROUGH THE
LENS OF MEDICAL SOCIOLOGY AND ANTHROPOLOGY
Annmarie Nkem Okoli, Ph.D, & Egwu Rachel Nkechi
Introduction
Traditional medicine is as old as humanity. Historically, it was a primary means of treating diseases
worldwide, particularly in Africa, before the advent of Western medicine. In some Asian countries like
China and India, traditional medicine is systematized and integrated into national healthcare.
Herbal remedies represent the historical foundation of pharmacological treatments (Schulz et al, 2001).
Traditional healing practices, particularly among indigenous populations, have long relied on herbs.
However, despite its importance in Africa, traditional African medicine is often excluded from national
health systems due to a lack of systematization and recognition, even in modern times (Nebudere,
2011). Globally, traditional medicine faces neglect, insufficient research, and various challenges within
the broader healthcare landscape (Cordell & Colvard, 2012).
Colonialism, foreign invasions, and apartheid historically suppressed African natural medicine.
However, traditional medicine has experienced a resurgence in recent years (Nebudere, 2011),
highlighting its importance in African society. Collaboration and integration between traditional
medicine are needed to improve the well-being of the African population. The potential of African
natural medicine lies in its classical medical cosmologies, practices, and epistemologies rooted in
ancient Africa. The use of natural medicine is ancient, and its origins in Africa are supported by
evidence such as rock paintings depicting healing rituals (Chabalala, Matsabisa, & Gqaleni, 2021). The
evolution of African traditional medicine is linked to the emergence of human civilizations in the Nile
Valley. Notably, Africa, the Americas, and Asia possess a significant number of unique plant species.
Nigerian herbalists source a vast array of herbal medicines, which are gaining government recognition,
evidenced by the establishment of the Herbal Medicine Board (Emuesiri, 2021).

Conceptualizing African Traditional Medicine

The development, systems, knowledge, and practices surrounding health and well-being vary across
societies. In nearly all cultures, health encompasses an individual's physical, mental, social, emotional,
psychological, and spiritual well-being within their environment. Monier (2016) defines traditional
medicine as the accumulated knowledge and practices, explicable or not, used for diagnosis,
prevention, and treatment of physical, mental, or social imbalances, relying on experience and
observation passed down through generations. In many African communities, plant-based remedies are
commonly used for minor ailments like headaches and fever, often without spiritual practices. WHO
(2020) defines traditional medicine as the holistic knowledge, skills, and practices recognized and
accepted by the community for maintaining health and treating diseases.
Traditional medicine, rooted in the theories, beliefs, and experiences of indigenous cultures, has been
passed down through generations. In Africa, traditional medicine and Western medicine are the two
primary healthcare systems. In Nigeria, indigenous medicine is a core traditional heritage practiced
nationwide and considered a cultural value. Its prominence is driven by the reasoning of the African
people. African and Nigerian traditional medicine, developed over centuries, primarily uses remedies
derived from roots and leaves, reflecting indigenous knowledge, nature, and practice. Traditional
medicine is essential for healthcare in low-income countries, with usage estimated between 40% and
71%. In sub-Saharan Africa, traditional medicine is used by an estimated 58.2% of the general
population.
The desire to preserve traditional healing wisdom has spurred a renewed interest in herbal medicines
globally, particularly in Europe and North America, where they are integrated into healthcare as
alternative or complementary therapies. While centuries of traditional use may suggest efficacy and
safety, challenges arise when incorporating these ingredients into modern practice. Notably, ingredients
traditionally used for symptomatic relief are now being used for health promotion and disease
prevention, shifting from acute treatment to chronic exposure.
In Nigeria, traditional medicine, deeply rooted in culture and economy, relies on conventional use and
personal experience to treat various ailments, including epilepsy, diabetes, hypertension, and cancer.
Herbal remedies are also used to treat conditions such as asthma, eczema, and irritable bowel
syndrome. However, the use of herbal medicines requires caution due to potential side effects. Diverse
socio-cultural backgrounds of traditional medicine practitioners in Nigeria, stemming from over 300
ethnic communities, hinder the development of a standardized national traditional medicine practice.
Western medicine, also known as conventional, orthodox, or allopathic medicine, employs drugs,
radiation, or surgery to treat symptoms and diseases. Its application relies on evidence-based medical
diagnoses and scientifically proven methods. While primarily rooted in scientific principles, Western
medicine also incorporates refined herbs in conventional medicines. Before the 19th century, medical
practices were largely traditional; however, experimentation and reason gradually replaced intuition
and superstition (Ampofo & Johnson-Ramauld, 1978). The adoption of Western medicine, often
introduced by foreign influence or returning scholars, has been concentrated in urban areas in some
nations. Despite the availability of modern medical facilities, many people in both rural and urban areas
still prefer traditional medicine (Chiwuzie et al, 1987).
In Nigeria, traditional medicine utilizes natural products to treat illness, maintain health, and prevent
disease, often alongside conventional medicine. It addresses various conditions, including: pain (treated
with acupuncture), mental health issues (managed with meditation and yoga for stress reduction),
serious/chronic conditions (using ginger, turmeric, and curcumin to address pain, inflammation,
immunity, and metabolic issues), aging conditions (Gingko biloba for circulation and memory), and
other ailments like digestive problems and skin injuries (treated with aloe vera).
Traditional medicine offers benefits such as improved mental and emotional well-being, increased
patient satisfaction, and diverse treatment options. Cultural factors, affordability, and accessibility drive
its use.
Practitioners have different names based on region. In Yorubaland, they are known as Babalawo,
Onisegun, and Olorisa, along with Alasotele, Awon 'leku-leja', Olola, Afaa/Mallams, and Aladura.
These practitioners use traditional methods and natural substances—vegetable, animal, and mineral—
within their community's sociocultural and religious context to provide healthcare. Traditional medicine
is especially vital in rural areas with limited access to orthodox medicine (Gureje et al., 2018).
In Igboland, traditional medicine practitioners are called Dibia, with varying specializations.
● Dibia Afa: A diviner
● Dibia Ogwu: A medicine man
● Dibia Ohu: A seer
● Dibia Ogala Mmuo: A communicator with the dead and spirits
● Dibia Nsi: A preparer of poisonous medicines and their antidotes
● Dibia Mmiri: A rain maker (Nwoko, 2020).

Igbo folk medicine, rooted in Omenala tradition and the ethical principle of Ọfọ and Ogu, guides
healers and patients. The World Health Organization (WHO) acknowledges the crucial role of
traditional healers in Africa, particularly in Nigeria, where traditional medicine is widely used due to its
cultural relevance, accessibility, availability, and perceived efficacy. Igbo practitioners employ diverse
treatments including herbs, massage, thermal therapies, prayers, dance, and, in some cases, flogging.
Other practices include magic, diet, exercise, exorcism, social engagement, counseling, incarnations,
bone setting, divination, herbalism, psychiatry, surgery, and traditional birth attendance. In Hausa land,
traditional medicine practitioners include malam, yan bori, bokaye, masu magani, wanzamai, madorai,
and malamai ungozomai.
● Malam and yan bori: Healers who use herbs and prayer to heal
● Bokaye, masu magani, wanzamai, madorai, and malamai ungozomai: Healers who specialize in
minor ailments and surgeries
● Mai maganin gargajiya: The Hausa term for traditional healers
● Wanzanchi: Traditional surgeons of the Hausas
In Hausa land, traditional healers can be sedentary or mobile, with mobile healers either following
market circuits or moving between villages. Traditional medicine, also called indigenous or folk
medicine, encompasses the medical knowledge developed within various societies' indigenous beliefs.
African traditional medicine is a holistic healthcare system with divination, spiritualism, and herbalism
specialties (Farley et al., 2019). Despite Africa's long history of civilization, particularly in the Nile
Valley (Chiwuzie et al, 1987), Western medicine has overshadowed traditional medicine. Critics of
traditional medicine cite issues such as practitioners' lack of knowledge and potential harm from unsafe
remedies, mirroring challenges also found in conventional medicine, such as allergies, drug
interactions, contamination, and trauma caused by inexperienced practitioners.
Traditional medicine (TM) remains prevalent in many African villages, including Nigeria, and to a
lesser extent in urban areas. This indicates a continued reliance on TM, either fully or partially.
Western-trained doctors often criticize TM, citing practitioners' lack of anatomical and physiological
knowledge, as well as the absence of standardized prescriptions and dosages. Concerns about
unhygienic practices and secrecy also persist.
Despite these challenges, countries in the EU, the UK, China, India, Japan, Malaysia, Korea, and
Australia have made significant progress in establishing national policies and regulations for traditional,
complementary/alternative, and herbal medicines. While these policies vary, they share the goal of
ensuring the safe use of herbal medicines. The WHO has also proposed organizing and training TM
practitioners for primary health care, integrating traditional systems into national health systems with
appropriate regulations.
Although TM has a long history and importance, it was often considered inferior to Western medicine
due to various sociopolitical factors. However, TM has re-emerged as a valuable health asset globally.
It is now recognized and protected by international organizations like the UN and WHO, with many
countries acknowledging it as a vital part of their healthcare systems. TM is also used as
complementary or alternative medicine. In 2012, 69 countries had TM policies, compared to only 25 in
1999, highlighting its growing recognition. Currently, at least half the global population uses TM, with
estimates exceeding 75% in developing countries, particularly in Africa.
Theories of Traditional Medicine
Traditional medicine (TM) theories, which vary by culture, encompass holistic approaches, beliefs in
supernatural causes, and the use of natural remedies. These theories emphasize the body's ability to heal
itself by balancing opposing forces and addressing imbalances caused by spiritual, environmental, or
lifestyle factors. Examples include Yin and Yang in Chinese medicine and beliefs in spiritual causes of
illness in some African traditions. TM considers an individual's mental, physical, and spiritual well-
being holistically (WHO, 2025).
Key aspects of traditional medicine theories:
● Holistic perspective: The body is viewed as a unified system where different parts are
interconnected, not just isolated organs.
● TM treats the body as a whole, rather than focusing on a specific part
● TM aims to balance opposing forces in the body
● TM emphasizes the body's ability to heal itself
● TM considers a person's lifestyle, mental state, physical activity, and spiritual beliefs, Belief in
supernatural causes
● Balance and harmony:
Disease is often seen as a disruption of natural balance within the body, typically represented by
concepts like Yin and Yang.
● Life force energy:
Many traditions believe in a vital life force (Qi in Chinese medicine, Prana in Ayurvedic medicine) that
needs to flow freely for health.
● Natural remedies:
Plant-based medicines, animal products, and mineral substances are commonly used as therapeutic
agents.
● Individualized treatment:
Traditional medicine often tailors treatments to the specific needs of each patient based on their
lifestyle, constitution, and presenting symptoms.
Examples of specific traditional medicine theories:
● Chinese Medicine (TCM):
Based on the concept of Yin and Yang, the five elements (wood, fire, earth, metal, water), and meridian
pathways through which energy flows in the body.
● Ayurveda (India):
Focuses on the three Doshas (Vata, Pitta, Kapha) representing different bodily energies and their
balance.
● African Traditional Medicine:
Often incorporates spiritual beliefs about ancestors and supernatural forces as contributors to illness,
with divination used for diagnosis.
● Unani Medicine (Middle East):
Based on the humoral theory, where the body is composed of four humors (blood, phlegm, yellow 28
bile, black bile) that need to be balanced.
Important points to remember about traditional medicine theories:
● Cultural context:
Traditional medicine practices are deeply rooted in the cultural beliefs and knowledge systems of
different communities.
● Scientific research:
While many traditional medicines have been used for centuries, ongoing research is needed to 63
understand their mechanisms of action and validate their effectiveness.
● Integration with modern medicine:
Traditional medicine, encompassing diverse cultural knowledge and practices, is sometimes integrated
with conventional treatments for health maintenance, disease prevention, diagnosis, and treatment
(WHO, 2025). The World Health Organization recommends governmental promotion of traditional
medicine via national policies, herbal medicine regulation, and research support..
● Create a national policy on traditional medicine that's part of the national health policy
● Establish a national expert committee
● Develop national standards and guidelines for evaluating safety, efficacy, and quality
● Develop a national list of herbal medicines and therapies
Regulations
● License the practice of traditional medicine
● Establish legislation that defines the rights and responsibilities of traditional medicine practitioners
● Address legal issues related to the cultivation, conservation, and exploitation of medicinal plants
Research
● Support research into traditional medicine
● Establish national research institutes for traditional medicine
● Develop an evidence base for safety and efficacy
● Consolidate data from existing national and international studies
Other activities
● Provide reliable information on traditional medicine to consumers and providers
● Create technical guidelines and information on traditional medicine
● Ensure the protection of traditional medicine knowledge
● Collaborate with other relevant organizations
Traditional medicine is a set of health practices that use plant, animal, and mineral-based medicines,
spiritual therapies, manual techniques, and exercises (WHO, 2005).

Conclusion
Nigeria is actively working to ensure the safe and effective use of herbal medicine. NAFDAC's newly
formed Scientific Committee on Verification of Herbal Medicine claims, focusing on safety, efficacy,
and quality, demonstrates this commitment. The Federal Ministry of Health is also expected to
convene. The primary challenge now is increased collaboration with stakeholders and training
workshops to raise awareness about herbal medicine safety and efficacy. Nigeria will likely require
assistance from global partners like the World Health Organization to fully address this challenge.
Strengthening WHO programs, such as information sharing on regulatory issues and capacity-building
workshops, is crucial. Ensuring herbal medicine safety hinges on effective policy and regulation.
Therefore, the government, international organizations, and stakeholders must harmonize efforts to
implement policies and regulations guaranteeing the safe use of herbal medicines in Nigeria.
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