Africa as Ethnopharmacological Treasury.

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="042085a3.jpg"> <div> <I><B>African Shaman</B></I></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFFFFF" TEXT="#080000" background="043d2e83.jpg"> <div> <A HREF="index.htm" TARGET="_top" TITLE="African Shaman : Specialists in African "><U><B><IMG SRC="08a78140.png" border=0 width="120" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <A HREF="http://www.africanshaman.com/shop" TARGET="_top" TITLE="http://www.africanshaman.com/shop"><U><IMG SRC="07f78140.png" border=0 width="120" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Articles :"><U><IMG SRC="08678140.png" border=0 width="120" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> <div> <A HREF="id18.htm" TARGET="_top" TITLE="Contact Us :"><U><IMG SRC="08878140.png" border=0 width="120" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000" background="04407073.jpg"> <div> Africa as Ethnopharmacological Treasury.</div> <div> Heavenly Herbs and Earthly Ailments: Africa as Ethnopharmacological Treasury.</div> <bR> <div> By <I>Peter A.G.M. De Smet</I></div> <div> <B>____________________________________________________________</B></div> <bR> <div> Ethnopharmacology is the scientific discipline that explores the pharmacological basis of traditional medicines, intoxicants, and poisons. Its focus ranges from the first-hand observation of native practices by early travelers and anthropologists through the identification of crude ingredients and their constituents by botanists, zoologists and chemists to the evaluation of wanted and unwanted drug effects by pharmacologists and toxicologists. </div> <bR> <bR> <div> Illustrated by hundreds of native objects, the exhibition reviews the ingenious ways in which sub-Saharan African natives use herbal and animal products as traditional medicines, intoxicants, and poisons in their struggle for survival and in their quest for religious experiences. It highlights the significance of traditional plants for African populations and for Western societies, and demonstrates that the plant kingdom has more to offer than a bouquet to cheer up the bedridden patient. This ethnopharmacological approach is not presented in isolation, but placed within a broad biomedical and anthropological context. The biomedical perspective makes clear which diseases African healers have to take care of and which biomedical methods other than herbal therapies are available to them. The anthropological outlook elucidates the African view on health and healing. The acts of African healers and patients become coherent as soon as their religious and social roots are understood. </div> <bR> <bR> <div> AFRICAN VIEW OF ILLNESS </div> <bR> <bR> <div> Traditional Africans believe that everything is imbued with a life force. This spirit or power is the essence of every living creature, deceased ancestor, inanimate object, and natural event, such as a thunderstorm. Preservation or restoration of health cannot be pursued without involving these life forces, all of which have their own personality and cosmic place. A healer's power is not determined by the number of medicinal tree barks he knows, but by his ability to apply his understanding of the intricate relations between all things for the good of the patient and the whole community. Unlike a physician trained in Western biomedicine, the traditional African healer looks for the cause of the patient's misfortune in the relation between the patient and his social and physical environment. African healing is an inextricable part of African religion; when this framework is understood, it no longer is an incoherent collection of rational and irrational acts but a condensed expr ession of basic beliefs concerning life, good and evil, and the etiology of illness. </div> <bR> <bR> <div> Sub-Saharan Africa carries 21 percent of the global burden of disease, whereas it only spends 0.7 percent of the total health care budget of the world (Murray, 1997). More than half of this burden is due to communicable diseases, such as malaria, and almost one-third is directly related to malnutrition. To visualize this aspect of African life, African masks and statues with recognizable pathological symptoms are displayed. Some representations serve a didactic or moralistic purpose. Other sculptures are used in healing and portray the pathological symptom they are intended to cure. Indigenous diseases may also be represented to please the Western customer ("tourist art"). </div> <bR> <bR> <div> DIVINATION AND HEALING </div> <bR> <bR> <div> Divination and healing in Africa are often practiced by the same person, since both acts can only be carried out by someone with the powers to deal with the spiritual realm. It is not surprising then that diviners are usually listed as one of the most important types of traditional African healers. Unlike Western fortune-tellers, who predict the future, diviners look for disturbing events in the past that would cause or continue to cause misfortune, if left untreated. </div> <bR> <bR> <div> Ethnopharmacologically, the most intriguing method of African divination is the poison ordeal, in which someone suspected of witchcraft is given a plant poison to determine his or her guilt or innocence. The accused was deemed innocent when the poison resulted in vomiting, whereas he was considered guilty when he retained the poison. In the latter case, he would be allowed to die from the effects or be punished in some other fashion. </div> <bR> <bR> <div> The magical inclination of African healers takes nothing away from the fact that many are experienced and skilled in one or more biomedical aspects of their profession, such as herbalism, midwifery, or surgery. There has been a tendency in Western medical journals to play down such expertise by predominantly presenting the iatrogenic [induced in a patient by a doctor's actions or treatment] risks of traditional African medicine. While it cannot be denied that sometimes there is genuine cause for concern, it would be unfair to pass judgment on African healing only on the basis of its worst outcomes. Instead, the exhibition considers African healing with a sympathetic eye and with emphasis on its best biomedical manifestations. </div> <bR> <bR> <div> HERBALISM </div> <bR> <bR> <div> In many parts of Africa, common ailments, such as headache or cough, are considered diseases due to natural causes. Their symptoms are treated at the household level, without resorting to magical practices. For other illnesses, or when a common ailment persists, recourse is made to divination or herbalism. </div> <bR> <bR> <div> African herbal medicines are applied to every part of the body in every conceivable way. There are oral dosage forms, enemas, fumes to be inhaled, vaginal preparations, fluids administered into the urethra, dermatological preparations, and lotions and drops for the eye, ear, and nose. Enemas are much more popular in sub-Saharan Africa than in Anglo-Saxon countries. Zulu natives may use up to three enemas a week, and it is estimated that at least one million enemas are applied every month in Soweto. Another characteristic dosage form for Africa is the so-called chewing brush, widely used for dental self-care. Pencil-sized sticks are fashioned from plant parts and chewed on one end until a brush results that can be used for teeth cleansing. The brushes have an obvious potential for mechanical cleansing when a correct technique is employed, and several types of sticks from some plants also have antibacterial effects. </div> <bR> <bR> <div> OTHER BIOMEDICAL TYPES OF HEALING </div> <bR> <bR> <div> In former times, a widespread form of prevention in Africa was variolation, the purposeful inoculation of live smallpox virus to create immunity. This technique differed from the Western method of vaccination, because the latter protected against human smallpox by use of the less dangerous cowpox virus. Variolation is no longer necessary, because smallpox has been eliminated by the World Health Organization and local health officials' eradication efforts. Traditional vaccinations are still common in Africa, however, to protect cattle against a variety of contagious diseases. </div> <bR> <bR> <div> Many African peoples perform some types of minor surgery, such as bloodletting and the cutting of the umbilical cord. They prefer to wield the surgical knife primarily for ritual or judicial purposes. Major surgery, as it is known in Western medicine, does not stand out in African medicine. Most often, bone setting is the only major traditional procedure, but abdominal surgery and craniotomy [the cutting or removal of part of the skull to relieve pressure or expose the brain for examination] have been documented for certain Eastern African peoples. </div> <bR> <bR> <div> Up to 80 percent of all births in Africa are attended by midwives or traditional birth attendants (Lefèber, 1994). The majority are elderly women, who are respected for their skills. Their procedures are on the whole sensible and not very different from practices elsewhere in the world. Many do more than just delivering babies. They share a cultural heritage with the women and their families, and they know which food taboos and local herbs are needed before, during, and after delivery. In recent years, several successful programs have been organized throughout Africa to train traditional birth attendants in Western-based hygiene, diagnosis of potentially dangerous complications, and technical obstetric skills. </div> <bR> <bR> <div> REJECTION OR COOPERATION </div> <bR> <bR> <div> Traditional healers constitute either the principal or only professional form of health care services for the large majority of Africans, particularly those living in rural areas. Surveys have consistently shown that they are willing to learn more about Western medicine and to cooperate with their biomedical counterparts, because they expect that this will increase their prestige, recognition, and income. With the exception of traditional birth attendants, however, well functioning programs of collaboration have been scarce, and no pilot project has ever reached the stage where it could be implemented at the level of a national health system. One of the reasons is opposition from the biomedical establishment. Another obstacle is that a traditional healer cannot be readily incorporated into the primary healthcare system as a community health worker, because this would imply acceptance of the superiority of Western medicine. That new role would cause alienation from his or her tra ditional roots and the clients would feel that the healer no longer had control over the total healing process. Since different paradigms of health and illness stand in the way of real integration, Western biomedicine and African traditional medicine will probably remain apart as two parallel systems. This medical pluralism is also flourishing in Western society. </div> <bR> <bR> <div> HERBAL INTOXICANTS </div> <bR> <bR> <div> Ethnopharmacologists not only explore traditional medicines, they also study indigenous poisons and intoxicants. The latter are valued everywhere in the world as ritual or recreational drugs. The native peoples of Africa are familiar with several intoxicants well known in Western society. From a pharmacological point of view, these universal agents can be divided into central depressants (alcoholic beverages), stimulants (coffee, kola, tobacco), and hallucinogens (hemp and jimsonweed). </div> <bR> <bR> <div> Hallucinogenic plants open the door to extraordinary changes in sensory perception, thought, and mood, and are, therefore, the vehicle par excellence to communicate with the spirits. It is becoming more clear that they are not only widely used in the Americas, but also in Africa. A good example is iboga (Tabernanthe iboga), a small shrub native to the tropical rain forests of Gabon and adjacent parts of the Congo. The Fang and neighboring peoples consume its yellowish root within the framework of secret Bwiti societies. Participants in Bwiti rituals usually receive low doses of 4-20 g of iboga, providing central stimulation without hallucinations. Once or twice in their career, however, they are given much higher and even dangerous amounts for the purpose of initiation. As much as 200-1000 g may be ingested in an 8-24 hour period to "break open the head," that is, to induce the collapse and hallucinations that provide contact with the ancestors and an anticipatory vision of life in the other world. The effect of such high doses can last up to a week and for that reason the Fang say they can only tolerate them once or twice in a lifetime. </div> <bR> <bR> <div> POISONS </div> <bR> <bR> <div> Many African peoples make their hunting trips more effective by applying poisonous materials to their arrow tips. More than 250 different African plants have been identified as ingredients of arrow poisons. Remarkably, the same or similar active principles occur in different poisons from different regions, and they are also found in arrow poisons from other continents. For instance, the root bark of Strychnos usambarensis, employed as an arrow poison by the Nyambo hunters of Rwanda and Tanzania, contains the same muscle relaxant alkaloids as the Strychnos species used by South American Indians to prepare a type of curare. </div> <bR> <bR> <div> Another widespread practice is the throwing of stupefying plants into the water, so that the fish start to float and can be gathered more easily. Again, there is a remarkable similarity in the active principles of fish poisons from other African regions and from different continents. The most important ones are either saponins or rotenoids. These classes of compounds have different mechanisms of action, but both have a toxic effect on the fish gill. (De Smet, 1992, 1992c; Neuwinger, 1994). </div> <bR> <bR> <div> MEDICINAL PLANT COMPOUNDS AND PLANT EXTRACTS </div> <bR> <bR> <div> It is often believed that today all major Western medicines come from a chemical laboratory and that it is, therefore, old-fashioned to study natural products. This is quite a misconception, because more than half of today's best-selling drugs are directly or indirectly based on naturally occurring substances (Table 1). </div> <bR> <bR> <div> The most important new anticancer drug, paclitaxel(R) or taxol(R), comes from the bark of the Pacific yew (Taxus brevifolia), a tree growing wild in the northwestern U.S. and western Canada. Paclitaxel has a complex molecular structure that would never have been dreamt up by an organic chemist, and it stops cancer growth in a previously unknown way. Since its introduction in 1993, it has gained a prominent place in the treatment of patients with ovarian and breast cancers. North American Indians valued the Pacific yew for its medicinal properties, but apparently did not use it as an anti-cancer agent. More often than not, however, plant drugs are discovered in studies that search for the bioactive principles of traditionally used plant materials. Almost three-quarters of classic plant drugs have the same or related uses as the traditional plant from which they were isolated. That is, the ethnopharmacological focus on traditional drugs and poisons offers an attractive avenue for the biomedical development of new drugs. A spectacular example is the antimalarial agent artemisin, derived from the Chinese medicinal herb qing hao (Artemisia annua). This herb was already recommended in China as a treatment for feverish illnesses in the fourth century C.E. </div> <bR> <bR> <div> Traditional African plants can also make an important contribution. A recent example is Cryptolepis sanguinolenta. Healers in Ghana use an aqueous root extract to treat symptoms that could occur in diabetes. A study of human patients with type 2 (non-insulin dependent) diabetes has confirmed that the aqueous root extract lowers blood glucose levels (Luo et al., 1998; Bierer et al., 1998), and laboratory testing has identified the alkaloid cryptolepine as the major antidiabetic constituent (Bierer et al., 1998). Cryptolepine is now being used as a lead for the development of new antidiabetic compounds. </div> <bR> <bR> <div> In addition to purified plant drugs, crude herbal preparations have gained or recovered a medicinal role in Western societies. Europeans spend at least US $6 billion per year on non-prescription herbal medicines (OTC bulletin 1996). Dutch examples of non-prescription food supplements prepared from African plants are rooibos tea (Aspalathus linearis) as a caffeine-free alternative to ordinary tea, and devil's claw (Harpagophytum procumbens) for rheumatic disorders and lower back pain. In Germany, there is also an impressive market for herbal prescription medicines. Every year, German physicians prescribe for more than DM 1 billion of herbal preparations (Schwabe and Paffrath,/ 1996). Some of these come from African plants: Umckaloabo(R) (from Pelargonium reniforme and P. sidoides) is often given for respiratory infections and Uzara(TM) (from Xysmalobium undulatum) for diarrhea. In 1995, these preparations were prescribed 200,000 times by German physicians, corresponding to total retail sales of DM 3.7 million (Schwabe and Paffrath, 1996). </div> <bR> <bR> <div> Crude herbal medicines are even more important for African societies. They are not only essential in traditional healing, but can also play a significant role in the Western medicine that is practiced in Africa. It is easier to incorporate herbal medicines into basic Western health care than it is to integrate traditional healers. Herbal medicines are readily accepted and widely used, and they offer the economic advantage that they are much less costly than Western synthetic pharmaceuticals. Ethnopharmacology can play an important role in this domain. Its critical evaluations can bring to light which traditional plants are effective and sufficiently safe for widespread promotion and incorporation into the formal healthcare system. </div> <bR> <bR> <div> BENEFIT SHARING AND CONSERVATION </div> <bR> <bR> <div> Western drug developers must respect the intellectual property rights of the indigenous users of plant medicines. When their search for new medicines starts from traditional knowledge about plants, they must provide adequate compensation for the sharing of that knowledge. This principle of equitable sharing of benefits has been formally laid down in the Convention on Biological Diversity, framed in 1992 during the Earth Summit in Rio de Janeiro. At the end of 1998, the Convention had been ratified by the European Community and 144 individual countries. Unfortunately, the Convention outlines the rights of nations to their biodiversity and to regulate access to genetic resources only in broad general terms, without providing concrete models for their execution and enforcement. As a result, the Convention has not even come close to achieving its goals. </div> <bR> <bR> <div> The Convention is not only built around benefit sharing but also concentrates on the conservation and sustainable use of biodiversity. After all, rights to traditional medicines can only be asserted as long as the source plants remain available for ethnopharmacological explorations. Since more than half of the world's plant species grow in tropical rain forests, it is disheartening that half of these forests are already gone forever. The remaining half disappears at an alarming rate of one hectare every three to four seconds. When we keep losing tropical rain forests at this rapid pace, the consequence of their enormous biodiversity is that at least two higher plant species become extinct every day. This loss of irreplaceable genetic resources is accompanied by the disappearance of traditional medicines and indigenous knowledge. To prevent that from happening, positive action is required at every possible level, ranging from local initiatives and scientific research to governmen tal support and international agreements. </div> <bR> <bR> <div> An example of a viable African initiative that translates the broad intentions of the Convention into specific activities is the Bioresources Development and Conservation program. This non-governmental program is active in five different African countries (Cameroon, Ghana, Guinea, Kenya, Nigeria). It develops and applies models and methods for the conservation of African plants and for their medicinal prospecting on the basis of leads from traditional knowledge. Through equitable arrangements with Western partners, the program enhances local scientific and technical capabilities, so that the local organizations become better equipped for the research and exploitation of their own environments. </div> <bR> <bR> <div> ACCOMPANYING BOOK </div> <bR> <bR> <div> The original idea for the African exhibition came from the author of this article, who was invited to act as an honorary curator. His scientific reviews on the significance of nature as a source of medicines, and on the traditional pharmacology and medicine in Africa, were transformed into a book called Herbs, Health and Healers. This publication accompanies the exhibition but is just as useful and enjoyable on its own. On the one hand, it can be read as a textbook, with more than 150 carefully selected references to readers interested in the scientific background of the various topics. On the other hand, it can be browsed as a coffee table book, with over 370 illustrations (mostly in color) of native objects, field photographs, and traditional plants. Unlike an average exhibition catalogue on African art, the book does not provide object-by-object descriptions that have been arranged in some cultural or geographical order. Instead, the pictures of African objects and tradition al practices illustrate the ethnopharmacological and ethnomedical stories that need to be told about Africa. To emphasize that this continent is a real ethnopharmacological treasury, the book provides over 40 well documented examples of plants and animals that are rightly valued by African natives for their pharmacological properties (Figure 20). </div> <bR> <bR> <div> REFERENCES </div> <bR> <div> Angenot L, Dubois M, Ginion C, Van Dorsser W, Dresse A. Chemical structure and pharmacological (curarizing properties of various indloe alkaloids extracted from an African Strychnos species. Arch Int Pharmacodynamie Therapie. 1975;215, 246-258. </div> <bR> <div> Anon. Germany leads in branded phytomedicines. OTC Bulletin. 1996 Jun 14:15. </div> <bR> <div> Bierer DE, Fort DM, Mendez CD, Luo J, Imbach PA, Dubenko LG, Jolad SD, et al. Ethnobotanical-directed discovery of the antihyperglycemic properties of cryptolepine: its isolation from Cryptolepsis sanguinolenta, synthesis, and in vitro and in vivo activities. J Med Chem. 1998;41:894-901. </div> <bR> <div> De Smet PAGM. 1992c. Ethnopharmacological Art in perspective: a Maya Rain God in shallow waters. Int Pharm J. 6:277-285. </div> <bR> <div> -- 1997. The role of plant-derived drugs and herbal medicines in health care. Drugs. 54:801-40. </div> <bR> <div> -- 1998. Traditional pharmacology and medicine in Africa. Ethnopharmacological themes in sub-Saharan art objects and utensils. J Ethnopharmacol. 63:1-179. </div> <bR> <div> -- 1999. Herbs, Health And Healers. Africa as Ethnopharmacological Treasury. Berg en Dal: Afrika Museum. </div> <bR> <div> Lefèber Y. 1994. Midwives without training. Practices and Beliefs of Traditional Birth Attendants in Africa, Asia, and Latin America. Ph.D. Thesis. Rijksuniversiteit Groningen, Groningen. </div> <bR> <div> Luo J, Fort DMN, Carlson RJ, Noamesi B, nii-Amon-Kotei D, King SR, et al. Cryptolepine, a potentially useful new antihyperglycemic agent isolated from Cryptolepis sanguinolenta: an example of the ethnobotanical approach to drug discovery. Diabetic Med. 1998;15:367-374. </div> <bR> <div> Murray CJ, Lopez AD. Global mortality, diability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349, 1436-1442. </div> <bR> <div> Neuwinger HD Fish poisoning plants in Africa. Botanica Acta. 1994;107:264-270. </div> <bR> <div> Schwabe U, Paffrath D, Eds. Arzneiverordnungs-Report '96. Aktuelle Daten, Kosten, Trands un Kommentare. Gustav Fischer Verlag: Stuttgart; 1996. </div> <DIV ALIGN="LEFT"></DIV> <div> <B>____________________________________________________________</B></div> <bR> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Articles :"><U>Return to Articles</U></A>.</div> <bR> </td> </tr></table></body>