The global market for traditional medicine is over US $60 billion and some of the essential medical drugs like quinine and salicylic acid came from traditional knowledge sources. Zimbabwe is blessed with flora with medical properties, with 10% of more than 5000 plant species having medicinal properties. It was found out that more than 80% of Zimbabweans use traditional medicine. The demand for traditional medicine is two-fold, being driven by chronic illnesses like cancer, diabetes, and HIV and AIDS, and by the need for enhancement drugs. However, there is stereotyping in the use of traditional medicine in Zimbabwe. Use of traditional medicines has been associated with witchcraft and traditional health practitioners have been labelled as witchdoctors. Use of traditional medicine is also complicated by the fact that Medicines Control Authority of Zimbabwe (MCAZ) that has been reluctant to license traditional medicine, despite the fact that herbal are widely used and they turn a blind eye. Challenges faced by traditional medical practitioners include deforestation and veld fires, and registration problems. The future of traditional medicine seem to be bright, especially in light of the WHO Traditional Medicine (TM) Strategy 2014-2023. The study recommend that there is need to register and change mind-set on traditional medicine, to ensure respect of intellectual property, and to protect ‘endangered’ plants and herbs. The study also recommend further research on traditional medicine because this study was a limited to key informants and there might be a need to conduct a detailed research on traditional medicine.
The utility value of traditional medicine, is becoming increasingly a matter of international concern as affirmed by the World Health Organisation (WHO, 2012). For instance, the global market for traditional medicine is over US$60 billion. In addition, most some of the essential medical drugs like quinine and salicylic acid came from traditional knowledge sources (WHO, 2012). There are also related natural sectors such as honey production, as well as agro-ecological agriculture that adds value to traditional medicine in terms values and utility. Zimbabwe with its flora, has a wide range of medical properties. Maroyi (2013) stated that out of more than 5000 plant species in Zimbabwe, about 10% of them have medicinal properties and are used as traditional medicines. Use of traditional medicine is mainly prominent in remote areas, where modern health facilities are not easily accessible.
The purpose of this policy brief if to……….
This study was a qualitative, explorative research. The researcher sought to generate knowledge about traditional medicine in Zimbabwe. Though there is a vast amount of literature on traditional medicine, such information seems not to be readily available. Much of the findings in this policy brief are from secondary sources of data. In addition, there was collection of primary data key informants, whose selection was through use of snowball-sampling method. The key informants included officials from Ministry of Health and Child Care (Traditional Medicine Practitioner’s Council), Pharmacists Council of Zimbabwe (PCZ), Zimbabwe National Traditional Healers Association (ZINATHA), and from James Mobb Immune Enhancement Centre.. James Mobb is a supplier of traditional medicine, based in Harare. The researcher made use of unstructured interviews and participants had room to provide detailed information. The study was conducted within a period of one month.
SOURCES – NATURAL VEGETATION
USAGE OF MEDICINES
PLANTS AS FOOD NUTRITION
There are many plant species with medical properties. According to Maroyi (2013), Out of more than 5000 plant species growing in Zimbabwe, about 10 per cent of these have medicinal properties and are used as traditional medicines. This section provides details on only four of the tree and plant species. These are Moringa, African Potato, Other herbal remedies come from a number of herbs, for example Gundamiti. Gundamiti is a concoction of about seven herbs, which was developed by University of Zimbabwe researchers and became popular at the height of the country’s economic crisis. Zimbabweans resorted to the herbal remedies after claims that it could reduce the viral load by more than 90% after two months of use.
Although moringa tree is essentially not indigenous to Zimbabwe, it has become part of the traditional diet in Binga District and many other places. The leaves of moringa are an excellent source of the sulphur containing amino acids. The high concentrations of essential amino acids, mineral ions and vitamins makes moringa an ideal nutritional supplement. Figure 3.1 shows the uses of moringa tree leaves. Its leaves can be dried and made into a powder by rubbing them over a sieve and stored for use as a nutritional additive to soups, sauces or meal dishes. Although some of the nutritional content is lost during the process, the powder remains an excellent source of vitamin A. As a nutritional additive, 2 or 3 spoonfuls of powder are usually added to rice, soups and sauces just before serving. Small amounts of leaf powder will not have a marked effect on the taste of the soup.
Regular intake of moringa in the form of relish made out of fresh leaves and dried leaf powder which can be added to porridge or other relishes prevent anaemia and most forms of malnutrition. It is therefore an ideal vegetable for young children and pregnant women. In Binga District, the Ministry of Health and Child Care encouraged the use of moringa tree as a vegetable especially to children under the age of five years as this can halt malnutrition. In many parts of Matebeleland, the leaves are widely eaten by women during pregnancy and after childbirth. This
African potato was traditionally used as a tonic for fatigue recuperation after a debilitating illness and to enhance mood. It is a perennial geophytes herb that belongs to the family Hypoxidaceae and is one of the larger species in the genus Hypoxis. African potato is used as a medicine that can prevent rheumatoid arthritis, heart disease, cancer, lung ailments and even Yuppie flu. It is an immune booster for people living with HIV and Aids and can also be used to treat dizziness, heart weakness, nervous disorder, bladder disorders, insanity, testicular tumours, prostate hypertrophy and urinary infections. In times of famine, the rootstocks are boiled or roasted for food and the juice is applied to burns (McMaster, 2001).
Mutamba is popular for its medicinal properties throughout the world. If used correctly, mutamba can help treat a variety of conditions and have fewer side effects than some conventional medications and its leaves are mostly exploited. Mutamba is believed to have been first used centuries ago by traditional healers of different countries to cure stomach ailments. Its bark contains a source of antioxidant chemicals and anti-bacterial properties that help promote boosting of the immune system. The preparation of the concoction is normally a formula mixed with water or juice and in other cases, capsules are made containing mutamba powder (Maroyi, 2013).
Aloe-vera it is a succulent plant species that grows naturally in forests. Rural folks mainly used aloe-vera as a remedy for treating diseases on poultry and humans. Use of aloe-vera by humans in Zimbabwe was mainly influenced by Forever Living products, who provided the herb in processed from, packaged in one litre bottle. Each bottle was being sold for between US $30-35.
Utility and governance of traditional medicines in Zimbabwe
The local people have a long history of traditional plant usage for medicinal purposes (Maroyi, 2013). Recognition of the utility of traditional medicine resulted in the enactment of the Traditional Medical Practitioners Act [Chapter 27:14] and the establishment of the Traditional Medicine Practitioners Council (TMPC), a division in the Ministry of Health and Child Care. TMPC is the regulating body for traditional medicine in Zimbabwe and work with associations like ZINATHA, who assist in the accreditation and vetting of traditional medicine practitioners.
The use of traditional medicine in Zimbabwe is believed to be high and Nkatazo (2010) pointed out that more than 80% of Zimbabweans use traditional medicines. In addition, an interview with ZINATHA’s official for information and publicity, Mr Kandiyero, showed that, at one stage in their lifetime, 98% of Zimbabweans made use of traditional medicine. Moreover, Mposhi, Manyeruke, and Hamauswa (2013), were of the opinion that the decade-long economic crisis (2000-2008), led to haemorrhaging of health professionals from public health institutions drove more Zimbabweans towards traditional medicines. Many Zimbabweans, unable to afford expensive private health care, turned to traditional healers. Despite the brain drain, many primary health care problems like fever, upper respiratory tract infections, diarrhoea, arthritic conditions, and certain gynaecological conditions have been managed at household level using traditional herbal remedies (Mposhi et al, 2013).
In addition, an official from the TMPC, Mr. Ndoro, pointed out that many Zimbabweans use traditional herds and the demand is two-fold. Firstly, there is demand driven by chronic illnesses like cancer, diabetes, and HIV/AIDS. The demand is mainly due to failure by Western medicines to cure these ailments.
Moreover, a discussion with the secretary at James Mobb Immune Enhancement Centre showed that traditional medicine could be useful in healing some of the chronic diseases. Table 4.1 shows some of the types of traditional herbs available at James Mobb.
Traditional Medicine at James Mobb
|Name of Traditional Medicine||Vernacular||Uses/Remedies||Price (US $)|
|Mucogen||Cough, fever, congested chest||5|
|ACT 5||Immune booster, kills fungal infections||10|
|GK 17||Anti-parasite and immune booster||10|
|Digestinzyme||Laxative, for constipation||5|
|Exocia ointment||Skin rush||5|
|Anti-fungal solution||Antiseptic, for cleaning wounds||5|
|Acnox cream||Pimples and facial rushes (a lotion)||5|
|Nutrivite||Nutrition supplement, appetiser||10|
James Mobb pack their medicine in containers and capsules, though some of the packaging like capsules is being imported. Mucogen is available in 200 ml bottles while ACT 5 is available in capsules. The revenue from sale of traditional medicine from James Mobb is around $60 per day.
The preceding findings showed that Zimbabweans are using traditional medicine. Nkatazo (2010) agitated that, after assessing the role of traditional medicines in addressing health care problems, the Zimbabwean Parliamentary Health Committee in 2010 recommended the government of Zimbabwe to create a regulatory framework on traditional medicine. The health committee called for guidelines on the manufacture and distribution of traditional medicines as a complement to the conventional medicine.
However, there is stereotyping in the use of traditional medicine in Zimbabwe. Use of traditional medicines has been associated with witchcraft and traditional health practitioners have been labelled as witchdoctors. This negative stereotype of the traditional health system resulted in loss of confidence in traditional medicine. Therefore, people who use traditional medicine usually visit traditional healers ‘nicodemously’. Use of traditional medicine is also complicated by the fact that Medicines Control Authority of Zimbabwe (MCAZ) is still to licence a single traditional medicine, despite the fact that herbal concoctions like gundamiti proved to be more effective that antiretroviral drugs (ARVs).
Threats to medicinal plans
According to ZINATHA, trees and herbs are fast diminishing. It was held that manufacture of Gundamiti, had to stop because the herbs were no longer found because of deforestation. This revelation was also collaborated by the official at James Mobb, who said that they travel for long distances to get herbs, and even go as far as Chipinge and Binga.
Deforestation is estimated around 330,000 hectares per year and between 1990 and 2010 Zimbabwe lost more than 30% of its forest cover. The major causes of deforestation are collection of firewood, veld fires, and agriculture, especially the increase in the number of small-scale tobacco farmers resulted in increased deforestation rate. The selective extraction of trees for various uses by local communities also leads to over exploitation. For example, warburgiasalutaris (muranga), which is well known for its medicinal properties in the Chipinge area, is almost extinct as a result of overharvesting. Anyone can just harvest traditional medicine, even those without knowledge, and this resulted in the ban on the African potato. According to Mr. Kandiyero, people were arbitrary harvesting the African Potato, even from contaminated water sources.
MACZ is supposed to register drugs but have not yet registered even one traditional medicine. Therefore, traditional medicine cannot be distributed using conventional medicine channels. The practitioners are the ones who prescribe and dispense their medications. Those who attempt to ensure wide distribution are doing that illegally because the medicines are not licensed. In addition, absence of licensing has resulted in conflicts between traditional medicine practitioners and MCAZ. There are issues to do with dosage and risks associated with the medicine. Also, due to the fact that traditional medicine is not registered, pharmacists do not receive any form of training on traditional medicine and cannot distribute it. PCZ argued that practitioners do not have use for traditional medicine.
In addition, in 2004, Mr Ngwenya, the owner of James Mobb once appeared before a Parliamentary Portfolio Committee on health, over allegations of distributing unregistered medicine. Some of the recommendations of the portfolio committee were that; there was need to formalise the practice of Mr. Ngwenya, and to harmonise legislation on health (The Health Professions Act and ZINATHA are separate and do not compliment each other). However, 10 years after the recommendations of the Parliamentary Portfolio Committee on Health, it seems as if nothing has happened to register traditional medicine in Zimbabwe.
MCAZ may lack capacity to analyse active ingredients in traditional medicine and seemed to be biased towards Western medicine. MCAZ follows certain protocol when licensing medicines, are these are mainly suited for Western medicines. The procedures for registering medicines may not be applicable to traditional medicines, which may fail to meet the criteria for licensing. Therefore, there is need for a framework for registering traditional medicine. WHO provide guidelines for registering traditional medicine and it is vital to make use of them. Countries like Burkina Faso and Ghana, after conducting research, have licensed traditional medicines, which are part of their essential drugs and Zimbabwe could learn.
Traditional medicines have strong curative powers and could be the answer to some chronic illnesses and medical disasters like HIV and AIDS. Change of mind-set on traditional medicine by Zimbabweans is important. However, use of traditional medicine is expected to increase, especially in light of the WHO Traditional Medicine (TM) Strategy 2014-2023, that seeks to member states in the harnessing of the potential contributions of traditional medicine to health, wellness and people centred health care.
The specific recommendations are: