Qi flows from Beijing to Gaborone (Part 4)
Baboki Kayawe | Friday March 4, 2016 13:07
There are significant strides on research in collaboration with the Centre for Scientific Research Indigenous Knowledge and Innovation (CECERC), which is responsible for documentation and promotion of indigenous knowledge.
The health ministry however, is yet to respond to traditional healer, Gladys Malebo’s HIV/AIDS healing claims or comment on whether government would recommend the herbal concoction.
It is intriguing that Dr Siambi Kikete, a Kenyan pharmacist based at Tianjin University of Traditional Chinese Medicine, solely uses Western medicine while in his home country, but combines Chinese and Western medicine while in the East.
“Choice of a specific healthcare type is a matter of perception,” he says. “My scientific background limits my choices to remedies that have been subjected to the rigours of scientific research, have been shown to be effective and also cause minimal harm to the body.”
For him the inconvenience about African medicine is that too little scientific research has been carried out to test the medicinal properties of these indigenous herbs and little has been done to formulate them into medicines that a patient can actually take. While he posits African medicine has a place in contemporary and mainstream health care systems, he emphasises that times have changed and indigenous care regimes ought to as well. “Historically, Africans utilised indigenous remedies to cure and control disease.
However, times have changed and we must change too.” “First we must separate the actual remedy from the superstitions and spiritualities that shroud many indigenous African prescriptions. I know of a practitioner who claims he can treat fertility.
In addition to the herbs, he gives nonsensical instructions like the time, place and direction the couple must face during sex for the remedy to work!” Secondly, Kikete argues that the evidence of efficacy of many African medicines is anecdotal, and the formulations are highly guarded secrets.
As a result, science cannot validate the claims made by these practitioners. “Consequently, we cannot develop a yardstick upon which we can train and regulate practitioners of indigenous African medicine,” he says.
Perhaps with herbalists, things are slowly changing as practitioners such as Malebo and others have started documenting the tools of their trade. However, academia in Africa is poorly funded and hence serious research on African herbal medicine is limited. Even when there is overwhelming evidence, Kikete says the continent lacks indigenous pharmaceutical companies that can translate research findings into commercial ventures such as is the case in China.
“Also, those who run healthcare in Africa prefer to copy paste healthcare models from the West without tailoring them to suit local needs and realities,” Kikete says. For him, the most important and perhaps most disturbing challenge with African Traditional Medicine is the societal perception that it is retrogressive and must be shunned at all costs.
Kikete’s greatest fear is that African countries may expend resources developing it, only for its uptake in the community to be too low to make sense.
Colonialism and the spread of Christianity in particular across the continent, have played a pivotal role in this imaging of indigenous medicine in Africa. “The early missionaries and colonialists ridiculed, demonised and even banned African Traditional Medicine.
At the time many Africans perceived these missionaries to be a superior race and accepted their healthcare models and culture blindly to the detriment of African Traditional Medicine. Even our foods that were nutritionally better and in part responsible for relative longevity then, were discarded in an attempt to ape the whites,” Kikete says. On a positive note though, the colonists documented the plants they found here.
“At least they documented the plants they found here, even though it may not have been for medicinal reasons,” he says. “In East Africa they founded a botanical collection called The East African Herbarium, which has been an invaluable asset in medicinal research on plants.”
Though both health systems have been in existence since time immemorial, Kikete commends Beijing for the fact that over the years the Chinese developed a very complex theory of TCM, “That is up to universally recognised by practitioners, the public and the government”.
“This informs the policy on promotion of TCM in China and abroad. Naturally resources follow policy and as such extensive research in Chinese herbs has led to scientific validation of many ancient claims while also discounting others,” he adds.
Moreover, Chinese pharmaceutical companies have been quick to collaborate with research institutions to commercially exploit such research findings. Even in Africa, there is a major footprint of Chinese herbs formulated as modern dosage forms that are convenient for the patient.
In contrast, however, many 21st century African herbal remedies are still marketed in their crude form or as voluminous, bitter and unhygienic concoctions, said Kikete. “Indeed several indigenous African herbs have entered the formal pharmaceutical system based on indigenous claims of their effectiveness in treating diseases. A good example is pygeum (Prunus africanus). Sadly the pygeum bark is harvested in Africa and exported crude at a pittance to the West,” he says.
“There it is processed into a potent drug for managing prostrate problems and sold for a handsome profit. Of course weak regulation in both the practice of African Traditional Medicine and trade in herbs is the genesis of this problem. But again Africa cannot regulate this effectively because we don’t have ‘experts’ in the formal sense since the practice is largely informal. The converse is true for China,” he explains.
China, meanwhile, has enjoyed global recognition, which is mainly as a result of government efforts to preserve and promote TCM. In addition, Kikete says acceptance outside China by scientists has been as a result of the formalisation of training at university level, which led to research that has now validated many of the ancient claims. However, like any science TCM has its limitations.
“These limitations are due to the fact that TCM is based on the knowledge of ancient times, which cannot be as wide as today’s knowledge. For example surgery was not done in TCM because knowledge of anatomy and physiology was not adequate at the time,” he says.
However, acupuncture has been shown to be effective in stimulating nerve regeneration after injury or surgery and this is a major area of integration in China. Africa can draw invaluable lessons from the East, argues Kikete. He says in China, herbal preparations can be used as alternatives to synthetic pharmaceuticals. “For example some African herbs could stimulate the immune system in HIV and cancer patients with less toxic side effects compared to their western contemporaries.”
For the integration to be effective and achieve fruition he says the issue of acceptance must be dealt with. Kikete says: “If it is not in your modern culture today to embrace African Traditional Medicine especially the policy maker, health worker and community member, even the most elaborate policy is unlikely to succeed. This can be addressed as a civic education matter and also at school level”.
In Botswana, policy must provide incentives for traditional healers to share their current knowledge with the formal system and find ways to retrospectively search for lost knowledge. This knowledge should then be scientifically tested.
Since African Traditional Medicine has no universal principles of diagnosis and only needs to focus on the effectiveness of the product in treating whatever it is being claimed to be useful for, Kikete says remedies that work should then be standardised and documented while those that do not are discarded. “Here we will expect some resistance since traditional healers mystify their methods with claims of supernatural influences. Secondly, most have no formal schooling and cannot be brought to class and expected to grasp modern science. More importantly it is the perceived monopoly of knowledge that attracts clients to them and they may not give it up easily.”
However, he says a curriculum could be developed to incorporate African Traditional Medicine into medical practice and training provided both parties are willing to mainstream the practice.
The Ministry of Health could then regulate the qualified practitioners and products, he adds.
“Of course if the market economics make sense, the pharmaceutical sector should be brought on board to manufacture convenient formulations that can guarantee safety and efficacy. As you know the conditions herbs are exposed to during growing, harvesting and preparation cannot be reproducible if every practitioner is left to his own devices.”
*This article was produced with funding from the China-Africa Reporting Project, coordinated by the University of the Witwatersrand in South Africa. Special thanks to China University of Communication Masters students Ma Xinhu and Hu Xiufang who did translations from Chinese to English. This edition’s insert is the last of a four-part series.