After a thirty-minute car ride from Anyinam, we stopped the car when the road got too rocky to go any further. After a short walk, we approached Dr. Forkuoh’s Herbal Clinic.
As a student planning on entering the medical field, I stepped into the herbal clinic skeptical and full of preconceived notions of what I would find there. From taking a class with a professor who is a medical doctor in Ghana with both an M.D. and PhD, I had come to understand traditional medicine as something that must be negotiated with in the face of modern medicine. Though they may fight it, medical doctors here accept that traditional medicine is an avenue many patients choose.
From our professor for “Health and Healing in Ghana,” we got an overview of the place of traditional medicine in the Ghanaian health system. Traditional medicine practitioners exist alongside orthodox medicine (the bio-medicine that dominates most Western countries) in both legality and in the public space. Traditional medicine is regulated by its own wing of government, separate from the Ministry of Health officials that oversee orthodox medicine. It is regulated by the Traditional Medicine Council, however it is debatable about the effectiveness of regulation, as the Council is made up entirely of traditional medicine practitioners. This makes it unlikely that the practices are actually checked in any substantial way. This is due in part because of the link between traditional medicine and spirituality. Regulation of traditional medicine is by extension seen as a regulation on spirituality. Because of the very religious and spiritual nature of the country, politicians avoid the issue by ignoring the lack of regulation on traditional medicine.
This lack of regulation is partially to blame for the bad rep traditional medicine gets if you talk to a medical doctor in Ghana. Without regulation, there are no set doses for treatments. A simple one-size-fits-all dose might exist as well, ignoring differences dues to size, age, and gender. Active ingredients are not listed on medicines given out, and that is assuming there are labels on the medicine to begin with. Without a strict regulatory body, there is no thorough testing or trials to determine the effectiveness of treatments. Our professor remembers when his mother took him to a traditional medicine doctor as a child when he was ill. The traditional medicine doctor make three short cuts on his forearm and covered them in a powder. He rolled up his sleeve to show us the lasting scars from the treatment. He recalled that, unsurprisingly, he remembers starting a round of pills a few days after the visit.
With all of this information swirling around in my head, we stepped into the light green building. Immediately, the smell hit me. It reminded me of a blend of a spice cabinet, the incense burned at the church I attended as a child, and my grandmother’s coat closet. We were ushered through a narrow hallway, through the waiting room where a mother and her child were waiting, and into the office of the head practitioner. He introduced himself as Dr. Isaac and offered us seats.
For the next hour, we got to explore the world of traditional medicine through his eyes. We asked about his training, his practice, how he chooses certain plants to use, how the clinic operates, and his views on orthodox medicine.
We began the conversation by simply asking “What do you treat?” His reply was that the clinic was able to treat a wide range of illnesses, from pain to infertility, with two very common ailments being diabetes and hypertension. Everything is treated through plants and herbs. Dr. Isaac came from a family of traditional medicine doctors, and so he cites much of his knowledge as coming from those who came before him. He showed us a few of the books that he owns that list a huge variety of plants, their uses, and doses. He also attends workshops around Ghana where he can meet with and learn from other herbalists.
I questioned him as to how he decides to use new plants that he hears about from these other herbalists at regional workshops. His answer surprised me. He says that often he sends the herb to KNUST for testing there. I didn’t get the chance to probe more into this process, but the very existence of preliminary testing of the medicinal value for the plants challenged my narrow view of traditional medicine.
As our conversation continued, I began to see how this particular herbalist balanced the orthodox and traditional sides of medicine. He firmly believed that his ancestors had been successful in relying on herbs and plants alone for their medicine, making the point that current Africans could do the same. I was reminded of how our professor had linked spirituality to traditional medicine. Dr. Isaac’s spiritual connection was less about religion and more about continuing an important piece of his heritage and culture. While he believed that his medicine’s could cure nearly any ailment, he conceded that sometimes patients needed a faster treatment or treatments like surgery that are not available at the clinic. In the case that his patient needs the assistance of orthodox medicine, Dr. Isaac sends the patient onwards to KATH, the teaching hospital nearby.
When touring the clinic, I found it to be an odd balance between the scientific and customary. Towards the back of the clinic was the lab, where samples of blood and urine are tested to identify parasites, bacteria, and STI’s. I was surrounded by the familiar: a stack of glass slides, a centrifuge machine, and a microscope with a urine sample under it. As a biology major, I recognized the validity of the tests they were running, even if I didn’t agree with the treatment they would recommend based on the results. Another room was devoted to physical therapy, and again I recognized many of the machines used in physical therapy programs in the States.
The dispensary was the most different room in the clinic from an orthodox medical providers. It was a small room towards the front of the clinic, with walls covered in shelves with boxes and bags contained powders and concoctions. On the table, dozens of small unmarked plastic bags containing brown and tan powders were mixed with reused soda bottles containing dark liquids. When I inquired about the lack of labels or packaging, I was told that it was to prevent customers from reselling the medicines on the street. The logic goes that if they packaged their herbs in boxes with labels and dosage information, a patient could buy it and resell it for a higher price elsewhere. But since the medicine comes in the plain plastic bags, buyers would be wary of buying a fake product. While I still bristle at the thought of dispensing unlabeled drugs, I admitted that this made sense to a point. I still worried about dosage information and labeling, as many of the powders looked very similar. After our tour, we thanked Dr. Isaac and his assistant for their time and began the walk back along the rocky dirt road.
I am still wrestling with how I feel about traditional medicine here in Ghana. On one hand, as a STEM student and as an individual looking to enter the medical field, I am frustrated that the patients who go to this clinic are not being treated with the most effective medicines and might be prolonging or even worsening their disease or ailment. Most of the (orthodox medicine) Ghanaian health care providers I have talked to have felt similarly; they feel that if the patients had come in sooner or before trying the herbal medicine, they could have saved the patient time and prevented pain by helping them.
However, after our visit to the herbalist, I saw traditional medicine a little differently. Instead of viewing them as opposing forces in Ghana, perhaps they can be viewed as simply different healthcare options. Viewing them this way allows a Ghanaian patient to access both, instead of making a choice. Traditional medicine is often much more affordable than orthodox medicine, making it an attractive option for low-income households. The placebo effect is a powerful phenomenon, and perhaps for minor aches and pains a herbal remedy could be all that’s needed for a psychological boost. It cannot be ignored that seeking traditional medicine can cause a patient harm when it prolongs an illness or makes other medicines less effective and its lack of regulation is certainly reason for concern. But perhaps Ghanaians in the future will find a way to balance the uses and regulation of both orthodox and traditional medicine in the Ghanaian health care system. From our visit, I came away with the impression that traditional medicine will continue to be an important part of Ghanaian culture, especially in impoverished or rural communities, but shouldn’t be viewed entirely as an opposing force to orthodox medicine, and instead as an option for those with minor ailments or for those who cannot seek treatment elsewhere.
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