Clinical practices of African traditional medicine

Thokoza Kehla, thank you to everyone who has been reading my blog and subscribed. I apologise for the absence of posts. It sometimes happens in a healers life that one has to go inside and search for wisdom and also deal with ones own issues.

I came across this article on the WHO website and thought it may be a thought-provoking article to share with you. I have been looking at how s treat  mental Illness and  other so-called medical problems. It is a rather long post so I have edited it and have not posted the references. You can read the full article on this link:

Clinical practice is the process of evaluating conditions of ill health of an individual and its management. The treatment guide used by traditional health practitioners (THPs) in general and diviners in particular, varies greatly and depends on the THP’s own knowledge and skills, as well as the nature of the patient’s illness. Satisfactory healing involves not merely recovery from physical symptoms, but also the social and psychological re-integration of the patient into his/her community.

In African traditional medicine clinical practice, THPs personally assess patients in order to diagnose, treat, and prevent disease using their clinical judgement. The THP – patient relationship typically begins with interrogations through case-history taking and recourse to basic diagnostic procedures such as divination to determine the cause of the patient’s complaint. Once the primary causes of the ailment are determined, the THP then prepares medicines, which may be derived from medicinal plants, animal parts or minerals.

The THP’s own experience, added to the accumulated knowledge handed down by their ancestors, allow the THPs to offer cheap, but effective remedies for treating the main ailments that afflict the populations of the African Region, such as malaria, stomach infections, respiratory problems, rheumatism, arthritis, sexual dysfunction, anaemia, parasitic infections, mental problems, bone fractures and conditions requiring midwifery services.


In African TM, health care delivery includes curative, apprenticeship (training), promotional and rehabilitation services. These services are being provided through tradition and cultural philosophy for example ubuntu philosophy. The philosophy requires a THP to provide health services under a “humanityfirst” consideration and not for material gain. There are many philosophical terminologies in African culture, used to describe a THP as a person of high standing in a community, open and available to serve others, when they need health care services.

Ubuntu philosophy requires THPs not to provide services for material gain. THPs are therefore obliged to provide health care services to their patients without demanding any charges. This taboo imposes on the practitioners a strong code of ethics in the provision of health care services to which they should always abide. This places a huge responsibility on the THP/ individual to demonstrate a high sense of “professionalism” and integrity in the discharge of their work. A THP, who believes in ubuntu strives to provide health care services according to the tenets of the taboo.

Examples of African traditional medicine practices that are recognized by almost all communities in the African Region include general traditional health services, traditional midwifery, bone setting and mental healthcare. Traditional health services that are not often recognized by all communities and governments include divination and circumcision.

Diagnosis is a key part of African traditional medicine. This entails a systematic quest for answers to the origins (immediate cause) of a particular disease to determine, who or what caused it (efficient cause), and why it has affected a particular person at a particular time (ultimate cause). In situations where divination is utilised, diagnosis may comprise of a combination of observation, where the patient’s physical symptoms are noted, and patient self diagnosis, where the patient reports their problem to the THP. Where necessary, the impressions of other family members regarding the patient’s illness may also be obtained. The process of divination will then involve such techniques and beliefs as the casting of divination objects, extra-sensory perception or ability (clairvoyance/ telepathy) or interpretation of dreams and visions.

 Satisfactory healing involves not merely the recovery from physical symptoms, but also the social and psychological reintegration of the patient into his/her community. Treatment is comprehensive and has curative, protective and preventive elements. Moreover, treatment can be either natural or ritual or both, depending on the cause of the disease. The mode of administration of medications includes, among others, oral ingestion, steaming, sniffing of substances, cuts (the African traditional medicine form of injection) and/or body piercing (the African traditional medicine form of acupuncture).

Another aspect of clinical practice of African traditional medicine are norms and taboos. These belief systems account for the widespread acceptability of THPs in the communities they serve.

In the African context and traditional medicine practices in particular, food taboos are a set of rules developed to control the dietary habits of humans. They ensure that people abstain from consuming certain foods and drinks for reasons, which may be religious, cultural or hygienic. They also give directions as to how certain foods may be prepared. The origin of these prohibitions or restrictions varies from one community to another.

Curative Services

Because of the limited access to antiretrovirals (ARVs) many people living with HIV/AIDS (PLWAs) rely totally on African traditional medicines for treatment. Also, several cases of bone fractures and psychiatric disorders are treated by THPs using traditional medicines. In respect of curative services, the efficacy and potency of herbs are very real in traditional health services provisions.

THPs also provide preventive health care. The experiences they accumulate, are transferred to their successors from one generation to another through apprenticeship.

Some African countries are locally producing traditional medicines used for various diseases such as chronic diarrhoea, liver disorders, amoebic dysentery, constipation, cough, eczema, ulcers, hypertension, diabetes, malaria, mental health and HIV/AIDS in order to improve people’s access to medicines. This will enhance the process of integrating traditional systems of medicine into the healthcare services (6).

Types of Practices/Services

Traditional health services cover many areas including general traditional health services; bone setting; traditional midwifery and traditional mental health services.


General clinical practices are services provided to clients by non-specialised healthcare providers. The general THP manages conditions such as malaria, stomach infections, respiratory problems , rheumatism, arthritis, sexual dysfunction, anaemia and parasitic infections.


The African concept of disease and medicine is the foundation of traditional medicine treatment. Unlike the situation elsewhere, in countries of the African Region, medicines have a personality and potent living force. For example, the management of neurosis is markedly different in Africa than elsewhere. African THPs make use of divination to unravel the mental and psychological problems of their patients. Divination therefore plays a significant role in the treatment of neurosis and helps re-trace a patient’s life from its metaphysical past to how it interplays with the present and future.

The THP provides for a link between a patient and the patient’s own social, cultural and intellectual environmental background.

Studies have shown that the number of common mental disorders recorded among patients consulting THPs is twice as great as that recorded for those attending a primary health care clinic. The most common symptoms presented in both settings, were fatigue, obsessions, worries about physical health and depression. However, people who seek traditional medicine treatment are more likely to have chronic complaints and to have seen several doctors.


Midwifery is a health care profession in which providers give prenatal care to expecting mothers, attend the birth of the infant, and provide postpartum care to the mother and her infant.

Midwives are autonomous practitioners who are specialists in a low-risk pregnancy, childbirth, and the postpartum stage. They generally strive to help women have a healthy pregnancy and natural birth experience. Midwives are trained to recognize and deal with deviations from the norm (9).

A midwife may practice in any setting including in the home, the community, hospitals, clinics or health units. Many traditional midwives live in rural, and often isolated communities. They may work at considerable distance from health facilities and are often older mothers; many are post-menopausal. Many midwives are also herbalists, or specialize in other traditional healing practices.


A bonesetter is a practitioner of joint manipulation. Before the advent of chiropractors, osteopaths and physical therapists, bonesetters were the main providers of this type of treatment. Bonesetters would also reduce joint dislocations and re-set bone fractures.

Another aspect of bone setting is spinal adjustment, which is a variation of a procedure known today as spinal manipulation. Records show that this form of treatment has been in existence since the time of Hippocrates and ancient Egypt and was passed down through the ages by families of bonesetters. The modern form of spinal manipulation techniques have characteristic biomechanical features, and are usually associated with an audible “popping” sound. In countries of WHO African Region, traditional bonesetting (TBS) has been practised for centuries (14).

Training and promotional services

Apprenticeship is a system of training a new generation of practitioners to acquire some skill. Most of this training is done on the job while working for an employer, who helps the apprentices learn their trade, in exchange for their continuing labour for an agreed period of time after they become skilled. Theoretical education may also be informally involved, via the workplace (14).

Although years of colonial rule repressed African traditions, culture, norms and taboos, African traditional medicine has survived to date. Traditional medicine practices have since been passed from one generation to another through training and apprenticeship. Grooming trainees to understand diseases, diagnostic procedures, medicinal resources and preparation of the required prescription and administration of the medications, requires appropriate theoretical and practical training methods.

The training and promotional aspects of African traditional medicine prepare practitioners to be responsible, accommodating, hardworking, good listeners, as well as having a sense of pride of themselves and their tradition and culture – the ubuntu philosophy.

Rehabilitative services

In the African context and ubuntu philosophy, rehabilitation is carried out as a family or community duty. Traditionally and culturally there is no system of skills development for disabled people leading to employment. Instead, the family and the community are responsible for the rehabilitation of the disabled person. This situation gives the disabled a sense of belonging, creating an accommodating way of living through tradition, culture, norms and taboos. Every disabled person is regarded as part of the family or community and is supported to lead a functional life.


The African philosophical clinical healthcare practice is the bridge between people’s well-being and life. It is the practice that is embedded in the tradition, culture and taboos that are still relevant to the way of life of Africans. In order to maximize health care coverage there is a need for formalization of traditional health services through the integration of traditional medicine into health systems. This calls for enhanced collaboration between practitioners of conventional medicine and traditional medicine for the benefit of the people in the WHO African Region. This realization is in line with the principles of the Regional Strategy. The aim of the Strategy is to contribute to the achievement of health for all in the Region by optimizing the use of traditional medicine and one of its principles is institutionalization of traditional medicine. This includes the development of mechanisms for collaboration between CHPs and THPs in areas such as patient referrals and information exchange at local level.

The future of African traditional medicine is bright if viewed in the context of service provision and increase of health care coverage, economic potential and poverty reduction. The increase of health care coverage will be achieved through collaboration and partnerships between THPs and CHPs which is already happening, particularly in the area of traditional medicine research. When a large number of scientifically evaluated traditional medicines become available, local production will be scaled up and this will improve access to medicines for the population. This in turn would reduce the cost of imported medicines, increase countries’ revenue and employment opportunities in both industry and practice. In addition, the African Region will be able to grow medicinal plants on a large scale as resources for research and local production. Industrial processing of locally produced medicines will require packaging and marketing thus contributing to poverty reduction.





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