INTRODUCTION
Prior
to the introduction of biomedicine in Cameroon in general and Nso in
particular, Indigenous medicine was the only source of health care therapy
available to the people. It was used for prevention, treatment of physical and
spiritual illnesses and also to meat broken relationship between the dead and
the living. IM was practiced in conformity with the culture and belief systems
of the people which made it part and parcel of the people. They were borne into
it, grow in it and continue to use it in times of health crisis. Conventional
medicine was introduced in Africa in general and Cameroon in particular in the
18th and 19th centuries (Fanso, 2010). The introduction
of CM in Nso was a mixed blessings and was welcomed with mixed feelings because
the European wanted to discard IM to ease the introduction of CM (Bong, 2016).
It should be noted that the first consignment of medicine brought by the
Europeans to Africa was not meant for the treatment of Africans, but for the
colonial administrators and missionaries. West Africa was referred to as the Whiteman’s
grave because they were killed in their numbers by malaria. They described IM
as dirty, witchcraft and superstition since they perceived it from a
Eurocentric perspective using the bible as a measuring rode. Missionaries used
health as a tool for evangelization and that explains why they established
health centers and hospitals in places like Shisong (Saint Elizabeth Catholic
Hospital), Nkavikeng (Banso Baptist Hospital), Kishong and Tatum.(Sunjo, 2016)
This paper seeks to establish the
benefits of collaboration between IM and BM. It should be noted that the
introduction of BM eradicated some illnesses like sleeping sickness and reduced
the spread of epilepsy. BM has also helped in the prevention of illnesses through
vaccination. Some traditional healers like Shamase Emmanuel sent patients to
the hospital to carry out laboratory test before and after treatment to ensure
the illness was well treated (Shamase, 2021). Some people in Nso utilized the
two systems simultaneously to treat illnesses. Some medical doctors threatened not
to treat patients when they realized that they started using IM before visiting
the hospital. Some patients sneak into the hospital with IM to administer
simultaneously with BM (Banfogha, 2011). The colonialists and the missionaries
on their part hated the practice of traditional medicine and urged their
followers to shun the practice and the use of indigenous medicine (Lantum, 1986) which
led to tension between IM and BM. In spite of the tension, the two systems of
therapy have some similarities and differences.
In 1979 the World Health Organization, (W.H.O) recognized indigenous
medicine at the Alma/Alta International Conference in Russia (Sarkey, 2010).
That was when Indigenous medicine received a green light to freely be practice
which reduced tension between the two systems of health to a certain extend.
Situating the Study
Area
Nso
is one of the largest Fondoms in the Bamenda Grassfields of Cameroon (Chilver,
1976). It covers 85 percent of the land surface of Bui Division and a surface
area of approximately 2300 square kilometers (Banfogha, 2011). Nso lies between
Latitude 5°, 60° and 6°, 25° North of the Equator and Longitudes 10°, 20° and
11°, 5° East of the Greenwich Meridians. Nso Fondom practice a centralize system of government with the fon at the helm of the administration.
He is assisted by the Vibaais, Faays
and the Yaahs. Other arms of
traditional administration include Nfu, the military wind of the administration
and Nwerong which acts as the
judiciary. Nso Fondom shares boundary with Mbum land to the North, Bum
in the North West, Kom fondom in the West and to the South West with the Ndop
plain(Banfogha, 2011). Nso has an Equatorial climate with two seasons that is
the rainy and dry seasons. Annual rainfall stands at 1873 millimeters and
annual temperature range from 18.3 degree Celsius and 19.6 degree Celsius with
an annual temperature of 19 degree Celsius (Njodzeka, 2018). Nso is 109
kilometers from Bamenda, the Regional head quarter of the North West Region of
Cameroon (Chilver,1976).
METHODOLOGY
The
study adopted a qualitative research method where primary and secondary sources
were consulted. Under primary sources, oral interviews were conducted one on
one and in groups of at most four traditional healers and biomedical doctors.
The targeted population was traditional healers, medical doctors and elites of
Nso who used the two systems of therapy. Secondary sources were also consulted
and included books and articles, newspapers and magazines. The data was
analyzed qualitatively and chronologically.
Conceptual Framework
Scholars within and out of Africa have
provided different meanings to their understanding of indigenous medicine.
Patrick A Twumasi posits that IM was the service performed through the
utilization of magico-religious acts and concepts with healers having notions
of physical cure and treatment. According to him, one cannot talk about IM
without reference to magico-religious therapy. African traditional medicine is
based both on physical and metaphysical forces of the universe (Twumasi, 1975).
These forces are responsible for causing most illnesses if not all. For proper
treatment of these illnesses both physical and metaphysical means are employed
According to the World Health Organization,
indigenous medicine is the sum total of all knowledge, skills and practices
based on the theories, believes and experiences of indigenous people to
different cultures, whether explicable or not used in the maintenance of health
as well as in the prevention, diagnosis, improvement or treatment of physical
and mental illnesses (Lusamba, 2010). This view encompasses every aspect of IM
and emphasizes it holistic nature. It also indicates the fact that traditional
medicine is culture bound, that is practice within the ambit of the culture of
a people within a geographically define area.
Daniel Lantum, on his part opines
that IM is a system of therapy that fight for the survival of man, his long
life, perpetuity, prosperity and happiness, by preventing premature dead
through the treatment of disease and by prolonging life through healing. Also,
by bestowing the health and power to man so that he can fight better for
his prosperity, by relieving misery and
long suffering through the healing process and by promoting the fertility of
man so that he can continue the procreation of human species (Lantum, 1985). Aderajew
perceived traditional medicine as a set of knowledge and practice which is used
in diagnosis, prevention and elimination of physical, mental and spiritual
illnesses (Aderajew, 2016).
Lantum painted a vivid picture of traditional
medicine as his concept of traditional medicine encircle everything about man
and his wellbeing, long life, prosperity and procreation. Man’s activities rely
exclusively on his health condition, no wonder the adage that “health is
wealth”. It can also be added that seek ye first good health and many other
things shall be added on to you, for a healthy man can do anything. Traditional
medicine is a system of healing where plants, animals and other mineral
resources are used to prognoses, diagnose, treat and predict illnesses within a
cultural sphere with common belief systems. It can also be seen as man’s
interaction with his environment for a quality life and healthy living void of
emotional or psychosocial imbalance (Lusamba, 2010).
The word medicine was loosely used to cover a
wide range of substances combined with operative acts and binding words, often
extended to anything associated with them.(National Archives Buea, 1993)
Natural substances, plants in particular, were placed on earth which can be
combined with others and activated by men without any other interposition. Medicine
can be static or mobile with different strengths in their effects and all
should be used for justifiable purposes against malefactors, trespasses, hostile
sorcerers, and witches (National Archives Buea, 1990). Since medicine possesses
a true quality and a tendency to bounce back against ill-intentioned or witch
possess sender, traditional healers avoided such ill intentions to be freed
from the consequences.(Ibid)
This practice is referred to as indigenous
because it was based on knowledge, practical experience and observation handed
down from generation to generation, either verbally or in written form from
African forefathers (Onah, 2018). Traditional medicine is an aspect of African
Religion and covers both natural healing agencies such as leaves, herbs, roots,
animal parts and invocation of rituals or spiritual influence.(Ibid) From the
above concepts of IM, the researcher perceived IM as a medium of treatment
wherein people are treated from physical and spiritual illnesses within a
geographical confine with the use of natural substances like herbs, animals,
water, soil, incantation and other mineral resources.
The second concept is biomedicine. The origin
of the term biomedicine can be traced back to the 1920s and it was first used by
America and British authors (Strasser, 2014). Biomedicine as define by the
American medical dictionary is clinical medicines based on the principles of
physiology and biochemistry, rather than on the art of healing or the expertise
physicians gained through the practice.(Ibid) Biomedicine and biomedical
research were understood as a kind of medicine that was closely associated with
experimentation and laboratory rather than doctor’s knowledge and clinic.(Ibid)
Socially, biomedicine is considered orthodox or scientific medicine and or
alternative medicine. In Nso it is referred to as “Shiv se barah” by the
indigenous people.
Introduction of
Biomedicine in Nso Fomdom
Biomedicine
was introduced in Nso land in the 19th century by the European
Missionaries and colonialists (Latum, 1986). Before 1916, the presence of
biomedicine in Cameroon in general and Nso in particular was not well known (Funteh,
2018). By this time, biomedicine existed only along the coast of Cameroon and
was meant for the colonial administrators, missionaries and not for
Cameroonians.(Ibid) During the German era in the Bamenda Grassfields,
biomedicine was scarce but as from 1916
when the British took over the territory biomedicine was introduced in Nso and
other interiors of Bamenda Grassfields. In 1925, the British created a hospital
in Bamenda and another one in Kumbo (Nso) (Kent, 2002). The funds for the
creation of these hospitals were provided by the Native authority and the
British government. The project was under the auspices of E.G Hawkesworth, the
District Officer for Bamenda (Funteh, 2018). This building consisted of a ward,
a central block, dispensaries, consultation rooms and an office.
The first Christian organization to
arrive and settle in Nso was the Catholics. This was the German Sacred Fathers
who arrived Nso in 1912. They started their mission work in Shisong and did not
only target the spiritual needs of the people but also the health care needs (Banfogha,
2011). In 1935, the Tertiary Sisters of
Saint Francis from Brittan, South Tyrol, Italy arrived Cameroon on the 12th
of October 1935 (Tssfcameroonhealth, 2023). These sisters were Martina Albenberger,
Dorothea Wild, Odilia Hillebrand, Camilla Geier and Cleopha Jocher (Banfogha,
2011). They started a clinic which was recognized as a hospital in 1952 with
registration number 224 and confirmed in 1974 with registration number
96/A/MSAP/DSP/SDFS/BESP. (Ibid) The first Cameroonian doctor to be appointed as
chief medical officer was Doctor Sunjo Leonard in 1972, a native of Nso.(Ibid).
The Baptist missionaries arrived Nso in 1930
headed by Doctor Gebauer and established their base in Mbem, in Donga Mantung
of the North West Province (Region) (Funteh, 2018). At Nkavikeng in Nso, they
established a hospital unit under the leadership of Doctor Chaffee. In 1948,
the Baptist mission bought the hospital from the colonial government that was
established in 1925 and named it Banso Baptist Hospital (BBH). (Ibid) Since
then the hospital has stood the test of time as one of the best hospitals in
the North West Region and Cameroon as a whole. In addition to their
evangelization work, they also owned mobile clinics where they moved from one
household to the other to treat patients (Konghadzem, 2016). The picture below
shows a structure hosting the Banso Baptist Hospital.
Another missionary body in Nso was the Basel
Mission which came to Nso in 1929 and their First evangelist John Mosi was
posted in 1930 (Shuka, 2000). The headquarters of the Basel Mission in Nso was
at Kishong. Just like the other missionary bodies, the Basel Mission was not
left out as far as the health of their followers was concern since health
service was a tool for evangelization. They created a First Aid station at
Kishong, where the people were treated from various illnesses like scabies,
ringworm, and leprosy (Wirsiy, 2016). Due to limited accommodation at this
station, some patients were treated at the comfort of their homes but major
cases were ferried to the First Aid station for proper treatment (Ibid). They
used vaccination to prevent some of these illnesses like tetanus, and
tuberculosis.
Native reactions to
the introduction of Biomedicine
The
introduction of biomedicine encountered limited resistance from the indigenes.
The initially consignment of medicine was not meant for the Africans in general
and Nso in particular but for the colonial administration and missionaries. The
majority of Nso indigenes received biomedicine with euphoria until when the
missionaries wanted to annihilate IM. (Banfoha, 2011) Missionaries used CM to
foster their evangelization work in Cameroon in general and Nso in particular.
Initially, it was administered free of charge to the people especially
plantation workers. (Kent, 2002 ) Hospital fees was introduced in the early
1940s and the introduction of this fees further scare the masses from BM. It
should be noted here that IM was free of charge and patients offered only
elements for sacrifices. It was not only cheap; it was also available at every
given moment (Kesiki, 2016).
Initially, many people were against routine
vaccination because of the pains that accompanied it. For example, in Nkar in
the 1930s, many people fled away from routine vaccination which was carried out
on market days.(Banfogha 2011)in recent times, a lot of controversies have
surrounded vaccination where in individual with bad faith claimed that vaccines
were meant to reduce the population. Also some churches also preach against
blood transfusion to her members.
Some patients decided to use the indigenous
as well as biomedicine in times of health challenges. Biomedicine was
introduced in Nso at the time when endemic diseases like yaws, syphilis,
leprosy, typhoid, malaria and small pox were rampant in Nso.(Ibid) Vaccination
aided to eradicate and reduced some of these illnesses to the admiration of the
people of Nso.(Wiraka, 2016) By so doing, biomedicine gained grounds and the
population had no choice than to welcome it. Some of the first medicines
introduced in Africa in general and Nso in particular were quinine and aspirin,
used to combat malaria.(Fanso,2010) This motivated the people to welcome
biomedicine but it should be noted that they did not abandon their traditional
healing methods. This buttress the relevance of collaboration between the
indigenous and convention systems of health care
The colonialists/missionaries upon their
arrival condemned the practice of traditional medicine. As opine by Fanso, they
referred to it as witchcraft, superstition, occult medicine, and dirty.(Fanso,
2010) Traditional healers were called witch doctors which demoralized some who
decided to practice in hiding. It should be noted that the Europeans came to
Africa with a mindset that Africa was a dark continent and have nothing to
offer to humanity. Their efforts to discard traditional medicine were futile
because biomedicine was scarce, expensive and the fact that they could not
treat spiritual illnesses unlike indigenous medicine.
Mission hospitals and some medical doctors
went threatened not to treat patients when they realized that the patient
visited a traditional healer before coming to the hospital. These doctors
believe that the patient could not be treated with indigenous medicine and that
explain why they decided to visit the hospital.
The Catholic churches in Nso threatened to expel church members who
practice and utilize indigenous medicine for treatment from the church. (Yarayen,
2016) In some areas like among the Bamilke of Cameroon and the settler colony
of South Africa, indigenous medicine was out rightly banned and traditional
healers practice in hiding. Traditional healers were also arrested especially
in situations where patients died during treatment.(Fanso, 2010).
Notwithstanding, the hatred portrayed by the Europeans on indigenous medicines
is strived as the demand for IM has been on a steady increase since it is
effective, affordable, and available unlike biomedicine which was scarce and
expensive. For example, in 1927, there were only two hospitals in the entire
Bamenda Grassfields, one in Bamenda and the other in kumbo.(Kent, 2002).
Patients trekked for kilometers to access medications and for this reason, the
masses decided to use what was indigenous to them.
Similarities between
Indigenous and Conventional Medicine
As
postulated by Daniel N Latum, a researcher and traditional
healer, all medicines are aimed at prolonging life.(Cameroon Tribune, 2002)
Traditional and modern medicines are meant to treat and restore the lives of
the people of their communities and also to reestablished broken relationship
between the living and the dead. Though the methodologies of treatment and
belief systems differ, they had a common goal to treat spiritual and physical
illnesses.
The origin of traditional and modern
medicines is traced from herbs. Hippocrates known as the father of biomedicine
got inspiration from Ancient Egypt that practice indigenous medicine.(Stuart,
1979) All societies in the world have
used indigenous medicines be it developed or developing. With the advent of
Industrial Revolution, some of these herbs were transformed into tablets. Dioscorides,
a Greek physician mentioned many plants with medicinal properties and most of
these plants like pepper, ginger and aniseed are still in used in contemporary
pharmacopeia for the production of biomedicines.(Ibid) According to the World
Health Organization, more than 30 percent of modern medicines were derived
directly or indirectly from plants. Examples included analgesics (aspirin,
bellaonna), anticancer medicines (vincristine and vinblastine),
antihypertensive agents (reserpine) and anti-malaria (quinine, artemisinin) (Kasilo,
2010) indigenous and conventional medicines have the same source of raw
material.
The transformation of medicinal properties in
plants to biomedicine started in the 18th and 19th
centuries and since then modern physicians still rely on plant extract for the
production of biomedicines.(Ibid) Indigenous medicines on it part also depended
highly on plants extract for the processing and production of medicines. Herbs
constitute 57 percent, trees 24 percent, shrubs 15 percent and climbers 4
percent of raw materials used for the production of indigenous medicine.(Simbo,
2010) Traditional and biomedical derived their raw material from a common
source which was mostly plants and other mineral resources, though the method
of processing differs.
The treatment process in IM and CM commence
with the establishment of the etiology of the illness. Before medicine was
administered to a patient, the physician sought to know the cause. Biomedical
doctors used the laboratory to diagnose illnesses through the examination of
blood, urine and excrement depending on the type of illness. On the other hand,
traditional healers establish the cause of an illness via divination which was
done with the used of cowries, kola nuts and kola nuts peelings. Through
divination, traditional healers were able to establish the cause of an illness and
how it could be treated.
Another similarity was the fact that
indigenous and medical doctors belief in the existence of a supreme being
(God). Biomedicine was affiliated to Christianity while indigenous medicine was
affiliated to African traditional religion. (Mumo, 2012) Biomedical and
traditional healers believed that they only treat but healing comes from God. In
the course of treatment, traditional healers perform sacrifices to the
ancestors who are belief to be the source of their powers to treat. Also, there
were some illnesses that effective treatment could only be done through
sacrifices to the gods. Mission hospitals on the other hand pray to God and
belief God is the mighty healer. There is a slogan used by indigenous and
medical doctors that says “we only treats and God heals.”
Indigenous and conventional medicines operate
under strict ethical considerations. Prior to becoming a medical doctor, an
oath commonly refers to as a hypocritical oath is taken before being granted
the license to function as a medical doctor. Indigenous healers on the part
also swear an oath before their trainer, other traditional healers and the
public before being recognized by the community as a healer. The aim of this
oath is to respect human beings in the course of treatment. (Lantum, 1986, Mbuy,
2021) It should be noted that the potency of indigenous medicine is anchored on
the respect of these norms. Violation of these norms led to inefficacy of
medicine and in some instances, healer were attacked by an illness as a
punishment. When medical doctors go contrary to these norms, they are
sanctioned.
Just like any human endeavor, indigenous and
biomedicines have strengths and weaknesses. While some people criticize
indigenous medicines because of poor hygienic conditions and the dosage,
biomedicine was also criticized for numerous side effects cause by toxic
chemicals found in it. Both sectors need to capitalize on their strength and
work on their weaknesses for the betterment of humanity.
The heart of traditional and conventional
medicines is research. Traditional and medical doctors embark on research to
discover new medicines and to improve on existing knowledge. New illnesses crop
up from time to time which gives doctors the task to diagnose, prognose and
developed medication for the treatment of such illnesses. For example in 2019,
the world witnessed the outbreak of a dreaded illness known as Covid 19. When
this illness started, there was no cure for it and it killed in thousands. After
intensive research in both traditional and conventional medicine, traditional
healers discovered the treatment of Covid 19. Bishop Samuel Kleder of Cameroon
and the president of Madagascar, through research discovered a herbal remedy
for Covid 19 which was proven to be effective. (The post Newspaper, 2021)
Biomedical doctors on their part discovered some vaccines for the
treatment of Covid 19. Also HIV/AIDS that surfaced some years back and had no
cure is curable today thanks to research. Many traditional healers have
discovered the treatment of HIV/AIDS and have treated some patients suffering
from this illness.(Kube, 2002) Although the methods used in carrying out
research differs between traditional and biomedicines, they are a common
direction which is the discovery of new medicines and the improvement of old
ones.
Traditional and conventional medicines
complement each other to meets the health care need of the people. In places
with inadequacy or absence of conventional medicine, the population relies on
indigenous medicine especially in the developing world in general and Cameroon
in particular. Patients who have the financial ability decide on which system
to use that will treat them within a short period of time. It should be noted
that illnesses with spiritual underpinnings are easily treated with indigenous
medicines. (Karngong, 2020) Some traditional healers advise their patients to
run some laboratory test in the hospital before and after treatment to ensure
that the illness was well treated. Some traditional healers encourage referrals.
That is, they refer patients to the hospital when they realized that the
illness will be easily treated at the level of the hospital. (Shamase, 2021)
For example, patients who need to undergo surgery and blood transfusion.
Traditional and biomedical doctors operate
under intellectual property right. Traditional healers use customary laws to
protect their rights, though not documented. These laws originated from the
peoples culture and differs from one community to the other. Individual
communities have complex and effective customary system to protect traditional
knowledge (Sarkey, 2010). The International Labor Organization Convention of
1989 in it article 169(20) recognized the rights of indigenous people to
conserve their institutions through customs and believes.(Ibid) These laws
determine the ownership of elements of traditional knowledge and other
responsibilities and the right of customary use of knowledge should be
permitted.
Conventional doctors on their part have a
documented intellectual property right which protects their products. Medical doctors
consider traditional healers to be secretive since they don’t expose certain
things about their practice to the general public. The intellectual property
right that guides traditional medicines was enshrine in community laws and was
not strong as compare to conventional medicine. Traditional medicine was
codified through language and culture of the respective communities. Just as
there were similarities, there are also differences that make each system of
health unique.
Differences between
Indigenous and Biomedicines
Indigenous
and conventional medicines have a common mission, which is to treat illnesses.
Despite this common mission, their methods of operation differs which make each
system unique. The first difference that could be advance is the fact that
indigenous medicine is culture bound and treats both spiritual and physical
illnesses. In most of Africa, it is believed that illnesses were cause by
spiritual and natural forces and for proper treatment; the illness was targeted
from the physically and spiritually angle. Biomedicines on it part deals with
the physical part of the illness and only solicit the services of Christians to
target spiritual illnesses through prayers.
Biomedicine
is standardized and treats patients across the globe using the same
medications. This means that a drug produced in any part of the world for the
treatment of malaria could be used to treat malaria in any part of the world.
CM is not limited to a cultural or geographical sphere (Sunjo, 2016). Indigenous
medicine on the other hand is limited to a geographical area or community with
a similar belief system and cultural norms. This is because IM is practice in
conformity with the culture of the people. There are herbs that are medicinal
in one area but not known in others since some of the medicinal herbs rely on
the belief system or culture to activate efficacy. (Ibid) Also, there are herbs
that are not transferable from one area to the other because its efficacy will be
destroyed in the course of movement.
Another major difference between IM
and CM was in the aspect of cost and availability. IM is cheap and available to
the population at any given moment. It is medicine of the people by the people
and for the people (Mokgobi, 2016). From its inception, traditional medicine
was not a commercial commodity as it was meant to “help” treat patients who
suffered from diverse illnesses, especially in the developing countries. IM was
meant for everyone that is the rich and the poor in the community. Conventional
medicine on its part was considered medicine for the rich because it was
expensive and scarce. To assess CM demanded a lot of money and in some
instances, the medicine was not available especially in the rural area and semi
urban areas.
Indigenous medicine is the oldest system of
health care therapy (Porter, 1997). It is as old as the existence of mankind
for man had always sought ways to meet up health care from within his
environment. All societies in the world at a certain moment had used indigenous
medicine, whether developed or less developed. Conventional medicine emanated
from the knowledge of IM as most pharmaceutical industries relied on herbs for
the production of medicines.(Simbo,2010) Modern medicine was a transformation
of indigenous healing methods in the western societies especially with the
advent of industrial revolution in Europe before it was introduced in Africa in the 19th
century during the colonial era.(Iddrisu, 2017)
Indigenous medicine is natural and has
limited side effects. Most if not all raw materials used by traditional healers
to produce medicines comes from natural environment and local methods are used
to process the medicines. Chemical substances are not added to it for whatever reason.
Though traditional healers could scientifically determine the side effect of
the medicines administer to patients, the side effects is limited since it is
natural. Conventional medicines on the contrary have a lot of side effect and
the side effects are scientifically established.CM undergoes a lot of
processing, coding, preservation agents and all these are toxic to the body.
All drugs have side effects and when drugs cure one illness, it damages another
gradually especially when the patients live on drugs (Fanso, 2020). Rampant
utilization of CM is discouraged as it damages the heart of man and other body
parts. One of the reasons why indigenous medicine is gaining grounds in the
developed countries is because of its limited side effects. Many patients have
resorted to the use of IM to avoid the side effects.
The method used to diagnosed patients before
treatments commence also differs. Medical doctors used a scientific laboratory
to diagnose and establish the cause of an illness meanwhile traditional healers
rely on divination. They tested the vital signs of the patient and examine the
blood, excrete urine and spittle. All these are taken to the laboratory for
examination and diagnoses. Indigenous healers use divination to establish the
cause of an illness and how the illness could be treated. Divination determines
whether the cause of an illness is spiritual or physical and also carryout prognosis
using the same process.
Documenting the medical history of a patient
is of utmost important in CM practice, while traditional healers hardly put
into writing the medical history of patients despite its importance. This stem
from the fact that most traditional healers were illiterates and documenting
medical history was not of any interest to them. The medical history of a
patient plays a significant role especially when visiting the hospital for the
second time. Medical history also helps in that not only one doctor treats a
patient. That is, the next medical doctor to work on the patient just need to
go through the medical history of the patient and continue from where the other
doctor ended. Traditional healers deal mostly with oral interviews to carry out
their treatment (Yusuf, 2015).
It takes a long period of time for medical
doctors to be trained and awarded licenses to operate as doctors as compare to traditional
healers. The duration to train a medical doctor depends on the specialty and in
most cases 7 years and above in recognized schools. (Ibid) Tradi-practitioners
on their part takes a shorter period of time to undergo the training. Most
tradi-practitioners inherited the skills from their parents and grandparents
while others acquired the skills through revelation. For those who were trained
to become traditional healers, the duration of training range from about one to
three years depending on the trainees ability to gain the skills (Shamase,
2021).
Conventional medicine is highly standardized
as compare to traditional medicine. Most activities carryout in pharmaceutical
industries are common in most part of the world. Treating an illness with the
use of a particular drug also cuts across, that is the same prescription will
be done for people of the same age across the board (Yusuf, 2015 ). Traditional
medicine on its part is not standardized with differences in the method of
treatment based on the culture of a particular ethnic group. For example
different methods and equipment are used to carry out divination. Some diviners
use kola nut peelings, cowries, water while others use sticks, broken iron and
bottles for the same exercise. Also traditional healers used different methods
to treat illnesses which are peculiar to them. Even within the same cultural
sphere, there is no standardization as each practitioner operates individually.
In
terms of dosage and preservation, there is a gap between CM and IM. Medical
doctors establish the dosage of every medication based on age, size, weight,
height and the duration the illness had been in the patient. All this is
possible because of the level of science and technology involved in conventional
medicine. Pharmaceutical industries have also developed well preservative
methods for the medicines they produced. They established the duration the medicine
could last before it expire and are exact with the duration. (Ibid) This has
been a major hurdle with indigenous medicine. Preservation of medicine has been
a herculean task in the indigenous medicines industry especially medicines
produce in liquid form. Because of this, traditional healers produce medicines
on command and it is consumed within a very short period of time (Shamase,
2021), this is to avoid fermentation which could instead cause damage to the
body. Transportation of indigenous medicine is also challenging especially to
long distance places. The medication may get bad before it reaches the consumer
or the patients. Modern medicines had overcome these challenges due to its high
level of science and technology.
Indigenous and modern medicines have
different conception on disease causation and treatment. Medical doctors
believe in the physical causes of illnesses and they target the illnesses physically.
Since indigenous medicines are in line with the belief systems and culture of
the people, they acknowledge two main causes of illnesses which are the physical
and spiritual. The treatment process handles the spiritual and physical causes,
thus making IM to be holistic. Treatment of illnesses with spiritual
underpinnings takes the form of sacrifice to appease the gods or ancestors.
Conventional medicine is highly recognized
all over the world but traditional medicine is still striving for recognition.
Prior to the introduction of conventional medicines in Africa in general and
among the Tikars of the Bamenda Grassfields, indigenous medicine was the only
means of therapy and it was recognized by the masses (Kent, 2002). Biomedicine
was introduced in Africa by the missionaries and the colonialists and in other
to ensure it supremacy in Africa, they castigated traditional medicine and
refer to it as witchcraft, dirty and superstition (Fanso, 2010). It was banned
in some places like the Republic of South Africa and among the Bamilikes of
Cameroon. It was only in 1978 that the W.H.O recognized IM at the Alma-Ata Conference
in Russia and urged her member states to recognized and promote this system of
health care (Lusamba, 2010). IM is not well regulated by most African
governments including Cameroon, meanwhile billions of Francs CFA are injected
into biomedicine. Traditional medicines do not have any legal backing in
Cameroon though practitioners have licenses issued by the government.
Indigenous and conventional medicines have
areas of giftedness. Some illnesses are better handled by indigenous medicine
while others are easily prevented and treated with conventional medicine. In
the Nso Fondom, it was believed that illnesses like epilepsy, leprosy and
madness were easily treated with indigenous medicine. This was because most of
these illnesses have spiritual underpinnings. With the introduction of
conventional medicine, it facilitated the treatment and eradication of some
illnesses like sleeping sickness (Yarayen, 2016).
The degree of safety between indigenous and
modern medicine differs. Conventional medicine is based on drug trials with
experimentation (Yusuf, 2015). The trial of medicine was at times first on
animals before administering it to human after being approved. Traditional
medicine do not undergo a rigorous experimentation since there don’t have a
laboratory. They relied on knowledge and experience handed down from one
generation to the other. The differences between indigenous and modern
medicines have led to tension between the health care systems instead of
collaborating with each other.
Tension between
Traditional and Biomedicine
Even
though indigenous and biomedicines had a common aspiration to treat patients
who suffered from one illness or the other, there have been tension over time
between the two systems of health care. This tension originated from the differences
that exist between IM and CM and the way the missionaries and colonialists
perceived indigenous medicine. They believed upon their arrival in Africa that in
anything, Africa was inferior and Europe was superior. They wanted to impose
their superiority complex in Africa even in the health care and that explain
why they castigated IM in favor of CM.
One of the reasons that accounted
for this tension was the fact that missionaries/colonialists upon their arrival
castigated indigenous medicine as dirty, witchcraft and superstition.
Traditional healers were called witch doctors which made them uncomfortable (Fanso,
2010). The missionaries did not even border to investigate how this system of
health care function but went ahead to discouraged their followers or converts
to shun the use and practice of Indigenous medicine. In some parts of Africa like South
Africa in 1953 and among the Bamileke of Cameroon, it was out rightly banned
and criminalize. When a patient died in the course of treatment, the
traditional healer was arrested and detained (Ibid). This made most
practitioners to practice underground or in hidings. All these led to tension
between the two systems of health.
These two systems of health care originated
from different areas with different beliefs systems. The introduction of
biomedicines and European culture in Africa led to cultural/ideological clash
which hitherto created an unequal power relation (Arazeem, 2011). Indigenous
medicine and Africans have a peculiar way they perceived health and how it was restored or treated. The West on the
other hand also had different ways to perceive an illness and how it could be
treated Mumo, 2012) while indigenous medicine was anchored on African
traditional religion, modern medicine was anchored on Christianity and other
religions. These disparities in belief system led to tension especially when
the missileries and colonialists believe that their system was the best and most
be imposed on the Africans. That was why upon their arrival, they wanted to
totally annihilate IM in favor of CM. Traditional healers and the population
resisted because indigenous medicine was not only available, but it was
affordable and effective in the treatment of illnesses. Ali Arazee posited that
“A century of
colonialism, cultural imperialism and Apartheid in South Africa have held back
the development of African traditional health care in general and medicines in
particular. During several centuries of conquest and invasion, European system
of medicine was introduced by colonizers. Pre-existing African systems were
stigmatized and marginalized and indigenous knowledge system were denied the
chance to systematize and developed”.(Arazeem, 2011).
Unlike biomedicine that was
officially recognized and supported by the government, indigenous medicine was
yet to be officially recognized. In 1978, the World Health Organization officially
recognized indigenous medicine in the Alma-Ata Conference and persuaded all her
member states to officially recognized this system of health care (Lusamba,
2010), this was because of the pivotal role IM played in the lives of many
especially in the Developing world. Even though some African countries like
Ghana, Nigeria and Senegal have officially recognized indigenous medicine by
developing it through various means, Cameroon is yet to recognize and fully
engaged in support of this sector. The recognition of one and not the other buttress
the superiority complex in the health care industry, thus leading to tension.
According to some medical doctors (Djai, 2022), they could not refer a patient
to a traditional doctor because they lack legal backings. Some claimed that if
they refer a patient to a herbalist and he end up dyeing, they cannot legally
back themselves (Sunjo, 2016). Some medical doctors went as far as threatening
to stop treating a patient when they realized that the patient visited a
traditional healer.
The government invested a lot of
money in biomedicine and very little on indigenous medicines despite the fact
that about eighty percent of the population relied and make use of this system
in times of health challenges. The government is yet to officially recognized
and subsidies it in other to boost the sector. Despite the money bumped by the
government into biomedicine, it is still expensive to the common man especially
in the rural areas when compare to indigenous medicines. The efforts of the
government to uplift the statuesque of traditional healers are slow.
Indigenous medicine industry was
invaded by many charlatans since the sector was not well regulated. The
activities of these charlatans tarnished the image of the sector giving room
for a lot of criticisms as some of them who hide as traditional healers lie to
patients, to extort money from them. Some even claimed to treat all illnesses
and failed to refer patients to expert in a particular domain. Because of this
many people who could have been treated if they sought the solution to their
problem from the right place ended up dying. All these activities cause pains
to biomedical doctors and made them not to have confidence in indigenous system
of health care.
Most traditional and biomedical
doctors perceived themselves as competitors instead of complementing each
other. The fact that they perceived themselves as competitors is a breathing
ground for tension between the two systems. They don’t speak well of each other
and instead capitalized on the weaknesses of each other rather than their
strength. On the National Radio and Television, biomedical doctors chastise
indigenous medicine and the activities of traditional healers. Traditional
healers who at first did not advertise themselves have invaded local radio/televisions
within the communities to advertise their products. They also advertised on
inter urban transport buses and along the major streets of towns and cities (Kent,
2002). They used this opportunity to also castigate conventional medicine and
exposed their weaknesses. Tension also arose when traditional healers claimed
they treated HIV/AIDS. Medical Doctors felt that they were being challenged by traditional
healers (Richter, 2003).
Benefits of Collaboration between Indigenous
and Conventional Medicines
Collaboration between indigenous and conventional
medicines is of utmost importance to traditional and medical doctors as well as
to the patients they treat. First and foremost, they complement each other especially
in places where one is inaccessible. The availability and affordability of
indigenous medicine is a plus for collaboration (Wirgo, 2016). In places where
conventional medicine was not available, the population relied on IM to meet up
their health care needs. Conventional
medicine was not only scarce in some areas but it was also expensive for some
people who could not afford it. It is a known fact that IM is utilized by about
eighty percent of the population of Africa (Wamba et al, 2012).
Collaboration is a
prerequisite for the exchange of skills and knowledge within the health
industry. In 1999, the World Health Organization organized a conference in
Beijing and China, where tradi-practitioners and biomedical doctors came
together to exchange ideas on collaboration (WHO, 1999). It was important for
the two systems to come together and to understand how each other function in
order to strengthen each other. Understanding the two systems of health care by
practitioners eased and facilitated external referrals, that is traditional
healers referring patients to medical doctors and medical doctors doing same
(Shamase, 2021). It has been established that there were illnesses that were
easily treated with IM while others were easily treated with CM. this will
facilitate the healing process.
Collaboration between
IM and CM led to a decline in mortality rate
especially in countries like Mali
where the two systems work together. For example, indigenous and medical
doctors targeted the treatment of
malaria in Mali and it reduced mortality due malaria from five percent in1997 to two percent in
1998 (Wamba, 2012). Within a period of only one year they succeeded to reduce
death rate caused by malaria by three percent. This showed that effective
collaboration facilitated the treatment of many illnesses. In 1977 two medical
doctors testified about two patients who visited the hospital, but they were
unable to treat them. They said:
“They
brought a senior chief to the hospital having flaccid quadriplegia with all
reflexes lost and we treated him without any result. After some time, they
requested me to let them take home their chief to the village. I thought he was
leaving to go and die but I found him on his feet quite fit and working again.
He lived for many years thereafter and died from alcoholic cirrhosis of the
liver.”(Lantum,1975)
The second doctor testified of a man who
suffered from mycosis of the foot, typical Madura mycosis with gangrenous
fistula and poor general condition which seems to justify amputation of the
foot. The patient was discharged from the hospital without being treated on
demand by the family. The family realized that the illness had spiritual
underpinnings and could not be treated at the level of the hospital. The
traditional healer started the treatment process by killing the man who
bewitched the chief. After six months, the chief return to the hospital
marching on his feet without any deformity (Wamba, 2012). He explained with
gesticulation how he killed the person who bewitched him and then was healed of
his infirmity.” These testimonies buttressed the significance of collaboration,
where IM is limited, CM comes in to complement for the wellbeing of the
patients.
Indigenous medicine commanded a lot of respect in the communities where
it was practiced. It was culturally accepted by the people as part of them.
Effective collaboration made it easy for medical doctors to understand the
population through traditional healers since they lived with the people in the
communities and understood their medical history. Collaboration influenced
exchanges that improved on the hygienic condition of tradi-practitioners and
also educated them to refer cases they could not handle to the hospital
earlier, instead of waiting until critical moments before the patient was
referred to the hospital. In Senegal for example, an association of traditional
doctors known as, “Promotion of Traditional medicine” (PROMOTRA) run a center
known as “Experimental Center for Traditional Medicine” (CEMETRA). This center
worked together with biomedical doctors who conduct laboratory tests and
collected vital signs of the patient like weight and height and the results
were handed to tradi-practitioners for treatment. After the treatment, the
patient was again diagnosed to determine the effectiveness of the treatment and
also examined if there were any side effects from the treatment (Kofi et al,
1999).
Charles,
Karngong. Age 69. Traditional Healer,
Wat. 06th August 2020
Solange,
Tabim Djai, Age 41, Nurse, Noni, 13th June 2022
Yarayen
Mohamadou. Age 45, Traditional Healer. Nseh, 15th June, 2016
Stephen
Bong. Age 62, Traditional healer, Menfu, 23th August 2016.
Anthony,
Konghadzem. Age 80, Traditional Healer, 30th August 2016.
Emmanuel
Wirsiy. Age 78, Traditional Healer, Memfu, 23th of August, 2016
Joseph
Kesiki, Age 64, Traditional Healer, Nseh, 28th August, 2016
Idrissu
Wiraka, Age 80, Traditional Healer, Menyar, 14th September 2016
Adamu
Wirngo, Age 60, Traditional Healer, Tatum, 15th June 2021
Banfogha,
Wirba Joan, Interaction between Traditional and Western Medicines in Nso,
1820-2000, Masters Theses in History, University of Bamenda, (2011)
E.M.
Chilver and P.M Kaberry, Traditional
Bamenda, The Pre-Historical History and Ethnography of the Bamenda Grassfields, Government printers Buea, (1976).
Njodzeka
Elvis, Ethnomedicines in the Nso Fondom, Constraints and Challenges, 1922-2010,
Masters Theses in History, University of Buea,2018
