Traditional Medicine Struggles in Nigeria

Climate change and a lack of training of practitioners threaten popular herbal remedies

Traditional Medicine Struggles in Nigeria
A woman sits at the gate of Shrines at the Oshogbo Sacred Grove, the last sacred forest in southwest Nigeria, on June 3, 2020 / Pius Utomi Ekpei / AFP via Getty Images

Jimoh Olaniyi finally feels some relief after making regular visits for five years to hospitals in Lagos for the treatment of typhoid fever, a life-threatening illness that is endemic in Nigeria. Before late last year, Olaniyi had checked into hospitals monthly to treat his fever. But he says despite all the medical treatment he received, he did not feel well until he switched to traditional medicine. He attributes this feat to taking an herbal drink made with the leaves of Senna alata — also widely known as candle bush or candletree — a soft-wooded shrub with yellow flowers and pods containing seeds.

“At one point I was given 16 injections. Still, the typhoid did not clear. But when I began taking herbal medicine, the symptoms cleared,” Olaniyi told New Lines in an interview.

Though Senna alata is known to be effective in the treatment of fungicides, some research has also shown it to work on the bacterium known as Salmonella typhi, which causes typhoid fever, according to a 2015 study published in the Journal of Applied Pharmaceutical Science.

Herbal medicine is a source of primary health care for up to 80% of people in developing countries, including Nigeria, according to the World Health Organization.

Herbal medicines come in varying forms. Roots, stems, leaves and barks are boiled, crushed into powder or soaked in liquid such as water, alcohol or carbonated soft drinks. They are believed to cure ailments including dysentery, fever, skin and internal infections, and fibroids.

Some herbs are processed into tablets and capsules. It is not uncommon to see them being hawked, displayed for sale at drug stores. While some herbal medicines have approval from the country’s drug regulator, the National Agency for Food and Drug Administration and Control (NAFDAC), others are sold illegally. People from all classes of society use herbal medicine for different reasons: For some, it is the only form of health care they can afford; others give it a try when conventional medicine does not yield desired results.

Nigeria has 91 indigenous flora species belonging to 44 families, according to the “Fifth National Biodiversity Report” published in 2015, the most recent of such surveys available. Rubiaceae — a family of flowering plants used for ornamental purposes and in African folk medicine to treat several diseases — accounts for the highest numbers. The International Union for Conservation of Nature lists 15 plant species as critically endangered, 18 as endangered and 146 as threatened in the country. The correlated problems of climate change, deforestation, development and urbanization together are threatening the availability and efficacy of medicinal plants in the country.

Data from the World Bank Group’s Climate Change Knowledge Portal for Nigeria already shows a pattern of increased temperature and reduced volume of rainfall. Over the past 120 years, the country has warmed up by 0.05 degrees Fahrenheit every decade and, in the past 30 years, this figure has risen to 0.34 degrees Fahrenheit per decade. Records also show that the volume of rainfall in the country has decreased since the 1960s, and predictability of future rainfall has also declined.

These issues relate to the recent international climate summit held in Glasgow, Scotland, where world leaders came to an agreement about how to proceed in answering the challenges that climate change poses.

Although most of Nigeria’s medicinal plants are not expected to go extinct anytime soon, their characteristics are already showing signs of abnormalities that are changing their medicinal value, according to experts.

“The plant may not be as efficacious as it used to be,” explained Akeem Kadiri, a botany professor at the University of Lagos. “And that is why you will hear herbal medicine practitioners say that in those days, the leaves of a plant used to be big, but now, they are small. The liquid from the plant used to be green, but now it is not,” he added.

In addition to enduring the effect of climate change, the oil boom in Nigeria in the 1970s stirred up development and construction but with little or no oversight of the environmental impact on such fast — and often wanton — urban sprawl.

Indeed, some practitioners in the value chain of herbal medicine production in various regions of Nigeria, including collectors, suppliers, vendors and producers of herbal medicine, said that infrastructure development poses an even bigger, more immediate challenge than climate change.

The practitioners, some of whom had seen better days of surplus medicinal plants, say they now struggle to get the herbs, which are available at increasingly exorbitant prices.

For Idowu Johnson, the founder of the Research Institute for Traditional and Alternative Medicine (RITAM) in Ogun State, southwest Nigeria, urbanization threatens the availability, for example, of African mistletoe, one of the plants he uses to make body detoxifying tea.

“African mistletoe grows on trees in the wild. When trees are cut, it affects the plant. Collectors of herbs now go deeper into the forest to get plants for medicine,” Johnson said.

In order to ensure a regular supply of raw material for the detoxifying tea protocol that he learned from his mother 50 years ago, he is now establishing a botanical garden of his own, though even this offers no guarantee of the potency of the herb amid so many changing factors.

Nigeria’s forests have gone through consistent depletion for years. In 2010, according to the Global Forest Watch, the country had 27 million acres of natural forest, extending over 12% of its land area. In 2020, it had lost 242,000 acres of the natural forest, which is equivalent to 59.5 million tons of carbon dioxide emissions.

Although natural factors such as parasites and floods could cause the loss of forest resources in the country, human activities including agriculture, infrastructure development and logging for fuel and charcoal — a trend seen moving in correlation with the banditry crisis that grips Nigeria, displacing tens of thousands of people and forcing them to rely on illegal logging for sustenance — are decreasing tree population. The rise in prices for gas and kerosene (used for cooking) also contributes to the illegal logging problem as people forage for wood.

“In the forest, loggers cut trees and destroy plants useful for medicine. There are also cases where the vegetation is cleared and buildings are erected. We have lost vital medicinal plants to development,” said Iliyasu Salisu, a former chairperson of Amalgamated Herbal Practitioners of Katsina State (in the northern part of the country) who has practiced alternative medicine for 25 years.

Indeed, at the Isale Oja Market in Agege, one of the largest markets for traditional medicine raw materials on the mainland of Lagos, herbalists are already noticing a scarcity of valuable herbs and a consequent rise in price.

Alhaji Mojeed Akanbi, the chairperson of traditional medicine vendors at the market, attributes this shortage in supply to the country’s ongoing deforestation crisis and urban sprawl.

“Roots and herbs were surplus. But now, our suppliers struggle to get them,” said Akanbi. “New settlements are springing up and people are clearing vegetation and building houses in places where we used to get herbs,” he added.

Nigeria’s conventional health care system is underfunded and unaffordable to many. Hospitals are sometimes out of commission for long periods of time. All this has been contributing to growing demand for herbal medicine, which is poorly regulated and has, on occasion, been known to endanger the health of patients who sought treatment from traditionalists.

The lack of formal training available to traditional practitioners also leaves the herbs they harvest more vulnerable. Kadiri explained some of the sustainability protocols are rarely taught to, or followed by, practitioners.

Herbal practitioners “need to imbibe the 10% harvesting attitude. If there are 100 leaves on a tree, they should take 10 leaves. If they must use the root of a plant, they should cut the adjoining roots attached to the main root. If they must take the bark, it should not be round the trunk of the tree because the bark contains vessels that move materials to different parts of the tree,” he said.

It does not help that superstition and a fatalistic attitude sometimes leads herbalists to rely on “God’s command” for the plant to regrow after it has been (unsustainably) harvested.

The Nigerian authorities say they are aware that medicinal plants are increasingly vulnerable to environmental and human-made factors. They say there are plans to establish botanical gardens to safeguard some of the most valuable flora. But there has been little in terms of concrete plans.

Perhaps equally alarming is the younger generations’ disinterest in traditional medicine due to the cultural stigma associated with animism, of its being pre-Christian or pre-Islamic. This stigma sometimes appears in Nigerian movies that portray herbalists as superstitious people who invoke evil and not so much as traditionalists who are guarding an age-old indigenous knowledge of the country’s medicinal plants.

However, to address the shortcomings of conventional health care in Nigeria, some conventionally trained health care providers are combining both conventional and traditional medicine to treat their patients. Kate Chinwe Eze makes a point of doing so and of identifying as a devout Christian.

“I use the two [approaches] so that my treatment will be fast,” she said, referring to the ailments she most addresses, which include infertility, fever and high blood pressure.

Islamic medicine, which sources its raw materials from Arab countries, is also increasingly becoming popular among Nigerians, especially in the northern parts of the country where it is mixed with the traditional Hausa medicine to treat ailments.

But for the country to better guard its medicinal herbs as the climate undergoes major changes, half-hearted government-led efforts of reforestation and botanical preservation plans may not be enough. Experts say there is a need for properly implemented environmental protection laws and incentives to pursue clean energy.

Otherwise, “millions of poor people who do not have access to hospitals will be impacted, and the well-off who now use herbs after seeing that it works will suffer, too, if medicinal plants are not protected,” said Ahmad Isyaku, an alternative medicine practitioner in Katsina State.

“A major health crisis stares us in the face if we allow climate change and urbanization to kill nature’s pharmacy,” he added.

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