Medicinal Plants and Traditional Medicine in Sierra Leone

by Cyrus Macfoy

Overview

Medicinal plants and traditional medical practices from Sierra Leone in West Africa have much to offer the rest of the world. Dr. Cyrus MacFoy, an experienced researcher and scientific consultant, highlights more than two hundred plants used to cure more than one hundred diseases and illnesses in this informational guide. He provides the plant location, their botanical and local names, English common names, and the ways they are used to treat and cure ailments and diseases. He also includes

• findings regarding the conservation, sustainable use, and development of new drugs;
• ways to incorporate different techniques into the health care delivery system; and
• chemical analyses and biological activity testing of plant species.

Discover how Africa’s traditional healers play a critical role in treating diseases such as HIV and AIDS. In developing countries with poor infrastructure, these healers are located in nearly every rural village setting as well as in the busy urban areas. While underappreciated, they may play a key role in solving the continent’s diverse health problems.

Product Details

ISBN-13:	9781491706114
Publisher:	iUniverse, Incorporated
Publication date:	12/05/2013
Sold by:	Barnes & Noble
Format:	eBook
Pages:	192
File size:	2 MB

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MEDICINAL PLANTS AND TRADITIONAL MEDICINE IN SIERRA LEONE

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By CYRUS MACFOY

iUniverse LLC

Copyright © 2013 Cyrus Macfoy, Ph.D.
All rights reserved.
ISBN: 978-1-4917-0609-1

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CHAPTER 1

Introduction to Traditional Medicine

What Is Health?

The World Health Organization (WHO) defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."

Health is therefore essential for all citizens of the world, to permit them to live socially and economically productive lives, and peoples of the world have been striving to achieve this state in one way or another over the years.

What Is Traditional Medicine?

WHO defines traditional medicine (TM) as the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement, or treatment of physical and mental illness.

The specialists include herbalists, traditional psychiatrists, traditional pediatricians, traditional birth attendants (TBA), bone setters, occult practitioners, herb sellers, and general practitioners. They are more readily available, accessible, and approachable than orthodox allopathic physicians, while their services are much more affordable than modern medical facilities, and they play a very important role in the health of many communities.

According to WHO, traditional medicine is a comprehensive term used to refer both to TM systems (such as traditional Chinese medicine, Indian ayurveda, and Arabic unani medicine) and to various forms of indigenous medicine. TM therapies include medication therapies, if they involve use of herbal medicines, animal parts or minerals, and nonmedication therapies, if they are carried out primarily without the use of medication, as in the case of acupuncture, manual therapies, and spiritual therapies. In countries where the dominant health care system is based on allopathic medicine, or where TM has not been incorporated into the national health care system, TM is often termed "complementary," "alternative," "ethnomedicine," or "non-conventional medicine" as opposed to biomedicine or allopathic medicine (WHO, 2013)

Brief History of Traditional Medicine

No one knows for sure when humans began using herbs for medicinal purposes. My guess is that they must have done so from the evolution of man in Africa; given that other primates were already using plants for that purpose (http://www.herbalremediesinfo.com/history-of-herbalmedicine.html), and many other animals including carnivores like dogs, feed on certain plants when they are ill.

Historical evidence, however, shows that the Middle East, including the cradle of ancient civilization, Egypt, and Iraq could also be the origin of traditional medicine (Finch 1990). Knowledge of herbal medicine is well documented from Mesopotamia (Iraq) (2900 BC), Egypt (1500 BC), China (1100 BC), India (1000 BC), Greece (300 BC), Rome (100 BC), and the Bible and other religious documents.

Over the years, traditional medicine has evolved in all countries in all regions of the world, developed and developing countries included (Soforowa 1982).

In developing countries, use of traditional medicine remains widespread. According to WHO, up to 80 percent of the population in Africa use TM, while use of complementary and alternative medicine (CAM) is increasing rapidly in developed countries (in the United States, for instance, 42 percent of the population has used CAM at least once; in Australia, 48 percent; Canada, 70 percent; France, 75 percent; and Belgium, 30 percent). The annual expenditure of CAM in the United Kingdom is estimated at $2,300 million. This popularity in use, according to WHO, is due to people worrying about side effects of chemical drugs; and the belief that CAM offer a gentler approach to taking care of their health problems.(WHO, 2002)

Traditional African medicine is a holistic discipline involving the use of indigenous herbs combined with aspects of African spirituality.

People rely on traditional medicine for their basic health needs. In some cases, traditional medicine is the only health care service available. It is accessible and affordable to many people on the continent. Therefore, this significant contribution of traditional medicine as a major provider of health care services in Africa cannot be underestimated. In Uganda, for example, the ratio of traditional healers to the population is between 1:200 and 1:400, while the ratio for allopathic doctors is 1:20,000, and most are located in the urban areas.

Studies on traditional medicine and medicinal plants are being conducted in almost every part of the world, from Europe, China, India, South America, and the United States, to Africa, Australia, and New Zealand. In some countries, TM is even incorporated into the health delivery system (Duke 1998; Soforowa 1982; WHO, 2013)

The earliest recorded form of herbal medicine was possibly the marshmallow root, which is a common grass chewed for settling an upset stomach; presumably, that plant is eaten for that reason by our closest evolutionary relatives, chimpanzees and bonobos (Herbal Medicine, 2013).

Many other plant species have been found to be eaten by wild chimpanzees to treat and protect themselves from injury and illnesses, such as Aspilia and Ficus species (Newton 1991). Research on these and other genera further indicates that Neanderthals used medicinal plants to combat illnesses (Lietava 1992).

Since the dawn of civilization, humans utilized plants for their medicinal and edible value. Using trial and error, they distinguished between beneficial and poisonous plants. People also observed that in large quantities, even medicinal and edible plants can be poisonous. They also learned about the usefulness of plants by observing sick animals, which often use certain plants that they usually ignore when they are in good health.

Today, this approach, called zoopharmacology, is one of the methods used by scientists to isolate active compounds from medicinal plants used by animals, with a view to developing new drugs.

Throughout the world, there is a vast reservoir of plants with multifarious medicinal and other properties. This untapped source consists of plants that are antidiabetic, abortifacients, insect repellants, attractants, and pesticides, to name a few. Over the years, people have used medicinal plants for the treatment of various diseases. These traditional practitioners (herbalists) have developed a store of knowledge concerning the therapeutic value of these herbs. In fact, their entire pharmacopoeia is in their heads, thus quite a lot of useful information is lost when a traditional healer dies, even though attempts are usually made to pass on this information to their children.

In view of the above, however, there is now a worldwide upsurge in the interest in traditional medicine in many countries, and organizations such as WHO, UNIDO, UNESCO, UNU, Commonwealth Secretariat, and the African Union have already recognized the use of these plants and are thus supporting, promoting, or developing traditional forms of medicine. Some institutions in the United States now have departments addressing and researching and practicing integrative medicine, such as the NCCAM, Duke University's integrative medicine department, and integrative centers at Harvard, Johns Hopkins, and Columbia University (Harvard's facility is the Harvard Medical School Division for Research and Education in Complementary and Integrative Medical Therapies). In terms of usage, herbal preparations are widely used in the United States, Germany, France, and the UK, among others, running into billions of dollars each year.

Also, most governments in other developed and developing countries, including African countries such as Ghana, Nigeria, Mali, and Zimbabwe, have produced publications on their medicinal plants usage in the form of pharmacopeias; these governments are researching these plants, and many (including Sierra Leone) have gone further by recognizing and training traditional birth attendants (Williams 1979; West 1981).

Some countries have institutionalized traditional medicine into their health care systems (e.g. Mali and Senegal have integrated TM into their health care delivery system in a more advanced way by collaboration between traditional and conventional practitioners (WHO-AFRO, 2010). Others, like Nigeria, are producing drugs from wild or cultivated plants (Natural Standard, 2013)

This renewed interest in medicinal plants has been necessitated by the rising costs of drugs and the already proven efficacy of crude plant extracts and purified compounds in many countries, including China, India, and Mexico (Dixon 1981; Kokwaro 1976). After all, it must be remembered that many conventional drugs produced in developed countries today were originally derived from raw plant material (more than 30 percent of modern medicines are derived directly or indirectly from medicinal plants). For example, aspirin is derived from the willow bark (Vickers and Zollman 1999); vincristine and vinblastine (antitumor drugs) come from Madagascar/rose periwinkle; digitalin (a heart regulator) comes from Digitalis and ephedrine (a bronchodilator used to decrease respiratory congestion) is derived from Ephedra; while atropine comes from Atropa belladonna; and cocaine, codeine, quinine, papain, and over one hundred other drugs were originally discovered through research on plants (See Table1), including the antimalaria drug artemisinin from Artemisia annua L., a plant used in China for almost 2000 years (WHO, 2013).

The Kenyan plant Maytenus buchananii produced an active compound in the United States, called Maytansine, which can suppress the growth of cancer-causing organisms, while Maytenus obscura and M. buchananii had been used by traditional healers in Nairobi for the treatment of cancer patients already discharged from hospitals as incurables (Kokwaro 1976).

However, in subsequent early clinical studies, maytansine was found to produce severe toxicity and unimpressive antitumor effects, which lead to the termination of its further development. Its side effects and lack of tumor specificity have prevented successful clinical use. But recently, antibody-conjugated maytansine derivatives have been developed to overcome these drawbacks (Lopus et al. 2010).

Catharanthus roseus (Madagascar/rose periwinkle) originally used for diabetes is now also used for blood cancer, ostensibly because of the two alkaloids, vinblastine and vincristine. Gossypol, which comes from cotton, is used for bronchitis in traditional medicine in China and now shows promise as a male contraceptive, and Nigerian Zanthoxylon zanthoxyloides, which contains p-amino-benzoic acid, other benzoic acids, and zanthoxylol, has antisickling activity (Soforowa 1982).

Taxol, which is also used in cancer chemotherapy, originates from Taxus brevifolia, the American Pacific yew tree. It is used in the treatment of many forms of cancer (e.g., breast, ovarian, prostate, lung, bladder, esophageal, and melanoma, as well as other types of solid tumor cancers). It has also been used in Kaposi's sarcoma, a cancer that causes lesions (abnormal tissue) to grow under the skin; in the lining of the mouth, nose, and throat; or in other organs, especially in AIDS patients (NCI, (2013).

More recently in Nigeria, a drug based on the ethanol/water extract of Fagara (Zanthoxylon zanthoxyloides) leaves, Piper guineense seeds, Pterocarpus osum stem, Eugenia caryophyllus fruit, and Sorghum bicolor leaves has been commercialized in the United States under the name Nicosan. This drug has been credited with alleviating sickle cell disease symptoms and reducing the number of sickle cell crises (Natural Standard, 2013). Unfortunately, this drug is no longer available in the United States at the present time.

In addition, jobelyn, Nigerian extracts from Sorghum bicolor, have now been commercialized as antioxidant and anti-HIV/AIDS medications (http://www.afritradomedic.com/), and the African cherry (Prunus africanus), a prostate treatment for benign prostatic hyperplasia, is used to increase libido, for treating cancer, and as an anti-inflammatory agent. The bark or processed extracts of this plant from countries such as Cameroon, Zaire, Kenya, and Madagascar are exported to Europe for preparation of the drugs (Stewart 2003).

Over the past few years, Moringa oleifera (the tree of life) (figure 2), a plant originally from India, has become very popular in many countries including Sierra Leone, where it is already being cultivated. It is thought to have nutritional and medicinal values that have the propensity to cure and prevent over three hundred diseases, including hypertension and diabetes. Advocates say that it can prevent diseases and malnutrition and can even boost development by creating job opportunities. It is thought to contain seven times the Vitamin C found in oranges, four times the calcium in milk, four times the vitamin A in carrots, and three times the potassium in bananas. According to an article by Adevu (2011) of the United Method Church on Relief (UMCOR) the plant contains some forty-six antioxidants and is very rich in phytonutrients, which flush toxins from the body, purify the liver, and bolster the immune system. It is regarded as a cure-all, and many people in some communities are no longer visiting the local clinics, as they are now either using Moringa oil or teabags, or sprinkling the powder on their daily meals.

The tables below document the widespread use and medicinal potential of various plant species.

Table 1 is a list of drugs derived from plants (Fabricant and Farnsworth, 2001) while Table 2 shows some potential drug plants from African forests, and Table 3 lists some African medicinal plants in the world market (Soforowa, 1993b).

Table 1 is not a full, comprehensive list of all patented drug names and herbal drugs sold in all countries, but it is quite representative. The chemical or drug names are given together with their action or clinical use and the plant names from which the drugs were developed (Fabricant and Farnsworth 2001)

Each plant species can be regarded as a distinct and complicated biochemical factory, producing many compounds with vast potentialities for medicinal use. However, it must always be borne in mind that the plant itself varies in its potential to biosynthesize its multifarious chemical constituents. For instance, there are seasonal and other variations due to the age, source, stage of maturity, part of the plant used, time of the day harvested and ecology in which the plant is grown. Some plants contain higher concentrations of the active ingredients in the morning than at night and vice versa. Others contain more ingredients when the yellow dead leaves on the ground are used instead of the healthy green leaves on the tree (Soforowa, 1982)

There is already a lot of evidence to support the view that to a great extent, most plants used in traditional medicine contain active chemical constituents responsible for curing the ailments of many patients. These chemicals include alkaloids, tannins, flavonoids, saponins, and essential oils. They are secondary metabolites biosynthesized by plants as defense mechanisms to fight off pathogens, pests, and herbivores (MacFoy 1988; 1992). Some of these plants can be powerful poisons, such as Mareya micrantha, hence the need for expertise and great caution in its use. However, the possibility that some plants only conform to the doctrine of signatures (that is, "an observable feature of a plant indicates its utility") should not be neglected. For example, by the doctrine of signatures, a plant which resembles the liver is used to cure liver problems; the yellow extract from Harungana madagadcariensis plant is used to cure yellow fever.

Other plants may just exhibit the placebo effect or placebo response. This is a phenomenon in which an inactive substance can sometimes improve a patient's condition simply because the person has the expectation that it will be helpful. This expectation plays a potent role in the placebo effect. The more a person believes they are going to benefit from a treatment, the more likely it is that they will experience a benefit.

There are various forms of traditional medicine in Africa:

1. Symbolism: This is when a particular quality is transferred from one site to another, usually by touch or even miles away. In the latter case, the magician or jujuman simply mentions the name of the person, stating the person is struck by an illness or death. An example of contagious or sympathetical magic involves the prescription of the heart of a lion for weakness or a bone treated with a magical portion and left on the road to prick the person for which it has been put.

2. Cupping: The medicine man sucks the affected part of the body and then spits out a piece of foreign object (e.g., worms, small horns, etc.) as evidence that he has drawn out the disease.

3. Removal of evil: The medicine man removes the evil spirit causing the illness from the patient and transfers it to an animal which is then driven into the forest, or the illness is left on the road to be picked up by a passerby.

4. Scarification: The medicine man makes pairs of linear incisions about a half-inch long on the site of the pain or disease, and powdered herbs are rubbed into the incision and tied. This method can also be used to provide protection.

5. Wearing of charms: This takes the form of an amulet or a piece of wood or other material suspended by a string around the neck (usually adults) or waist (usually children). Charms are usually intended for protection against evil spirits, ill luck, or bad health, and for strength (Soforowa 1982).

(Continues...)

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Excerpted from MEDICINAL PLANTS AND TRADITIONAL MEDICINE IN SIERRA LEONE by CYRUS MACFOY. Copyright © 2013 Cyrus Macfoy, Ph.D.. Excerpted by permission of iUniverse LLC.
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Table of Contents

Contents

Foreword, vii,
Acknowledgments, xi,
Introduction, xiii,
Part I. Introduction to Traditional Medicine, 1,
Part II. Plants Species Grouped under Medicinal Uses in Alphabetical Order, 39,
Part III. Plant Family (in Alphabetical Order), Species, Uses, and Method of Drug Preparation, 53,
Part IV. Chemical Analysis and Biological Activity of Selected Sierra Leonean Plants, 128,
Glossary, 139,
Common Names (English), 143,
Bibliography, 153,
About the Author, 161,
Index, 163,