Africa, often referred to as the cradle of humankind, is known for its rich cultural heritage and diverse traditions. One aspect that truly stands out is the incredible array of healing practices and medicinal knowledge deeply rooted in African cultures. The continent has a long history of holistic remedies and therapeutic techniques that have been passed down through generations.
The term "African traditional medicine" (also called African folk medicine or African indigenous medicine or African ethno-medicine) refers to the indigenous medicine of Africa, based on traditional indigenous knowledge systems (traditional medicinal knowledge) and passed down, by word of mouth, from generation to generation within the particular indigenous community either along familial lines or traditional apprenticeships.
Traditional African medicine, with its belief that illness is not derived from chance occurrences, but through spiritual or social imbalance, differs greatly from modern scientific medicine, which is technically and analytically based.
For centuries, East African communities have developed rich traditions of healing that address the whole person. Traditional East African healing systems share a fundamental principle: they view health as a state of balance between the physical body, the mind, the spirit, and the community.
Traditional healers see and manage most of the mental health problems in East Africa. Our understanding of the pharmacology of the herbs they use is limited, but this is not so with psychotherapy. The challenge is to psychiatrists trained on the Western model. Are they willing to learn from the traditional healers? Are they willing to work with them? They can say no to this only to the detriment of the patients they seek to heal, and more significantly to the detriment of science, which they seek to embrace.
Read also: A History of Islam
Even today, the use of traditional healers is common, despite the introduction of modern drugs. It is estimated that traditional practitioners manage at least 80% of the healthcare needs of rural inhabitants in East Africa.
Traditional medicines are one of Africa's primary response mechanisms to medical emergencies, while, in other communities, all healthcare decisions are based on indigenous traditions and beliefs. For millions of individuals who reside in rural areas throughout low‐ and middle‐income nations, those healers serve as their only primary healthcare practitioners.
MEDLIFE is proud to offer Service Learning Trips to Tanzania for volunteers who are interested in assisting rural communities to access comprehensive health care.
The geographical reach of this article is Sub-Saharan Africa.
Modern science has considered methods of traditional knowledge as primitive and under colonial rule some traditional medical practices were outlawed. During this time, attempts were also made to control the sale of herbal medicines. For example, after Mozambique gained independence in 1975, attempts to control traditional medicine went as far as sending diviner-healers to re-education camps.
Read also: Flavors and Traditions of East Africa
Holistic Approach to Healing
African cultures believe that illness is not solely physical but also involves spiritual and emotional imbalance. Traditional healing practices often include rituals, ceremonies, and spiritual interventions to address the root causes of a person’s ailment. Sangomas and other traditional healers use divination tools, such as bones, shells, or stones, to communicate with ancestors and spirits in order to gain insights into the patient’s condition.
The medical diagnoses and chosen methods of treatment in traditional African medicine rely heavily on spiritual aspects, often based on the belief that psycho-spiritual aspects should be addressed before the medical aspects. There is the belief among the practitioners of traditional healing that the ability to diagnose and treat illnesses are a gift from God.
Rather than looking for the medical or physical reasons behind an illness (or a spell of bad luck), traditional healers attempt to determine the root cause underlying it, which is believed to stem from a lack of balance between the patient and their social environment or the spiritual world. In other words, supernatural causes, not natural causes, are attributed to illnesses.
When a person falls ill, a traditional practitioner uses incantations to make a diagnosis. The incantations are thought to give the air of mystical and cosmic connections. Divination is typically used if the illness is not easily identified, otherwise, the sickness may be quickly diagnosed and a remedy prescribed. Sometimes the practitioner will advise the patient to consult a diviner who can give a diagnosis and recommend a treatment.
The traditions of healing and medicine in African cultures are deeply rooted in ancient wisdom and continue to play a vital role in the lives of many Africans today. The use of indigenous plants, rituals, massage techniques, and music therapy all contribute to a holistic approach to healthcare. While modern medicine has become more prominent, African traditional healing practices serve as a reminder of the importance of physical, spiritual, and emotional well-being.
Read also: The Cosmopolitan City of Port Said
Role of Traditional Healers
Traditional African medicine is a range of traditional medicine disciplines involving indigenous herbalism and African spirituality, typically including diviners, midwives, and herbalists. Diagnosis is reached through spiritual means and a treatment is prescribed, usually consisting of a herbal remedy that is considered to have not only healing abilities but also symbolic and spiritual significance.
Traditional healers have theories that recognise genetic, social, psychological and environmental factors in the causation and maintenance of illness. They also embrace spiritual causation, usually ancestral.
Traditional healers, like any other profession, are rewarded for their services. In African societies, the payment for a treatment depends on its efficacy. They do not request payment until after the treatment is given. Some healers learn the trade through personal experience while being treated as a patient who decide to become healers upon recovery.
As observed by R. W. In a manner similar to orthodox medicinal practice, the practitioners of traditional medicine specialize in particular areas of their profession. Some, such as the inyangas of Eswatini are experts in herbalism, whilst others, such as the South African sangomas, are experts in spiritual healing as diviners, and others specialize in a combination of both forms of practice. There are also traditional bone setters and birth attendants.
In Africa, traditional healers and remedies made from indigenous plants play a crucial role in the health of millions since as many as 85% of African routinely use these services for primary health care in Sub-Saharan Africa. The relative ratios of traditional practitioners and university trained doctors in relation to the whole population in African countries underscores this importance. Across Sub-Saharan Africa, from Ghana to Eswatini there are, on average almost, 100 traditional practitioner for every university trained doctor.
In many parts of Africa there are few practitioners trained in modern medicine and traditional healers are a large and influential group in primary health care and an integral part of the African culture. Medications and treatments that Western pharmaceutical companies manufacture are far too costly and not available widely enough for most Africans.
An advantage of the traditional healer in rural areas is that they are conveniently located within the community. Modern medicine is normally not as accessible in rural areas because it is much more costly. Older rural women particularly tend to utilize traditional healers in their communities.
Traditional Medicine vs. Witchcraft
At this point, it is important to differentiate between traditional medicine and witchcraft, although overlaps can be seen, especially in theories of causation. Witchcraft focuses on evil designs, usually on or by close relatives, associates or competitors, and its prescriptions are usually designed to bring pain and suffering or even death to assumed or alleged enemies, based on jealousy, the need to obtain wealth, fame, popularity and so on. This is usually done through agents known as witches. Witches are generally shunned and are often thrown out of their own communities.
Traditional African medicine and its classification
Herbal Medicine and Natural Remedies
African cultures have a deep understanding of the healing properties found in their local flora. Indigenous plants and herbs have played a significant role in African medicine for centuries. Traditional healers, known as herbalists or sangomas, possess vast knowledge of these natural remedies and employ them in their healing practices.
Traditional practitioners use a wide variety of treatments ranging from standard medical treatments to the pseudoscientific and "magical". A steaming mixture of herbs is both consumed and inhaled in the treatment of Malaria. Animals are also sometimes used to transfer the illness to afterward or for the manufacture of medicines for zootherapy.
There are many plants in Africa that can be used for medicinal purposes and more than 4000 are used for this purpose in the tropical regions of Africa. Medicinal plants are used in the treatments of many diseases and illnesses, the uses and effects of which are of growing interest to Western societies. Not only are plants used and chosen for their healing abilities, but they also often have symbolic and spiritual significance.
The range of herbs used is broad and such herbs are widely available. They are still under study using modern pharmacological assays. An example of a plant with medicinal properties is Rauwolfia, which is rich in reserpine. This plant is found as an ornamental plant in many parts of Kenya and Tanzania, especially around the Mt Kilimanjaro area, where it also grows in the wild. It is known for the treatment of ‘madness’, by which is meant psychosis, regardless of the cause or type. There is a story of Chief Adetona from Nigeria who travelled to the UK in 1925 with Rauwolfia extracts to treat a Nigerian who had become psychotic there.
The botanical knowledge preserved by traditional healers represents centuries of careful observation and experimentation. For example, the bark of the Prunus africana tree has been used to treat urinary and prostate conditions-a use now validated by scientific research and incorporated into some pharmaceutical products. Aloe vera, known locally as “kigaji,” is applied to wounds, burns, and skin conditions.
Aloe Vera Flower is commonly used for wound healing in traditional African medicine.
Examples of Plants Used in Traditional Medicine
A 2000 study of thirty-three species of plants, found in the Eastern Cape province of South Africa, that are considered weeds, alien invaders or problem plants were investigated for their uses in traditional medicine. Some examples include:
- Anredera cordifolia (iDlula): Used to treat various ailments.
- Araucaria bidwillii (iNdiyandyiya): Grated bark mixed with water is consumed to treat amenorrhea caused by congenital problems, tuberculosis and malnutrition.
- Bidens pilosa (uMhlabangubo): The water from the boiled roots is consumed to treat infertility in women. Bathing in water in which the leaves have been soaked is believed to protect one from evil spirits (imoya emdaka), ill feeling, jealousy or animosity.
- Cannabis sativa (iNtsango): Used in various traditional treatments.
- Carduus tenuiflorus (uMhlakavuthwa): The patient is given an emetic and instructed to vomit onto the plant.
- Datura stramonium (uQhwangu-qhwangu): Used in traditional medicine.
- Emex australis (iNkunzane): Used in traditional medicine.
- Galenia secunda (uMvenyathi): Used in traditional medicine.
- Lantana camara (iQunube): The roots are boiled and the liquid consumed for lower back or abdominal pain, or used as an enema to treat gonococcal infections and urinary tract infections.
- Opuntia ficus-indica (iTolofiya): A poultice of the cooked leaves is used to treat sores between toes and the fingers caused by fungal infections.
- Rumex sagittatus (iBhathatha): Used in traditional medicine.
- Schinus molle (iPepile or Peperboom): Fever and influenza are treated by consuming a leaf decoction or steaming.
- Araujia sericifera (iQuwa): It is used to treat amafufunyana, which is described by Ngubane as an extreme form of depression coupled with psychotic symptoms such as delusions, hysteria, violent outburst and suicide ideations.
- Argemone mexicana (iKhakhakhakha): Used in traditional medicine.
Spiritual and Ritual Practices
Many East African healing traditions recognize spiritual dimensions of health and illness. Ceremonial practices often involve rhythmic drumming, movement, and community participation to shift energy patterns and restore harmony.
Some healers may employ the use of charms, incantations, and the casting of spells in their treatments. For example, there is the belief among the Ibos of Nigeria that medicine men can implant something into a person from a distance to inflict sickness on them, in a process referred to asegba ogwu. To remove the malignant object, the intervention of a second medicine man is typically required, who then removes it by making an incision in the patient.
A form of sympathetic magic is also used, in which a model is made of the victim and it is believed that actions performed on the model are transferred to the victim, in a manner similar to the familiar voodoo doll.
According to Onwuanibe, Africans hold a religious world view which includes divine or spiritual intervention in medical practice. For example, the !Kung people of the Kalahari Desert believe that the great God Hishe created all things and, therefore, controls all sickness and death. Hishe presents himself to these medicine men in dreams and hallucinations, giving them curative power and this god is generous enough to give this power to the medicine men, they are expected to practice healing freely.
In African Traditional Medicine (ATM), healing revolves around religious and cultural cosmologies that define illness, its causes, and the treatment processes. These cosmologies are integrated into all spheres of life but exert considerable influence on traditional African healthcare with a distinct concept of the aetiology of illness. This system understands illness as an imbalance of the body and one's socio-spiritual life and is treated by involving the interaction of physical and spiritual therapies (e.g., divination, incantations, animal sacrifice, exorcism, herbs) with no single dominant therapy.
Religion has always been part of the healing process from time immemorial. In the ancient Near East, there was an intimate connection between the office of the priesthood and the medical profession because illness and healing were religious concerns. The separation of religion from medicine only took place only within the last 200-300 years, courtesy of the 18th century Enlightenment that promoted critical thinking and displaced religion from the centre of natural philosophy (“science”).
Psychotherapy and Behavioral Therapy
The practice of psychotherapy and behavioral therapy is so very much advanced in traditional practice in East Africa that these therapies as practised in the West are not a match. This is illustrated by a statement by Rappoport & Dent (1979) on family therapy in Tanzania.
In the early 1980s, the present author had the opportunity to sit in on a clinic of a traditional healer deep in a rural area in Kenya. This healer specialised in the treatment of sexual dysfunctions using herbs and psychotherapy. The herbs must have acted very much like Viagra, for they helped men to achieve and sustain erection. But most impressive was the psychotherapeutic and behavioural approach, involving couple therapy. Without ever having heard of the Masters and Johnson technique, and himself never having travelled far from his home, and also being totally illiterate, this traditional healer prescribed almost to the letter that technique for sexual dysfunction.
Family therapy groups and group therapy are prescribed as a form of psychotherapy by many traditional healers. Of course, they do not call it psychotherapy, but in practice it is psychotherapy as we psychiatrists understand it today. The operational procedures are much the same as those practised in the West. In the process of these types of psychotherapy, individual psychodynamics are explored.
Integration with Modern Medicine
Integrative approaches that combine the strengths of traditional and conventional medicine show particular promise. At Bisoboka, we work with respected traditional healers who share appropriate aspects.
There has been more interest expressed recently in the effects of some of the medicinal plants of Africa. "The pharmaceutical industry has come to consider traditional medicine as a source for identification of bio-active agents that can be used in the preparation of medicine." Pharmaceutical industries are looking into the medicinal effects of the most commonly and widely used plants to use in drugs.
Sub-Saharan countries have found ways to unite modern medicine with traditional medicine due to the urgency of the HIV/AIDS epidemic.
The continued existence of multi-health seeking behaviour in Africa calls for purposive therapeutic collaboration between ATM and CM.
Over the past decades, Africa has experienced a steep rise in the rural-to-urban diffusion of ATM. The increased use of ATM is mainly due to urbanisation, low cost, affordability, availability, acceptability, and dissatisfaction with conventional treatment outcomes of some pandemics and chronic health conditions.
Study on Traditional Medicine in North Kordofan, Sudan
A descriptive cross‐sectional study was carried out in two conveniently chosen localities in North Kordofan state, namely Barrah, and Shaikan.
This study included a total of 302 participants from two localities in North Kordofan state: Bara (36.3%) and Shikan (63.3%). The most common age group was 15-30 years (41%), males to females’ ratio was nearly equal. All participants were Muslims, and most of them were married (67.5%) and almost half of them (48%) received primary education. The family was the main source of information about traditional medicine use (92.4%) followed by friends (37.5%), most of the participants in this study practiced traditional medicine (89.1%) in an irregular pattern\when unwell (94%), and after informing a physician in almost half of cases.
Here's a summary of the key findings from the study presented in a table:
| Characteristic | Percentage (%) |
|---|---|
| Participants Practicing Traditional Medicine | 89.1% |
| Source of Information about Traditional Medicine |
|
| Pattern of Traditional Medicine Use | Irregular/When Unwell: 94% |
| Informing a Physician Before Use | Almost Half of Cases |
| Outcome of Using Traditional Medicine | Symptomatic Relief: 89.4% |
| Most Preferable Type of Medicine | Modern Medicine: 69.9% |
| Most Common Health Problems Treated |
|
| Most Popular Type of Traditional Medicine | Medical Herbs-Herb Practitioner: 60.3% |
| Reasons for Seeking Traditional Medicine |
|
Map of Sudan and the region of North Kordofan State.
