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AFRICAN TRADITIONAL MEDICINE
HERBERT W. VILAKAZI*
(*Director: Vilakazi Development Strategies, P. O. Box 70357; Die Wilgers; Pretoria; 0041; Telephone/Fax: 012 807-4265; Cell: 0725609752; Email: email@example.com)
[MMed Week; Medunsa: 2 February 2005)
Any discussion of medicine must begin with the statement that just about all diseases have social causes, rather than biological courses.
It is to conditions and tendencies in society and culture that we must look for the causes and roots of almost all diseases. This is true of water-related diseases that kill millions of children and adults every year; this is also true of diabetes, heart attacks, hypertension, and cancers related to what is referred to as `life style’. Likewise, it is also conditions and tendencies in society and culture which are responsible for existing capacities and abilities to cure diseases; it is also the same conditions and tendencies in society and culture which are responsible for absent capacities and absent abilities to cure diseases.
Medicine, then, is not a pure science: indeed, no science is a pure science. There are many, many errors, blind-sports, untruths, ignorance, omissions, prejudices, and crimes against masses of human beings, which are forced into, or incorporated within, medicine, by the conditions and tendencies of a particular society and culture. The blessings and powers of medicine, and the light of science shining within medicine, are all bestowed upon medicine by the conditions and tendencies of a particular society and particular culture.
However, I must be fast to add that the blessings and powers of medicine in modern society are distributed to members of society in a very selective and discriminatory manner; this discrimination and selective distribution, within medicine, is forced upon the system of medicine by social class inequality, by the enduring power of racism in society, by the caste system, by the profit-motive driving health care, by the evil of bureaucracy, by city people’s prejudices against rural people, by gender differences, and by budget considerations.
Sometimes this discrimination and selective criteria within medicine rise, willy-nilly, almost to the level of genocide and crimes against humankind; when certain diseases target mainly the poor, or children of poor mothers; when certain diseases target mainly the people of Third World countries; when Aids, for example, targets mainly Africans.
Therefore, issues of medicine are, first and foremost, not issues of science, but issues of tendencies in society and culture, issues of politics, issues of prejudice and racism, issues of ignorance bred by prejudice, racism, politics, and a particular society and culture.
This is particularly the case when we encounter the issue of African Traditional Medicine. We are dealing here, first and foremost, not with medicine, but with prejudice in modern Western culture against African people, with prejudice against African culture, with the prejudice of city people against rural people, and with the prejudice of educated professional people against peasants. All this prejudice creates a gigantic cloud, fog, and sphere of ignorance, which harms us all, and hampers our way towards creating a humane society.
We then, unthinkingly, choose to live within that sphere of ignorance and prejudice against African traditional medicine, and then proceed to tell and to believe all sorts of lies about African traditional medicine.
African traditional medicine arose out of the experience of Africans in African traditional society, a society which is the oldest society in all human history. We know that human beings first emerged in Africa: Africa is the Mother of Humankind. It was only approximately 60,000 years ago that some of the Africans walked out of Africa, to other regions of the world, and there, after some time, changed skin colour, hair texture, and shape of nose and lips.
Africans, Whites, Indians, Asians, Arabs, Jews, Native Americans, Amerindians, Eskimos, are all cousin brothers and cousin sisters long lost to one another psychologically, mentally, and spiritually. Tens of centuries later, some of these cousin brothers and cousin sisters came back to Africa and abused, killed, enslaved, and poured deep contempt upon their first cousin brothers and first cousin sisters: The abuse of Africans, and contempt for Africans, from the cousin brothers and cousin sisters of Africans, is the biggest tragedy of entire human history; this is the cause of the deepest psychiatric disorder in the personalities of men, women, and youth the world-over. The contempt for African traditional medicine must be seen in this larger context.
One of the greatest gifts Africa bestowed upon Humankind is the science of African medicine. Because of racism, the contempt for Africa, Africans, and African culture which was introduced into the world by the African Slave Trade, the science of African medicine was demoted to the status of rubbish and superstition. The Slave Trade, itself, the attack upon Africa, the rampant destruction and vandalism meted to African society, first by Arabs, then by Europeans, destroyed a lot of this science.
Impoverishment and underdevelopment, and displacement of people, have resulted in the corruption and distortion of considerable portions of this knowledge: some men and women, thrown into desperation by such impoverishment, underdevelopment, and displacements, have emerged as imposters and fake traditional doctors, thereby casting an additional bad light on the science of African medicine. However, not all was destroyed and corrupted. Continuity of the original science, and its development, are embodied in the work of many African men and women still practicing African traditional medicine.
The great challenge we face is that of separating the chaff from the real stuff, to identify the genuine practitioners who are embodiments of the real science of African medicine. That red thread is still visible in our history: we should trace it and follow it to the living geniuses and talents of African traditional medicine.
The great challenge facing modern Western medical doctors, and modern Western medical researchers, and Public Health officials, is to study carefully the work of these living geniuses and talents of African traditional medicine; establish the scientific validity of traditional medicine; and then to start a process of improving Public Health and medical practice through incorporating the science of African traditional medicine into modern Public Health policy and medical practice.
The outstanding, recorded history of the science of African traditional medicine begins thousands of years ago, in Ancient Egypt –and I am talking about Egypt when it was still ruled by Africans similar to Africans in Swaziland or South Africa, before that land was conquered by Arabs, when Egypt was still part of African civilization, and was the fountain of African civilization, not part of Islamic civilization. Herodotus, who traveled to Egypt in the 400s B. C., described the Egyptians as having “black skins and wooly hair”. (Herodotus, The Histories, London, Penguin, 1972, p. 167)
The important point to stress is that African traditional medicine was part and parcel of what today we would call Public Health policy, whose principles were practiced and implemented in every household, village, and community. That was part and parcel of African traditional culture. I must stress that I am not talking about African culture practiced within the desperate, cruel, cramped conditions of conquest by the West. Culture, in conditions of underdevelopment, poverty, starvation, and oppression, gets warped, broken, and distorted.
In a proper society, culture and medicine work together towards maintaining the good health of everyone in society. African traditional medicine was intimately tied to African culture.
Let us begin with the simple matter of cleanliness, the washing of hands, and the washing of the human body, all a crucial pre-requisite for the prevention and control of diseases. We are told that at the foundation of prevention and control of diseases is what medical people call “the germ theory of disease.” Writing about Europe, the historian Peter Gay states: “For decades after 1800, the causes of most diseases were embarrassing enigmas…” (Gay, Peter, The Cultivation of Hatred, London, HarperCollins, 1994, p. 453) Writing about mid-19th century life in US Southern States, Clement Eaton stated: “Ignorance of the germ theory of disease was universal.” (Eaton, Clement, The Growth of Southern Civilization:1790-1860, New York, Harper, 1961, p. 253) In the absence of the germ theory of diseases, the most outrageous explanations for diseases were given. Professor Gay tells us: “The germ theory of disease, that historic discovery, was adumbrated only in the late 1840s, by Semmelweis, and then established two decades later by Pasteur. And until a few rebels in the mid-1820s demonstrated that bleeding was really a licensed form of murder, most physicians commended it as the therapy of choice” (Gay, op. cit., p. 454).
The story of how the theory of germs, as the cause of diseases, was discovered is worth re-telling, as a prelude to the discussion of the situation in traditional African society. Let us follow the story, from Peter Gay:
Semmelweis…took his medical degree at the University of Vienna, and remained to specialize in obstetrics at the Vienna General Hospital. It was a disheartening assignment; he had too many opportunities to perform autopsies on mothers who had succumbed to childbed fever. They were dying in numbers that made the most callous bureaucrats take notice…the official figures revealed that in 1844…some 260 mothers out of 3,157, or 8.2 percent, had died in the First Maternity Division, where he worked; two years later, the figure had risen to 11.4 percent. The actual number of casualties was much higher, probably one in five of the mothers in the First Division, perhaps as many as one on four, did not leave the hospital alive…What made this plague even more mysterious was that the figures for the Second Maternity Division, located next to the First, were dramatically lower…Compounding the mystery was the fact that these appalling rates of death from childbed fever occurred nowhere but in the First Division; women delivered at home or in the streets survived with virtually no risk of falling victim to the fever…the mothers in the First Division were attended by obstetricians and medical students; those in the Second, next door, by midwives…
What could explain such an event? Everyone was puzzled, and offered many guesses as probable causes. Semmelweis came to a probable explanation by accident.
…one of his cherished teachers… died of an infection after puncturing his finger during an autopsy. As Semmelweis mourned this loss, his reflections gave him the decisive clue; Kolletscha had died of …-blood poisoning- that was killing mothers in the First Division every day…The medical students assigned to his ward usually came to work after dissecting cadavers –a task that midwives did not perform- the foul odors of the autopsy room still clinging to them. At best they might casually splash their hands with water. Semmelweis ordered his staff to wash their hands in a solution of chlorinated lime. The results surpassed his wildest fantasies: in 1848, the figures for death caused by childbed fever in the First Division dropped to 1.27 percent, even below the 1.33 percent in the Second Division.” (Gay, op. cit., pp455-456)
This is how “the germ theory of disease” was discovered in Europe: the theory that small, invisible moving bodies, which can transfer from place to person, from person to person, are the causes of infections and diseases. From this insight flowed the basic rule or injunction for the prevention of infections: cleanliness, the washing of hands, of surfaces, and keeping the human body clean. This was a discovery made in Europe, and in European medicine, only in the 1840s, by Semmelweis, and finally pronounced authoritatively by Pasteur in the 1860s.
Western medical doctors and medical researchers are free to say that this theory was discovered, for the first time, for the West, in the 1840s and 1860s; but they cannot say this is true for the whole world.
I shall argue now that the germ theory was known in African society before Colonialism; evidence for that is found in the teachings and principles for behavior in African society, teachings and principles of behavior which were aimed at prevention of infections.
These teachings and principles for behavior were found in just about all African societies and communities, from Ancient Egypt to the our time. Opportunities for implementing these principles have been heavily undermined by poverty, slave conditions of existence, by oppression, by starvation, famine, and underdevelopment.
I was brought up in Zulu culture, so I shall speak of teachings and principles of behavior in Zulu culture.
In traditional African society, the greatest stress was put on cleanliness, on washing of hands, and on the washing of the body. Keeping the body clean and protected, obviously from germs and harmful elements, is very important in African culture. Let us begin in Ancient Egypt: Herodotus tells us that the Egyptians “wear linen clothes which they make a special point of continually washing. They circumcise themselves for cleanliness’ sake, preferring to be clean rather than comely. The priests shave their bodies all over every other day to guard against the presence of lice…” (Herodotus, op. cit., p. 143)
African culture put a lot of stress on preventing food from being infected by germs carried by human beings.
1. Upon waking up, every person was expected to wash the face and hands before touching food.
2. One had to wash one’s hands, and the udder of the cow, before starting to milk the cow, to prevent milk from becoming infected by germs.
3. Our culture did not allow anyone to sweep the floor next to where people were eating. Even when people were not eating, it was taught that one had to sprinkle water on the floor, before beginning to sweep, to keep the germs imprisoned on the floor, preventing them from flying all over.
4. Zulus, most of the time, did not lift food from the containers to their mouths with spoons and folks. They used hands. But the hands had to washed, first. To prevent germs coming from the mouths of the people eating from one bowl, the hand that lifts food to the mouth does not pick the food from the bowl. The right hand picks the food from the bowl, and delivers the food to the left hand; and it is the left hand which lifts the food to the mouth. This was for hygienic reasons!
THE DEAD BODY (CADAVER) AND PREVENTION OF INFECTIONS
In the light of the connection between contact with dead human bodies and the discovery of the germ theory of diseases by Semmelweis, in Vienna, in 1848, it is very interesting to learn about the hygienic concerns of Africans regarding dead bodies.
Lecturers in medical schools stress to their students how dangerous a dead body is, from the point of view of possible infections which can be derived from the hosts of germs in and around a dead body. The medical students who had been working with cadavers in the First Maternity Division, in the Vienna of the 1840s, infected the mothers who had just given birth, resulting in the death of many of them.
If there is anything in African culture which shows that Africans had a germ theory of disease, it is the precautionary customs intended by Africans to keep the germs in and around a dead body in check.
In most African cultures, there is an important ritual that must be performed by everyone coming from the grave to the homestead, but before entering the home of the deceased: that is to wash hands. C. T. Msimang has written as follows regarding this ritual:
“Emva komngcwabo, sebezokhukhula bonke baqonde emfuleni. Isifazane kwelaso izibuko siyogeza, nesilisa sigeze sodwa. Abanye bathi kugezwa ngomsuzwane wonke umzimba, nokho-ke iningi ligeza ngamanzi ewodwa. Abanye njalo bageza ngesiqunga. Bazothi bangageza bese bechitheka abantu, babuyele emizini yabo, abomndeni babuyele kwamufi.” (Msimang, C. T., Kusadliwa Ngoludala, Pietermaritzburg, Shuter and Shooter, 1975, p. 144)
What is very interesting is that, not infrequently, a herb with strong disinfectant and antibiotic powers (such as inhlaba) is put in the water that is used for washing hands and the body after a funeral.
What also happens is the thorough, disinfectant cleaning of the house, particularly of the room in which the body was placed: (Lapha kwamufi sekuzosindwa zonke izindlu.” (Ibid., p. 145) Even the clothing and blankets used by the deceased were thoroughly cleansed.
If you take time to think seriously about the meaning and implication of all these teachings and principles of behaviour, discussed above, which are contained in African culture, and were contained in African cultures for centuries before conquest by European nations, you should see clearly that all these teachings and principles of behavior presupposed the possession of a germ theory of disease by Africans, for centuries before this theory was discovered in Europe in the 19th century. This was the germ theory of diseases in action, contained in African culture.
What I have been discussing has been health policy, what today we would call Public Health Policy, ingrained, contained, and implemented in day-to-day behavior and customs of Africans in traditional African society.
Let me also stress the importance of correct, nutritious food in African cultures, before the destruction and abandonment of many traditional African crops and foods, as a result of the collapse of the African village economy, due to land dispossession, impoverishment of both the people and of the soil, and the imposition of the Western market economy at the expense of the traditional African economy. The principle held in Ancient Egypt was more or less contained in most African cultures. Herodotus tells us the following:
“The Egyptians who live in the cultivated parts of the country…have made themselves much the most learned of any nation of which I have had experience…every month for three successive days they purge themselves, for their health’s sake, with emetics and clysters, in the belief that all diseases come from the food a man eats; and it is a fact…that next to the Libyans they are the healthiest people in the world.” (Herodotus, op. cit., p. 158)
Zulus also purged the body periodically (ukuchatha, ukuphalaza, ukugquma).
The attitude towards eating taught in many African cultures, e. g., in Zulu culture, was very different from the attitude towards eating in modern culture. Eating was revered as a ceremony, and there was a strong perception that the method of eating, the attitude towards food and the eating process, the spiritual context of eating, were related to health. The manner of eating, and respect for the process of eating, the spiritual context of eating, were in traditional African culture meant to harmonize with the rhythm, pace, and pulse, of the human body, as a physical, mental, and spiritual body alive and linked to the rhythm, pace, pulse, and electro-magnetic unity and interrelationship of the entire universe. The theory was that the body, as a complex system, had to be given a chance to absorb food in its own pace and proper rhythm.
In Zulu culture, we were taught and instructed not to eat in a hurried pace. We were scolded, threatened with punishment, for eating out of rhythm, i. e. eating fast. Mus’ukuphanga!
The culture forbad everyone from eating standing up, or kneeling upright. You had to respect the rhythm of the body, and of the universe, by eating seated respectfully.
You were also taught not to think other complex, distant thoughts, while eating. When the food went down the wrong pipe, and you started coughing helplessly, you were scolded: Mus’ukucabanga. Your soul and mind had to take leave of the bothersome matters of the world, while at meal.
These teachings and principles are diametrically opposed to many of the practices of today: eating while standing; a business breakfast, or a business lunch, or a business dinner; and a quick meal during a heavy day of work at the office or at the shop, or giving workers 30 minutes for lunch.
In African culture, all this is conducive to ill-health, physically, mentally, and spiritually.
In ending, let me stress that African traditional medicine is based on research. It is research not conducted in an artificial laboratory, as in modern scientific research; the geniuses and talents of African traditional medicine conduct their research in the real world. The real world is their laboratory.
The Traditional healer knows that nature and the entire universe is a totality of interrelated millions upon millions of processes, all held together in a relationship of conflict and accommodation, of harmony and disharmony, of equilibrium and disequilibrium. True healing is a result of the mutual action of all these processes, never of one chemical compound, but of many, many interrelated chemical compounds and actions, which are in harmony and disharmony, of conflict and accommodation, of equilibrium and disequilibrium.
The modern Western medical scientist’s desire to isolate and identify only one chemical compound as the cause of healing is a violation of the truth of nature and the universe as a unity of millions upon millions of processes interacting upon one another and with the human body, millions upon millions of processes which are a unity of conflict and accommodation, of equilibrium and disequilibrium, of harmony and disharmony. One chemical compound can never be the proper cure of a bodily disorder, the same body made up of billions of cells. African traditional medicine uses the whole leaf, or the whole root, or stem. Isolating and extracting only one chemical compound, or two, or three, and preparing that as a cure, is most likely to disorient the inner-processes of the human body, and this disorientation is what we call “side effects.”
The modern scientific mind, guided by the methodological and philosophical prescriptions of modern science, is very unaccommodating, skeptical, even contemptuous, of the methods of diagnosis followed by traditional healers.
To traditional healers, nature is both matter and spirit; nature is a material fact, but it also possesses spirituality and personality –to be more specific, certain aspects of nature, especially certain aspects of organic nature, have spirituality and personality. The science of traditional society
Modern science is uncompromisingly based on concrete, quantifiable, mathematically logical facts, derived mainly from experiments in laboratories. To modern scientists, nature has no immanent spirituality, no mind of its own, and no personality. To modern science, there can be no two-way communication between nature, on one hand, and human beings, on the other. even though human beings evolved from nature, and are the children of nature, and should bear some features derived from the parent, nature.
I cannot help ending by mentioning a gigantic triumph of the science of African medicine.
The hand and mind of the practitioner of African traditional medicine were guided by prior study and search for knowledge. How could a Caesarean section operation have been performed, in 1879, by an African traditional healer surgeon, without intensive prior study and research? Let us follow this event carefully:
“It is pertinent now to consider one of the most remarkable examples of African surgery ever documented. This is an eye-witness account by a missionary doctor named Felkin of a Caesarean section performed by a Banyoro surgeon in Uganda in 1879:
The patient was a healthy-looking primipara (first pregnancy) of about twenty years of age and she lay on an inclined bed, the head of which rested against the side of the hut. She was half-intoxicated with banana wine, was quite naked and was tied down on the bed by bands of bark cloth over the thorax and thighs. Her ankles were held by a man…while another man stood on her right steadying her abdomen…the surgeon was standing on her left side holding the knife aloft and muttering an incantation. He then washed his hands and the patient’s abdomen first with banana wine and then water. The surgeon made a quick cut upwards from just above the pubis to just below the umbilicus severing the whole abdominal wall and uterus so that amniotic fluid escaped. Some bleeding points in the abdominal wall were touched with red hot irons. The surgeon completed the uterine incision, the assistant helping by holding up the sides of the abdominal wall with his hand and hooking two fingers into the uterus. The child was removed, the cord cut, and the child was handed to an assistant.
The report goes on to say that the surgeon squeezed the uterus until it contracted, dilated the cervix from inside with his fingers (to allow post-partum blood to escape), remove clots and the placenta from the uterus, and then sparingly used red hot irons to seal the bleeding points. A porous mat was tightly secured over the wound and the patient turned over to the edge of the bed to permit drainage of any remaining fluid. The peritoneum, the abdominal wall, and the skin were approximated back together and secured with seven sharp spikes. A root paste was applied over the wound and a bandage of cloth was tightly wrapped around it. Within six days, all the spikes were removed. Felkin observed the patient for 11 days and when he left, mother and child were alive and well. In Scotland, Lister had pioneered antiseptic surgery just two years prior to this event but universal application of his methods in the operating rooms of Europe was still years away. Caesarean sections were performed only under the most desperate circumstances and only to save the life of the infant. A Caesarean section to save the lives of both mother and child was unheard of in Europe nor are there records of such a procedure among the great civilizations of antiquity.” (Finch, Charles S., The African Background To Medical Science, London, Karnak House, 1990, pp. 135-136)
Yes, I repeat: one of the greatest gifts that Africa gave to Humankind was the science of African medicine, which is African traditional medicine.