•‘Why we abandoned orthodox medicine, opted for local herbs, clinics’
With the cost of medications and hospital bills now well beyond the reach of the average Nigerian, many appear to have put their fate in alternative medicines and self-medication, which are considered cheaper and more easily accessible. GBENGA ADERANTI looks at the new trend and the dangers involved.
When Alhaja Abibat Gbadegesin, a retired nurse hit the rider of a commercial motorcycle, popularly called okada, with her Four Runner Toyota, she quickly resolved to take him to the Lagos State University Teaching Hospital, Ifako, Lagos for proper medical attention. From her experience as a medical practitioner, she could hazard a guess about what could be done to stabilise the victim and get him back on his feet.
The sexagenarian was, however, shocked to the marrow when the okada rider refused bluntly to go to the hospital but rather insisted on going to a traditional bone setter in a nearby Ogun community.
All the entreaties the retired nurse made to the injured motorbike rider to visit Lagos State University Teaching Hospital (LASUTH) or any other conventional hospital fell on deaf ears as he stood his ground on not going to the hospital, insisting that he was better off in a local bone setter’s home.
“I don’t want to go to any hospital. I don’t have any money. I know you will make the initial payment, but who takes care of the bills?” the okada rider asked.
Like many other Nigerians who have either resorted to self-medication or embraced the use of herbs and leaves, Sighetu Edu’bane Edeke, one of the biggest fashion designers in the 1990s, said he has embraced the use of leaves and herbs to fight his ailment.
According to him, while he does not have anything against going to the hospital, he believes it is cheaper and more convenient to use herbs.
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Explaining why he no longer visits the hospital, he said: “You have herbs all around you; you just need to know how to take and use them.
“As you can see, I have in my compound a moringa tree. You can see phyllanthus leaves which I use for malaria. To cure malaria, I just need to add ginger to it, boil for about two minutes, let it simmer for 20-30 minutes, then drink it to treat malaria.”
According to him, the simple process would save him between N20,000 and N30,000 which he would have spent if he had gone to the hospital.
Sighetu disagrees with those who consider the use of leaves and herbs for treating ailment as dangerous, saying such a notion is laughable. “Remember that before the Europeans came, we Africans had access to nature and plants. We had the knowledge.
“Are you saying that before Western medicine came we were not treating ourselves of ailments? Of course, we were.
“I use aloe vera for minor cuts and wounds.”
He, however, warned that it is dangerous to seek self-help without being adequately tutored on what to do.
Narrating her experience in a conversation with our correspondent, 32-year-old Abigail Sunday said when she got pregnant the first time, she desired to register in a private or a public hospital. But that was not to be as her in-laws insisted she would have to patronise Iya Alagbo (traditional medical practitioner) for her antenatal.
“My husband’s family felt it was expensive to give birth in a hospital. They told me that they had no money or time to spend in any orthodox hospital. I sheepishly agreed and eventually lost the baby,” she told our correspondent.
Also, Pastor David Dare, an ulcer patient for quite a while, has had the best of medical care.
He was always in the hospital for regular checkups, and if he had a crisis at times, he would visit the hospital for treatment.
But he decided not to visit his regular hospital again after getting what he described as an “outrageous bill” from one of the private hospitals.
He decided to take his destiny in his hands, thinking he knew it all.
He said: “I felt there was no need for me to go to the hospital again since I knew what they would give me. It has become a routine to give me the same drug after examining me. So I felt there was no need to be visiting the hospital again because I felt it was more or less a waste of resources.”
But the decision to save cost nearly cost David his life. Believing that he knew what drugs to buy, he procured one from a ‘reputable’ pharmacy only to discover that the drug he bought was fake.
“It was when I had a crisis again that my wife took me to our family hospital. There the doctor requested the drug that I was using and discovered that what I bought was a fake drug.”
David is still regretting the decision he took as it turned out to be penny-wise pound foolish.
Before Mrs Cecilia Aiyedogbon got introduced to a traditional medical practitioner, she had spent a fortune on her grandson, who was a sickle cell anemia patient.
According to her, each time she took her grandson to the hospital, the bill was always humongous. If the bill had been huge and she had seen an improvement in the health of her grandchild, possibly, she said, would have compensated for the money, but this was not the case. Her grandson’s health witnessed little or no improvement despite visits to hospitals. “It was like planting boiled maize; no improvement. Even if his health improves today, his situation would worsen next tomorrow.
“But since I was introduced to Iya Moria, owner of one of the traditional herbal shops in the community, things have been different. Since my grandson started drinking the herbs she made for us, his condition has been a bit better,” the 73 -old grandmother told our correspondent.
A bricklayer, popularly called Baba Ayo in the neighbourhood, was seen on a Sunday morning cutting the branches of a mango tree.
“You must have been paid handsomely to cut these branches?” our correspondent asked jokingly.
To this, he responded: “I want to use the leaves to prepare herbs. I’ve been down with malaria for a while. There is no way you will go to the hospital and you will not pay anything. I don’t have money to pay any doctor.”
Despite the huge budgetary allocation to health, many Nigerians cannot afford good health care. In the 2024 Federal Health Budget, the sum allocated out of the overall expenditure of N27.5 trillion was N1.2 trillion, including the N125.7 billion provided for the Basic Health Care Provision Fund (BHCPF).
An investigation by our correspondent revealed that many Nigerians who can’t afford the bills charged in hospitals have taken their fate in their own hands by either patronising herbal shops or visiting pharmacies to seek remedies to their ailments.
Investigation also revealed that the increase in the prices of drugs has also made traditional herbal homes attractive. In one of the big pharmacies visited, Ventolin inhaler now sells for N8,870 as against N2,000 it sold some months ago. This is also true of drugs like Augmentin which now sells for between N23,000 and 25,000 as against N3,000 to N5,000 previously.
The continued increase in the prices of drugs has also been blamed on the exchange rate of the naira. For example,
Lonart, which is now N3,300, was sold N1900 last year. Lonart by 24, which is subsidised by government, was sold for N800 last year now goes for N1300.
Augmentin (branded), which was sold for N6,500 now goes for between N16,000 and N30,000. Arenax Plus Forte, which was selling for N600 is now N1,300 while Lonarts DS has jumped from N1,900 to N3,300.
Fleming jumped from N4,500 to N7,000. Amoskislal, which used to be N6500 is now N10,000 while Virset which used to be N7000 is now N14,000.
Traditional herbal shops, pharmacies experience boom
Mrs Bolaji Okuwa, a traditional herbal shop dealer also known as ‘Elewe Omo’ in Akute, Ogun State, confirmed the recent boom in business. According to her, beyond the exorbitant prices of orthodox drugs, many people are rediscovering themselves by going back to their roots.
While the reporter was in the shop, a lady, probably in her late 30s, dressed in a three-quarter trousers and leg chain, approached Mrs Okuwa, saying in Yoruba, “Ejoo, mofe ra ewe dongoyaro (please I want to buy neem leave).”
Her interaction with the herbs seller showed she was a regular visitor to the herbal shop.
Curious, our reporter asked if she was always coming to patronise the herbs seller. To this, Okuwa said: “Many of them come here to buy herbs instead of going to the hospital. The traffic of people coming here has increased over time, probably because they have seen the efficacy of local herbs and roots.”
While admitting that she was not against orthodox medicine, she was of the view that many are now recognising the efficacy of herbs, which is why they prefer traditional herbal shops.
Explaining the efficacy of herbal medicine, she said: “Rather than remove the teeth, for example, it is better to use herbal remedy because they get damaged with germs. Removing them won’t solve any problem because the germs will still be there.
“But if you are using herbs, with time, it will kill all the germs. If you take it to the hospital, after treatment, it will still relapse.”
She also believes that health issues like fibroid and hypertension are best treated with traditional herbs.
“A fibroid, for instance, rather than operate it, if you continue with herbs for a long time, the fibroid may disappear as a result of continuous use of herbal medicine instead of orthodox one.
“The process may be slow, but it will surely go. It did not get to the body once, so it can’t go once.”
On the issue of herbs having side effects, she explained that this may not be true as they are made with water, saying if you drink excess of it, you will piss out the excess.
She said: “It is only tablets that can have side effects on people, not herbs. There are some herbs that when you use them in excess they could have side effects. But you can’t compare this with what you get when you use overdose on tablets.”
She also said it is cheaper to treat people with herbs and roots. For example, herbs for the treatment of hypertension go between N10,000 and N20,0000.
Investigation by our correspondent revealed that many who are down with one ailment or the other now engage the services of pharmacists or visit herbal homes to find solutions to their health challenges.
Most traditional herbal practitioners and operators of pharmacy shops who spoke to our correspondents confirmed that since last year, there has been an increase in patronage and sales.
While an orthodox hospital would charge between N30,000 and N24,000 for the treatment of ulcers, a patient only needs N4,000 to get the mixture of roots and herbs in a herbal shop for the treatment of the same ailment.
A mild malaria which could cost a patient more than N10,000 in an orthodox hospital would only cost less than N1,000 in a traditional herbal shop.
While, a patient may have to cough out about N50,000 – N100,000 to treat smallpox, a serious and often deadly viral infection in an orthodox hospital, the same ailment would be treated with less than N24,000 if a patient decides to visit a pharmacy or less if he or she patronises an herbal shop.
Orthodox medicine practitioners react
Explaining the preference for traditional medicine, a United Kingdom-based medical doctor, Temmy Dada, said it could be because people have always used herbal remedies from time immemorial and still believe so much in them.
She also cited the accessibility and affordability of herbs coupled with the fact that the orthodox ones have become less affordable and difficult to access.
“The other possible explanation is the incurable nature of some chronic illnesses like hypertension, diabetes, or terminal illnesses like cancer, which some of these healers would tell people that they can cure.
“So belief or tradition will be the first reason people use herbal remedies or homes. There are.people who would never go to the hospital to deliver babies or those who run to herbal homes when they tell them in the hospital they need surgery.”
But while many may rev in their use of traditional medicines, there could be danger they are not aware of, Temmy warned.
According to her, some get the results they hoped for while some end up with complications due to reasons like lack of regulation which opens the system up for sharp and unwholesome practices. Also the effectiveness of some of the treatments is not proven by research.
She also noted that the quality and quantity are not certain in some instances, while blaming economic challenge as one of the reasons many are doing self-medication
“Unfortunately, health care is not exempted from the high cost of living crisis currently experienced in the country. This makes health care unaffordable for a lot of people.”
Another medical doctor, who incidentally is a traditional medical practitioner and a traditional ruler, Oba Adedayo Olusina Adekoya, the Légùşęn of Odè Ulé Kingdom of Légùşęnland, Odè Ulé City, Remo North LGA, Ogun State, said the surge in the number of people visiting herbal homes for treatment is not a new development.
According to him, it is a development that had previously not been noticed or numbly ignored because the section of the population who patronised such were low classed and saw it as normal because they did not practically have access to the western practices except for vaccination and antenatal needs.
According to the medical doctors, the newsmakers who generally belong to the upper middle level and upper economic level of society have now found more reasons to attend herbal medicine practitioners’ clinics, either consequent on their upbringing before rising to the top or by induction whereby they adopted this new habits due to personal experiences or recommendation by friends and acquaintances.
Adekoya also explained that there is the issue of rising population whereby more people, relative to the past, are now seen taking herbal treatment.
He said: “In 1963, the population of Nigeria was 55 million. Now it is about 200 million. There are therefore about four times the population who use the herbal medicine method now available for same in absolute population terms.”
While many medical doctors warn against the use of herbal remedies, Dr. Adekoya sees nothing inimical about it. He described health as a phenomenon that is a state of complete physical, mental and social well-being.
He said: “It is not just the absence of disease or infirmity. The implications of more people visiting herbal medicine practitioners when in the news is a very good thing for the society, because apart from ensuring that people maintain their health status in a very sustainable manner and become more reliant on their environment, the indigenous practice of treatment which had sustained us for centuries before the contact with other forms of treatment has become more relevant to our lives.
“More research towards better applications of the time-tested methods and methods of treatment are now being available, thus brings more improvement into our ways of life improving our economy and social lives.
“We are now able to derive the advantage of the indigenous knowledge system in our health care producing and consuming. All those which we had been brainwashed to detest are now being well appreciated.
“The bitter cola experience in the tackling of the Ebola and Covid scourge are examples that easily come to mind.”
He also believes that people will continue to patronise herbal medicine because “the orthodox health care delivery system is quite expensive. But in herbal medicine and care system, things are relatively cheap because almost all the inputs are sourced locally. “
He warned that traditional medicine could go the way of orthodox medicine because “every place is being built up and a lot of deforestation is going on, which is seriously affecting the availability of herbal inputs into health care practice. Something should be done to stop this trend.”
Penny wise, pound foolish
The Medical Director of Ibot Clinic, Dr. Oluwatobi Adeleye, attributes the reduction in the traffic of patients to hospitals to trying to run away from heavy costs.
He said it is not a wise decision for anybody to visit pharmacies on their own or patronise traditional medicine shops in an attempt to cut costs because “when complications come, the cost they are trying to run away from, they end up paying 20 to 30 times of what they ran away from.
“It is like someone who ran away from a N20,000 bill and settled for N1,000. But by the time he pays N1,000 10 times, you have paid N10,000. And by the time complications set in, you would end up spending N100,000 to N200,000.
“But generally there is a reduction in traffic. People tend to visit traditional/herbal practitioners or visit pharmacies, but hospitals will continue to wait for them because sooner or later, they will come.”
He warned that ‘concortionists’ take advantage of people because there is no standardization in their practices.
According to him, those who engage in pseudo-medical practices are driven by greed as they tend to make sure they supply ‘concoctions’ to the users “even if it will take them to risk the overall health of the consumer, and they get their money.”
He advised Nigerians patronising untrained ‘medical personnel’ to think it through.”
Unknown to those who patronise ‘untrained medical personnel,’ The Nation gathered, there is a tendency for their health to get worse. “Some people don’t even know what is happening to them. They don’t know the diagnosis. They just believe that every headache and every fever is malaria and typhoid.
“That is why there is increase in liver failure and kidney problems, and the funniest thing is that ‘concortionists’ will still tell them to take these things with dry gin. “In the long run, they come down with liver diseases, kidney problems and lots of other health complications.”
Adeleye advised that Nigerians should try as much as possible to seek professionals. “No matter how little it may be, “there is always a professional for everyone rather than wait till complications set in.”
Adeleye admitted that the threat to the medical profession is temporary. He believes though there is a drop in traffic in the hospitals in terms of cash flow and display of expertise but definitely because there would be a continuous evaluation of the health scheme, and continuous monitoring, “it is still coming back to the table even far from where it was before. But presently, it could look threatened .
How structure affects medical practice in Nigeria
Probably, the condition of health practices would not have been catastrophic if structure had been put in place.
According to Adeleye, “in developed countries, it does not happen this way. You can’t even walk into a drug dispensary station and say you want a particular drug without a doctor’s prescription. But presently as it is in the country, it is threatened, coupled with the economic meltdown.”
Adeleye, therefore, advised the government to put structures in place for evaluating, monitoring, and sensitising the populace about the dangers of visiting such people, contortionists or self-medication as it were, and also ensuring that the right agencies are up to task in terms of monitoring quackery in the health care system.
Temmy also advised the government to rise to the occasion by providing and ensuring that quality, accessible, affordable, and acceptable health care is available for all.
She aligned with Adeleye, saying the way to stop Nigerians from continuing on this dangerous path is for the government to embark on public enlightenment, research, health policy, and implementation. And finally, Nigerians should be made to embrace health insurance.
Adekoya sees no threat to orthodox medicine because it is in a class of its own without any overlap or clash with any aspect of the healthcare chain.
“Apart from the fact that there is a great shortage of medical practitioners,
pharmacists, herbal medicine practitioners, Babalawo, Olorisa, Olosun, Olosanyin, Alaafa, religious and spiritual practices such as Ìşẹ̀şe practices and all other professionals on the health care delivery roles and are not for any reason in a state to clash because they are mutually exclusive to each other. They see themselves as partners in progress.
“The medical practice profession is not under any threat at all. The only major thing that could happen is non-early reporting of many complications.”
Way forward
Adekoya, therefore, advised the government to incorporate the indigenous knowledge system into the educational curriculum of schools in Nigeria such that subjects like herbal medicine, must be made compulsory in primary to secondary schools. “Tertiary degrees must be done at the universities. Some private institutions like Dimef Institute Ode Ule City, Ogun State, have provided such facilities and training.”
He also suggested that every health centre should have an herbal medicine department to provide the services.
“Two institutions, Losi Clinic Group Odè Ulé City and, I think one in Benin, practice the ‘Integrated Medicine’ which has brought indigenous medicine to merge with western medicine as advocated by the WHO sometime the 1970s.
“This integrated medicine is based on the principle that it is a foolish person who has the benefit of having two types of knowledge and just using one, abandoning the other. It is wise to use both knowledge systems in harmony.”
Adekoya is full of praise for those who have embraced herbal medicines, saying “Utilising an alternative form of knowledge is not being lackadaisical. It is rather a demonstration of wisdom and the art of being clever to have been able to appreciate goodness in one’s ways and not sheepishly abandon it and go on to follow a non-indigenous methodology that may not even suit ourselves and our environment.”
Food is medicine
While the argument of orthodox medicine and traditional medicine continues, a conservationist and landscape planner at Dreamscape Garden, Thomas Emmanuel, says good food is medicine which keeps one less dependent on pharmaceutical or traditional medicines.
According to Emmanuel, people are becoming more aware of the side effects of allopathic or pharmaceutical medicines and are wary that it doesn’t solve the problem, sometimes that is why they have embraced roots and herbs.
“Like the blood pressure pills, people just keep taking it, medicine should have a time frame, and however, food too has a serious challenge, from fertilisers to genetic modifications,”Emmanuel said.