Specialised Traditions of Knowledge

and Health Delivery Practices

Learning Objectives
By the end of this lesson, students would be able to:

Discuss categories of Traditional Medical Practitioners.

Explain the ways by which Trad. Medical skills are acquired.
Discuss the functions of Traditional Medical Practitioners in
contemporary societies of Africa.
State the impact of social change on Traditional Medical Systems.
Examine the reasons that account for the increase in patronage of
Traditional Medicine.
Discuss the challenges facing Traditional Medical Practitioners.
Africans ways of health delivery is from time immemorial.
Different labels: IMPs, TMPs, TH (Traditional Healers) etc.

Examples of Traditional Medical Practitioners (TMPs):

 Bone-setters,
 Diviners,
 Priest-healers,
 Traditional Birth Attendants,
 Traditional Surgeons
 Other fields of specialties such as healers of rheumatism, headache
etc.

In Ghana or Africa, Indigenous Medical Practices (IMP) vary in

their cosmological notions, modes of therapy management etc.
Diff. labels of Indigenous Medical System:

Traditional Medicine (TM):

Indigenous Medicine (IM)

Alternate Medicine (AM)

COUNTRY PROFILE OF USE OF TRADITIONAL MEDICINE

Countries in Africa, Asia and Latin America use traditional medicine (TM)
for primary health care.

In Africa, up to 80% of the population use TM for primary healthcare.

In China, traditional herbal preparations account for 30%-50% of the

total medicine consumption.

In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of
children with high fever resulting from malaria is the use of herbal
medicine at home (WHO, 2003).

Estimated 80% of the Ghanaian populace rely on herbal preparations

for primary health care (UNDP 2007 Human Development Report ).
 Associations/Categories of Traditional Healers
 Healers, were first categorised into two;
 Ghana Psychic and Traditional Healers Association (GHPTHA)
 Ghana National Association of Traditional Healers (GNATH).

 ‘Psychicism’ in GHPTHA meant those traditional healers within the

purview of spiritual health care.

 Similarity: GHPTHA and GNATH use herbal powers. NB: GNATH

also make use of divination techniques and rituals related to the
supernatural.

 GNATH was established in opposition to the mixture: that is labeling

those who use supernatural powers and those who do not use them with a
single name, GHPTHA.
In Africa, the medicine man is considered to have enormous power
and control over herbs, roots, and other natural substances.

Both men and women can serve in this profession.

Traditional healers are reputed to have some supernatural powers

and consider themselves as agents of the divine healer who works
through them.

Traditional priests are more or less confined to the shrine, but

healers are mobile

The traditional healer is a very good friend of the community,

accessible to everyone at all times.
 Who is a traditional healer?

What is the name of the traditional healer in your local

language?
Who is a traditional healer?

WHO’s definition:
A person …recognised by the community … as competent
to provide health care by using vegetable, animal and
mineral substances, and … other methods based on the
social, cultural and religious background as well as on
the knowledge , attitudes and beliefs that are prevalent in
the community regarding physical, mental and social
well-being, and the causation of disease and disability
(WHO 1977:4).

In almost every family, one finds someone with

knowledge of medicinal plants.
Categories of traditional healers

(Appiah-Kubi 1981: 37)

Common knowledge of remedies used by many people. The

materials gathered here are without any religious interpretation.

Family secrets; knowledge concerning certain illnesses and

treatment. This is passed on from generation to generation within
a matrilineage.

Professional medical knowledge: usually obtained from priest

healers who went through an initiation rite.
Twumasi’s classification
Twumasi identifies four categories of indigenous medical
practitioners:

Traditional Birth Attendants

Faith healers
Spiritualists i.e Diviners and Fetish priests and
Traditional herbalists.
Diviners: Diviners are important in every community or village. They are
consulted on many occasions. He is a ‘medicine-man’, and often also a
‘witch-doctor’.

He deals in drugs, most of which have magical rather than a

pharmaceutical value.

He diagnoses the spiritual cause of disease and does not consider it as
purely physical.

Using bones or nuts he may tell fortunes, reveal the past, predict the
future, find lost articles, or discover thieves.

He uses gossip to draw correct conclusions (Adegbola 1983: 58).

The family head also takes care of all the needs of the household both
material and spiritual.
Most traditional healers use magico-religious rituals.
Leaves used must be ‘pacified’ to perform the right function.

Diviners diagnose the cause of illness and administer

treatment (Amedjorteh 1997:59-61).

The person undergoing treatment would generally observe a

number of taboos.
Soothsayers or diviners are those who usually explain the ‘whys’
of certain diseases and may foretell the outcome of (intended)
actions.

It is said that good diviners are from Eweland (Ghana, Togo and
Benin). The most popular deity responsible for divination is Afa.

These TMPs also predominate in the Northern regions of

Ghana and include Mallams (Islamic teachers).

Categories of Mallams:
those who use only prayers or Qur’anic verses for the healing.

those who combine herbal treatment with divination and prayers.

 Traditional Birth Attendants
An important category of healers in Africa is Traditional Birth
Attendants (TBAs).

TBAs are (old) women who assist in delivery. They are

usually listed with TMPs.

They play an important role in the Ghanaian health care system

and many of them have participated in training courses
organised by official health care workers.

TBAs exhibit adequate skills during birth.

Some TBAs in Ghana consider themselves as spiritual healers

while others practice general herbal medicine.
Mode of Learning or Acquiring Skills
 Most healers have had no form of formal education.

They acquired their knowledge through family members. Usually,

young healers learned about new medicines during the sickness of a
family member who was successfully treated by a healer.

After the cure, the family members would beg the healer for the
medicine. They buy the recipe to compensate for the knowledge.

NB: Treatment of diseases is normally done in the open, thus people

learn some techniques of healing.

Some healers claim that they acquired their knowledge about herbs
through supernatural means, sometimes through abduction by dwarfs.
 MODE OF ACQUIRING SKILLS CONT’D

Inheritance: from direct blood relations mostly parents or some have also
been chosen by their ancestors to heal.

 These were the assistants who used to help their parents or grandparents
in treating people and thus took over the practice after the death of these
relations.

Others acquire the knowledge to heal from friends or people who treated
them when they suffered the same conditions earlier in life.

The means by which knowledge and skills were acquired illustrates how
skills are usually held sacred by traditional families.

They are considered secrets that are only disclosed to trusted family
members, therefore, not all children of a parent qualify to inherit the
knowledge and skills on the practice.
Role of Assistants
TMPs work with assistants. These assistants are mostly the male
children of the practitioners themselves or the extended family.

Duties of Assistants:
 Searching for the plants in the bush
 Preparation of the medicine and
 helping with the actual treatment where clients are too weak to
do anything on their own or in cases where the practitioners
themselves are old and weak.

They spend most of their time traveling long distances on foot or

on bicycles looking for medicinal plant parts.
Consultation hours and referrals
Traditional healers generally do not have consultation hours. Only
healers who are mediums for a supernatural entity have special
days, based on the traditional calendar for which the deity can be
consulted.

Schedule for review may however be important.

Healers may refer patients to each other or ask each other for
advice.

Kinship relations may play an important role for those informal

type of referrals and consultations. The patient may know which
healer to go to with a certain complaint.
Components of T. medicine
The physical component: use of potions prepared from
herbs, plants, powders, bones, roots, juices, liquids,
minerals, charcoals, etc.

The mystical or spiritual component: use of

incantations, exorcism, and ventriloquism etc.

There is some form of monopoly over treatment of certain

diseases.
 Priest healers
Called in Akan as AkƆmfoƆ, the priest-/priestess-healers, are the specialist of
the Akan religion. These are highly respected.

Dress code: They may appear with amulets. Their hairstyle sets them apart
from others.

Priests combine the roles of religious specialist, diagnostician and healer.

 They may use substances such as plants, minerals and parts of animals.

Major characteristic of priest healers: they can fall into trance or can
become possessed by their agent of worship.

The actual healing of diseases, however, is only a part of their activities

as priest-healers.
Training the priest-healer
A person may be called by a deity.

Thus, he or she has to follow an extensive training period

under the guidance of an older AkƆmfoƆ.
As apprentice he learns how to make use of medicinal
herbs.

Normally, the AkƆmfoƆ are attached to a shrine which is

also an abode for a spiritual force.
Trainees also learn about the
 causes,
 cures, and
 prevention of diseases and other forms of misfortune and sufferings, such as
 barrenness,
 failure in business
 poor harvest.

They also learn about:

 magic,
 witchcraft,
 and sorcery, and how to neutralize them.

The training further involves learning the nature and handling of spirits and the
ancestors.

There are many other things that the trainees learn that are considered top secret in
the profession – secrets that would never be revealed to any scholar or researcher.
Basic concerns of Trad. Healers
The primary concerns of the traditional healer are;
sickness,
diseases, and
misfortune.

They are believed to be caused mainly by magic, witchcraft, and sorcery.

Responsibility of the healer:

find out the cause of the sickness

discover who is responsible
diagnose the nature of the disease
apply the right remedy, and
supply means of preventing the misfortune from occurring again.

This process of dealing with illness and misfortune thus involves a combination of
both spiritual and physical healing (Essien 2013: 243).
Priesthood training and Taboos
In the course of training, novices observe the following
prohibitions.

He must not break the vow of celibacy; if he does, he must

make a sacrifice to the deity, and begin his training right
from the start again.

All sexual taboos are observed.

He is admonished not to drink alcoholic beverages.

 Call to/abduction into healing
In Africa, the calling to be a healer may come at any point in the
life of the individual.

In most cases, the calling usually comes when the person is still
young and single or in the middle or later years in life.

The call may come from spirits or the ancestors in the dreams
and visions.

Training is on the ff: the medical value, quality, and use of

herbs, roots, fruits, grasses, and various other objects, such as
minerals, dead insects, bones, feathers, powders, excreta of
animals and insects, shells, and eggs.
In some Ghanaian societies, the candidate may be taken to
the cemetery for a ritual bathe in order to acquaint him
with the spirits of his ancestors.
 The Akan training system
Training among the Akan took three years:

Year 1- No much training takes place. It affords the priest the opportunity to
examine the conduct of the novice and report back to his parents.

On some occasions, the trainee fasts, others too he is asked not to eat too much.

No hair cut is allowed as long hair sets him apart from ordinary members of the
community.

Year 2- Learns names of trees, plants and ferns and their correspondent spiritual
properties.

Year two then is reserved for therapeutic techniques, the properties of plants or
trees and their location.
He is also introduced to animals and herbs: leaf, plant or root.
Teachings about propitiatory sacrifices, and how to kneel during such offerings.
Year 3- the technique of water gazing and other relevant acts
of divination

Impregnating charms with various spirits, interpretation of

voices.

Taught respect to certain ‘spiritual animals’ some of which

are totems.
The final rite is a covenant carried out before the deity of
the shrine; of blood and of secrecy.
 At the end of this training, he qualifies to enter into the
traditional medical profession.

 This is followed by celebrations; while dressed with charms and

other forms of regalia around him.

 Role of the interpreter: the medicine man has a

spokesman, Okyeame.
 Are children qualified as Traditional Medical Practitioners?

A child may qualify to train as a TMP when and if the following

happen:
1. The child shows a predilection for an interest in herbs.

2. The shrine chooses the child, for example, through the

possession of a returning ancestor who was a healer.

3. The parents are informed through the shrine of the child's past
knowledge before her or his birth.
 Basic requirements of children TMPs
The child must have the necessary attributes such as
humility, compassion, thoughtfulness, and obedience.

The child must also have respect and be respected and be

able to listen carefully, follow instructions strictly, be
patient and an introvert (quietly reflective), and so on.

Children learn about herbs and shrines between the ages

of 4 and 10, but selection and training of TMPs takes
place when the girls and boys are teenagers (Dove 2010:
824).
 Herbalists (NnunsinfoƆ)
Herbalists are not possessed by any supernatural agent.
However, they can work with less powerful spirits (suman).

They can use medicines to enable them diagnose spiritual

causes.

A special kind of herbalist is the bone-setter who has

specialty in treatment of fractures (broken bone?).

The attitude of herbalists towards magico-religious practices

may vary – some may engage the supernatural during
health delivery, some may not.
 Amulet or charm makers

An amulet or charm maker (asumanfo) made amulets (suman) that

were generally used for personal ends.

Often kept in the user's house in order to cure sicknesses or

alternatively to poison others.

The amulet's power come from the physical and spiritual

properties of plants or trees conferred on it from forest dwarfs,
forest monsters (sasabonsom), witches, or the spirits of the dead.
 
Making and distributing amulets for various health and protective
purposes was often referred to as making medicine.
 Ritual and secular functions of traditional healers
 Diagnosis: knowing the mystical cause of the misfortune helps to
combat it effectively.
provide antidote for the misfortune of any person, and then proceed
with preventive measures to ensure that the misfortune does not recur.

preventive medicines include: charms, amulets, talismans, or medicine.

Help people with problems and misfortunes to overcome them.

barren women or their husbands or relations consult healers to help them

conceive, or impotent men desire help in order to perform.

Healers assist a man or a woman to win more love from their wives
or husbands or lovers.
Functions cont’d.
Farmers consult them to increase fertility/productivity.

Business people, politicians, civil and public servants, as well as

students – approach the traditional healer for help.

Medicine men symbolize society’s hopes for good health, protection,

security from malevolent or evil forces, prosperity and good fortune,
and ritual cleansing when harm or impurities are contracted.

For traditional African villages and communities, the traditional

healers are the friends, pastors, counsellors, and doctors of the
people.

What reasons could possibly account for patronage of traditional med.?

 Patronage of Trad. Med.
Affordability: Relatively cheaper cost involved.
Nearness: may not involve so much cost of transportation.

Availability: TMPs are readily available.

Comparative advantage of treatment of certain forms of diseases over Orthodox

medicine.

Convenient atmosphere for interaction between patient, family members, and TMP.
o Medicine is administered in the compound of the healer, with children
playing, women cooking, and neighbours passing by which contrasts sharply with
orthodox hospitals.

It is also believed to be more effective.

Fear of amputation.

Bad attitude of Orthodox medical practitioners towards clients.

 T. Medicine, Pregnancy protection and delivery

Fisher (1998:82) West African Religious Traditions confirms the

use of traditional medicine by pregnant women.

– “a pregnant woman makes mixtures from the tree bark and roots,
seeds and leaves”. This is to help her to have a good and sound
labour.

A pregnant woman wears talisman around her waist to prevent

evil forces roaming around the world.

What are some of the challenges confronting Traditional Medical Practitioners in Ghana?
Challenges
Prescription/Dosage
Inappropriate treatment methods could lead to spread of
diseases (use of unsterilised equipments, common towels).
Illness disclosure
Diviners can also heighten tension in communities when
people are falsely accused as the cause of ill-health.
Some healers may ask their clients to even visit the
cemetery or pick items from there for treatment purposes.
The secrecy issue.
Globalisation (Urbanisation) and impact on herbs.
The Hygiene problem
THANK YOU AND SEE YOU NEXT WEEK