My earlier submission, I wrote on alternative system of medicines. The practice in Ghana faces lot of challenges and this current paper looks at some of the challenges.
(1). Ghanaian traditional medicine and health care practice systems are not well documented and characterized in writing.
(2). Traditional medicine practitioners are mainly illiterate and practice in the general community or in secret shrines which are mostly in rural areas.
(3). The mutual suspicion between Traditional Medicine Practitioners on one hand, and allopathic medicine practitioners, academics and the educated elite on the other hand, is still rather strong.
(4). Traditional secrecy and the absence of effective specific protection of intellectual property rights are barriers to making knowledge easily available by the practitioners. However there are indications that some of the healers are prepared to divulge some the secrets.
(5). Lack of adequate financial support through out the system limits rapid progress in developing traditional medicine.
(6). The systems for legal control and management of traditional medicine in Ghana are still weak.
(7). There is no legal or administrative instrument to control complementary medicine practice in this country.
(8). Although there is a growing interest in phyto-medicine research, there is no known organization or individuals in Ghana that conduct scientific research into the esoteric component of traditional medicine and the other healing modalities.
(9). Efficacy tests have not been done on virtually all of the traditional and complementary medicine products on the commercial market.
(10). There are no formal schools in Ghana for Traditional Medicine and any of the types of complementary medicine.
(11). Modalities for establishing useful working relationship between allopathic and
Traditional and other medicine practitioners are yet to be clearly defined.
(12). There is no national standard research protocol and no national ethical committee on TM.
(13). Poor agricultural practices, indiscriminate bush burning and uncontrolled harvesting are threatening the easy availability of some medicinal plants.
(14). There are many quacks and opportunists in the field of traditional and complementary medicine practice in this country.
(15). There has not been any formal or any real research, to the best of my knowledge, in any of the types of complementary medicine in Ghana.
(16). One still hears of professionals in allopathic/modern medicine who openly and severely rebuke patients and/or their relations for visiting a traditional medicine practitioner(s) during the course of an illness. Because of fear of rebuke patients normally deny that they ever visited a traditional medicine practitioner(s).
(17). Herbal Medicine grade has now been establishment in the Ministry of Health. But it is taking much too long to establish the facilities in the various chosen institutions for them to start any meaningful work.
(18) Lack of specialization programs for these practitioners in the field as in India and other countries.
There is therefore the need for collaboration in Ghana to transform the health system for instance, the Allopathic Medicine Practitioner by virtue of his/her training is in the best position to play a leading role in the team work for the development and practice of the Traditional and Complementary medicines in a holistic health care system. In the advance world allopathic practitioner are offering complementary medicine care facilities in their clinic especially the cancer centers. In Ghana for instance the Centre in Mampong runs purely herbal medicine clinic. Currently there is one medical practitioner in Ghana who have also specialized in herbal medicine and managing men with prostate disease using herbal medicine. The health system in Ghana must integrate the practice and the Allopathic Medicine Practitioner must have a leading role in:
(1). The wider question of continuing clinical research and documentation in all aspects of traditional and complementary medicines, especially for common diseases of public health importance.
(2). Understanding traditional cosmogony, philosophy and the concepts of health and ill health in the African context.
(3). Production of protocols and modalities for clinical evaluation of the efficacy of herbal and other products and healing modalities.
(4). Developing working relationships between allopathic, traditional and complementary/alternative medicine practitioners
(5). Establishing comparisons of the various aspects of African traditional and complementary medicines with those of the modern medical sciences and practices.
(6). Defining and comparing the causes, signs, symptoms and diagnosis of diseases in traditional, complementary and allopathic medicines, especially, for common diseases of public health interest.
(7). Examining traditional names as compared with allopathic medicine ones for diseases.
(8). Production of essential drug list for traditional and complementary medicines.
(9). The development of formal education and training for traditional as well as complementary medicine practitioners and their establishment in the public health services delivery system.
(10). Development of modalities for holistic health care system in the country.
(11). Development of regulatory mechanisms for all categories of practitioners.
(12). Monitoring, supervision and evaluation of practices (both ethical and technical) and the efficacy of remedies.
(13) The mainstream medical school should also include alternative medical system of medicine practice so they abreast themselves with the practice of alternative medicine. In finding a lasting solution to these challenges there should be a way forward for instance:
(1). A permanent forum or entity needs to be established for the co-ordination of the activities of all stakeholders in traditional and complementary medicine. The Traditional and Alternative Medicine Directorate of the Ministry of Health should be charged with the responsibility to initiate this. This should be backed by law or an administrative instrument or directives.
(2). The Centre for Scientific Research into Plant Medicine should be charged with additional responsibilities to enable the Centre play a lead role in research into other aspects of traditional medicine.
(3). Quality and suitably qualified Allopathic medicine clinical researchers need to be attached to the Centre for Scientific Research into Plant Medicine to make sure that clinical observations on the use of the herbal remedies prescribed at the Centre are scientifically documented. These records are requirements for the patent and protection of intellectual property rights and also for the registration of the products with the Food and Drugs Board.
(4). A special institute for scientific research into the esoteric aspect of traditional and complementary medicines needs to be established.
(5). The specific legal framework and the modalities for the protection of intellectual property rights of traditional medicine practitioners needs to be put in place as soon as practicable.
(6). The five categories of traditional medicine practitioners identified in the country need to be studied in greater detail and the beliefs and procedures documented for use in the preparation of training manuals for traditional as well as allopathic medicine practitioners.
(7). There is an urgent need for traditional rulers and the highest political authorities to dialogue with the keepers of the shrines and cults to reveal at lest some the ancient esoteric and all of the exoteric knowledge base of their practices.
(8). The etymology of our languages and the cosmogony of our forefathers are to be found in these shrines and cults. Individual researchers have made some progress talking to individual practitioners. There is need for more and better coordinated sociological research in the field of traditional medicine.
(9). If there are any real defects in the existing laws these must be discussed with all stakeholders so that the necessary amendments can be made by parliament. In-action and inertia are contributing to the slowing down of the development of traditional medicine in the country.
(10). Not much of the activities planned in the previous Strategic Plans were implemented. This needs to be evaluated to determine the reasons for this so as to make sure that there is greater success with the fourth plan.
(11). The Traditional and Alternative Medicine Directorate should take the initiative to discuss the degree course in herbal medicine with the authorities in KNUST with the view of determining how the products are to be placed in the health delivery system. The course is an innovation in Ghana and deserves commendation and not condemnation.
(12). The herbal medicine graduates constitute the best link for development, practice and control of traditional medicine practice in this country.
(13). KNUST should consider developing the herbal medicine course into a traditional medicine course within the shortest possible time.
(14). There is the need to look into the possibility of development of traditional and complementary courses at polytechnic level.
(15). There are research protocols for plant and natural products. A team of researchers made up of allopathic, complementary and traditional medicine practitioners and various research scientists needs to be put together to produce a Standard national protocol(s) to be made available to the institutions.
(16). The MOH/Ghana Health Service should officially authorize all health institutions to conduct, at lest the preliminary, clinical trails on traditional and complementary healing remedies in the cases of selected diseases of public health and social importance.
(17). The Government needs to seriously support the development of facilities for large scale cultivation of raw materials and for large scale commercial manufacture and constant supply of traditional remedies for diseases of public health interest.
(18). In order to foster closer cooperation and collaboration between allopathic, complementary and traditional medicine practice, patients must be encouraged to disclose the fact they did visit a traditional or complementary medicine practitioner during the course of a particular illness. Patients should be told that they have the choice to visit traditional or complementary healers but they must visit allopathic clinics very early in the course their illness to enable early diagnosis and treatment so as to prevent possible severe complications and avoidable death.
(19). A permanent body needs to be put in place and charged to review the Ghana Herbal Pharmacopoeia on regular periodic basis.
(20). Traditional and complementary medicine practitioners must be impressed upon to device a mechanism(s) to control quackery among their ranks.
(21). Much more money needs to be made available by Government for the development of traditional medicine than is currently given. This must be given the national priority that it deserves.
(22). The call by the Ghana Federation of Traditional Medicine Practitioners Associations that traditional medicine development must be made one of the Special Presidential Initiative Programmes should be supported.
(23). The Ghana College of Physicians and Surgeons may consider sourcing special funds to support clinical and basic research in designated aspects of traditional and complementary medicine products as one of the core prerequisites for fellowship qualifications. The College may need to dialogue with the West African Network of Natural Products Research Scientists. This also implies a lot of issues to be resolved with the owners of the products, research institutions and service provider agencies.
(24). It time that basic information on traditional and the other health care systems are introduced into the curriculum of the medical schools, the School of Public Health and the training institutions for the other allied health professions. Unless people are tasked to get that done within a time frame it is likely that we shall talk a lot about it but nothing will happen any time soon.
(25) The Traditional and Alternative Medicine Practice council in Ghana should introduce workshop and postgraduate programs in alternative medicine to pave way for specialization
(26) There should be check on medical advertisement in the Ghanaian media to prevent misinformation on alternative medical practitioners.
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”