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A QUALITATIVE STUDY OF TRADITIONAL HEALTHCARE PRACTICES:
EVIDENCE FROM ILORIN LESS CITY
Ahmed Ahmed Olaitan1' 2, Muhammad Asmawi Ibrahim3, Nosiru Mojisola Olubukola4, Tokede Abiodun Morenike5
1Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia ORCID: https://orcid.org/0000-0001-9427-8190
2Department of Forestry Economics and Extension, Forestry Research Institute of Nigeria, Ibadan, Nigeria 3Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
4Department of Forestry Economics and Extension, Forestry Research Institute of Nigeria, Ibadan, Nigeria 5Department of Forestry Economics and Extension, Forestry Research Institute of Nigeria, Ibadan, Nigeria E] Corresponding author: Ahmed Ahmed Olaitan, e-mail: ahmadsquare8@gmail.com
ARTICLE INFO
ABSTRACT
Article history: Received date 11.07.2022 Accepted date 20.08.2022 Published date 31.08.2022
Section:
Social aspects of healthcare
10.21303/2313-8416.2022.002689
KEYWORDS
Traditional healthcare
practice
Tewe-tegbo
Balsam
Apaarun
Apagu
qualitative study inhabitants Egbejila Nigeria
The object of research: This study aimed to explore different forms of healthcare practice in Egbejila an Ilorin less city, Nigeria.
The investigated problem: Throughout the world, traditional healthcare practice leads the edge with regards to healthcare delivery for humanity. It follows that rural inhabitants marshal various forms of healthcare practice. This study investigated peculiar healthcare practices performed by traditional healthcare practitioners in Egbejila a rural Nigeria. The main scientific results: The research study unveiled different and various dimensions and approaches of healthcare practice that are visualized and sustained as an indispensable component of continuity and survival of human entity. The area of practical use of the research results: The results of this research study gave insight to various traditional healthcare services being sought after by rural inhabitants of variant cultural, religious, socio-political and economic backgrounds aside the orthodox medicine.
Scope of the innovative technological product: The study adopted purposive sampling procedure for the selection of key informants. A total of twenty-five (25) key informants were purposively selected. Data obtained through the recorded interviews were transcribed into Microsoft Word and was analyzed by using N-Vivo software.
© The Author(s) 2021. This is an open access article under the Creative Commons CC BY license
1. Introduction
1.1. The object of research
This study aimed to identify different forms of healthcare practice in Egbejila a Nigerian rural community. Notwithstanding, the fact that majority of the inhabitants in this community are Muslims, traditional healthcare practices form an integral and important part of the healthcare systems of the people. The indulgence in and use of traditional healthcare practices by these people could be traced to their historical background. Going down history lane, prior to the advent of Islam and Christianity the people in the community was mostly traditional believers. For that reason, there is still widespread belief and practice in traditional healthcare. These rural inhabitants that form the participants of this study utilize medicinal plants and other indigenous materials for healthcare. Thereupon, the main objective of this study is to examine the different traditional healthcare practices performed by traditional healthcare practitioners in Ilorin less city, Nigeria.
1. 2. Problem description
Historically, traditional healthcare has been an integral part of the healthcare system for
survival when there are health problems among many cultures and peoples in almost all countries
of the world, including Nigeria. Considering that, this method of healthcare has existed long before the emergence and dominance of modern forms of Western medical practice [1-3]. Research statistics from the World Health Organization (WHO) show that the world's population is increasing in
demand and increasing dependence on conventional healthcare. It is estimated that in developing countries including Nigeria, about 80 % of the sick population depends on traditional healthcare for
their primary healthcare needs. This means that two out of every three people in the world go for traditional healthcare for their basic healthcare needs [4].
1. 3. Suggested solution to the problem
Traditional healthcare, which is often considered a holistic healthcare system in many academic studies, includes several disciplines including osteopathy, herbal medicine, homeopathy, spiritual healing, maternity care, circumcision, massage therapy, music therapy, aromatherapy and psychiatry among others. In addition to traditional healthcare, there are spiritual healers, herbalists, chiropractors, traditional paediatricians, indigenous surgeons, traditional psychiatrists, occult doctors, herbalists and general practitioners and a lot of others [1, 5-10].
Meanwhile, traditional healthcare practitioners (THP) refers those who do not have any formal medical training but are recognized by the community in which they live as competent enough to provide health care by using vegetable, animal and/or mineral substances and certain other methods based on the social, cultural and religious background as well as the knowledge, attitudes and beliefs that are prevalent in the community regarding physical, mental and social wellbeing and the causation of diseases and disability [3, 11]. In the words of [12], African traditional healthcare is an African way of responding to health challenges in various ways. Traditional healthcare refers to holistic healthcare that treats diseases, illnesses, and disorders of the body using, among other methods, traditional therapies, drugs and technology.
2. Materials and Mmethods
Study area. Egbejila, the study area is a typical example of a rural community in Nigeria under the Wara/Osin/Egbejila ward in the Ilorin West local government area of Kwara State. Kwara State is located in the North Central geo-political zone of Nigeria. It is bordered by Niger State to the north, Osun and Ondo States to the south, Kogi State to the east and Oyo State to the west. Internationally, it is bordered by the Republic of Benin. With a land mass of 35,705 km2 [13,947.27 square miles] and its location between latitude 80 30'N and longitude 50 00'E [13-15].
Method of data collection and sampling techniques. Data for this study was collected with the aid of interview schedule conducted with traditional healthcare practitioners and community inhabitants from Egbejila, an Ilorin less city in which information are solicited on the objectives of the study using the local dialect (Yoruba), the language they best understood. The research study utilized qualitative research design to obtain relevant data for this study. The study adopted purposive sampling procedure for the selection of key informants. A total of twenty-five (25) key informants were purposively selected. Data obtained through the recorded interviews were transcribed into Microsoft Word and was analyzed by using N-Vivo software; a qualitative data analysis software package.
3. Results and discussion
The findings of the research study analysis and presented the forms of healthcare practice as described by participants. The exploration of the healthcare practice in the traditional ambience revealed that healthcare system is visualized and sustained as an indispensable component of continuity and survival of human entity. In Ilorin less city, different and various dimensions and approaches of healthcare practice are adopted as expressed by the key informants. These include: Tewe-tegbo, Balsam, Apaarun and Apagun therapies as well as religious healthcare practices.
Tewe-tegbo therapy.
Tewe-tegbo refers to herbal therapy among the rural inhabitants in the study area. The Tewe-teg-bo healthcare practice involves the utilization of medicinal plants (comprising the leaves, fruits, flowers, seeds, creepers, stems, bark and root), as well as locally-available substances gotten from animals and insects. The traditional practitioners in this field are referred to as Oniseegun. Thus, quite to note that most of the practitioners, in the research study, are gifted in indigenous knowledge of making use of medicinal plants or floras as herbal therapies that are considered to have healing abilities to challenge human illness and sickness and disorder. In the same manner, it was found that inhabitants in the study area believed that herbal therapies are a common phenomenon for healthcare purposes. This is to firmly establish that the herbal medicine or therapy form of the traditional healthcare system is practiced worldwide [1, 16, 17]. The following comments revealed their ideas and insights:
"We utilise a lot of plants and leaves for Tewe-tegbo healthcare. Some of the plants we use in Tewe-tegbo to cure illness are for example Mango tree to cure typhoid, Lemon grass to cure malaria...
I give credence to the Tewe-tegbo practitioners; they are versatile in various medicinal plants that cure illnesses."
The study recorded that in treating ailments key informants provided descriptions of plant species used. Key informants could nominate up to 13 used plant species. The plants' species that were commonly used for therapeutic purposes in Tewe-tegbo healthcare practices for curing myriads of sickness and diseases made mentioned include the tender stem of Neem leaves for tooth decay, the saturate leaves of Soursop for cancer, the juice of Sandpaper tree for haemorrhoid, the sap of Moringa leaves for healthy blood circulation and digestion, and the likes of juice of Pigeon wood leaves as a poison nullifier. Others that are used in the rural community include the extract of Bitter leaf with honey for diabetes, the seed extract of African locust bean for cholera, the oil extract of palm fruit with sugar as an expectorant, the juice of lemon grass leaves for malaria. The samples of these aforementioned medicinal leaves and others are shown in Table 1.
Table 1
Medicinal species utilized by the Traditional Healthcare Practitioners
Photo Description
1 2
A sample of Neem leaves
Local name (Yoruba): Dongoyaro
Common name: Neem leaf Botanical name: Azadirachtaindica Treatment for: Tooth Decay Plant part used: Stem
A sample of Soursop leaves
Local name (Yoruba): Eko-omode
Common name: Soursop Botanical name: Annona muricata L Treatment for: Cancer, skin disease Plant part used: Leave
A sample of Sandpaper leaves
Local name (Yoruba): Ipin Common name: Sandpaper tree Botanical name: Ficusasperifolia Treatment for: Haemorrhoid Plant part used: Leaves
Continuation of Table 1
1
A sample of Moringa leaves
Local name (Yoruba): Igbale
Common name: Moringa, drumstick tree
Botanical name: Moringa oleífera
Treatment for: Healthy blood circulation and digestion
Plant part used: Leave
A sample of Pigeon wood leaves
Local name (Yoruba): Afee
Common name: Pigeon wood
Botanical name: Tremaorientalis
Treatment for: Asthma, poisoning nullifier.
Plant part used: Leaves
A sample of Shea tree
Local name (Yoruba): Emi
Common name: Shea tree
Botanical name: Vitellaria paradoxa
Treatment for: Haemorrhage
Plant part used: Fruits
A sample of Cape fig leaves
Local name (Yoruba): Opoto
Common name: Cape fig
Botanical name: Ficus sur Forssk
Treatment for: Convulsion, stomach ache, threatened abortion
Plant part used: Leaves
2
Continuation of Table 1
l
A sample of Bitter leaves
Local name (Yoruba): Ewuro
Common name: Bitter leaf
Botanical name: Vernonia amygdalina
Treatment for: Diabetes and Stomach problem
Plant Part used: Leaves
A sample of Siam weed leaves
Local name (Yoruba): Ewe Akintola Common name: Siam weeds Botanical name: Chromolaena Odorata Treatment for: Stoppage of bleeding, wound
Plant part used: Leave
A sample of African locust bean tree
Local name (Yoruba): Igba Common name: African locust bean Botanical name: Parkia biglobosa Treatment for: Cholera
Plant part used: Seed
A sample of Pawpaw tree
Local name (Yoruba):Ibepe
Common name: Pawpaw
Botanical name: Carica Papaya
Treatment for: Diabetes, urinary problem, dysentery
Plant part used: Leave
2
Continuation of Table 1
A sample of Oil palm tree
Local name (Yoruba): Igi ope
Common name: Oil palm tree Botanical name: Elaeis guineensis Treatment for: Cough, high body temperature Plant part used: Fruit
A sample of Lemon grass
Local name (Yoruba): Ewe tea
Common name: Lemon grass Botanical name: Cymbopogon citrates Treatment for: Malaria
Plant part used: Leaves and rhizomes
Source: Field study, 2022
From the above, it could be rightly there is high conviction in the efficacy of Tewe-tegbo medicine as a healthcare solution to treat most of their illnesses. These are herbal medicines which are prepared in the form of concoction, decoctions, grinded powder, juice etc. A community inhabitant posited:
"I do approach a traditional practitioner to get Tewe-tegbo medicine to treat the pile because it is very effective; it will flush out all the bad elements in the body system".
Balsam therapy.
What can be called a demulcent substance including coconut oil, shea butter, palm oil etc is used as major ingredients for healthcare treatment. Practitioners indicated that these demulcent substances are separately used or mixed with other ingredients including animal parts, alum, salts among other things in preparing therapy. This therapy is given to patients as concoction with direction on its usage either to be licking it, massaging affected body parts or a lot more.
A woman who had a long stand belief in the efficacy of balsam therapy as treatment stated:
"Whenever I have a baby I make sure I get balsam medicine (aadi) to massage my baby body. This will prevent illness and body rashes (pox) that commonly befall new born babies".
The use of balsam therapy against illness was also made known by a practitioner. The practitioner stated:
"I hope you know that coughs defile many medicines. Then there is an effective balsam I usually prepare with "epo" (palm oil) for patients suffering from coughs that will give them quick relief. I prepare the balsam as a cough syrup".
Apaarun and Apagun therapy.
Apaarun and Apagun treatment form the basis of spiritual healthcare among the traditional practitioners in Egbejila. Fundamentally, these anti-sorcery preparations can be a water induced solution or powered substance. In the community of study, Apaarun and Apagun serve as antidotes for a patient suffering from spiritual attack in the form of sorcery, witchcraft, and bewitchments. This therapy is meant to cure ailments which void physical symptoms, having considered it to be handiwork of evil entities. Among the rural inhabitants of study, these remedies are capable of neutralising and casting out spiritual attacks including sorcery attack (Aasasi), spell (Ata), nightmare served food (Ounje oju orun) or any other black magic.
Meanwhile, in the arrangement of this remedy, a patient with embodiment of black magic or evil entities is given this preparation, it may prompt the patient to vomit, excrete or sweating profusely. With any or some of these circumstances happening to a patient, it is believed it will abrogate any spell, exorcism or evil machination cast against such a patient. Insight on the use of Apaarun and Apagun as form of healthcare practice was confirmed by two traditional practitioner in the following statements:
"For most of the spiritual attacks or illnesses brought to me, I first engage in the use of Apaarun and Apagun [anti sorcery mechanism] to counterpoise any diabolical and demoniac sorcery in a patient sent against him in real life or through dream.
We consider the effectiveness of Apaarun as capable in restoring normalcy of human beings considered to be suffering from disease, harm, disorder and other problems that have no root cause [spiritually inclined]. This disorder is as a result of sorcery, black magic and witchcraft as well that cannot be cured by orthodox medicine".
The disposition of this form of healthcare treatment and practice give the impression of spirituality as justifiably indicated by a key informant. Similarly, there are also some cases where distinct water sources such as omi ojo (rain water), omi odo (river water), omi kanga (well water), ito (saliva) etc are used as spiritual treatment mechanisms. This is noted by a practitioner:
"We collect rainwater descending directly from the sky that has not dropped on the house roof or any material or stream water that we didn't know its source likewise destination or well water. We considered all these forms of distinct water significant in preparing spiritual medicine for patients in special cases".
Practitioners also indicated that they also devices other means for treating people's illness such as incision (gbere) make up, use of amulet (onde), use of ring (oruka). They argued that all these encompass the spiritual realm in this healthcare system.
Religious healthcare practices.
Religious healthcare practice is also a major component of the traditional healthcare system in the community of study. This practice under this sphere, probably counts up the diverse, unique and spiritual nature of traditional healthcare practice. It forms a pathway in proffering solutions and taking care of illness, sickness, ailment, ill-health, disorder, malady, adversity, misfortune, or disease considered to have spiritual causal origin. This religious healthcare practice anchored on the basis of Islamic context involves putting up devotional prayer of supplications (Dua), burning incense, inscribing religious texts (e.g. Quranic (This is the Islamic religion Holy Scripture) verses) for the sake of good health and fortune for patients.
These inscriptions taken from Quran or any other religious texts were commonly written on a Wa'la (a wood or metal tablet) and later washed with water or other specific liquid contents and solution given to patients either for drinking, bathing or to add to something else. Likewise sometimes these texts were written on leaves, paper, and cloth and then wrapped with a thread and then given as Tira (amulet). The latter is referred to as Tira-wiwe while the former is known Hantu (Traditionally made ink called Tadawa and sharpened stick popularly known as Qalam are both used to inscribe the religious text on any intended material to inscribe on. Thereafter it will be washed with liquid content to have what is christened as Hantu.). Meanwhile, in an inconsequential
case did they organise what is popularly referred to as Ruqqiya for patients. Ruqaiya is a form of spiritual healthcare arrangement in which some verses of the Quran are recited to exonerate or drive away Jinn or other evil spirits from a 'possessed' patient. One of the inhabitants recounts the following experience:
"Whenever my wife is pregnant I consult the traditional practitioner to get Hantu [herbal drink concoction] which she will take [drinking it] until she gives birth. We take these steps to ensure smooth and easy delivery during childbirth".
Limitations of the Study.
The limitation of this research study was that the inquiry is confined to a limited number of participants. Besides, the research study was exclusively centered on a Nigerian rural community and its inhabitants. This study cannot claim overall conclusion of all rural communities in Nigeria. However, a further study of this can be conducted in other rural areas with much more participants.
4. Conclusion
The cynosure of this research study is to present the various traditional healthcare practices in Ilorin less city, Nigeria. A qualitative approach was employed. In line with this, the key informants were drawn from Egbejila to solicit relevant data from them and were analyzed using appropriate statistical tools to bring out the results. The findings showed that healthcare practices in the study area comprise Tewe-tegbo healthcare system (the use of medicinal plants as well as locally-available substances gotten from creatures is utilized for healing purposes), balsam therapy (utilization of demulcent substance for healthcare treatment) and Apaarun and Apaogun are make use of as antithetical for any sorcery or black magic. It was also established the use of verses and inscriptions taken from religious texts such as the Al-Quran, holding forth (Dua) prayer sessions for good health and fortune for the patients in the community. Based on the findings of this study, it was concluded that traditional healthcare practices not only hold forth in the study area but it was also found to be differential.
Conflict of interest
The authors declare that there is no conflict of interest in relation to this paper, as well as the published research results, including the financial aspects of conducting the research, obtaining and using its results, as well as any non-financial personal relationships.
Funding
The study was performed without financial support. Acknowledgments
The authors are indeed grateful to the traditional healthcare practitioners and all the inhabitants that agreed to partake in this research study and share their knowledge and experiences.
References
[1] Kwame, A. (2016). Traditional Medicine and Healing among the Dagomba of Ghana. Arctic University of Norway.
[2] Haque, Md. I., Chowdhury, A. B. M. A., Shahjahan, Md., Harun, Md. G. D. (2018). Traditional healing practices in rural Bangladesh: a qualitative investigation. BMC Complementary and Alternative Medicine, 18 (1). doi: https://doi.org/10.1186/ s12906-018-2129-5
[3] Agama, C. S., Onyeakazi, J. C. (2021). Traditional medicine in the face of new era: a better safeguard for the progression of healthcare claim in Igbo-African World. Proceedings of the International Conference of the Association for the Promotion of African Studies on African Ideologies and Innovative Trends and Advances: Honouring the Past and Shaping the Future.
[4] WHO traditional medicine strategy: 2014-2023 (2013). World Health Organization. Available at: http://apps.who.int/iris/ bitstream/10665/92455/1/9789241506090_eng.pdf?ua=1
[5] Homsy, J., King, R., Tenywa, J., Kyeyune, P., Opio, A., Balaba, D. (2004). Defining Minimum Standards of Practice for Incorporating African Traditional Medicine into HIV/AIDS Prevention, Care, and Support: A Regional Initiative in East-
ern and Southern Africa. The Journal of Alternative and Complementary Medicine, 10 (5), 905-910. doi: https://doi.org/ 10.1089/1075553042476731
[6] Gyasi, R. M., Mensah, C. M., Adjei, P. O.-W., Agyemang, S. (2011). Public Perceptions of the Role of Traditional Medicine in the Health Care Delivery System in Ghana. Global Journal of Health Science, 3 (2). doi: https://doi.org/10.5539/gjhs.v3n2p40
[7] Barimah, B. K. (2013). Traditional healers as service providers in Ghana's National Health Insurance Scheme: The wrong way forward? Global Public Health, 8 (2), 202-208. doi: https://doi.org/10.1080/17441692.2012.761262
[8] Gyasi, R. M., Asante, F., Abass, K., Yeboah, J. Y., Adu-Gyamfi, S., Amoah, P. A. (2016). Do health beliefs explain traditional medical therapies utilisation? Evidence from Ghana. Cogent Social Sciences, 2 (1), 1209995. doi: https://doi.org/10.1080/ 23311886.2016.1209995
[9] Asante, E., Avornyo, R. (2013). Enhancing Healthcare System in Ghana through Integration of Traditional Medicine. Journal of Sociological Research, 4 (2), 256-272. doi: https://doi.org/10.5296/jsr.v4i2.4224
[10] Borokini, T. I., Lawal, I. O. (2014). Traditional medicine practices among the Yoruba people of Nigeria: a historical perspective. Journal of Medicinal Plants Studies, 2 (6).
[11] WHO traditional medicine strategy 2002-2005 (2002). World Health Organization. Available at: https://apps.who.int/iris/ handle/10665/67163
[12] Ndubisi, J. O., Kanu, I. A. (2021). Innovative Trends in African Traditional Medicine. Proceedings of the International Conference of the Association for the Promotion of African Studies on African Ideologies and Innovative Trends and Advances: Honouring the Past and Shaping the Future.
[13] Mustapha, O.-O., Akintunde, O., Alaga, A., Badru, R., Ogbole, J., Samuel, P., Samuel, S. (2016). Spatial Distribution of Primary Schools in Ilorin West Local Government Area, Kwara State, Nigeria. Journal of Scientific Research and Reports, 9 (6), 1-10. doi: https://doi.org/10.9734/jsrr/2016/22128
[14] National Bureau of Statistics (2010). Nigeria poverty profile report: NBS Office. Abuja.
[15] National Population Commission (NPC) (2010). Countdown Strategy: 2010-2015. Abuja.
[16] Aquaowo, M. G. U. (2000). A Socio-Religious Study of Health and Healing in Annang Society. University of Port Harcourt.
[17] Otto, O. A, Ngbara, C. M., Amadi, S. E., Lionel, K. E. (2021). Presure, Space and Identity in the Practice of Traditional Medicine in Ogba, Gokana, Degema and Ikwerre Traditions Proceedings of the International Conference of the Association for the Promotion of African Studies on African Ideologies and Innovative Trends and Advances: Honouring the Past and Shaping the Future.
