quinta-feira, 13 de setembro de 2012

Traditional medicine practice in Nigeria: Targets and transformation


Text of the keynote address by Professor Olukemi Odukoya of the Department of Pharmacognosy, Faculty of Pharmacy, University of Lagos at theAfrican Traditional Medicine Day Celebration organised by Lagos State Traditional Medicine Board.

Mr Halfdan Mahler (1978) a former Director General of the WHO stated as follows: We at the WHO pledge ourselves to an ambitious target, to provide health for all by the year 2000. This ambitious goal is quite simply beyond the scope of the present health care system and personnel trained in modern medicine.

Note that the main Target is health! Not for one household but for All! Through Primary Health care!

The importance of traditional medicine as a source of primary health care was first officially recognised by the World Health Organisation (WHO) in the Primary Health Care (PHC) Declaration of Alma Ata in the former USSR (1978) and has been globally addressed since 1976 by the Traditional Medicine Programme of the WHO. 

That Programme define traditional medicine as: The sum total of all the knowledge and practices, whether explicable or not, used in diagnosis, prevention and elimination of physical, mental or social imbalance and relying exclusively on practical experience and observation handed down from generation to generation, whether verbally or in writing.

This approach was endorsed by the International Conference on Primary Health Care. The declaration of Alma Ata, in describing PHC, referred to the need for a variety of health workers including Traditional Medical Practitioners (TMP's) who are suitably trained socially and technically to work as a health team and to respond to the expressed needs of the community. TMP's include: herbalists, bone setters, TBA's traditional psychiatrists, spiritual healers and other specialists. These traditional practitioners are recognised in some countries by the community as providers of health care who use herbs, animal and mineral substances and certain other methods.

Lagos State Government has been the pace-setter in the adherence to the Alma-Ata declaration with the establishment of the first Traditional Medicine Board in 1980 by Alhaji Lateef Kayode Jakande's administration; the law has been reviewed over and over to meet the challenges of modern day trend in the practice of traditional medicine, with the inauguration of board members of Traditional Medicine Board which is to implement the Lagos State Health sector reform law as it affects the practice of Traditional Medicine in the State.

Vital role of traditional medicine in PHC: 

The traditional system of medicine is engrained in our culture, and a large population of the Nigerian population depends on this indigenous system for relief.

About 80 per cent of the people in the developing world depend on traditional medicine for primary health care. This is due to the fact that orthodox medicine is mostly out of reach in both physical terms as hospitals are far away from the rural populace and in financial terms, the poverty level is high. Solutions to economic problems are therefore seriously hampered by poverty and ignorance to diseases.

The relative ratios of traditional practitioners and University-trained doctors in relation to the whole population in African countries are revealing. In Ghana, for example, in Kwahu district, for every traditional practitioner there are 224 people, compared to one university trained doctor for nearly 21,000 people. The same applies to Swaziland where the ratios are 110 people for the number of traditional practitioners, in Tanzania it is 30,000 to 40,000 in comparison to 600 medical doctors. In Malawi, there are 17,000 traditional medical practitioners and only 35 conventional medical doctors in practice. Where are we in Nigeria with records?

The work force presented by Traditional Medicine Practitioners (TMPs) and traditional Birth Attendants (TBAs) is an important resource for the delivery of PHC. Over two-thirds of births are delivered by local or traditional midwives or TBAs. In some rural areas, TBAs are the only source of assistance and care and deliver over 90 per cent of the births.

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