Alternative Medicines In Ghana

Ghana has come to a point where we cannot do way with alternative medicines. We can compete with the best in the world if we are given the needed support, education and funding into research into alternative medicines. We can become one of the medical powerhouses in the world.

The Indians have the schools in alternative medicines and we need more in Ghana to compete with the mainstream medical schools in Ghana. So what exactly are alternative systems of medicines? Alternative medicine practices are used instead of standard medical treatments. Alternative medicine is different from complementary medicine which is meant to accompany, not to replace, standard medical practices.

Alternative medical practices are generally not recognized by the medical community as standard or conventional medical approaches. Alternative medicine includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, and spiritual healing. Complementary and alternative medicine therapies fall into five major categories, namely:

1. Alternative Medical Systems

Alternative medical systems are built upon complete systems of theory and practice. Often, these systems have evolved apart from and earlier than the conventional medical approach used in the United States. Examples of alternative medical systems that have developed in Western cultures include homeopathic medicine and naturopathic medicine. Examples of systems that have developed in non-Western cultures include traditional Chinese medicine and Ayurveda.

2. Mind-Body Interventions

Mind-body medicine uses a variety of techniques designed to enhance the mind's capacity to affect bodily function and symptoms. Some techniques that were considered CAM in the past have become mainstream (for example, patient support groups and cognitive-behavioral therapy). Other mind-body techniques are still considered CAM, including meditation, prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.

3. Biologically Based Therapies

Biologically based therapies in CAM use substances found in nature, such as herbs, foods, and vitamins. Some examples include dietary supplements, herbal products, and the use of other so-called natural but as yet scientifically unproven therapies (for example, using shark cartilage to treat cancer).

4. Manipulative and Body-Based Methods

Manipulative and body-based methods in CAM are based on manipulation and/or movement of one or more parts of the body. Some examples include chiropractic or osteopathic manipulation, and massage.

5. Energy Therapies

Energy therapies involve the use of energy fields. They are of two types:

· Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body. The existence of such fields has not yet been scientifically proven. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields. Examples include qi gong, Reiki, and Therapeutic Touch.

· Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating-current or direct-current fields.

In Ghana , the Ministry of Health Traditional & Alternative Medicines regulate the practice.

The directorate is responsible for planning and development of Traditional and Alternative Medicines policy in the country. It monitors and evaluates the delivery of traditional and alternative health care in the country.

It consists of the following units:

· Human Resource Development and Training

· Information, Research, Monitoring and Evaluation

· Traditional/Alternative Medicine Practice

With objective to ensure effective development and integration of Traditional and Alternative Medicine as a distinctive medical practice system within the National Health Care System.

The responsibilities are:

· Initiates the formulation of policies on Traditional and Alternative Medicine.

· Organizes and monitors Traditional and Alternative Medicine Practices within the public sector

· Collaborates with appropriate agencies to determine which Traditional and Alternative Medicine practices are safe and efficacious

· Support Traditional and Alternative Medicine practices through mobilization of resources.

· Liaises with the statutory bodies for the regulation and control of Traditional and Alternative Medicine products and practices and to provide support in the performance of their functions.

· Promotes and co-ordinates research into all aspects of traditional and alternative medicine

· Promotes and formulates plans for the Health Insurance coverage for Traditional and Alternative Medicine.

· Liaises with relevant agencies to promote the cultivation of medicinal plants on a sustainable basis.

· Develop policies and guidelines for the training of Traditional and Alternative Medicine practitioners.

· Liaises with relevant agencies to ensure that mechanisms exist for the patenting of formulations in Traditional and Alternative medicine.

· Facilitates collaboration and co-operation between traditional and alternative and allopathic medicine practitioners within the context of the Health Care delivery system.

· Maintains a database for Traditional and Alternative Medicine practices and services.

· Organizes public education in support of Traditional and alternative medicines.

The art and the science of treating body malfunction or diseases have been practiced by all human societies since time immemorial. Traditional healing in all cultures all over the world involves the use herbs, minerals, animal parts and other physical and spiritual techniques in various combinations. Several systems have evolved and are still being used. The well known ones are those documented in writing from India, China and some of the countries in the Americas. The practice also has different forms based on practice for instance, In Ghana; the Ministry of Health uses three broad classifications namely;

(i). Traditional, (ii). Complementary and (iii) Allopathic medicines, to differentiate the various health care systems available to us.

Traditional Medicines

Traditional medicine here refers to the indigenous African health care and healing modalities. Traditional health care and healing modalities are components of the African traditional health care systems, cosmology and cosmogony. The advent of colonization, foreign religions and cultures, secular education, the introduction of modern/allopathic medicine and the pressures of socio-economic development have adversely affected the image and the practice of indigenous African health care systems and the use of traditional healing modalities. Foreign religions tend to demonize the cultural and traditional medicine practices. The negative perceptions still persist, especially among the educated African elite. The attitude and behaviour of ignorant or dishonest and/or self self-important traditional medicine practitioners further worsen the situation.

All these have contributed to the loss of a lot of some of the knowledge base and skills in African traditional medicine practice and health care systems. The extent of what is already lost, we may never know.

The various ethnic groups in Ghana, and for that matter in West Africa and other parts of Africa, have well defined etymology, cosmogony, signs and symbols. The meaning and significance of some of these are no longer clearly understood by many who currently use them.

However, there is evidence to suggest that a lot of the knowledge of African traditional philosophies, esoteric systems, cosmogony, health care systems and healing modalities still exit. There is now a wave of rebirth in traditional medicine and the less known complementary therapeutic/healing modalities all over the world.

Attitudes towards traditional or indigenous medicine and health care practices are changing for the better all over the world due to the work of modern anthropologists and scientists who believe in evidence rather than mere impressions by heavily biased and casual observers and Ghana is no exception.

Fortunately in Ghana, many individuals, groups and various successive governments have recognized the potentials and the importance of traditional medicine in holistic health care.

Several international resolutions for the promotion and development of traditional medicine have been passed by the World Health Organization (WHO), the Commonwealth Science Council and the African Union. These resolutions provide wider international context for the development of traditional medicine in Ghana.

It stands to reason that traditional health care practices and complementary medicine have survived, in spite of the challenges, because of the value the people have found in them. It is usually estimated that about 60-80% of our people, especially those in the rural areas, use traditional remedies regularly.

A lot of research in plant medicine is currently being done in universities and research institutions in Ghana, West African and other African countries. There is now a degree program running in Herbal medicine at the Kwame University of Science and Technology to train expert in Traditional Herbal Medicine.

The research institutions and individual researchers work on herbal or plant remedies and all tend to carefully avoid the esoteric or psychic component. In Ghana practitioners of Herbal who inherit from their parents don’t document what they do and also refused to collaborate with the allopathic practitioner because of fear of the practitioners stealing their concept. One notable example is a program I attended by the Traditional practice week held in Kumasi in 2012. I met lots of herbal practitioners who have good plant medicine , one man I came across he call himself the wizard in the forest, the ma knows the plant and you need to do is just tell him about the plant you looking and quickely he goes o the forest to bring the plant. Another who claim to heal sickle cells diseases also refused to collaborate with allopathic practitioners, another man who claim to cure HIV/AIDS is also refusing to collaborate eventually less than a year after I left I was told he died with his knowledge; so most of the practitioners die with their knowledge.

So for fear of allopathic practitioners stealing their concept they end up selling the herbal medicines in cars an on the street. The practice also has geographical definition and prior to the millennium according to the WHO, Traditional medicine is defined as all knowledge and practices used in the diagnosis, prevention and treatment of physical, mental or social imbalance which rely on practical ancestral experience and observation handed down verbally or in writing.

This earlier WHO definition presupposes that traditional medicine is based only on empiricism. This definition also does not explicitly recognize the spiritual or esoteric component of traditional medicine and health care practices.

So after the millennium, Traditional medicine, by the new definition from WHO, refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose, and prevent illnesses or maintain well-being. (WHO. Fact Sheet, No.134, 2003).

In Ghana the effective definition for traditional medicine is that it is the diverse health practices of the people based on the traditional knowledge and beliefs incorporating plant, animal, mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or combination to maintain well-being, diagnose, treat or prevent illness or physical, mental, social and spiritual imbalances. (MOH Documents).

Herbal medicine is a product obtained from plant, animal, naturally occurring inorganic substances and may be in the form of concoctions, decoctions, powders, infusions, lotions, ointments, suppositories, inhalations and which does not contain any active substances used in allopathic medicine. Herbal medicine involves more than plant medicine. (Ministry of Health Documents). Plant Medicine is a preparation from plant sources only.

‘Spiritual’ or ‘faith’ healing refers to healing through prayer, with or without the use of holy oils, water or laying on of hands on the patient, as practiced by the very many religious (mainly Christian) charismatic groups is not accepted as part of traditional or complementary medicine healing modality. Looking at the philosophy, principles and practice, African traditional medicine, In Ghana, and for that subject in Africa, it is believe that the human being is a tripartite entity consisting of mind (soul), body and spirit. The well being therefore requires the fostering of harmony between the body, mind and spirit. Also that, the rhythm of biological activity in life is influenced by the rhythm of activity within the planet and the larger cosmos. It is strongly believed that the health of the human being has a link with the Creator, divinities and ancestral spirits (the metaphysical world). The causation of disease therefore, has both spiritual and physical dimensions (i.e. psychosomatic).

Ill-health or disease is therefore the result of failure of humankind to maintain a well balanced relationship with the physical as well as the ancestral world. Deviant behavior, what goes contrary to accepted social norms can lead to imbalance and cause disease. Also that, disease no matter its cause appears on the spiritual body (bio-energetic body) long before it manifests on the physical body.

Dr Gbodossou who is an Obstetrician and Gynaecologist and also a trained traditional medicine practitioner stated in his book “The African Concept from God to Man” that,

“In the African conception, man as a whole, is related to all that is terrestrial, extra-terrestrial and cosmological. Man is a living organism made up of integral elements having the nature as those of the social, cosmic and spiritual worlds. Some of man’s elements are perishable, others imperishable. Man’s biological cycle begins with the integration of the component elements around a principle of personalization. It ends with the breaking up of the human component, offering the possibility of reincarnation and a new fate. In fact, all the constituent elements of man are gathered before birth and persist beyond death. Life is only a benefit of death, the first creation of God” (Gbodossou, 2004).

The African Man believes that the bio-energetic or bioluminescent body does create a sensitive and permanent energy contact between human being and the immediate environment. This bio-luminescent body can be augmented through external phenomena to restore health or disturb health and cause disease to manifest on the physical body. Health is equilibrium and disease disequilibrium. What affects the bio-energetic or ethereal body will almost instantly affect the physical body and what affects the physical body will eventually affect the energy body. The traditional medicine practitioners say that it is necessary to perform esoteric rituals in certain cases of ill-health to heal the ethereal body before the disease condition of the physical body can also heal.

Traditional Medicine Practitioners say that they must first determine through divination the causes of ill-health and ascertain the remedies to use for a given patient before starting the healing process. Some of them admit that it is not always that they know before hand which remedies to apply in given cases. It means that different people with similar symptoms and signs may need different items to effect healing. Constant divination is said to be central to successful healing and maintenance of good health.

There are many methods of divination. Divination may take the form of reading the palms of the client, looking into mirrors or water, casting of special objects or direct communication with the soul of the client and spirit entities. Some of the information on what is needed to treat an ailment is said be obtained through dreams and clairvoyant observance of the human aura.

The healers say that all trees have spirits that nurture them and that the healing potential of each plant depends on the hierarchy and power of the spirit that nurtures it. These spirits are what are seen by some people and referred to as fairies or dwarfs. This is said to be the reason why these spirits (dwarfs) are more frequently seen in forests. It is believed that practitioners of Traditional Medicine have some spiritual connotation. Now this spiritual practice are almost everywhere in Ghana with sign post mounted by these spiritual healers and the TV’s are not left because they are licensed by the Traditional medicine council to operate. They appear on Televisions to displace their magic, promising wealth and long life, they no longer hide in the bush as it used to be previously. They publically displace their magic. The love of money sometimes make these practitioners to prepare some quack concoction to their client some also ends up deceiving their patients. Prayer Camps also another area these practitioners attend to their patients so eventually mots atienst diagnosed with disease late end up in the prayer camp and by the time the disease becomes worse before they reer them to the allopathic practitioners.

The afa ( efa or fa ) system of divination is practiced in parts of Ghana, Togo, Benin and Nigeria. Afa is believed to be a direct contact with all beings of the spiritual realm and the soul of the client and through it information on the remedies to apply are obtained. Afa is one of the components of the Hu-Yehweh system which is the ancient African teaching on God, the Creator, and His relationship with humankind and the cosmos as a whole. The Hu-Yehweh system is still very much alive but is covered in strict secrecy and practiced by initiates in Shrines in Ghana, Togo, Benin and Nigeria. According to the tenets of this system the planets, animals and all things on the earth, and the whole cosmos came into existence through the universal creative substance composed of a spectrum of 16x16x16 light/colour and sound vibrations that emanated from God. It is the female aspect of the universal creative substance that is involved in healing.

There is evidence that traditionally distinguish clearly between good and evil. They talk of evil spirits, benevolent spirits and evil or beneficial spiritual practices. They talk about good or accepted morality and do have codes of acceptable socio-cultural norms and religious/spiritual practices. Know of the rather severe punishment which is still imposed by banishing those accused of practicing cannibalistic witchcraft to “witches colonies”. There is still the now degraded “trokosi” system where young girls are placed in shrines in atonement for past wrong doings by their family members. Some witches have a camp in Ghana because they are believed to be pronounced witches.

Ill-health or disease may be prevented using scarification, taking preparations orally, spiritual baths, amulets, spiritual sacrifices with various objects and animals, observance of moral codes and injunctions, none eating of certain food items and environmental cleanliness.

Alternative medicines was been practice long before western medicine and it is believed that Jesus Christ was even a practitioner of Traditional or alternative medicine using prayer, faith or saliva to heal the sick. He never used conventional medicine to heal the sick. The land marks in development of traditional medicines in Ghana;

(1). Traditional medicine practice had been established in Ghana since

time unknown. The practice came under severe pressure with colonization and the

introduction of foreign secular education and religions and western modern/

allopathic medicine into the Gold Coast colony by the colonial administration.

(2). In 1878, the Native Customs Regulation Ordinance was passed to prohibit many customary practices which offended the sensitivity of the Europeans.

(3). In 1930, the Society of African Herbalists was formed and based in Sekondi in the western region of Ghana.

(4). In about 1940-42, Dr Oku Ampofo left the colonial medical system to set up a private practice in Akwapim-Mampong. He invited herbalists to practice in his clinic. That was the first known practical relationship to be established between an allopathic medical set up and traditional medical practice in this country. Dr Ampofo single handedly compiled a list of over 300 medicinal plants, herbal remedies and names of the healers he came into contact with. He later transferred the clinic and the documents to the Center for Scientific Research into Plant Medicine.

(5). In 1960, Osagyefo Dr Kwame Nkrumah initiated the formation of the Ghana Psychic and Traditional Healing Association. The Association was charged, among others, to promote and encourage the study of herbalism and psychicism in Ghana. Very little was achieved by this association. Meanwhile several other associations and groups emerged, each struggling for recognition.

(6). In 1971, a group of researchers came together and submitted a memorandum to the then government recommending that a center to facilitate the co-ordination of all research work into plant medicine be established.

(7). NRC Decree 344 legally established the Center for Scientific Research into Plant Medicine in 1975.

(8). The Danfa Comprehensive Rural Health and Family Planning Project of the Community Health Department of the University of Ghana Medical School was started in 1969/70 with support by USAID. This project studied some service delivery aspects of traditional medicine and trained a lot of practitioners to ensure their safe service delivery.

(9). The Brong Ahafo Rural Integrated Development Programme of the Ministry of Health supported by WHO and UNICEF started in 1976 and trained a large number of practitioners in an area now covered by the Techiman, Nkoranza and Wenchi districts.

(10). The Alma Ata Declaration of Primary Health Care in 1978 provided the basis for WHO support for the development and use traditional and complementary medicines as integral component of holistic health care systems.

(11). 1985. UNICEF support to Training of TMPs on ORS use in Brong Ahafo.

(12). 1985. UNIDO support to review the pharmaceutical industry with special reference to the herbal industry.

(13). A Traditional Medicine Directorate was established in the Ministry of Health in 1991. The directorate is now known as the Traditional and Alternative Medicines Directorate (TAMD).

(14). In 1992, the Ghana Herbal Pharmacopoeia was prepared.

(15). 1992, The Food and Drugs Law, PNDCL 305B and amended as FDB Act 523 is to regulate the introduction of traditional medicine preparations on to the commercial market.

(16). 1999 saw the inauguration of the Ghana Federation of Traditional Medicine Practitioners’ Associations (GHAFTRAM).

(17). 1999-2004, The First MOH Strategic Plan for TM development with focus on

reorganization of TMPs under MOH support.

(18). 1999. Formation and inauguration of GHAFTRAM. An umbrella body and

spokes agency for all TM associations

(19). 1999. TAM Directorate was set up by MOH.

(20). 2000 to Date. PROMETRA International (NGO) has been working with the

MOH for TM development and promotion.

(21). In 2000, the Traditional Medicine Practice Act, (Act 575) was enacted.

(22). 2000, was the First National Strategic Plan for Traditional and Alternative Medicine (2000 – 2004) was launched.

(23). The TAMD did a land mark baseline study in 2001into traditional medicine practice in Ghana with the support of DANIDA.

(24). The Kwame Nkrumah University of Science and Technology started a degree course in herbal medicine in 2001/2002.

(25). In 2001, the Traditional and Alternative Medicine Directorate (TAMD) did another study to assess the institutional capacity of 21 institutions for research and testing of plant medicinal products.

(26). 2002-2004. Second MOH Strategy with focus on training of TMPs. Within this period , the National Traditional Medicine Week and WHO African TM Day launched.

(27). 2002-2004 WHO: Strategy for Traditional Medicine development launched.

(28). 2001 – 2010. African Union Decade of Traditional Medicine development.

(29). In 2004, the Code of Ethics and Standards of Traditional Medicine Practitioners document was finalized and launched.

(30). The first batch of students successfully graduated from the Herbal course at Faculty of Pharmacy of the Kwame Nkrumah University of Science and Technology in 2005.

(31). 2005, the Second National Strategic Plan of TAMD started.

(32) 2008. The Ouagadougou declaration on PHC and Health System.

(33) 2002-2010. Project (NSBCP) Support by MDAs and Northern Savanna

Biodiversity Conservation for cultivation of herbal medicine plantations in the

northern region.

(34). 2005- 2010. The Third Strategy focused in development tools training,

accreditation, standardization, safety and control for TM products development

(35). 2010-2014. the Fourth MoH Strategy with focus on institutionalization of TM

practice in the National Health care delivery system.

Protocols to guide the institutionalization have been developed. About 14 Ghana Health Service facilities have targeted for the initial phase about 160 herbal medicine preparations have been selected into the essential herbal medicine list.

The base line study conducted by TAMD revealed that there are about 20,000 traditional medicine practitioners in Ghana. However there are indications that the actual number may be about twice this figure. There are different types of TM practices in Ghana

There are five main types of practices and practitioners/healers, namely,

(i). Herbalists (including bonesetters and circumcisers),

(ii). Herbalist-spiritualists,

(iii). Diviners/Soothsayers (including mallams or Islamic healers),

(iv). Shrine Devotees and

(v). Herbalist-Traditional Birth Attendants (TBAs).

It was found that the practitioners are generally illiterate and quite advanced in age and live mainly in the rural areas. There are some fairly literate Christians and Muslims among them.

The tendency of Traditional medicine practitioners isolating themselves from formal education is partly self imposed to ward off the onslaught of foreign religions and foreign secular education that condemn our traditional values and heritage.

In practical terms, nothing much has been achieved in the promotion, development, practice and control of traditional medicine in this country.

The passing on of the knowledge and skills of traditional medicine is still done in Ghana mainly through oral communication, including songs, and informal apprenticeship. A few countries in Africa, eg Egypt, Uganda and La Cote d’Ivoire have recently established courses in traditional medicine at tertiary levels. Ghana has started a degree programme in Herbal Medicine.

Most of the traditional medicine practitioners encountered in study done by TAMD live in the rural areas and do not belong to any healers’ association.

Commercial production and sale of traditional medicine products on market are on the increase. Foreign plant preparations are also widely available on the local market as food supplements. About 415 of such food supplements and 449 of herbal preparations have been registered by the Food and Drugs Board between January 2002 and December2004. In 2005 the Board set up a special Unit to handle the registration of herbal preparations to be marketed in Ghana.

There are 6 major and about 19 minor Traditional Medicine Practitioners associations in Ghana.

The efforts by the Food and Drugs Board are not yet yielding the desired coverage and control.

Over 1000 herbal medicine products, both foreign and local, have been registered with FDB to date. However, as at the close of 2010, only 184 local and 208 foreign are in good standing in respect of renewal of registration(E.N Mensah 2011)

The Council for Traditional Medicine Practice was finally established in April 2010.

TAMD, TMPC and FDB have been organizing training in safe patient care and clinic management for practitioners.

There are WHO guidelines on research into and the use of traditional medicine products. A lot of primary research has been done and is being done on herbal medicines or natural products. Very few quality clinical trails have done to date. Much more is waiting to be done.

The Researchers from Ghanaian universities and research institutions and their colleagues from the other West African Countries have formed the “West African Network of Natural Products Research Scientists (WANPRES). The major aim of the network is to organize their members so that all the various aspects of a given product can be researched upon concurrently so that as complete as possible information can be obtained on the product within the shortest possible time. The clinical research component of the programme of activities of WANPRES is not very much visible.

Dr. Raphael Nyarkotey Obu is a registered Naturopathic doctor who specializes in prostate cancer and a PhD candidate in prostate cancer and alternative medicines –IBAM Academy, Kolkata, India. My research focuses on men of West African descent and prostate cancer and the dangme people. He can be reached on 0500106570 for all contributions. E-mail:[email protected]. He is the director of Men’s Health Foundation Ghana; De Men’s Clinic & Prostate Research Lab-Dodowa,Akoo House. He is currently working on his book” The state of the dangme Land”