“All that man needs for health and healing has been provided by God in nature, the challenge for science is to find it”-Paracelsus.
More people are becoming savvy to the insights of herbal medicine in healthcare, especially in the area of clinical herbalism. Whilst groundbreaking discoveries are being made in the discipline, many other longstanding ideas about the subject are being reassessed and are either accepted or rejected.
For many centuries, Ghanaians have had their own perception about who a herbalist is. I have had my own mental picture of the person and his environment when the term ‘herbalist’ is mentioned. Whatever the perception may be is as a result of how the practice has been branded in the past.
A Paradigm Shift
Apart from the indigenous traditional medicine practice, in which apprentices understudy by mentorship, there has been an increase in the establishment of institutions for the training of herbal medicine professionals to sanitize the practice by eliminating crude methodologies used by quacks, addressing topical issues of safety, efficacy and standardization amongst many others which was non-existent for many centuries. In Ghana, the establishment of the Traditional Medicine Practice Council, the Traditional and Alternative Medicine Directorate, the Centre for Plant Medicine Research at Mampong Akwapim, and the Herbal Medicine Division at the Food and Drug Authority, are clear pointers to the new approach towards herbal medicine for the optimization of the health of Ghanaians.
The climax of this paradigm shift towards improving the practice of herbal medicine and making it safe for patients, as well as developing potent herbal based medicaments, is the formal training of prescribers by the School of Pharmacy of the Kwame Nkrumah University of Science and Technology (KNUST). The philosophy behind this novel idea was to produce a crop of Herbal Medicine Practitioners equipped with a formal knowledge of medicinal plants and their identification, conduct proper diagnoses from the conceptual view point as in allopathic medicine and who could also use scientifically-produced herbal medicines to treat diseases.
Who are Medical Herbalists and what do they do differently?
Medical Herbalists are healthcare professionals who have the ability to make definitive diagnosis based on patient history, physical examination, and symptoms and other clinical investigations including diagnostic imaging, and making a treatment plan based on approved herbal medicines.
They make use of plants whose traditional uses are backed by modern scientific research and clinical trials.
Also, Medical Herbalists take a holistic approach to illness by focusing treatment on the underlying cause of a disease rather than just the symptoms.
Although the term Medical Herbalist is quite recent in Ghana, it has been used in the United Kingdom since 1864.
In Ghana, a qualified Medical Herbalist has a BSc. in Herbal Medicine and is trained in the same diagnostic skills as a General Practitioner. After completing the four (4) year programme at the KNUST, the practitioner is required to serve for a year in a health related institution.
Afterwards, the practitioner spends another year on internship at the Centre for Plant Medicine Research, Mampong-Akwapim where they acquire practical training in Phytochemistry, Pharmacology, production of herbal medicines, Pharmaceutics, Botany, and Microbiology; and intensive clinical practice at the Out-Patient Clinic of the Centre for Plant Medicine Research as well as the Tetteh Quarshie Memorial Hospital.
These placements take place under the supervision of experienced medical herbalist, and allopathic specialists respectively. Additionally, one is required to write a Professional Qualifying Examination to evaluate their ability to take history and examine patients, recognize patients at risk for prompt referral and manage some of the chronic diseases.
The examination also seeks to evaluate their knowledge of medicinal plants in the West African sub region, their ability to apply these plants for the management of the top ten diseases in Ghana and other diseases, as well as their research skills in evaluating herbal medicines for treatment. Following a successful passing of the examination, the practitioner obtains a license to practice as a qualified Medical Herbalist. In all, a qualified Medical Herbalist goes through six (6) years of comprehensive theoretical and practical training.
Challenges so far
Although the policy of incorporating herbal medicine in the healthcare delivery system of Ghana has been hailed as a very good one, with some successes chalked in the implementation, there are still major challenges characteristic of every new policy. These challenges have a rippling effect on all stakeholders including Medical Herbalists.
First is the non-coverage of herbal medicines under the National Health Insurance Scheme. Also, the level of recognition, acceptability and cooperation from other health professionals in some government hospitals leaves much to be desired. There are also serious delays in the posting of Medical Herbalists coupled with the relatively slow pace in the establishment of herbal units in all government hospitals as part of the integration process.
All these diminish access to the services of such a unique crop of professionals in our healthcare delivery system. What is more crucial is the fact that about 70% of Ghanaians use herbal medicines for their healthcare hence the need to ensure accessibility. Lastly, as opposed to allopathic interns, Medical Herbalists are not on any allowance during the period of internship which has the potential to demoralize practitioners.
Healthcare is all-inclusive and all facets crucial for the advancement in the health of Ghanaians.