African medicine is the health practice involving the application of indigenous resources, spiritual and material, in providing mental, psychological, social, and physical well-being and wholeness to a human being and his or her environment. It addresses the well-being of the individual and the community, the fertility of the soil, and animal production. The material resources include the use of elements from plants (roots, leaves, and barks), animals (blood, intestines, flesh, bones, and shells), and minerals. Spiritual resources involve interaction of the human with spiritual entities, including the use of words—symbols employed to invoke the power of spiritual beings.
Medicine involves the triad practice of explanation, prognostication, and control (treatment and/or prevention) of disease or illness. The African conception of wholeness and well-being goes beyond a simplistic perception of the soundness of body and mind and the stability of mental and physical conditions only; it also expresses harmonious relationship with the spiritual and physical environments. Africans conceive of disease and illness, in a holistic manner, as having a deep spiritual and metaphysical nature and causation.
Traditional medical practices therefore include nonempirical and empirical means to heal human beings from spiritual, psychological, social, physical, and political dislocations, and to restore cosmic balance. The different peoples of Africa, in varieties of culturally constructed ways, express their notion and understanding of the means through which disease and illness are communicated, diagnosed, and treated. All these are closely linked to and connected with mythic narratives and ritual practices, the dimensions through which the peoples offer explanations for the causes of disease, prognosticating into the possible cure and control, and removal or prevention of disease in some ways different from Western medical practice.
The similarity in their understanding of disease and illness, and approach to healing notwithstanding, African medicine provides indigenous resources for maintaining and restoring of health by the use of spiritual and material elements that are available in their different environments. This entry looks at the African view of disease, its health and healing practices, the people who employ them, and the spread of African ideas to the larger health community.
- 1 Disease and African Worldview
- 2 Spiritual Causative Agents
- 3 Social Causative Agents
- 4 Healing and Healing Practices
- 5 Sources of Healing Power
- 6 Methods
- 7 Traditional Medicine Specialists
- 8 Herbalists
- 9 Diviners
- 10 Priest and Priestess Healers
- 11 Contemporary Appropriation
- 12 References
Disease and African Worldview
The worldviews of the Africans are wrapped up in myths describing the vertical (spiritual) and horizontal (social) dimensions of the complex relationships of human beings to other universal entities. The origins, causes, diagnosis, prevention, and cure of disease are embedded and enshrined in cosmological myths. Diseases or illnesses are usually attributed to two main agents: the spiritual and social.
Spiritual Causative Agents
This spiritual dimension explains the African universe as possessing an array of deities with hierarchical structures and pervasive vital powers or forces. Spiritual causative agents, who populate the seen and unseen, visible and invisible spaces, and the animate and inanimate, are believed to be actively instrumental in primordial origin of diseases. These agents include the Supreme Being, lesser deities, ancestors and ancestresses, and humans' personal spiritual duplicates. By nature and functions, they could be categorized mainly into two, the benevolent and malevolent, a few of them ambivalent.
Although most African communities hold the Supreme Being as the creator or source of other beings, only a few of them ascribe to him the primary spiritual agency of disease causation as expressed in the myth of the Akan of Ghana and the practice of the Lugbara. To the Lugbara, disturbances and virulent diseases resulting from mental afflictions are believed to be caused by the Supreme Being. Others attribute the causes of disease to the weak characters of the first created deities as we have in the myth of the Edo of Nigeria; although a few others attribute the cause to the weakness of the first created human beings, as expressed in the myth of the Yao, a Bantu-speaking people of Malawi and Mozambique; and misbehavior of the first created beings as revealed in the myths of the Mende of Sierra Leone and Dinka of southern Sudan, at a primordial time.
The Yoruba, Basoga, and Gisu attribute some disease to deities who represent the Supreme Being's aspect of the wrath and judgment on human beings who contravene important rituals or violate communal taboos. Yet several of the peoples who maintain the joint responsibility of disease causality by deities and humans offer destiny or predestination as an explanation.
Social Causative Agents
Most Africans see human beings as the primary social agent of disease causation, which concerns interactions, relationships and activities that result in disharmony and disturbance in the social world, and cosmic imbalance. Some human beings are believed to be capable of assuming extra-human positions to afflict and harm their alleged offenders, enemies, and rivals through mystical means; they often take vengeance on behalf of those who solicit their assistance. Witches, sorcerers, and evil eyes are in this category. Of particular note, witches are a commonplace and most dreaded phenomenon among most African peoples. Misbehavior and other social vices, desecration of some sacred spaces, a breach or violation of a community's taboos, and disregard or contempt for culturally constructed rituals are also social causes of illness or disease.
The spiritual and social dimensions, however, interact because both are claimed to have originated from the same source; they always have on them the stamp of spiritual beings. Illness or disease includes all forms of human discomfort and suffering (mental, social, and physical), misfortunes, ill luck or bad luck, failure, and barrenness; environmental crises including drought and famine and their unpleasant effects on such phenomena as animals and land; and natural disaster and calamity.
Healing and Healing Practices
Healing concerns the mental (psychological), social, and physical aspects of human life, as well as a harmonious and peaceful environment. The diagnostic and healing techniques, the kind of healing agents to consult, prescription and application of medical elements, and material contents of the medicine are determined by the cause and nature of disease and illnesses, the courses and duration of episodes, and the effects on victim or patient and the community.
Myth is the primary source of African peoples' understanding of healing practices. Ritual practices constitute the centerpiece of diagnosis, explanation, control, and treatment of disease. Ritual practices aim at returning human beings and the environment to a normal state or condition and preventing unseen influences of evil spiritual forces and soliciting the support of benevolent spirit forces.
Sources of Healing Power
The nonempirical and empirical resources both constitute the sources of African healing power in sustaining their universe. The nonempirical involves the tapping of the power, by therapeutic specialists, from the Supreme Being, lesser deities, ancestral spirits, and living individuals who are believed to have been endowed by spiritual beings. Also, certain statements, expressions, and invocations that embody spiritual references are strong and potential sources of enhancing and enforcing healing.
The empirical resources include biotic elements including animals, plants, and water, which enhance healing and wholeness. Other material elements including natural phenomena and objects that are spiritually strengthened by ritual activities are potential sources of medicinal efficacy. In both cases, the sources are claimed to have been revealed to the forebears of medical practice who continued to pass them on to generations after them in a conscious manner, through training of their offspring or those divinely chosen, or in an unconscious way through normal daily uses.
Africans employ a comprehensive approach in their methods of healing. These nonexclusive categories include psychotherapy, somatherapy, metaphysicotherapy, and hydrotherapy. Psychotherapy involves the use of symbolic elements, actions, and words that could affect calmness and physical and spiritual upliftment. Ritual specialists engage patients with diverse health problems in collective domestic activities in their backyards. Sometimes patients jointly perform some dramatic socioritual activities where the ritual specialist ecstatically invokes blessings on individuals.
Somatherapy deals with the application of some physical measures like incision, chaining, or tying of consecrated thread and chains on wrists, necks, and waists. Objects are also symbolically used to counter the activities of perceived enemies of the victim to remove misfortunes and command success and harmony. The ritual specialist may tell the victim or community to provide ritual elements for human beings or spirit forces to share; the victim or the community may also be instructed to carry ritual elements to a particular sacred place or shrine to restore health or affect ontological equilibrium.
Metaphysicotherapy deals with the application of nonempirical means to affect healing. In this sense, the ritual specialist plays an active role in private consultation of the Spiritual Being, whose nature and function are associated with the illness, and the spiritual being whose responsibility it is to affect the healing. The ritual specialist uses incantations, spells, and other invocatory statements to bring order into chaos. Hydrotherapy, the use of water for healing, has its strong effect and efficacy not only in African ethnocosmology, but also in several creation myths of the other peoples of the world. There is the universal belief in the importance of water, first as the foremost element in the cosmic order. Some myths claim that water is a female deity who characterizes coolness and ubiquity, and is thus available for all purposes and cures. However, no method is used in exclusion of the other.
Traditional Medicine Specialists
It is difficult to make a clear classification of healing agents or traditional medicine specialists who could be male or female. Their functions overlap in most cases because what Africans define as disease or illness covers a wide range of personal and communal problems of life. Some of the indigenous languages of the different peoples lack such distinctions as those the scholars make. It is important to note that they could be classified, roughly however, in relation to their main and primary functions. There are herbalists, diviners, and priest- and priestess-healers. All of these could also be designated as mediums because they serve as intermediaries between the human and the spiritual. One other kind of medium of special recognition among some African peoples are the rainmakers. These healers are made through family inheritance, deity chosen, or voluntary decision. A conviction of the individual is, however, crucial to the practice.
All of these groups require some processes of initiation or formal and informal training with different and varied duration. The initiation usually requires the candidate to swallow some ritual ingredients for empowerment to be able to see beyond the ordinary so as to be able to deal with all spiritual forces and with visible and invisible cases. The training of herbalists, diviners, and priests and priestesses takes a relatively longer time, up to 7 or 9 years, because they have to learn the mechanisms of dealing with all cases relating to diseases ranging from personal to communal, from domestic to economic, in matters relating to life and death.
Mostly women, herbalists could be described as medicine men and women par excellence because they possess the science and art of making use of several substances from animals and plants, as well as supernatural forces, in therapeutic activities.
They acquire as much knowledge as they can from their masters and mistresses. The competence of an herbalist depends greatly on the depth of the knowledge and skill of his or her tutor, the vegetative materials available in the training environment, the duration of the apprenticeship, the kind of diseases that are addressed during his or her apprenticeship, and his or her own level of intelligence, as well as his or her attitude (patience, endurance, faithfulness, painstakingness, etc.) to the teacher.
A successful herbalist possesses knowledge of and skill in using medicines, animals, insects, eggs, and shells; the nature of physical objects; the nature of spirits and the living-dead; and many other secrets. All of the materials derive their efficacy, power, and use from primordial origins, with the effect that, as the practitioners would claim among the Yoruba, the existential power and names that they symbolically apply in their practice command healing on their clients.
Herbalists deal primarily with individual problems, paying much attention to each client to be able to deal with such a case spiritually, psychologically, and physically. They cure and prevent diseases, and they intervene between the client (victim) and the witches. They solicit the assistance of spiritual forces who maintain ontological equilibrium in the universe.
Herbalists, after their formal initiation and having been known by several clients who patronized their master or mistress, already gain their own clients from those who are acquainted with their skills while with their master or mistress. Because Africans' gregarious nature allows the people to share in the experience of persons who have one disease or the other, they are familiar with those specialists who perform those duties. They introduce such herbalists when needed.
Herbalists diagnose patients primarily through information by either the client or the relatives. Herbalists also observe the client and subsequently make consultation with spiritual beings on the cause and possible remedy. Regardless of whether the disease or illness is known by name, consultation with the spiritual world is common to the users. During the consultation, herbalists plead on behalf of the sick for the materials to be used to be efficacious.
They then prepare the specific herbs from plants, animals, and barks that have curative properties for such a disease or illness. Several words or incantations are chanted on the herbs.
Sometimes a whole living animal is used. In a case of protracted illness, a whole living animal like a goat or a hen may be provided. The illness on the client is symbolically transferred on it by laying hands on it, dragging and beating it to death, or pursuing it until it becomes weak and tired, caught, and killed. Some of these may be cooked for the client to eat all alone. Such activities are believed to be capable of expelling the illness from the body of the client.
Among the herbalists are the bone-setters who also use animals like chickens. They break the legs of such animals and begin to care for them, the effect of which transfers to the client. In a case of contagious disease, some roots, leaves, seeds, and barks are sometimes burned and ground into dry powder and rubbed on the body of the client for a number of days. Specific precautionary instructions are given to the client on how to use it, usually followed by taboos. These taboos may include seclusion or restriction from movement at a particular time of the day or night or to a particular place of ritual significance. The instructions may also include making a feast for a group of persons and giving some gifts to a specific group of people.
People who engage in divination occupy important and prominent positions in the public life of Africans. Most of them are priests and priestesses who are connected with certain deities. Diviners serve heuristic purposes in mysterious and hidden matters. They reveal hidden matters, foretell the future, and interpret mysteries relating to individual human beings and their community.
Systems of divination among the Africans include the Ifa oracle, with its main forms (the use of palm nuts, divining chain, and the 16 cowrie shells) being kolanut, water gazing, mirror gazing, star gazing, palm reading, sand cutting, necromancy, spirit possession, vision, and so on. Some of these practices, like the use of palm nuts and divining chains as we have in Ifa, are peculiar to men among the Yoruba of Nigeria while the others could be used by both, particularly priestesses and priests.
Each African group has specific types of divination that are peculiar to them. It is important to note, however, that the most developed and technical type that is common as a reliable means of revelation among the West African people and the African diaspora is the 16 cowrie divination. The use of kolanut is prominent. Diviners acquire their knowledge through memorization of thousands of primordial stories that have been passed down from generation to generation.
Their initiation into the training comes in stages. Pretraining is when the candidate is ritually confirmed mentally and emotionally fit to enter the training. He or she is given ritual ingredients to swallow that will stimulate and enhance memorization of the stories that are orally delivered by the trainer. These stories, which are connected to certain deities, are structured mostly in prose, retelling the primordial incident of the disease or illness that the client brings. The diviner chants and explains the story, revealing the origin of the disease, what (in most cases, ritual) was prescribed for the original client, the reaction of the client to the prescription, and the effect(s). It is believed that every disease or illness has its primordial occurrence to which a healing solution was proffered.
Unlike the herbalists, the diviners deal primarily with hidden matters of high spiritual significance, such as interpreting dreams, revealing the divine wish in matters of rites of passage, revealing the mystery behind a protracted illness (even those that are not treatable by the herbalists), and proffering solutions into explicable and crisis situations and matters, all of which are considered as ill health to individuals and the community.
Dream is perhaps the most dreaded and terrible experience for which people consult diviners. The reason is that dream experiences affect the mental state of most indigenous peoples, which in most cases cause psychological disorder, leading to misbehavior and maladjustment. Dream covers a wide range of human affairs. A few cases will suffice. Persons with illness often claim that they have a dream before they fall sick; a pregnant woman who dreams is filled with dread by the experience whatever the content, or a suitor is afraid of getting into a relationship with the one who is not his or her destined fiancé or fiancée.
At the political level, a community wants to enjoy the blessing and continual healing of the spiritual beings that are associated with the people; hence, the choice of the ruler, the chief, engages the people's mind. It is the duty of the diviners in some of the communities in Africa. Furthermore, whenever there is communal crisis that arises from the wrath of some deities who are offended, the diviners are called on to find out the cause of the disease or illness and to inquire of the solution to the problem.
When the diviner is consulted, he inquires through his divination instruments. He goes into a period of recitation of the verses of what the signature of the divination reads until the matter is revealed. He then confirms from the client whether the divination is correct. He prescribes the necessary rituals. The rituals prescribed usually include blood and food items to be shared by human, spiritual, and natural entities. Certain designated places are prescribed where the rituals are to be laid. Some items may be instructed to be shared by a group of people so designated by spiritual beings according to the oracle. Such cases that are brought to diviners include barrenness, seeking the divine will on marriage, the cause of premature death, causes and cures for protracted diseases, divine will for the town, bringing order into communal chaos and crisis, and so on.
Priest and Priestess Healers
The third category of healing specialists includes priest and priestess healers, who also serve as mediums between the human and spirit beings as well as the living dead. In the Akan community, for example, priest healers who handle various health needs can be classified into three main categories: herbalists, diviners, and birth attendants. As some scholars have aptly noted, their assistance is sought out as soon as a crisis or trouble erupts in the community. They provide not only physical relief, but also emotional and spiritual assistance and comfort.
Healers are connected to cults of deities. They address similar cases as herbalists and diviners, but within the function of the cult. Each deity has a unique and specialized function among the Africans. There are deities connected with certain needs and certain diseases. Certain deities focus on childbearing and child-nursing cases, some on farmland and for proper crop yielding, and some with important seasons such as rain. These priests and priestesses also use certain instruments of revelation to be able to prescribe solutions to the needs of their clients. They offer their clients special foods that are claimed to be the food of the deities to which they are attached. They instruct on the taboos to observe for restoration of health. However, there are some special classes of mediums who are distinguished from priests and priestesses. One of these is the rainmakers.
The practice of African medicine, particularly herbal medicine, has found relevance in global medical discourse. Most herbalists have botanical gardens where herbs and roots are plucked and processed to heal diseases. Western medical practitioners, pharmacists, and those concerned with human well-being have discovered beyond a doubt that indigenous Africans have the material resources, spiritual sensibility, and competence in terms of indigenous knowledge of the contents and uses of medicinal plants.
It has been suggested that Western biomedicine had a strong historical connection to religious beliefs and practices. The attempt at dealing with medical issues without recognizing the relevance of indigenous knowledge and religious sensibility of the diversity of people around the globe to the Africans is obnoxious to holistic therapy. This recognition is why some African peoples have found it necessary to engage the twin practices, that is, side by side, of Western biomedicine and African medicine. This does not suggest incorporation, but recognition and compromise.
Furthermore, the intensity and sporadic influence of African indigenous medical practice on a new form of Christianity (the Pentecostal and Evangelical) explains the resilience of African medical practice. Biomedicai practice, however, needs to be appreciated as scientific improvement helps to unearth and advance the somewhat secret, hidden, and private knowledge to public space and utility. Rather than continue to describe African medical practice as alternative, a term derogatorily used to show that it is inferior to Western biomedicine, and engage in debate on the perceived and self-labeled conflict between science, which Western biomedicine represents, and religion, wherein African medicine is located, an engagement of complementary efforts could be made.
Recently, practitioners in the field of medical sciences in some African universities have begun to discover and engage an intersection in the practice of the two systems of therapy, lending credence to holistic medical practice. Western biomedicai practitioners now collaborate with practitioners of indigenous medicine to find out the plant and animal materials that they use for the cure of certain diseases. They test such materials in laboratories to discover the therapeutic power in them as used by African medical practitioners.
A reconsideration of the old preconceptions about medicine, science, and religion is now being done in Africa, as is being done elsewhere, in places such as India and New Zealand, where indigenous medical practices involving the use of herbs help in procuring holistic health and healing. African medicine is one of the many incredible varieties that are made use of throughout the world.
- African people
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