Ashley Valdivieso and Dr. Melinda Ostraff, Integrated Biology
Diabetes is an escalating health risk in Ghana, and it is estimated that approximately 22% of Ghanaians who develop the disease will die of it.1 While government programs intended to provide treatment for diabetes patients have focused on traditional western medicine, Dr. Kwabena Beecham, President of the Ghana Diabetes Association reports that “over 50% of people with diabetes do not experience full health and quality of life despite the availability of medicine.” 3 Studies have also shown that some diabetics have chosen not to treat the disease at all.4 This apparent failure to meet the needs of diabetes patients indicates that more attention to other therapeutic options, particularly herbal medications, is justified.
The purpose of my research was (1) to focus on the cultural and biomedical views of herbal medications in the treatment of diabetes; (2) to determine why patients select one type of treatment over another, how diligently a prescribed regimen is followed, the barriers to treatment, and the perceived level of efficacy achieved; (3) to understand the role of traditional healers and the herbal medicines they provide; and (4) to obtain feedback from diabetics and health care providers on how overall treatment for type 2 diabetes may be improved.
The data for my research came from personal interviews with diabetics, traditional healers, doctors, pharmacists, and a professor of herbal medicine. Most of the interviews were conducted at the Komfo Anokye Teaching Hospital in Kumasi, Ghana’s second biggest city, and in the general area of Mampong, a rural village located about 45 miles away from Kumasi. In addition, I collected specimens of most of the plants that traditional healers reported using. Detailed information regarding the plants collected (scientific name, location, environment, usage, etc.) can be found in the BYU Herbarium where the plants will be on display.
My interviews revealed that most Ghanaians, particularly in rural areas, are very comfortable using herbal medicines. Everyone knows some sort of herbal remedy that has been passed down in his or her family. Herbal medicines are widely used because they are available to anyone at little or no cost. Ingredients can be found on a typical family farm, in the bush, or even on the side of the road. Prepared herbal medicines can be purchased from an herbalist or hawker.
Ninety percent of the patients I interviewed had tried herbal medicines at least once in treating their disease. Some patients had concerns about the lack of testing and unknown side effects of herbal treatments, but this did not prevent them from trying them. The doctors and pharmacists I interviewed strongly discourage patients from using herbal medicines. Doctors maintain that traditional healers lack sufficient training to treat the disease. Biomedical personnel are also concerned that herbal medicines have not been sufficiently tested and may have dangerous side effects either taken alone or in conjunction with modern medications.
All of the patients I interviewed were prescribed a regimen of modern medicine at diagnosis. The patients who switched to herbal medicine did so for two reasons: cost of prescribed medicine and/or unsatisfactory results. As shown in the accompanying chart, most patients interviewed use herbal medicines as a supplement to modern medicine but do not follow a prescribed regimen for doing so. Interestingly, none of the patients use herbal medicine as their only treatment option, and some patients who tried herbal medicine suspected that the herbs actually increased their blood sugar levels. It is particularly noteworthy that all patients who regularly follow a prescribed regimen reported that their treatment worked well for them.
Two kinds of traditional healers were interviewed for the study: okomfos, who believe their healing powers come from the gods they worship, and herbalists, who claim no supernatural powers and generally learn their trade from another family member. Traditional healers claim that herbal medicine works because it “gets into the blood.” If a healer has success with an herbal remedy for one disease, they are likely to use it in treating other diseases. Traditional healers stress that some healing plants have been scientifically proven to naturally lower blood sugar. They believe their treatments are better suited to most patients and are viable, effective options.
The sharply divided opinions of traditional healers and biomedical personnel have not been helpful for patients. Ghanaians have a tradition of using herbal medicines, but doctors and pharmacists do not seem willing to help patients integrate modern and herbal medicines in a combined treatment approach. Admittedly, herbal medicines are difficult to replicate and study because they are not standardized. There are multiple names for the same plants and different plants may have the same name. Herbal medicines for diabetes may contain the same ingredients, but each healer uses different proportions and different dosage requirements.
Given the overwhelming tendency for patients to combine herbal and modern medicines, however, it is recommended that a team of biomedical personnel and traditional healers work together to identify and study complimentary treatment options for patients who want to incorporate both practices into a prescribed regimen.
References
- Amoah, Albert G. B., “Comprehensive Care in a Low-Income Country: The Ghana Federation, DiabetesVoice, Volume 47, Issue 2, June 2002, International Diabetes Federation, diabetesvoice.org/issues/2002-06
- “Diabetes Kills Slowly,” September 22, 2005, Diabetes.co.uk
- De-Graft Aikins, Ama, BMJ: British Medical Journal, Healer shopping in Africa: new evidence from rural-urban qualitative study of Ghanian diabetes experiences, 10/1/2005, Vol. 331, Issue 7519, p737-742, 6p